Body Worlds and the Cycle of Life Essay

The Body Worlds display was an astounding voyage through in excess of 200 fantastic plastinates; genuine human examples that have been protected. Dr. von Hagen’s is the man behind his unfathomable creation called plastination; preserving and anatomical analyzation, connective tissue evacuation, muscle to fat ratio and water expulsion, constrained impregnation with a polymer arrangement at that point set in a vacuum chamber expelling the CH3)2CO bringing it down to a phone level, and afterward ultimately the example solidifies and is then situated as wanted. This marvelous display has allowed numerous individuals the chance to see the whole interior structure of the human body. The composed clarifications close to each show were extremely enlightening; giving a superior comprehension on how the decisions we make for an incredible duration can really influence us as we proceed with our excursion through the maturing procedure. As per Dr. von Hagen, it takes roughly 1,500 hours (1-2 years) of devotion for each figure, alongside 350 others helping him all through the procedure. Every one of the 20 of the bodies that have been given stay mysterious; no insights regarding them or their reason for death were shared keeping in mind every one of the givers. This display was a stunning excursion giving us how the human body changes through time; from origination and as one age’s. The display begins with the zygote; a solitary cell framed from the father’s sperm, the mother’s egg, and the human genome; the outlines of all living people. Human incipient organisms and hatchlings were in plain view demonstrating each phase of cell division from origination through pre-natal turn of events. The moment were conceived, our physical productivity builds arriving at its top in our mid-twenties, at that point gradually begins to decrease all through the remainder of our lives. There were ordinary clean lungs of a non-smoker in plain view close to dark lungs of a smoker, which were a large portion of the size contrasted with the spotless lung. The composed clarification expressed that every year you smoke about a cup size brimming with tar collects within your lungs. There were sectional showcases of the thoracic hole indicating the gas trade that happens inside the alveoli of our lungs. There were sound hearts in plain view alongside hearts that had pacemakers. There was a solid liver close to a liver that has been harmed by inordinate measures of liquor; indicating visual cirrhosis. There were a few presentations of the human mind. One of the presentations demonstrated a cerebrum at ideal wellbeing contrasted with a mind that has been determined to have Alzheimer’s sickness. I thought that it was fascinating that the human cerebrum quits developing when you are 15 years of age and people under 30 years old take in twice as much oxygen contrasted with people 80 years old or more established. There was a 540lb figure, showing the perilous impacts of weight contrasted with a sound 140lb person. There were likewise sectional presentations demonstrating us a perspective on the stomach divider and how every organ is influenced by this extra superfluous fat. The type of food you eat will affect you general health! Sugar, as straightforward, refined starches, is viewed as one of the body’s major â€Å"agers†. Overabundance sugar in the eating routine changes the structure of the protein atom, keeping it from working appropriately and prompting the hardening of the body’s tissues. Hypertension can abbreviate one’s future by 10 to 20 years, and 9 out of 10 individuals are in danger of creating hypertension after age 50. We as a whole need vitality to work appropriately, however as we age our body doesn’t require as much vitality as it did when we were more youthful. Our bones are adaptable at a youthful age and teenagers. In adulthood, our body increments in quality and endurance, however loses its adaptability. The Artist’s Gaze was a presentation immediately and vision during childbirth and sometime down the road. It was centered around the artist’s Claude Monet who experienced waterfalls, and Edgar Degas who experienced retinal eye infection. A condition called Presbyopia; a continuously reduced capacity to concentrate on close to objects, is a typical piece of maturing and creates when the focal point of the eye bit by bit loses it flexibility. A newborn child can see things close up with no issue, while a multi year old would need to hold to question around 6 inches away. During childbirth, you have around 300 bones, as you develop more seasoned, little joints combine bringing about roughly 206 bones. At 52 years old lady for the most part experience menopause; end of life’s rich stage. As men age their testosterone levels decrease, yet not at all like lady, they can recreate all through their later years. I discovered that the world’s most seasoned individuals live in Okinawa, Japan and Ovadda, Sardinia. They shared a portion of their way of life rehearses, which I figure we could all profit by if we somehow managed to take their solid propensities and make them our own. Close to the furthest limit of the display, I truly delighted in perusing one of the banners that expressed, â€Å"Age is an issue of psyche over issue, in the event that you don’t mind it doesn’t matter†. Body World’s and The Cycle of Life was an unbelievable encounter and has disobediently changed my perspective with regards to the significance of life and passing. It has additionally given me a superior comprehension of our bodies and a totally alternate point of view on the fact that it is so essential to acknowledge life and care more for myself!

Why i am for the NO CHILD LEFT BEHIND ACT Assignment

Why I am for the NO CHILD LEFT BEHIND ACT - Assignment Example llars of responsibility for results; an accentuation on doing what works dependent on logical research; extended parental choices; and extended neighborhood control and adaptability. While the entirety of this sounds positive, it is the responsibility for results that most upsets given the way that test outcomes equivalent government reserves, not a positive carrot as I would like to think for the accomplishment of instructive greatness. The announcement by President Bush (2001) is at the core of what I see as an intense defect in the command relating to its accentuation on testing which he calls. ...â€Å"the pith of greatness [and the methods for judging that] in education....† (para 7).The U.S. Division of Education USDE demands No Child Left Behind puts an uncommon accentuation on actualizing instructive projects and practices that have been obviously exhibited to be successful through thorough logical research. While the entirety of this sounds promising, different parts of a test-arranged program by which the destiny of areas rise or fall is a startling one thinking about what is at stakeâ€again, government financing. While reps Becky Fleischauer from the National Education Association (NEA) (2002) claims that â€Å"we will start to see testing and responsibility and instructor quality† (para. 2), different specialists have an altogether different take that doesn't ingrain a similar certainty, particularly with regards to testing. Training master James Pophan (2010) found the accompanying: â€Å"An astounding measure of cheating is occurring on the tests that measure progress†(para. 1), rendering psychometric rules touted as delivered through â€Å"rigorous logical research† by psychometric specialists for all intents and purposes useless. Incredibly different examples of instructor duping range from educators permitting understudies more than the distributed time, to the organization of pre-tests with real last test questions. I discover this very upsetting given these tests should precisely anticipate understudy and area accomplishment. Different issues

How Quitting Smoking Can Impact the Medicines You Take

How Quitting Smoking Can Impact the Medicines You Take Addiction Nicotine Use After You Quit Print How Quitting Smoking Can Impact the Medicines You Take By Terry Martin facebook twitter Terry Martin quit smoking after 26 years and is now an advocate for those seeking freedom from nicotine addiction. Learn about our editorial policy Terry Martin Medically reviewed by Medically reviewed by Sanja Jelic, MD on April 28, 2016 Sanja Jelic, MD, is board-certified in sleep medicine, critical care medicine, pulmonary disease, and internal medicine.   Learn about our Medical Review Board Sanja Jelic, MD Updated on December 08, 2019 Tim Robberts / Getty Images More in Addiction Nicotine Use After You Quit How to Quit Smoking Nicotine Withdrawal Smoking-Related Diseases The Inside of Cigarettes Alcohol Use Addictive Behaviors Drug Use Coping and Recovery Prescription drugs are known to interact with other drugs and certain foods, but they can also be affected by smokingâ€"and smoking cessation. How Some Prescription Drugs Are Influenced by Cigarette Smoke Foods that we eat are broken down (metabolized) into nutrients that our bodies can use. This process starts with enzymes,  which act as catalysts for the digestive process. There are many types of enzymes. Some of them help break down proteins, some work on carbohydrates, and others on fats. In a similar way, there are enzymes that metabolize prescription drugs. One of these enzymes, CYP1A2, is affected by some of the chemicals in cigarette smoke. These toxins, called PAHs (polycyclic aromatic hydrocarbons) are known to be some of the most potent carcinogens in tobacco smoke.   When PAHs come in contact with CYP1A2 the enzyme becomes more active. This causes medicines that are broken down by CYP1A2 to be metabolized more quickly than they should be. As a result, smokers often require a higher dose than would normally be given. When smoking stops abruptly, such as going into the hospital where smoking isnt allowed or quitting cold turkey, CYP1A2 activity slows down and the larger dose can suddenly be too much.  The chance of negative side effects of medications abruptly increases  as well. It is important that medications be reviewed and possibly adjusted by the prescribing doctor when a person quits smoking. Prescription Drugs That Are Metabolized by CYP1A2 As you can see from this list, a wide variety of medications are metabolized by CYP1A2. Some of them wont cause an adverse reaction following smoking cessation, but others can cause serious side effects if the dose isnt modified or adjusted once a person stops smoking. Dont hesitate to share your quit smoking journey with your healthcare team so that they can keep an eye on any changes you might be experiencing. Alosetron (Lotronex): Antidiarrheal used to treat irritable bowel syndromeClozapine: Sedative drug used to treat  schizophreniaFlutamide (Eulexin): Hormone-based chemotherapy medicineFluvoxamine (Luvox): Used to treat obsessive or compulsive behaviors  Frovatriptan (Frova): Used to treat migraine headachesHaloperidol (Haldol): Treats  schizophrenia, acute psychosis, and is used for tics and vocal utterances of Tourettes syndromeImipramine (Tofranil): Used to treat depressionMelatonin: Over-the-counter supplement used for sleepMexiletine (Mexitil): Antiarrhythmic used to treat irregular heartbeatMirtazapine (Remeron): Antidepressant used to treat depression.  Olanzapine (Zyprexa): Used for schizophrenia, bipolar disorderPropanolol (Inderal): Used to treat  tremors, angina (chest pain), high blood pressure, heart rhythm disorders, and other heart or circulatory conditions. Also used to treat migraine headachesRamelteon (Rozerem): Sedative used for insomniaRasagiline (Azilect): MAOI and antidepressant that can be used to treat Parkinsons diseaseRopinirole (Requip): Dopamine promoter that can be used to treat Parkinsons disease and restless leg syndromeTacrine (Cognex): Used to treat Alzheimers diseaseTheophylline:  Long-term asthma control medicationTizanidine (Zanaflex): Muscle relaxant used to treat muscle spasmsTriamterene (Dyrenium): Diuretic used for fluid retention and high blood pressureZolmitriptan (Zomig): Triptan used to treat migraine headaches Caffeine Is Also Metabolized by CYP1A2 Most ex-smokers will tell you that coffee had a much stronger effect on them after quitting smoking. The usual cup or two in the morning left them jittery and nervous. Theyd chalk it up to the lack of nicotine, and that does play a role, but it probably had more to do with CYP1A2. Smokers metabolize caffeine at approximately four times the rate of non-smokers. It is no wonder that drinking the usual amount of coffee or other caffeinated drink is suddenly uncomfortable following smoking cessation. If you recently quit, you might try cutting your caffeine consumption by half and see how you feel. You can then reduce or increase based on that. Nicotine and Prescription Medicines Nicotine in tobacco and in nicotine replacement therapy can also influence how the body is able to respond to some medications. Nicotine constricts blood vessels and may inhibit the absorption of insulin shots. Nicotine is a stimulant that raises heart rate and blood pressure.  It may contribute to reduced sensitivity to medications used to treat the same.  It is also associated with reduced  sedation from benzodiazepines (tranquilizers) and less pain relief from some opioids. Schedule an Appointment With Your Doctor If you take any prescription medicines and have stopped smoking (or you plan to), check in with your doctor to review how they may be affected by smoking cessation. The good news is that quitting smoking will improve your health and vitality. You may even find that some medications can be eliminated once your body recovers from nicotine addiction. If youre ready to quit, use these quit smoking resources  as a starting point.  There is no time like the present to start work on making your dreams a reality.

Federal, State, And Local Rules Essay - 1970 Words

The focus of this paper was to research the federal, state, and local rules, regulations, laws, policies, and procedures pertaining to an oil spill. Oil spills can happen and asserting a plan of action and response will help minimize the impact and effects that can cause severe damage to property, businesses and the environment. One of the main agencies that react when an oil spill occurs is the Florida Department of Environmental Protection (FDEPA). Questions were asked and evidence from several sources was accessed to formulate answers. The research discovered fortified the thesis which confirms that there is various federal, state, and local policies and procedures in place in the instance an oil spill does occur. Keywords: rules, regulations, laws, policies, procedures Impact of Oil Spills Any oil business bears the risk of an oil spill. It is critical to know how to avoid and react to this kind of catastrophes, to minimalize the effect on humanity and the environment. There are several agencies that work together to guarantee that these oil spills do not happen and to resourcefully react in the event a spill occurs. Oil spills have occurred in the past and with federal, state and local agencies working together, they can plan, respond and cleanup the contamination from the oil. In this research paper, I will explore the regulations, environmental and humanity safeguards, the cost of cleanup, loss of revenues, lawsuits, internal city policies and execution, andShow MoreRelatedCritique Of The Current Policy Challenge Essay1321 Words   |  6 Pagesresponsibility of a public servant is to its preamble declarations of the Untied State Constitution and its protection enumerated promise of fundamental fairness towards the rights of the people and by the laws in which ca me forth by its union of states’. Consequently, as the population grows and desires begins to inquire more demands on its unity to respond. The efforts of our forefathers knew their intentions of the United States Constitution were not to design a perfect set of the laws, but a set of theRead MoreFederal State And State Government890 Words   |  4 PagesThe United State Constitution provides the authority and power of the federal and state government’s jurisdictions (Cropf, 2008). This means that both federal and state governments maintain their own separate laws and officials that govern over the territories and citizenry. The one part of governing left out of the initial constitution but picked up later was the local governments. Local government levels connects to the federal system through the state processes of governing. 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In this case, Shaw Development as the owner, appointed Southern Builders Inc. as the contractor, to construct a $7.5 million, 23-unit condominium and restaurant project, known as Captain’s Galley, in Somerset County, Maryland along with obtaining the LEED-Silver certification. The thing was

Where You Live Influences Health and Well-Being Essay

Social science has proven that where you live can influence your health and well-being in either a positive or negative way. Living in poverty and growing up in a deprived neighbourhood has a direct link to various social problems such as a lack of employment opportunities, poor housing conditions, educational problems, lack of amenities, and not feeling safe in your neighbourhood. These disparities are especially prevalent amongst minority communities due to their lower socioeconomic status (CDC), and are happening in our own community. Therefore, I propose that we as a group volunteer our time to raise awareness, combat the negative effects of poverty with the use of outreach and advocacy schemes, and be aware of the possible opposition†¦show more content†¦In addition, minority groups living in America are more likely to face disparities in regards to the following: education, prison sentences, arrests, lower pay, and unemployment (Minority Rights). These issues have rea l, dangerous implications for young people and can affect them throughout their whole life. Elis Cose, a cultural critic, wrote in a column for USA Today, â€Å"Black youngsters are much more likely than whites to be stuck in second-rate schools—or in lower tracks in decent schools—and to face a future of joblessness or marginal employment (Racial Disparities).† Overall, these disparities are highly connected to the unfortunate fact that many live in deprived neighborhoods; and therefore, experience all the social disadvantages that this brings (Crime and Race). Three components—physical, mental, and social—make up health and well-being. Living in poverty can negatively affect all three components (BetterHealth). Poverty is not just about lacking money but is more complex as it can affect everyday living in countless ways. The Centers for Disease Control and Prevention 2013 Health Disparities and Inequalities Report findings demonstrate that every aspect of health is worse for people living in deprived circumstances. Poverty leads people to feel hopeless, powerless, and inferior, and these emotions have powerful negative effectsShow MoreRelatedHealth / Wellness And Illness1551 Words   |  7 PagesHealth and wellness is a state of well-being when an individual is completely capable physically, psychologically, and socially. Everyone has a different view of what healthy means due to their age, gender, race, beliefs, and the environment they live in. Comparing Health/Wellness and Illness/Disease When comparing health and wellness to disease and illness there are various differences and some similarities. 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Income Tax Free Essays

1. Near year end, P, a cash basis, calendar year taxpayer, paid for various deductible expenses as described below. 1. We will write a custom essay sample on Income Tax or any similar topic only for you Order Now The payment was dropped in the mail before year end. 2. P gave a note evidencing her promise to pay the amount in three months. 3. The amount was charged on her Master Card on December 28. The charge appeared on her bill for the period December 1 through December 31, which she received in January and which she paid on January 20. The bank actually paid the expense in January. 4. The amount was paid using the pay by phone service provided by her bank. P called in the charge on December 20. The bank sent her a statement indicating that it had paid the charge on January 3. P may deduct the expense in which cases? a. 1 b. 1 and 2 c. 1 and 3 d. 1, 3, and 4 e. 1, 2, 3, and 4 2. The crucial reason for determining whether an item is deductible as an expense under  § 162 or under  § 212 is that a. production of income expenses are not deductible. b.  § 162 business expenses usually are deductions for A. G. I. , while  § 212 production of income expenses usually are miscellaneous itemized deductions. c.  § 162 business expenses are deductions from A. G. I. , while  § 212 production of income expenses are deductions for A. G. I. d. it resolves certain ownership questions. 3. C purchased two cars in 2010 a Corvette for $20,000 and a Buick for $10,000. Both cars were used solely for personal purposes. During the year, C sold the Corvette to a car collector for $24,000 and the Buick for $7,000. Based on these two transactions he will report a. a gain of $1,000. b. a gain of $4,000. c. a gain of $4,000 and a loss of $3,000. d. no gain or loss. 4. F, a calendar year, cash basis taxpayer, started a business on June 1. Her lease required monthly payments of $1,000 beginning on June 1. Insurance for the premises, also begun on June 1, was to be paid every six months and cost $600 for each six month period (she paid her premiums due on June 1 and December 1). F’s deductions for these expenses total a. $7,000. b. $7,100. c. $7,600. d. $8,200. $1,000 * 7 months = $7,000 rent expense $600 premium paid 6/1 = 600 insurance expense $600 premium paid 12/1 = 600 7,000 + 600 + 600 = $8,200 insurance expense 5. Which of the following is not a deduction for A. G. I.? a. Lawn mowing expense for a rental property actively managed by the taxpayer. . Deductible expenses related to a physician’s home office. c. Employee transportation expense not reimbursed by the employer. d. Employee transportation expense reimbursed by the employer and included in employee’s income. 6K is an attorney who had to travel to Chicago for a trial. Her law firm reimbursed her for the $1,200 hotel bill and $200 for f ood, but only half of her $200 entertainment expense eligible for deduction under  § 162. If the law firm includes the $1,500 in K’s compensation on her Form W 2, she may a. include the $1,500 as a miscellaneous itemized deduction. b. educt the $1,500 for A. G. I. c. include the $100 unreimbursed entertainment expense with the miscellaneous itemized deductions. d. Both b and c are true. 7F, an attorney in New York, also operates a small farm in New Jersey. During the year, he reported the following income and expenses from the farm: Gross income$8,000 Depreciation(3,000) Property taxes(6,000) Other operating expenses(4,000) Assuming the activity is considered a hobby, F may deduct a. taxes $6,000, other $0, depreciation $0. b. taxes $6,000, other $0, depreciation $2,000. c. taxes $6,000, other $2,000, depreciation $0. . taxes $6,000, other $4,000, depreciation $3,000. 8Which one of the following would qualify, at least in part, as a deductible educational expense? a. The co st of transportation between home and school on a nonworking day. b. Transportation between work and school on a working day. c. Both of the above. d. Neither of the above. 9. C obtained a new job in Alaska with HJ Engineering. She incurred the following moving expenses: Transportation of furniture and household goods$1,000 House hunting trip1,900 Attorney’s fees on sale of former residence1,400 Assuming C is eligible to deduct her moving expenses, what is the amount of the deduction? a. $1,000 b. $2,900 c. $3,400 d. $3,900 e. $4,400 10. Which of the following statements regarding deductions for home office expenses is true? a. Deductions may be taken only if the home office is used for the taxpayer’s main business. b. Deductions may be taken if the home office is used regularly for meeting clients or customers in the normal course of the taxpayer’s business. c. Deductions may not be claimed if the taxpayer merely performs administrative tasks related to his business in the home office. d. All of above are true. e. None of the above is true. 11. K is an attorney who had to travel to Chicago for a trial. Her law firm reimbursed her for the $1,200 hotel bill and $200 for food, but only half of her $200 entertainment expense eligible for deduction under  § 162. If the law firm includes the $1,500 in K’s compensation on her Form W 2, she may a. include the $1,500 as a miscellaneous itemized deduction. b. deduct the $1,500 for A. G. I. c. include the $100 unreimbursed entertainment expense with the miscellaneous itemized deductions. d. Both b and c are true. 12. Which one of the following statements is true? . The expenses of commuting are personal, and as such are never deductible regardless of the surrounding circumstances. b. The expenses of commuting from Job A to Job B are deductible to the extent that the distance between Jobs A and B does not exceed the distance from home to Job A. c. The expenses of commuting to a temporary assignment and returning the same day when the temporary assignment is outside the vicinity in which the taxpayer conducts his business (the tax home) are deductible and are determined based on the cost of transportation from the employee’s office to the temporary location. . b and c are true. e. All are false. 13. Which statement concerning deductible transportation costs is true? a. B drives 20 miles to his office, then later in the day drives to meet a client at the client’s office. By the time he gets home that night he has driven 63 miles. He can deduct the cost of driving 23 miles. b. F, an architect, usually drives 40 miles round trip from home to office. Today, she skips the office and drives directly to a job site to inspect the construction. Her round trip is 50 miles. She may deduct a cost of 50 miles. c. M, a contractor, works out of her home. She may deduct the cost of driving to a client’s place of business. d. More than one answer is true. e. All are true. 14S maintains a principal residence in St. Louis, Missouri. He lays brick for a living. S’s employer asked him to go to Chicago, Illinois to work on a single job for six months. Due to difficulties with weather, S was forced to stay in Chicago for a total of eleven months. S wants to deduct a portion of the cost of meals and lodging in Chicago while on the job. S will be a. denied the deduction because the job in Chicago was only a temporary assignment. . allowed the deduction because the job in Chicago will be considered temporary, as it was not an indefinite assignment. c. allowed the deduction because the job in Chicago will be considered indefinite, as it was not a temporary assignment. d. denied the deduction because living expenses are always nondeductible personal expenses. 15D owns and operates her own real estate business. She loves to entertain . Indicate which of the following statements is true. Assume the expenditure is deductible unless otherwise implied. a. D takes her new neighbor to the ball game. The expense is deductible, assuming D’s entertainment expense creates goodwill that may lead the individual to become D’s client if and when he decides to sell his house. b. D takes a prospective client to the theater. Unless the taxpayer can prove otherwise, the IRS presumes the expense is not deductible because the nature of the event precludes business discussion. c. D holds a golf outing for all of her employees. D may deduct the expense, assuming it is primarily for her employees. d. More than one but less than all of the statements above are true. e. None of the statements above is true. How to cite Income Tax, Papers Income Tax Free Essays History Income tax levels in India were very high during 1950-1980, in 1970-71 there were 11 tax slabs with highest tax rate being 93. 5% including surcharges. In 1973-74 highest rate was 97. We will write a custom essay sample on Income Tax or any similar topic only for you Order Now 5%. But to reduce tax evasion tax rates were reduced later on, by â€Å"1992-93† maximum tax rates were reduced to 40%. [2][3] [edit]Residential status, Scope of taxable income Charge [edit]Charge to Income-tax Whose income exceeds the maximum amount, which is not chargeable to the income tax, is an assesse, and shall be chargeable to the income tax at the rate or rates prescribed under the finance act for the relevant assessment year, shall be determined on basis of his residential status. Income tax is a tax payable, at the rate enacted by the Union Budget (Finance Act) for every Assessment Year, on the Total Income earned in the Previous Year by every Person. The chargeability is based on nature of income, i. e. , whether it is revenue or capital. The rates of taxation of income are-: Income Tax Rates/Slabs Rate (%) (applicable for assessment year 2013-14) Net income range (For resident woman below 60 years on the last day of the previous year)Net income range (For resident senior citizen1)Net income range (For super senior citizen2)Net income range (For any other person excluding companies and co-operative societies)Income Tax rates3 Up to Rs. 200000Up to Rs. 250000Up to Rs. 500000Up to Rs. 200000Nil Rs. 200001-500000Rs. 250001-500000-Rs. 200001-50000010% Rs. 500001-1000000Rs. 500001-1000000Rs. 00001-1000000Rs. 500001-100000020% Above Rs. 1000000Above Rs. 1000000Above Rs. 1000000Above Rs. 100000030% ^1 Senior citizen is one who is 60 years or more at any time during the previous year but not more than 80 years on the last day of the previous year. ^2 Super senior citizen is one who is 80 years or more at any time during the previous year. ^3 Surcharge isn’t applicable for any person excluding companies whose taxable in come exceed Rs. 1 crore. Education cess at 2% and Secondary and higher education cess at 1% of income-tax applicable for all person. These slab-rates aren’t applicable for the incomes which are to be taxed at special rates under section 111A, 112, 115, 161, 164 and 167. For instance, long-term capital gains (except the one mentioned in section 10(38))for all assessees is taxable at 20%. [edit]Residential Status The residential status of the assessee is useful in determining the scope or chargeability of the income for the assessee, i. e, whether taxable or not. For an individual person, to be a resident, any one of the following basic conditions must be satisfied:- Presence of at least 182 days in India during the previous year. Presence of at least 60 days in India during the previous year and 365 days during 4 years immediately preceding the relevant previous year. However, in case the individual is an Indian citizen who leaves India during the previous year for the purpose of employment (or as a member of a crew of an Indian ship) or in case the individual is a person of Indian origin who comes on a visit to India during the previous year, then only the first of the above basic condition is applicable. To determine whether the resident individual is ordinarily resident the following both additional conditions are to be satisfied:- Resident in India in at least 2 out of 10 years immediately preceding the relevant previous year. Presence of at least 730 days in India during 7 years immediately preceding the relevant previous year. If the individual resident satisfies only one or none of the additional conditions, then he is not ordinarily resident. In case the person is not an individual or an HUF, then the residential status can only be either resident or non-resident) [edit]Residential status of a person other than an individual Type of personControl management of affairs of the taxpayer is wholly in IndiaControl management of affairs of the taxpayer is wholly outside IndiaControl management of affairs of the taxpayer is partly in India partly outside India HUF1ResidentNon-residentResident FirmResidentNon-residentResident Association of personsResidentNon-residentResident Indian company2ResidentResidentResident Foreign company3ResidentNon-residentNon-resident Any other person except an individualResidentNon-residentResident ^1 After determining whether an HUF is resident or non-resident, the additional conditions (as laid down for an individual) should be checked for the karta to determine whether the HUF is ordinary or not-ordinary resident. ^2 An Indian company is the one which satisfies the conditions as laid down under section 2(26) of the Act. ^3 Foreign company is the one which satisfies the conditions as laid down under section 2(23A) of the Act. [edit]Scope of total income Indian income1 is always taxable in India notwithstanding residential status of the taxpayer. Foreign income1 is not taxable in the hands of a non-resident in India. For resident (in case of firm, association of persons, company and every other person) or resident ordinarily resident (in case of an individual or an HUF), foreign income is always taxable. For resident but not ordinarily resident foreign income is taxable only if it is business income and business is controlled wholly or partly in India or it is a professional income and profession is set up in India. 1 Foreign income is the one which satisfies both the following conditions:- Income is not received (or not deemed to be received under section 7) in India, and Income doesn’t accrue (or doesn’t deemed to be accrued under section 9) in India. If such an income satisfies one or none the above conditions then it is an Indian income. [edit]Heads of Income The total income of a person is segregated into five hea ds:- Income from Salary Income from house property Income from business or profession Capital Gain and Income from other sources [edit]Income from Salary All income received as salary under Employer-Employee relationship is taxed under this head, on due or receipt basis, whichever arises earlier. Employers must withhold tax compulsorily (subject to Section 192), if income exceeds minimum exemption limit, as Tax Deducted at Source (TDS), and provide their employees with a Form 16 which shows the tax deductions and net paid income. The Act contains exemptions including (the list isn’t exhaustive):- ParticularsRelevant section for computing exemption Leave travel concession10(5) Death-cum-Retirement Gratuity10(10) Commuted value of Pension (not taxable for specified Government employees)10(10A) Leave encashment10(10AA) Retrenchment Compensation10(10B) Compensation received at time of Voluntary Retirement10(10C) Tax on perquisite paid by employer10(10CC) Amount received from Superannuation Fund to legal heirs of employee10(13) House Rent Allowance10(13A) Some Special Allowances10(14) The Act contains list of Perquisites which are always taxable in all cases and a list of Perquisites which are exempt in all cases (List I). All other Perquisites are to be calculated according to specified provision and rules for each. Only two deductions are allowed under Section 16, viz. Professional Tax and Entertainment Allowance (the latter only available for specified government employees). [edit]Income from House property Income under this head is taxable if the assessee is the owner of a property consisting of building or land appurtenant thereto and is not used by him for his business or professional purpose. An individual or an Hindu Undivided Family (HUF) is eligible to claim any one property as Self-occupied if it is used for own or family’s residential purpose. In that case, the Net Annual Value (as explained below) will be nil. Such a benefit can only be claimed for one house property. However, the individual (or HUF) will still be entitled to to claim Interest on borrowed capital as deduction under section 24, subject to some conditions. In the case of a self occupied house deduction on account of interest on borrowed capital is subject to a maximum limit of Rs. 1,50,000 (if loan is taken on or after 1 April 1999 and construction is completed within 3 years) and Rs. 30,000 (if the loan is taken before 1 April 1999). For let-out property, all interest is deductible, with no upper limits. The balance is added to taxable income. The computation of income from let-out property is as under:- Gross Annual Value (GAV)1xxxx Less:Municipal Taxes paid(xxx) Net Annual Value (NAV)xxxx Less:Deductions under section 242(xxx) Income from House propertyxxxx ^1 The GAV is higher of Annual Letting Value (ALV) and Actual rent received/receivable during the year. The ALV is higher of fair rent and municipal value, but restricted to standard rent fixed by Rent Control Act. 2 Only two deductions are allowed under this heaad by virtue of section 24, viz. , 30% of Net annual value as Standard deduction Interest on capital borrowed for the purpose of acquisition, construction, repairs, renewals or reconstruction of property (subject to certain provisions). Income from Business or Profession The income referred to in section 28, i. e. , the incomes chargeable as â€Å"Income from Business or Profession† shall be computed in accordance with the provisions contained in sections 30 to 43D. However, there are few more sections under this Chapter, viz. Sections 44 to 44DA (except sections 44AA, 44AB 44C), which contain the computation completely within itself. Section 44C is a disallowance provision in the case non-residents. Section 44AA deals with maintenance of books and section 44AB deals with audit of accounts. In summary, the sections relating to computation of business income can be grouped as under: – Specific deductionsSections 30 to 37 cover expenses which are expressly allowed as deduction while computing business income. Specific disallowanceSections 40, 40A and 43B cover inadmissible expenses. Deemed IncomesSections 33AB, 33ABA, 33AC, 35A, 35ABB, 41. Special provisionsSections 42, 43C, 43D, 44, 44A, 44B, 44BB, 44BBA, 44BBB, 44DA, 44DB. Presumptive IncomeSections 44AD, 44AE. The computation of income under the head â€Å"Profits and Gains of Business or Profession† depends on the particulars and information available. [4] If regular books of accounts are not maintained, then the computation would be as under: – Income (including Deemed Incomes) chargeable as income under this head xxx Less: Expenses deductible (net of disallowances) under this ead xxx Profits and Gains of Business or Profession xxx However, if regular books of accounts have been maintained and Profit and Loss Account has been prepared, then the computation would be as under: – Net Profit as per Profit and Loss Account xxx Add : Inadmissible Expenses debited to Profit and Loss Account xxx Deemed Incomes not credited to Profit and Loss Account xxx xxx Less: Deductible Expenses not debited to Profit and Loss Account xxx Incomes chargeable under other heads credited to Profit Loss A/c xxx xxx Profits and Gains of Business or Profession xxx [edit]Income from Capital Gains Transfer of capital assets results in capital gains. A Capital asset is defined under section 2(14) of the I. T. Act, 1961 as property of any kind held by an assessee such as real estate, equity shares, bonds, jewellery, paintings, art etc. but does not include some items like any stock-in-trade for businesses and personal effects. Transfer has been defined under section 2(47) to include sale, exchange, relinquishment of asset extinguishment of rights in an asset, etc. Certain transactions are not regarded as ‘Transfer’ under section 47. Computation of Capital Gains:- Full value of consideration1xxx Less:Cost of acquisition2(xx) Less:Cost of improvement2(xx) Less:Expenditure pertaining to transfer incurred by the transferor(xx) ^1 In case of transfer of land or building, if sale consideration is less than the stamp duty valuation, then such stamp duty value shall be taken as full value of consideration by virtue of Section 50C. The transferor is entitled to challenge the stamp duty valuation before the Assessing Officer. ^2 Cost of acquisition cost of improvement shall be indexed in case the capital asset is long term. For tax purposes, there are two types of capital assets: Long term and short term. Transfer of long term assets gives rise to long term capital gains. The benefit of indexation is available only for long term capital assets. If the period of holding is more than 36 months, the capital asset is long term, otherwise it is short term. However, in the below mentioned cases, the capital asset held for more than 12 months will be treated as long term:- Any share in any company Government securities Listed debentures Units of UTI or mutual fund, and Zero-coupon bond Also, in certain cases, indexation benefit is not be available even though the capital asset is long term. Such cases include depreciable asset (Section 50), Slump Sale (Section 50B), Bonds/debentures (other than capital indexed bonds) and certain other express provisions in the Act. There are different scheme of taxation of long term capital gains. These are: As per Section 10(38) of Income Tax Act, 1961 long term capital gains on shares or securities or mutual funds on which Securities Transaction Tax (STT) has been deducted and paid, no tax is payable. STT has been applied on all stock market transactions since October 2004 but does not apply to off-market transactions and company buybacks; therefore, the higher capital gains taxes will apply to such transactions where STT is not paid. In case of other shares and securities, person has an option to either index costs to inflation and pay 20% of indexed gains, or pay 10% of non indexed gains. The cost inflation index rates are released by the I-T department each year. In case of all other long term capital gains, indexation benefit is available and tax rate is 20%. All capital gains that are not long term are short term capital gains, which are taxed as such: Under section 111A, for shares or mutual funds where STT is paid, tax rate is 10% from Assessment Year (AY) 2005-06 as per Finance Act 2004. With effect from AY 2009-10 the tax rate is 15%. In all other cases, it is part of gross total income and normal tax rate is applicable. For companies abroad, the tax liability is 20% of such gains suitably indexed (since STT is not paid). Besides exemptions under section 10(33), 10(37) 10(38) certain specific exemptions are available under section 54, 54B, 54D, 54EC, 54F, 54G 54GA. [edit]Income from Other Sources This is a residual head, under this head income which does not meet criteria to go to other heads is taxed. There are also some specific incomes which are to be always taxed under this head. Income by way of Dividends. Income from horse races/lotteries. Employees’ contribution towards staff welfare scheme. Interest on securities (debentures, Government securities and bonds). Any amount received from keyman insurance policy as donation. Gifts (subject to certain conditions and exemptions). Interest on compensation/enhanced compensation. edit]Permissible deductions from Gross Total Income This section requires expansion. (November 2012) While exemptions is on income some deduction in calculation of taxable income is allowed for certain payments given under Chapter VI-A ie. , sections 80C to 80U. [edit] Section 80C Deductions Section 80C of the Income Tax Act [1] allows certain investments and expenditure to be deducted from total income up to the maximum of 1 lac. The total limit under this section is ? 100,000 ) which can be any combination of the below: Contribution to Provident Fund or Public Provident Fund. PPF provides 8. 8% [5] return compounded annually. Maximum limit to contribute in it is 100,000 for each year. It is a long term investment with complete withdrawal not possible till 15 years though partial withdrawal is possible after 5 years. The interest earned on PPF investments is not taxable. Besides, there is employee providend fund which is deducted from the salary of the person. This is about 10% to 12% of the BASIC salary component. Recent changes are being discussed regarding reducing the instances of withdrawal from EPF especially when one changes the job. EPF has the option of full settlement on leaving the job, taking VRS, retirement after 58. It also has options of withdrawal for certain expenses related to home, marriage or medical. EPF contribution includes 12% of basic salary from employee and employer. It is distributed in ratio of 8. 33:3. 7 in Pension fund and Providend fund Payment of life insurance premium. It is allowed on premium paid on self, spouse and children even if they are not dependent on father or mother. Investment in pension Plans. National Pension Scheme i s meant to save money for the post retirement which invests money in different combination of equity and debt. depending upon age up to 50% can go in equity. Annuity payable after retirement is dependent upon age. NPS has six fund managers. Individual can make minimum contribution of Rs6000/- . It has 22 point of purchase (banks). Investment in Equity Linked Savings schemes (ELSS) of mutual funds. Among other investment opportunities, ELSS has the least lock-in period of 3 years. However, one should note that after the Direct Tax Code is in place, ELSS will no longer be an investment for 80C deduction. Investment in National Savings Certificates (interest of past NSCs is reinvested every year and can be added to the Section 80 limit) Tax saving Fixed Deposits provided by banks for a tenure of 5 years. Interest is also taxable. Payments towards principal repayment of housing loans. Also any registration fee or stamp duty paid. Payments towards tuition fees for children to any school or college or university or similar institution (Only for 2 children) Post office investments The investment can be from any source and not necessarily from income chargeable to tax. edit]Section 80CCF: Investment in Infrastructure Bonds From April, 1 2011, a maximum of ? 20,000 is deductible under section 80CCF provided that amount is invested in infrastructure bonds. This is in addition to the 100,000 deduction allowed under Section 80C. However this deduction has not been extend ed to Financial year 2012-13. [6] Omiitted with effect from F. Y. 2012-13. [edit]Section 80D: Medical Insurance Premiums Health insurance, popularly known as Mediclaim Policies, provides a deduction of up to 35,000. 00 (? 15,000. 00 for premium payments towards policies on self, spouse and children and ? 15,000. 00 for premium payment towards non-senior citizen dependent parents or ? 20,000. 0 for premium payment towards senior citizen dependent). This deduction is in addition to ? 1,00,000 savings under IT deductions clause 80C. For consideration under a senior citizen category, the incumbent’s age should be 60 years during any part of the current fiscal, e. g. for the fiscal year 2010-11, the incumbent should already be 60 as on March 31, 2011), This deduction is also applicable to the cheques paid by proprietor firm. [edit]Interest on Housing Loans Section For self occupied properties, interest paid on a housing loan up to Rs 150,000 per year is exempt from tax. This deduc tion is in addition to the deductions under sections 80C, 80CCF and 80D. However, this is only applicable for a residence constructed within three financial years after the loan is taken and also the loan if taken after April 1, 1999. If the house is not occupied due to employment, the house will be considered self occupied. For let out properties, the entire interest paid is deductible under section 24 of the Income Tax act. However, the rent is to be shown as income from such properties. 30% of rent received and municipal taxes paid are available for deduction of tax. The losses from all properties shall be allowed to be adjusted against salary income at the source itself. Therefore, refund claims of T. D. S. deducted in excess, on this count, will no more be necessary. 7] [edit]Section 80DDB : Deduction in respect of Medical Treatment, etc Deduction is allowed to resident individual or HUF in respect of expenditure actually during the PY incurred for the medical treatment of specified disease or ailment as specified in the rules 11DD for himself or a d ependent relative or a member of a HUF[8] [edit]Refund Status State Bank of India (SBI) is the refund banker to the Indian Income Tax Department(ITD). Your tax refund details are sent to SBI, by the Income tax department. Then SBI will process the refund, and send you the refund intimation. While filing your return you can choose any one of the two Refund modes ECS or Paper(cheque). The refund status can be checked online at the NSDL site. [edit]Due Date of submission of return The due date of submission of return shall be ascertained according to section 139(1) of the Act as under:- September 30 of the Assessment Year(AY)-If the assessee is a company (not having any inter-nation transaction), or -If the assessee is any person other than a company whose books of accounts are required to be audited under any law, or -If the assessee is a working partner in a firm whose books of accounts are required to be audited under any law. November 30 of the AYIf the assessee is a company and it is required to furnish report under section 92E pertaining to international transactions. July 31 of the AYIn any other case. [edit]Advance Tax Under this scheme, every assessee is required to pay tax in a particular financial year, preceding the assessment year, on an estimated basis. However, if such estimated income is less than Rs. 10000, then no advance tax is payable. The due dates of payment of advance tax are:- In case of corporate assesseeOtherwise On or before 15 June of the previous yearUpto 15% of advance tax payable- On or before 15 September of the previous yearUpto 45% of advance tax payableUpto 30% of advance tax payable On or before 15 December of the previous yearUpto 75% of advance tax payableUpto 60% of advance tax payable On or before 15 March of the previous yearUpto 100% of advance tax payableUpto 100% of advance tax payable Any default in payment of advance tax attracts penalty under section 234B and any deferment of advance tax attracts penalty under section 234C. [edit]Tax deducted at Source (TDS) The general rule is that the total income of an assessee for the previous year is taxable in the relevant assessment year. however income-tax is recovered from the assessee in the previous year itself by way of TDS. The relevant provisions therein are listed below. (To be used for reference only. The detailed provisions therein are not listed below. 1) SectionNature of paymentThreshold limit (upto which no tax is deductible)TDS to be deducted 192Salary to any personExemption limitAs specified for individual in Part III of I Schedule 193 2Interest on securities to any residentSubject to detailed provisions of given section10% 194A 2Interest (other than interest on securities) to any residentRs. 10000 (for Bank/cooperative bank) Rs. 5000 otherwise10% 194BWinning from lotteries etc. to any personRs. 1000030% 194BBWinning from horse races to any personRs. 500030% 94C 2Payment to resident contractorsRs. 30000 (for single contract) Rs. 75000 (for aggregate consideration in a financial year)2% (for companies/firms) 1% otherwise 194DInsurance commission to residentRs. 2000010% 194EPayment to non-resident sportsmen or sports associationNot applicable10% 194EEPayment of deposit under National Savings S cheme to any personRs. 250020% 194GCommission on sale of lottery tickets to any personRs. 100010% 194H 2Commission/brokerage to a residentRs. 500010% 194-I 2Rents paid to any residentRs. 1800002% (for plant,machinery,equipment) 10% (for land,building,furniture) 194J 2Fees for professional/technical services; RoyaltyRs. 000010% 194LBInterest paid by Infrastructure Development Fund under section 10(47) to non-resident or foreign company-5% 195Interest or other sums (not being salary) paid to non-residents or foreign company except under section 115O-As per double taxation avoidance treaty ^1 At what time tax has to be deducted at source and some other specifications are subject to the above sections. ^2 In most cases, these payments shall not to deducted by an individual or an HUF if books of accounts are not required to be audited in the immediately preceding financial year. In most cases, the tax deducted should be deposited within 7 days from the end of the month in which tax was deducted. [edit]Corporate Income tax For companies, income is taxed at a flat rate of 30% for Indian companies, with a 5% surcharge applied on the tax paid by companies with gross turnover over ? 1 crore (10 million). Foreign companies pay 40%. [9] An education cess of 3% (on both the tax and the surcharge) are payable, yielding effective tax rates of 32. 5% for domestic companies and 41. 2% for foreign companies. [10] From 2005-06, electronic filing of company returns is mandatory. [11] [edit]Tax Returns There are five categories of Income Tax returns. Normal Return Belated Return Revised Return Defective Return Returns In Response To Notices [edit]Normal Return Returns filed within the return filing due date, that is 31 July or 30 September of concerned assessment year. [12] [edit]Belated Return In case of failure to file the return on or before the due date, belated return can be filed before the expiry of one year from the end of the relevant assessment year. [edit]Revised Return In case of any omission or any wrong statement mentioned in the normal return can be revised at any time before the expiry of one year from the end of the relevant assessment year. [edit]Defective Return Assessing Officer considers that the return is defective, he may intimate the defect. One has to rectify the defect within a period of fifteen days from the date of such intimation. If the assessee wants more time, he can file an application to the A O and a further 15 days can be granted at the instance of the A O. [edit]Returns In Response To Notices Assessing officer in the process of making assessment, may serve a notice under various sections like 142(1), 148(1), 153A(a) or 153C. Returns are required to be furnished within the date specified on the respective notices. [edit]Annual Information Return and Statements [edit]Annual Information Return Those who is responsible for registering, or, maintaining books of account or other documents containing a record of any specified financial transaction,[13] shall furnish an annual information return in Form No. 61A. [edit]Statements By Producers Producers of a cinematographic film during the financial year shall, prepare and deliver to the Assessing Officer a statement in the Form No. 2A, within 30 days from the end of such financial year or within 30 days from the date of the completion of the production of the film, whichever is earlier. [edit]Statements By Non-Resident Having A Liaison Office In India With effect from 01,June 2011, Non-Resident having a liaison office in India sha ll prepare and deliver a statement in Form No. 49C to the Assessing Officer within sixty days from the end of such financial year. [edit]Tax Penalties The major number of penalties initiated every year as a ritual by I-T Authorities is under section 271(1)(c)[14] which is for either concealment of income or for furnishing inaccurate particulars of income. If the Assessing Officer or the Commissioner (Appeals) or the Commissioner in the course of any proceedings under this Act, is satisfied that any person- (b) has failed to comply with a notice under sub-section (1) of section 142 or sub-section (2) of section 143 or fails to comply with a direction issued under sub-section (2A) of section 142, or (c) has concealed the particulars of his income or furnished inaccurate particulars of such income, he may direct that such person shall pay by way of penalty,- (ii) in the cases referred to in clause (b), in addition to any tax payable by him, a sum of ten thousand rupees for each such fa ilure; (iii) in the cases referred to in clause (c), in addition to any tax payable by him, a sum which shall not be less than, but which shall not exceed three times, the amount of tax sought to be evaded by reason of the concealment of particulars of his income or the furnishing of inaccurate particulars of such income. How to cite Income Tax, Papers

Movie Overview Ang Lees Life of Pi Essay Example For Students

Movie Overview Ang Lees Life of Pi Essay The movie The Life of Pi ? directed by Ang Lee explores the nature of life itself, amongst the humans and the animals existing on this planet through love, morals, beliefs, values and particularly life lessons. We grasp the idea that life is balanced with the people and the animal, how they need each other, in order to survive just like our food chain. Even though they are morally distinct upon several factors of life such as survival and habitual instincts, how there are different dimensions of philosophies between the two types of creatures, it still prevails to be a balance within nature. How we configure this balance is what the movie explores and lets the ideas unravel itself amongst the audience. We started off with an interview conducted by Yann Martel who is a Canadian novelist. He was interested upon the life of Pi, who is an Indian man named Piscine Molitor, referred in the movie as Pi. ? Martel wanted to uncover the mysteries of the nature between good and evil, and how is it distinct from human and animal. Therefore we begin his life story reflected to the audience what exactly is the idea behind Good and Evil ? between two different types of beings. Is it formed through habitual factors, or is it originated from aspects of life and circumstance? The ideas that the movie prevails are religion perspectives, how they are combined as one through Pis eyes, and how they looked upon from societys expectations of religion. Secondly, we explore the relationship between Pi and the Bengal Tiger Richard Parker. How did the relationship grow through struggles of survival, did it test their standards of morals, beliefs? How was Pis religion and beliefs tested? What is the value of a friend; it is tested through the relationship between Pi and Parker. Pi separated himself from his families and societys selective views and commitments of various religions. Pi realized that perception is that a knowledge rather than an oppressions of ones views thinking of life. He believed that there many ways of loving god through many different types of religions, thus he wanted to respect and understand Islam, Christianity and Hindu, giving him that combination of commitment, and self morals towards God and himself. Many are trained and engraved into believing one religion to guide them morally throughout society and life. In the movie Pis father wished of him to study and practice Hindu with the rest of the family. Society itself are ingrained and programmed to believe in one type of religion and what your parents teach you, we have been imprinted of our family values such as the religion selected, thus we automatically accept the religion that we are born into. Pi, on the other hand was different; he believed that, None of us knows God until someone introduces us. I was first introduced to God as a Hindu. There are 33 million Gods in the Hindu religion. How can I not come to know a few of them? Though, some people change religion through life experiences of trial and error, but they dont accept all religions at once to show a sign of their love for god, because they have a particular mindset or perception upon the image of god, due to the religion that they are committed into since they were born or expected by the society. Pi believes through all the monotheisms and polytheism religions that exist in the modern society, are only taught one way of loving many gods or just one god, not accepting and integrating many religion into your life such as what Pi did. .ubab359abf54ce3bd954c89b2ec7db2e6 , .ubab359abf54ce3bd954c89b2ec7db2e6 .postImageUrl , .ubab359abf54ce3bd954c89b2ec7db2e6 .centered-text-area { min-height: 80px; position: relative; } .ubab359abf54ce3bd954c89b2ec7db2e6 , .ubab359abf54ce3bd954c89b2ec7db2e6:hover , .ubab359abf54ce3bd954c89b2ec7db2e6:visited , .ubab359abf54ce3bd954c89b2ec7db2e6:active { border:0!important; } .ubab359abf54ce3bd954c89b2ec7db2e6 .clearfix:after { content: ""; display: table; clear: both; } .ubab359abf54ce3bd954c89b2ec7db2e6 { display: block; transition: background-color 250ms; webkit-transition: background-color 250ms; width: 100%; opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; background-color: #95A5A6; } .ubab359abf54ce3bd954c89b2ec7db2e6:active , .ubab359abf54ce3bd954c89b2ec7db2e6:hover { opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; background-color: #2C3E50; } .ubab359abf54ce3bd954c89b2ec7db2e6 .centered-text-area { width: 100%; position: relative ; } .ubab359abf54ce3bd954c89b2ec7db2e6 .ctaText { border-bottom: 0 solid #fff; color: #2980B9; font-size: 16px; font-weight: bold; margin: 0; padding: 0; text-decoration: underline; } .ubab359abf54ce3bd954c89b2ec7db2e6 .postTitle { color: #FFFFFF; font-size: 16px; font-weight: 600; margin: 0; padding: 0; width: 100%; } .ubab359abf54ce3bd954c89b2ec7db2e6 .ctaButton { background-color: #7F8C8D!important; color: #2980B9; border: none; border-radius: 3px; box-shadow: none; font-size: 14px; font-weight: bold; line-height: 26px; moz-border-radius: 3px; text-align: center; text-decoration: none; text-shadow: none; width: 80px; min-height: 80px; background: url(https://artscolumbia.org/wp-content/plugins/intelly-related-posts/assets/images/simple-arrow.png)no-repeat; position: absolute; right: 0; top: 0; } .ubab359abf54ce3bd954c89b2ec7db2e6:hover .ctaButton { background-color: #34495E!important; } .ubab359abf54ce3bd954c89b2ec7db2e6 .centered-text { display: table; height: 80px; padding-left : 18px; top: 0; } .ubab359abf54ce3bd954c89b2ec7db2e6 .ubab359abf54ce3bd954c89b2ec7db2e6-content { display: table-cell; margin: 0; padding: 0; padding-right: 108px; position: relative; vertical-align: middle; width: 100%; } .ubab359abf54ce3bd954c89b2ec7db2e6:after { content: ""; display: block; clear: both; } READ: The film progresses EssayAs Martel gathered information of Pi during lunch they had a conversation, which reflects our theory, Amen. Yeah, lets eat. I didnt know Hindus said Amen. Catholic Hindus do. ? Many religious people are either bias or dont care about learning different religions or are not open-minded. Societys expectation of religion is very narrow-minded as we are programmed to believe that one religion is the only perception of god and believing or loving god. Pis views reflected on Christ at first didnt make sense why god sent his son to die on the cross. But he was able to grab the concept of Christianity from father martins principles of how the belief towards Christianity is born, because you have good faith, you are automatically in a sense believing of Jesus Christs faith, which is overall Christianity. Form then on, Pi started to practice Christianity and integrated into his life as Hindu and as a believer of Islam. If you try to integrate and believe in many different religions, in a sense you dont miss out on any aspect of god, whether it be love, commitment or support and practicing gods will. Pi attempted to be acquainted and connect with the tiger by feeding the tiger red meat. A distinction was brought up as Pis dad addressed towards Pi and the whole family, that animals dont have souls and what you see in their eyes is a projection of your own thoughts and emotions. That they are not your friends, as their main purpose is what to eat. Pi tried to integrate the feelings and perception of animals with his, he felt for the tiger, but his father quickly distinguished that animals will be animals and humans will be humans, that there is no sort of connection between the two groups. As if two different mind sets, tigers will always strategize to eat the pray whereas a human thinks in a deeper level with philosophies, facts, opinions, experiences, emotions and all other aspects of life. Their projection of life is different to the animals projection of life, and Pi didnt clearly distinguish this fact, he thought it was a theory rather than a fact, that it can be falsifiable as we are all beings of god. An example would be when Pi and Parker are stranded on the boat, and Parker on a daily basis eats five kilograms of meat every day has been reduced too none or to Pis mass. Pi stated, Hunger can change everything you thought and knew about yourself ? is the first inception of survival between the two beings stranded on the boat. But then as time gradually went by, and their habitat changed from captivation in the zoo to being stranded in the middle of the Pacific Ocean, they had to learn how to live with each other, even though there is a clear distinction between Parker who is a hungry tiger living off five kilograms of meat per day compared to Pi who is a human vegetarian. Pi had a choice to kill the tiger but made a choice that in turn saved both of their lives. Every aspect of the situation changed, he tamed the tiger, which then the tiger adapted to life on the boat rather then living the zoo life on the boat. Parker adapted his perception to fit both of Pi and himself. When in the boat Pi, tried to include Parker in his unique religion views Were dying, Richard Parker. Im sorry. Can you feel the rain, God, thank you for giving me my life, Im ready now ? signifies how Pi submits to the universe on the second storm with Parker, as he thought it was gods will to let go or trust in him, as life wasnt the place that it once used to be for Pi. .ua8ee740b98edb0cb475a55708e93a62b , .ua8ee740b98edb0cb475a55708e93a62b .postImageUrl , .ua8ee740b98edb0cb475a55708e93a62b .centered-text-area { min-height: 80px; position: relative; } .ua8ee740b98edb0cb475a55708e93a62b , .ua8ee740b98edb0cb475a55708e93a62b:hover , .ua8ee740b98edb0cb475a55708e93a62b:visited , .ua8ee740b98edb0cb475a55708e93a62b:active { border:0!important; } .ua8ee740b98edb0cb475a55708e93a62b .clearfix:after { content: ""; display: table; clear: both; } .ua8ee740b98edb0cb475a55708e93a62b { display: block; transition: background-color 250ms; webkit-transition: background-color 250ms; width: 100%; opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; background-color: #95A5A6; } .ua8ee740b98edb0cb475a55708e93a62b:active , .ua8ee740b98edb0cb475a55708e93a62b:hover { opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; background-color: #2C3E50; } .ua8ee740b98edb0cb475a55708e93a62b .centered-text-area { width: 100%; position: relative ; } .ua8ee740b98edb0cb475a55708e93a62b .ctaText { border-bottom: 0 solid #fff; color: #2980B9; font-size: 16px; font-weight: bold; margin: 0; padding: 0; text-decoration: underline; } .ua8ee740b98edb0cb475a55708e93a62b .postTitle { color: #FFFFFF; font-size: 16px; font-weight: 600; margin: 0; padding: 0; width: 100%; } .ua8ee740b98edb0cb475a55708e93a62b .ctaButton { background-color: #7F8C8D!important; color: #2980B9; border: none; border-radius: 3px; box-shadow: none; font-size: 14px; font-weight: bold; line-height: 26px; moz-border-radius: 3px; text-align: center; text-decoration: none; text-shadow: none; width: 80px; min-height: 80px; background: url(https://artscolumbia.org/wp-content/plugins/intelly-related-posts/assets/images/simple-arrow.png)no-repeat; position: absolute; right: 0; top: 0; } .ua8ee740b98edb0cb475a55708e93a62b:hover .ctaButton { background-color: #34495E!important; } .ua8ee740b98edb0cb475a55708e93a62b .centered-text { display: table; height: 80px; padding-left : 18px; top: 0; } .ua8ee740b98edb0cb475a55708e93a62b .ua8ee740b98edb0cb475a55708e93a62b-content { display: table-cell; margin: 0; padding: 0; padding-right: 108px; position: relative; vertical-align: middle; width: 100%; } .ua8ee740b98edb0cb475a55708e93a62b:after { content: ""; display: block; clear: both; } READ: Analyse three film trailers EssayHe endured all things magical and beautiful with Parker, he experienced through nature, through his, and Parkers perspective with the circumstances such as losing his family, being stranded on a boat, the will to survive was driven through gods will, the beauty of life and love that he learnt through the integration of religion beliefs. Because Pi had to share his environment with only Parker, a wild captive animal that was consistently fed meat during period of time. He had to learn and adapt through Parkers perspective and feel what the tiger was feeling in order for his hope to stay strong. We as humans thats how we survive, we are able to think what other beings were perceiving, feel their perspective and what they are feeling, such that we can make conclusions and decisions of their actions. Pi used this natural human instinct to his advantage of surviving, even though he has lost everything true to his life, which gave meaning and purpose. But he didnt lose everything as he had god and his beauty upon earth through nature and the hope to keep living no matter what the circumstance. In conclusion the movie portrays various different life lessons and experiences that captivate the reader and relates and questions their own values beliefs on life itself. What it means to them and what is their purpose of living life. What makes this film intriguing is that we are able to grasp what society projects on religion the laws of nature such as perceiving an animal that has a soul, and the difference between being a close minded being compared to being an open minded being. Through Pis eyes we see the fine line between integrating different religions together in order to fully love god and his will, than solely perceiving that gods love and will is related to only one type of religion. Also we explore how the environment can influence two opposite beings attitudes towards each other and upon life values and beliefs whether it be spiritual or mental. We see this through the relationship between Pi and the Richard Parker stranded on the boat in the middle of the Pacific Ocean.

Why Students Dont Read The Newspaper free essay sample

People read newspapers such as Borneo Post, The Star, News Strait Times and Berita Harian. Newspaper gives us a lot of latest information about the issues around us either in or out the country. During break and lunch time, students and staff always take along with them a newspaper. Reading newspapers give a lot of information but only a few students read newspapers because students are not really interested with this kind of reference, as they know that they can surf news-online and they have no time to read newspaper. Firstly, almost all students are not really interested to read newspaper. They pay more attention on magazines, novels, and books on what they are study. Students focus on what they aim. Almost all of them ignore the newspaper and read books on what they have study to complete their assignments and to get information for their research. Secondly, time is precious. We will write a custom essay sample on Why Students Dont Read The Newspaper or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page Lately, students are very busy with their assignments and tasks given by their lecturers. Besides that, they want to study to get high marks and scores in their examination. Most of them do not read the newspaper because they have no time to read it. Some students update themselves about the latest news by watching the news on the television. Besides that, they can also find out latest news from friends or people around them. Lastly, students can also get news online. Nowadays, every cafà © or places in the campus such as the library, labs etc, the students go have wireless internet connection which is known as the wi-fi. This gives a great opportunity to the students to get online and surf the internet easily. Reading news-online is faster than buy a newspaper. Besides that, they can read the news-online anywhere they want. Moreover, they can save their pocket money from buying the newspaper. As a conclusion, although only a few students read the newspaper, this does not mean that they do not keep up to date with the latest news. Some of them get latest news from their lecturers, friends and also while surfing the internet.

The Snake essays

The Snake essays A short story by John Steinbeck, The Snake depicts the strange encounter between a man, Dr. Phillips, and a mysterious woman who arrives at his laboratory one night. The central theme of the tale revolves around Steinbecks interpretation of the contrast between men and women. It appears that his idea was: Men represent reason; Women represent nature. In the story we watch as the two opposing sides meet each other in the dark laboratory. Steinbeck uses the first two pages of the story to characterize the differences between the male character and the female. Dr. Phillips is portrayed as being a young man in seemingly good shape, as he is able to climb up over the rocks, and having preoccupied eyes of one who looks through the microscope a great deal Right away Steinbeck illustrates Phillips masculinity by showing his attempt at mastering nature; when the Doctor calmly selects a cat from a cage and kills the animal in the quest of scientific knowledge, he does it because it is reasonable and logical to try and better understand the way that nature works. It stark contrast to the clean cut Dr. Phillips, the woman visitor is shown as A tall, lean woman... dressed in a severe dark suit-her straight black hair, growing low on a flat forehead, was mussed as though the wind had been blowing it. Her black eyes glittered in the strong light. The description of her hair is very important in that it shows she is allowing nat ure to affect her as it would naturally, and not trying to be a master over its effects like Phillips when he wore rubber boots and leather coat while out in the tide pool. Now that the characters have met face to face, Phillips continues about his work while the woman waits patiently for him to finish. The tone of the story begins to change at this point away from a story about the scientific work of Dr. Phillips to a battle between the forces of man ...

Comerical law. sale of goods Case Study Example | Topics and Well Written Essays - 250 words

Comerical law. sale of goods - Case Study Example Under this UCC, John can claim that ABC’s president promised him that they roofing sheets were of high quality through the phone call and that is why he opted to buy them (Cornell University Law School 1). John can claim that the roofing sheets did not meet the fitness purposes for which goods of the kind of roofing sheets he wanted to buy meet. Such roofing sheets should be able to withstand poor weather. The roofing sheets lacked freedom from minor defects; they endanger the lives of the workers in the company safe and its durability was short term. John can file a claim against all these factors since ABC’s president promised him that all these issues will be addressed yet they were not (Hooley 19). If someone has been sold a faulty product, then they are lawfully entitled to claim from the seller any direct expenses that they have incurred (Adams 53). John can, therefore, file a claim on the expense of restoring back his company. This includes the $125,000 spent on the new roofing and the roughly $200,000 lost on damages by the previously damaged

Case Study about Multisystem Assignment Example | Topics and Well Written Essays - 750 words

Case Study about Multisystem - Assignment Example Physical examination must be made in a systematic fashion from head to toe with attention to the skin. Special attention must be paid to any abnormal vital signs or evidence of toxicity (Cash, & Glass, 2011). An important aspect of the physical examination will require the patient to get naked so that a proper evaluation can be made. This is needed as patients are often unaware of a rash on their back, buttocks, soles, or perineum. During the physical examination, involvement of the mucous membranes must be examined in areas including mouth, lips, conjunctiva, anus, and vagina. General diagnostic testing must be made so as to support the diagnosis. Biopsy is done by extracting a tissue sample from the patient’s skin for examination under the microscope. The biopsy results upon diagnosis will demonstrate detachment of the epidermis from the dermis. Recommendations for Management The initial step to be done in managing this disease is to identify the probable cause of the condit ion. If the disease is caused by medicine; then the subsequent action is to discontinue any medications suspected of causing Stevens Johnson Syndrome. According to Patterson, Grammer, & Greenberger early discontinuation of the etiologic drug has been reported to improve survival in patients (Patterson, Grammer, & Greenberger, Pg. 234, 2009). All medication started within the past months should be discontinued. Patients affected by this situation require immediate hospitalization; in burn centers or intensive care units. Such patients are treated in a manner similar to that of burn patients. Treatment for Stevens Johnson Syndrome is symptomatic and supportive. Supportive... The initial step to be done in managing this disease is to identify the probable cause of the condition. If the disease is caused by medicine; then the subsequent action is to discontinue any medications suspected of causing Stevens Johnson Syndrome. According to Patterson, Grammer, & Greenberger early discontinuation of the etiologic drug has been reported to improve survival in patients. All medication started within the past months should be discontinued. Patients affected by this situation require immediate hospitalization; in burn centers or intensive care units. Such patients are treated in a manner similar to that of burn patients. Treatment for Stevens Johnson Syndrome is symptomatic and supportive. Supportive care given to the patient while he is hospitalized includes; fluid replacement, nutrition, wound care, and eye care. Special consideration must be given to airway as well as hemodynamic stability. Fluid status must also be considered in cases whereby the patient lost fl uid via affected seeping areas where the skin came off. Its management focuses on the removal of the offending agent and replacement of fluid losses. This is done by intravenous fluid repletion. Great volumes of colloids and crystalloids are important in maintenance of electrolyte balance. Care of the wound must be made.

Clinical Risk Management Health And Social Care Essay

Clinical Risk Management Health And Social Care Essay The aim of this essay to provide the reader with insight to the term clinical risk management and how this is implemented within NHS trusts focusing particularly on the role of Pharmacists in doing this. Objectives: Defining clinical risk management and discussing its importance Discussing ways in which trusts implement clinical risk management Defining what is a medication error and identifying the role of the pharmacist to reduce these Discussing systems or processes in place in my base hospital to reduce medication errors 1.0 Importance of clinical risk management Clinical governance was first mentioned in British Health policy in 1997 as a term used to describe the accountability processes for clinical quality of care. It evolved as a system to address and respond to a series of high profile media cases highlighting poor quality patient care as revealed in the Nottingham IT vincristine disaster, Bristol Heart surgery, Shimpan and Alder Hey organ retention. During I997 in England, the Department of Health published the white paper the New NHS; modern, dependable which introduced Clinical governance as a method of accounting for clinical quality in health care but really came to prominence in 1998 when Scally and Donaldson appraised Clinical governance and the drive for quality improvement in the NHS   in the British Medical Journal. The paper highlighted four components of quality as initially identified by the World Health Organisation: Professional performance (technical quality) Resource use (efficiency) Risk management (risk of injury or illness associated with the service provided) Patient satisfaction with the service provided. Majority of NHS care is of a very high standard and in comparison to the high volume of care provided on a daily basis in hospital and community, incidence of serious failures are uncommon.1 However when they do occur, they have devastating consequences for individual patients and families.1 Greater patient expectations, knowledge and media exposure of high profile cases have resulted in the NHS being scrutinized focusing on its policies of operation, facilities and operating culture. It is estimated that an average of 850,000 adverse events may occur in the NHS hospital sector each year resulting in a  £2billion direct cost in additional hospital days alone.1 Poor clinical performance results in patient harm and loss of patients confidence in the NHS services as well as an increase in litigation costs.4 In 2009/10, 6,652 claims of clinical negligence and 4,074 claims of non-clinical negligence against NHS bodies were received by the NHS Litigation Authority, up from 6,088 claims of clinical negligence and 3,743 claims of non-clinical negligence in 2008/09.4  £787 million was paid in connection with clinical negligence claims during 2009/10, up from  £769 million in 2008/09.4 Errors are discussed as either human or systematic in the Department of Health document An organisation with a memory. As an NHS organisation the focus is systematic, a more holistic approach when dealing with errors. This approach recognises the importance of resilience within organisations and that errors result as a number of interacting factors and failures within the system.1 NHS Quality Improvement Scotland (NHS QIS) clinical governance and risk management standards define risk management as the: Systematic identification and treatment of risk Continuous process of reducing risk to organisations and individuals alike Culture, processes and structures that are directed towards realising potential opportunities whilst managing adverse events In the past, clinical risk management was poorly managed in the NHS. There were no individuals designated to manage risk management, incident reporting in primary care was largely ignored, there was no standard approach to incident investigation, and existing systems did not facilitate learning across the NHS.1 In the 1990s there was a concerted drive to develop risk management and risk management within NHS organisations.1 Following on from this there has been an increased awareness of the cause of medication errors in NHS trusts and how these can be prevented.1 In 2000, the government made a commitment to reduce the rate of serious errors by 40%. The advances in technology and knowledge in recent decades has resulted in a more complex healthcare system.2 This complexity carries risks and evidence indicates that things do and will go wrong in the NHS sometimes resulting in patient harm.2 The NHS quality improvement strategy1 encompasses; Clear national quality standards; NICE, NSF Dependable local delivery; systems of clinical governance in NHS organisations Strong monitoring mechanisms; a new statutory commission for health improvement, an NHS performance assessment framework, and a national survey of NHS patient and user experience. It is hoped adaptation of these approaches in individual NHS organisations should have a positive impact on the development to detect, prevent and learn from system failures at a local level.1 The introduction of clinical governance provides NHS organisations with a powerful imperative to focus on tackling adverse health care events1. The time is right for a fundamental re-thinking of the way that the NHS approaches the challenges of learning from an adverse health care event.1 2.0 Implementing Risk Management within NHS trusts The Department of Health publication An organisation with a memory facilitated the patient safety movement in the NHS.2 It proposed solutions to risk management incidences through a culture of openness, reporting and safety consciousness within NHS organisations.2 Four Key areas highlighted from this report were:2 Unified mechanisms for reporting and analysis when things go wrong; A more open culture in which incidents or service failures can be reported and discussed; Systems and monitoring processes to ensure that where lessons are identified the necessary changes are put into practice; A much wider appreciation of the value of the systems approach in preventing, analyzing and learning from patient safety incidents. In response to an organisation with a memory, the Government report Building a safer NHS for patients focuses on how to implement these recommendations2. It outlined a blueprint for a national Incident reporting system and discussed the role of the National Patient Safety Agency (NPSA).2 The NPSA was set up by the Department of Health in 2001 with the aim of preventing harm from high risk medicines. The NPSA produced the National Incident reporting and Learning system (NRLS) to set priorities, develop and disseminate actionable learning following reports of patient safety incidents. Following this guidance all NHS trusts should have a risk management strategy in place. This includes systems for the identification of all risks which may compromise delivery of patient care. To aid with this trusts are obliged to deliver patient services in compliance with statutory regulations according to national and local requirements highlighting the level and quality of services required. The implementation of risk management policies within NHS trusts will be overseen by Clinical Governance managers and Risk managers4. Trust Risk management strategies will need to be regularly reviewed and audited; individual trusts will have Risk Managers within each department to oversee this4. The Trust Board will ensure that risk management, quality and safety receive priority and the necessary resources within budgets. Pharmacy departments will have a medicines management team comprising of a risk management pharmacist to implement risk management at a local level. The Risk management pharmacist will ensure staff are aware of risk management issues both locally and nationally and will update staff on actions to be taken to minimise risk thereby promoting compliance with external risk management standards. The risk management pharmacist will also need to ensure local risk management policies are kept up to date. In order to deliver the risk management agenda, individual trusts must meet the requirements of the NHS Litigation Authority Risk Management standards and the Care Quality Commission standards (CQC) from the Health and Social Act 2008. From April 2010, NHS providers will need to register with the CQC and provide proof of adherence to standards set by the CQC5. 2.1 National Patient safety agency and National Reporting Learning System In 2001, following the publication of the Department of Health document and Organisation with a Memory1 the National Patient safety agency (NPSA) was set up. The introduction of the NPSA has for the first time provided a systematic focus on medication safety6. The aim of the NPSA is to lead and contribute to improved, safe patient care by informing, supporting and influencing organisations and people working in the health sector with one core purpose to improve patient safety by reducing the risk of harm through error7. The NPSAs initiative was to identify patterns and trends in avoidable adverse events so that the NHS could implement changes to prevent these incidents from reoccurring. The NPSA will 2, 8: Collect and analyze information an adverse events in the NHS Assimilate other safety-related information from a variety of existing reporting systems Learn lessons and ensure that they are fed back into practice Where risks are identified, produce solutions to prevent harm, specify national goal and establish mechanisms to track progress The NPSA then went onto produce the National Incident Reporting and Learning system (NRLS) which aims to identify and reduce the risks to patients receiving NHS care and leads on national initiatives to improve patient safety. There are NHSLA risk management standards for each type of NHS health care organisation. The standards will address clinical and non-clinical health and safety risks.4 Individual trusts will be examined regularly and measured against standards to ensure a risk management strategy has been devised, it is in place throughout the trust, it is workable.4 This will minimise litigation costs resulting in more funds available to trusts to improve patient care; providing an incentive for better clinical and non-clinical risk management. The NRLS collects confidential data on medication errors from all NHS trusts in England and Wales and improves patient safety by enabling the NHS to learn from patient safety incidents8. This builds on incident reporting systems that were previously used on an adhoc basis in individual trusts. The NRLS reporting system has been designed to be compatible with local risk management systems that are used in majority of NHS organisations.2 NRLS reports are analyzed by clinicians and safety experts8 and key themes and trends contributing to patient safety incidents are identified.2 Steps are then taken to minimize these risks through the development and prioritisation of national solutions. Trusts reporting incidents regularly suggest a stronger organisational culture of safety.8 Encouraging staff to report clinical incidents affecting patient safety can help implement risk management strategies within NHS trusts. The more incident reports submitted the more data available to rapidly identify and act upon patient safety incidents. The NRLS suggests trusts should be submitting incident reports monthly.8 In pharmacy these will mostly involve incidents relating to medication errors. The development and promotion of the NHS fair blame culture encouraged error reporting reassuring staff the root causes of errors will be looked into. However, lack of awareness and fear of disciplinary action remain as some of the main barriers to incident reporting.8 To overcome this staff need to be adequately trained on when and how to report clinical incidents. At my base hospital, incident-reporting training is included in the trust induction and at a local pharmacy level as an in-house induction. Each trust incident is graded in accordance to standardised NPSA scoring systems; 1 being minor with no harm to patient ranging to catastrophic level 5 i.e. patient death. Following the completion of an online incident form, the risk lead for that particular area will receive a copy of the report. These reports will be analysed and appropriately graded and any serious incidents will then be reported to the Trust Board via the risk management committee. A report by the NPSA stated the most commonly reported medicine related incidents to be:8 Wrong dose, strength and frequency of medicines Wrong medicine Delayed and omitted doses Medicine related incidents will be reported to the Risk Management pharmacist who will provide feedback to the pharmacy team. All category 4 and 5 incidents have a full root-cause analysis performed and are submitted to the NRLS. These reports are then analysed by the NPSA, and if necessary rapid response alerts are produced.1, 8 Rapid response alerts act as a crucial means to focus the efforts of trust clinical risk managers into proven high risk areas.8 Delayed and omitted doses of medication led to the production of a recent rapid response alert. This alert was delivered to trusts by the NPSA via the NHSs Central Alerting system.8 On receipt of this alert, trusts were expected to respond and act upon requests contained within it within the specified deadline provided. Each alert contains instructions for regular audits in order to review the action taken. 3.0 Medication Errors Most medication are not without adverse effects and most side effects and adverse events are predictable, thus exposure to these adverse events can be minimised or avoided through careful prescribing and usage. Nevertheless some adverse effects are unpredictable and therefore unavoidable.6 However medication errors occurring as a result of mistakes or lapses when medications are prescribed dispensed or used are avoidable. These can be related to practice, procedures, products or systems. 6 Medication errors as defined by the NPSA are any preventable event(s) that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the health care professional, patient or consumer. Such events may be related to professional practice, health care products, procedures and systems, including prescribing; order communication; product labeling, packaging and nomenclature; compounding; dispensing; distribution; administration; education; monitoring; and use. 10 Numerous studies have been conducted to investigate the incidence and outcomes of medication-related harm. A 2008 study conducted in an emergency department in Scotland found 2.7% of admissions were related to adverse drug reactions. 11 In 56.7% of cases the adverse drug reaction was the documented reason for admission but only 13.3% were considered to be unavoidable.11 Another study carried out by Charles Vincent reviewed more than 1000 records and found that 10.8% of patients experienced an adverse event and that half of these were preventable.12 It was found that a third of these adverse events led to either serious consequences or death.12 Medication errors also occur in other health care systems, and is estimated harmful errors occur in 1.8% of hospital admissions in the United States, leading to about 7,000 deaths each year.6 Similarly, an Australian study showed that 0.8% of inpatients suffered a harmful medication error.6 3.1 Why do medication errors occur? To be able to reduce the risk of medication errors, the cause of medication errors need to be understood.6 Previously medication errors were thought to be the sole responsibility of the individuals considered to be the cause of the error. However, now a more holistic approach is taken and it is acknowledged errors occur when both human and system factors interact in a chain of events often complex- resulting in an undesirable outcome.6 Not only the individual at fault but latent conditions within an organisation and triggering factors in clinical practice should also be considered as important causes of error as well.6 As Lucian Leape, the Physician and Professor at Harvan school of Public Health said: Human beings make mistakes because the systems, tasks and processes they work in are poorly designed. 6 Human factors result from the individual and may occur due to lack of training and education and lapses in concentration. System errors result from the running of the organisation and the lack of policies and procedures in place to reduce clinical risk. Recent experience shows in certain situations those safeguards have not been adequate and have failed to prevent serious error and harm to the patient.6 Active failures and latent conditions cause holes in the defence system to open up.6 The active failures occur as a result of unsafe practices of the people working with a system, examples include the prescriber failing to double check a prescription, or the pharmacist failing to identify an incorrect dose on a prescription.6 Latent conditions occur due to the structure of the organisation and its resources, management and processes in place.6 These either alone or in combination with an active failure, can lead to error. Examples include the lack of a computerised prescribing system with inbuilt systems to highlight an erroneous prescription or the lack of an effective communication system between primary and secondary care.6 3.2 The role of the pharmacist in managing medication errors Pharmacists as experts in medicines have an invaluable role in reducing medication errors. As a profession and specialists in the careful use of medicines we are best placed to minimise the risks associated with medication usage.12 The government safety of doses report recommended seven action points to improve medication safety. These are:13 Increase reporting and learning from medication incident. Implementation and audit of NPSA medication alerts guidance. Improve staff training and competence. Minimising dose errors. Ensure medicines not omitted. Ensure correct medicine correctly labeled gets to the patient. Document patient allergy status. The three areas of focus in medication error reduction for Pharmacists to detect and prevent are:12 Risk in the medicine itself. Risk in the manufacture, storage, and distribution of medicines. Risk in use of medicines. Pharmacy departments as a whole are similar to high quality manufacturing units and test each stage in the production, storage and distribution of medicines.12 Pharmacists are involved in almost all stages of the medication cycle from clinically checking of the prescription to the accuracy checking and final release of the medication dispensed. Within the pharmacy culture there is the expectation for errors to occur and consequently systems have been developed and put in place to minimise these.12 Examples of pharmacy services to reduce medication related errors in hospitals are:12 Checking of prescriptions and supplying of drugs. Ward drug charts. Use of our knowledge and pharmacokinetics to assess toxic and sub-therapeutic doses. Quality control and assurance measures. 3.2.1 Ward based Pharmacy services Pharmacy services at ward level were first proposed as a health policy in 1970 and have proven to detect and prevent prescribing errors.12 The role of the pharmacist is ever evolving and pharmacists are becoming recognised as an integral part of the multi-disciplinary team. The pharmacists role has moved on from the traditional supply role to a more clinical role allowing pharmacists to use their specialist knowledge surrounding medication use to reduce medication errors at ward level. Pharmacists are a lot more active at ward level and as such are now the first port of call for advice on medication by patients and other health care professionals. The pharmacists role also extends to medicines management and formulary development, medicines information and involvement in various dispensing stages. Throughout these different roles the pharmacists remain active in promoting safer practice and reduction of medication errors. 3.2.2 Medicines Reconciliation Medicines reconciliation is a process designed to ensure that all medication a patient is currently taking is correctly documented on admission and at each transfer of care. It encompasses: Collection Checking Communicating The National Institute for Health and Clinical Excellence (NICE) in collaboration with the NPSA issued guidance to ensure appropriate processes are in place to assure any medication patients are taking prior to admission is properly documented on admission to hospital.8 The NPSA reported the number of incidents of medication errors involving admission and discharge as 7070 with 2 fatalities and 30 that caused severe harm (figures from November 2003 and March 2007).8 An accurate medication history is necessary to aid safe prescribing. To improve medicines reconciliation at hospital admission NICE/NPSA has recommended that:8 pharmacists are involved in medicines reconciliation as soon as possible after admission the responsibilities of pharmacists and other staff in the medicines reconciliation process are clearly defined; these responsibilities may differ between clinical areas strategies are incorporated to obtain information about medications for people with communication difficulties. At my base hospital, medicines reconciliation involves doctors, nurses, pharmacists and pharmacy technicians. Systems and policies are in place to deliver medicines reconciliation in different areas of care and to ensure all staff involved in the medicines reconciliation process are accredited and adequately trained. 3.2.3 Education and Training At my base hospital information regarding clinical risk management is widely accessible to all staff through a variety of sources; alongside co-operate clinical mandatory training sessions and in-house local training sessions, a wide variety of information is available on the local trust intranet. These include a governance newsletter entitled Lessons Learned detailing adverse events which have occurred and steps taken to prevent reoccurrence of such events, risk management manuals available on-line and the NPSA patient safety literature. At a local pharmacy level, the monthly medicines management bulletin includes medication safety updates and is distributed to all pharmacy staff. As well as these measures education and training to other health care professionals and patients on medication is paramount. Pharmacists are the professionals best placed to do this. The Central Manchester Foundation Trust took part in a prescribing error audit known as the EQUIP study. This showed pharmacists as experts in medicines held invaluable knowledge and through organised education programmes can help reduce medication errors.14 The main cause of prescribing errors amongst newly qualified medical staff was simply due to lack of knowledge regarding medicines.14 Results demonstrated the need for pharmacists at ward based level and the prevention of potentially serious medication errors through their presence on the ward.14 Pharmacists on wards gave medical staff immediate access to advice regarding dosing, interactions and therapeutic monitoring of drugs.14 Pharmacists are also more likely to complete incident reports involving medicines and should encourage other staff to do the same. Ensuring staff are aware the only way to improve the systems in place is to learn what we are doing wrong. Pharmacists are also involved in developing and delivering teaching sessions for various groups of staff. Examples included at my base hospital are VTE prophylaxis, IV drug calculations and monitoring for unfractionated heparin. All Pharmacists are encouraged to deliver and attend teaching sessions early on in their career. As well as educating medical staff, pharmacists counselling of patients in outpatients and at discharge will also aid reduction in medication errors. As well as delivering information and teaching packages, pharmacists need to ensure information provided is sufficient, easily accessible and up to date. Medicine information pharmacists will review how best to provide information for safe prescribing and drug administration.6 The formulation and dissemination of medicine policies and clinical guidelines by pharmacists contributes to risk management. Pharmacists also advice clinicians on risk issues arising from quality assurance reports e.g. NPSA, national and local clinical audit.4 3.3 Reduction in medication errors Medication errors occur due to a number of failures. Pharmacists clinically reviewing a prescription can detect and prevent prescribing errors, but prescribing is only one aspect of the medication cycle.7 Failures in the processes of reviewing, dispensing, administering and monitoring of medicines also occur.7 To overcome these adequate systems and checks to prevent medication errors need to be in place. Examples of such systems include:13 Effective communication Education of all health care professionals Integrated electronic care records Systems and policies in place for ordering, dispensing, administering and transporting in medicines Providing 24 hours medicines information services and support to medical staff Increase specialists staff, more training for junior staff from an undergraduate level and improved discharge procedures Development of information technology services and standardised electronic incident reporting systems 3.3.1 Information Technology The developments of technological systems have helped in the running of medicine based services and include automated dispensing systems and electronic prescribing. Similar packagings of medications by the same manufacture lead to frequent dispensing errors. The implementation of an automated dispensing robot in my trust has significantly reduced error rates through the incorrect selection of medication. It also minimises administration errors through the production of standard warning labels such as Methotrexate weekly dosing warnings, and reminders to attach penicillin containing stickers to relevant antibiotics. However, the system is not fool proof and as such errors still occur mainly due to over reliance causing staff to become deskilled. Near miss audits to identify potential errors are conducted regularly within my trust to highlight areas of concern and systems put in place to prevent these errors reoccurring. Implementation of electronic prescribing systems (medisec) for discharge and electronic dose calculator on our neonatal unit has also proven to reduce medication errors. Medication errors due to illegible handwriting no longer occur minimising risk of dispensing errors. The availability of drug name, dose, formulation and dosing schedule have also reduced the risk of medication errors.7 3.3.2 Medication safety at discharge Poor communication between different health care professionals can lead to medication errors at discharge. Medicines reconciliation on admission has proven to be useful in linking patients care at primary care and secondary care. However, more focus needs to be placed on ensuring community pharmacists and GPs are aware of changes to medication at the point of discharge. Improved communication will prevent GPs from prescribing drugs that are no longer indicated, contra-indicated or even duplicate drugs.7 The implementation of the electronic discharge system medisec and the automated electronic copy of the discharge summary detailing information regarding medication changes has proven to be a useful tool in improving communication to GPs, and maintaining the link between primary care and secondary care. In addition to this, patients receiving a copy of their discharge summary and being counseled on their medication at the point of discharge will contribute to reducing medication errors . 4.0 Conclusion The need to manage risks is particularly important in the NHS because of: Finite resource the NHS has a limited amount of money and staff to provide a service Complexity the service we provide is extremely complex because of both the size and nature of the task Expectation we strive to meet the expectations of an increasingly aware public Clinical Risk Management is an integral part of clinical governance and thus everyones business. Managers in all areas are responsible for ensuring that risks in the area are identified, monitored and controlled in line with the Trusts Risk Management Strategy. This will contribute to improved delivery of services by providing a structured approach to decision-making. . All staff working in the NHS have a responsibility to be aware of and implement risk management within their individual job roles. The development of technology, systems and processes and education of all staff will be the key to implement clinical risk management at local and national levels in individual trusts. Word count: 4,338