Gender Bashing essays

Gender Bashing essays The Mens Right Movement: Male is Not a Four-Letter Word Jack Kammers article seeks to point out that negative aspects have stemmed from the growing womens liberation movement. This article does a good job bringing to light the anti-male feelings that are sometimes associated with the word feminism. However, it does not really have a concrete basis that supports this authors opinions. Kammers article does share one concept common among some of the other critiques I have read on this man vs. women phenomenon. That is, without a factual base they tend to sound like simple complaints. I feel that articles such as these tend to take attention off of real problems that are embedded in our society. They also lead other reader to perceive the whole subject as a joke rather than a social science seeking solutions to real problems. Kammer does take the time to include some statistics on the many ways a mans life is worse than that of a women, but these can be quickly thrown out. For example, women have typically not been allowed to work in death professions. I am sure that as our society grows everyone will have an equal chance at these wonderful jobs. I found it appalling that he even objected to differential treatment of children in hostage situations. I have shared some of the same feelings that Kramer describes, but I tend to ignore those as just differences of opinion or an ignorant person speaking to quickly. His use of the media portraying men as secret admirer and blood brother to the gang rapist is useless. The media will do anything to sell their product. That is something we can all agree on. We as a society are the police force that must control the media. Refuse to buy their product and they will change. I agree with Krammer in that many feminists tend to focus on mens shortcomings as a way to further their cause. ...

Huckleberry Finn Rebel or Traitor Professor Ramos Blog

Huckleberry Finn Rebel or Traitor Adventures of Huckleberry Finn, ever since its publication, has been seen as one of the most controversial books in American history. In the American Library Association’s list for the Top 100 Banned/Challenged Books for 2000-2009, the novel placed at number fourteen (Top 100 Banned/Challenged Books: 2000-2009) . Coincidentally, the ALA’s same list for the 1990s also placed The Adventures of Tom Sawyer at number eighty-three (100 Most Frequently Challenged Books: 1990-1999). However, my main focus is to explain not only how much Huckleberry Finn has changed throughout the book but also how society has perceived the character throughout history. When we are introduced to Huck in this novel, he is not doing too bad for a thirteen (maybe fourteen) year old boy. Finn has become rich from his share of the treasure found at the end of The Adventures of Tom Sawyer and also lives in a house and is getting an education at school. The two women he lives with, his guardian, the Widow Douglas and her sister, Miss Watson, attempt to civilize Huck and teach him about God and Christianity. Looking back at the beginning of the novel, I have already noticed a couple of interesting parallels – the two women attempted to civilize Huck into what society deemed acceptable, similar to Zitkala-Sa’s experience in the Indian boarding schools. However, it is important to note that Zitkala-Sa’s case had a more severe level of harshness than the attempted civilization for Huck . The second thingmay be a little more obvious Miss Watson tries to civilize Huck in a proper, Christian way yet Watson herself is a slave owner, something that was acceptable in the 1830-40s but would now be considered appalling for anyone, let alone a Christian. The part where everything goes wrong is when Huck’s father, only referred to as Pap, comes into the picture. Pap kidnaps his son and takes him to his cabin in the woods, isolated from society. Huckleberry is then subject to repeated beatings by his father until he cannot take it any more – he fakes his own death and flees to Jackson’s Island where he sees Jim, a black slave owned by Miss Watson who had fled from St. Petersburg after hearing that she was going to sell him for $800. Huck and Jim then leave Jackson’s Island after the former discovers that the town is searching for the latter. What is it that makes Huck change his mind about Jim at this point? Because, keep in mind that beforehand, Huck was perfectly fine with Jim’s status as a slave until now, deciding to help him escape. My answer to this question comes from a quote in the book: â€Å"Before night they wanted to lynch him, but he was gone, you see. Well, next day they found out the nigger was gone† (Twain and Levine). This line is spoken by Judith Loftus, a minor character that Huck has a conversation with shortly before he and Jim leave Jackson’s Island. If this quote is considered as a counterpart to this question, Huckleberry may have wanted to save Jim because he knew him – he did not want his friend to be lynched by the townspeople because of his faked death. Finn could have also felt guilty that the citizens were looking for Jim despite the fact that he had no way of knowing that they would pin his â€Å"murder† on this newly escaped slave. Tuire Valkeakari, in her academic journal Huck, Twain, and the Freedman’s Shackles: Struggling with Huckleberry Finn Today, claims that Jim could also connect with Huck at an emotional level: â€Å"A slave, Jim can relate, at a most personal level, both to the agony generated by uncertainty about a family member’s fate and to the fear of becoming a target of physical violence† (Valkeakari). When the two leave Jackson’s Island, these realizations could perhaps be why Huck no longer sees Jim as a slave. There are multiple scenes in Adventures of Huckleberry Finn where Huck proves his loyalty to Jim after Jackson’s Island: he apologizes to Jim after attempting to trick him into believing that the fog which separated them was just a dream; another time was when Huck lied to a man, saying that a black man was not onboard the raft. As the book progresses, Huck gets his share of life-changing experiences – he is practically adopted by the Grangerfords and then becomes emotionally scarred after witnessing the deaths of all the Grangerford men in a gunfight. Finn also sees a town drunk get shot in cold blood and deals with the Duke and the King, the latter situation also experienced by Jim. Adventures of Huckleberry Finn has been the subject of criticism in two different ways: the first, â€Å"its hero a boy who smoked, loafed, and preferred the company of a runaway slave to Sunday School† (Levine). By the 21st century, the reason changed because the novel continually uses the word â€Å"n†. Even Huckleberry uses thisword throughout the book, so has he really changed? The pivotal moment where I believe Huckleberry truly changes is in the conclusion of the second part: he has the choice of either sending a letter to Miss Watson saying that he knows where Jim is and collecting the reward money for his capture or do nothing. This point in the book is similar to the other ones where Huck proves his loyalty to Jim, so what makes it so different? It is different because not only does Huck choose not to send the letter but he accepts the fact of going to Hell in his vow of freeing his black slave friend: â€Å" ‘All right, then, I’ll go to hell’- and tore it up† (Twain and Levine). In this moment, Huck has now seen Jim as he should truly be seen – as a human being with feelings and not property that can be chained or sold like an animal. It is also safe to say with certainty that God would not have sent Huck to Hell just because he helped free a slave. This is the definitive moment where Huck no longer sees Jim as a nigger. Huckleberry Finn, at the conclusion of the novel, would be seen as a traitor to his state because he helped free a slave. Society today would see him as a rebel who realized the system was wrong and decided to fight against it. This is probably why Huckleberry is not the main controversy associated with the novel as in the past and why the use of â€Å"n† has taken his place. Finn could also be seen as a symbol of America in terms of his journey – while he noticed how atrocious slavery was to the black people, (eventually) so did the United States. As for Jim, he may have achieved freedom but his struggle would undoubtedly continue: â€Å"The character Jim, to whom racial epithets are most often attached, remains a ‘nigger’ at the end of the novel but not a ‘slave’† (Smith). While Huckleberry now saw Jim as a person, other people would not give him that same leisure. In the time of the 1830-40s, black people would always be discriminated against, free or not. Racism against the African American people still continued after the Civil War in the 1860s and even today, people still see black people as an inferior race. If this were not true, The Klan and blackface would be racial blots of America’s past. 100 Most Frequently Challenged Books: 1990-1999. Advocacy, Legislation Issues, 18 July 2017, www.ala.org/advocacy/bbooks/100-most-frequently-challenged-books-1990–1999. Levine, Robert S. Critical Controversy: Race and the Ending of Adventures of Huckleberry Finn. The Norton Anthology of American Literature: Ninth Shorter Edition, Volume 2, W.W. Norton Company, 2017, p. 291. Smith, Cassander L. Nigger or Slave: Why Labels Matter for Jim (and Twain) in Adventures of Huckleberry Finn. Papers on Language Literature, vol. 50, no. 2, Spring 2014, p. 2, EBSCO Academic Search Complete. web.b.ebscohost.com/ehost/pdfviewerpdfviewer?vid=6sid=4465e805-38f8-40af-bca0-e179118fce22%40sessionmgr102. Accessed 18 Feb. 2019. Top 100 Banned/Challenged Books: 2000-2009. Advocacy, Legislation Issues, 18 July 2017, www.ala.org/advocacy/bbooks/top-100-bannedchallenged-books-2000-2009. Twain, Mark, and Robert S. Levine. Adventures of Huckleberry Finn: â€Å"Chapter XI. The Norton Anthology of American Literature: Ninth Shorter Edition, Volume 2, W. W. Norton Company, 2017, p. 143, 242. Valkeakari, Tuire. Huck, Twain, and the Freedman’s Shackles: Struggling with Huckleberry Finn Today. Atlantis, vol. 28, no. 2, 1 Dec. 2006, p. 6, EBSCO Academic Search Complete . web.b.ebscohost.com/ehost/pdfviewer/pdfviewer?vid=5sid=fb9842de-dd13-4ed7-b764-646d48d671b3%40sessionmgr120. Accessed 18 Feb. 2019.

The Book of Romans Term Paper Example | Topics and Well Written Essays - 750 words

The Book of Romans - Term Paper Example Jewish Christian: What did you receive through Jesus? Saint Paul: I received apostleship and grace so that I would be able to proclaim the word of the lord. Jewish Christian: What was the main reason of writing the Book of Romans? Saint Paul: the main reason for writing this book was to share the word of God to all the people of Rome. Jewish Christian: why do you confer to the holy people residing in the city of Rome? Saint Paul: I confer to them through grace and peace that is obtained from God and passed to us through Jesus Christ. I believe that Grace is regarded as a blessing and strength from God. Divine peace indicates the presence of Christ in our mind and heart (Lin 32). Jewish Christian: Why are you not ashamed of the Good News? Saint Paul: This is because the power of God to offer salvation to every individual who believes in him. Jewish Christian: how will God deal each person during the hour of judgment? Saint Paul: Basically, according to what he or she has done. Being a teacher and apostle of God, I believe that I am a classic example of a person saved by the righteousness of God. We should be saved by God’s grace and not by the Jewish law (Stendahl 43). Jewish Christian: What is the true attitude of God towards sin? Saint Paul: regards of you being a Jew or a Christian, everybody will have to pay for their sins. Nobody can escape judgment day. Jewish Christian: Who is justified in the eyes of God? Saint Paul: The people who are justified in the sight of God are not the hearers of the law but it is the doers of the law. Jewish Christian: what are the personal questions that a Jew is supposed to ask himself? Saint Paul: if you are a person who teaches the Law of Moses to other, are you also teaching yourself? If you claim that a man should not steal, then why do steal? If you say thy shy not commit adultery, then why does someone commit adultery? You should follow the Laws of Moses to the latter. Jewish Christian: Who do you believe is a tru e Jew? Saint Paul: a true Jew is a person that follows his religion inwardly. This is a spiritual convent with you and your God. Jewish Christian: regardless of religion what can you say about righteousness? Saint Paul: A man will be regarded as righteousness as long as he places his faith on God. The law does not define this. Jewish Christian: Thank you for your time Saint Paul: you are welcome. Analysis and issues raised This book provides good insight of the perspective and sociological approaches that help to understand the practices of the Jewish communities. This was evident in the first century when the Romans and the Roman society were experiencing some tension with regards to Paul’s mission for the churches (Engberg-Pedersen 54). The Book of Romans is basically about the life of Paul, who is the apostle of Christ to the Jews and Gentiles. Despite the fact that this is not a comprehensive biography, this book provides a segment of Paul’s life when he had to str uggle with the spread of Gospel amongst God’s people. The issue of whether or not to engage with the Gentile mission was quite a daunting task since there was a serious tension in early Christianity while it was still a Jewish phenomenon. Paul had to deal with a clash between the Gentiles and the Jews both in the practical and theological terms. Paul had a difficult time defending the gospel. One of the reasons why Paul wrote the book to the Romans is because he saw that the Romans lacked leadership as there were no apostolic leaders (Porter 65). Christianity in Rome was not

Leadership roles and responsibilites Essay Example | Topics and Well Written Essays - 1250 words

Leadership roles and responsibilites - Essay Example It has been viewed in Ofsted report that additional funding is accessible for the college in order to deliver well-equipped preparation courses to its learners throughout the globe. The additional funding, curriculum design and the offers which formulate by the college ultimately pose significant impact upon teaching and learning of the students by a greater extent. The college seeks to deliver more standard preparation courses by investing substantial amount in human capital for attracting as well as increasing its students level. In order to build skills within the team, the college introduces online training courses and establishes curriculum sessions as training modes for its teaching staffs (Ealing, Hammersmith & West London College, 2012). 9 References 10 Part 1 Organizational Context The person possessed 12 years of knowledge or experience as a tutor, teacher and manager in the field of education. The tutor within the educational context performed certain effective leadership qualities such as development manager, course team leader, program manager and technical team leader. Moreover, the tutor also provided active support in different areas which include classroom management, resource planning and quality control of the teaching courses. In relation to organisational context and Ofsted report, it has been viewed that Ealing Hammersmith and West London College aims to deliver a welcoming multicultural setting for its staffs, learner as well as visitors. In order to fulfil this aim, the college regularly performs ethical and legal responsibilities in order to eradicate any sort of discrimination or harassment and tends to promote better relations with every member linked with the college. The management section of the report affirmed that the college has implemented a kind of whole organisation approach which ensures that the learners of the college are able to perform their roles in a secured and inspiring environment. The Ofsted report also stated that as the college is the biggest provider of Further Education (FE) programs in the United Kingdom, the managerial approach of the college might reflect or play a chief contributory part upon the position of FE in the ever changing arena of funding (Ealing, Hammersmith & West London College, n.d.). A Brief Description of Three External and Three Internal Factors External- Changing policies of British Government and UK Border Agency (UKBA), rapid emergence of Information Technology (IT) and alterations in visa regulations for entry to international students. Internal- Interdepartmental competitiveness and lack of a unified delivery approach, standard hours of teaching and superior level of diversity in all classes. The aforementioned external as well as internal factors can impose significant impact upon the educational culture by a significant level. In this similar context, the external factor of changing policies of British Gov’ and UKBA can reduce the inflow of international students to the UK. The rapid emergence of IT might support the teachers to keep themselves with regular updates relating to current technologies. The alterations in visa regulations might affect the students coming to study in different colleges. The internal factor of interdepartmental competiveness along with lack of a unified delivery approach can negatively affect the organizational culture. Another internal factor of

Health Care Roles in Communication Essay Example for Free

Health Care Roles in Communication Essay Elisabeth Kubler-Ross once said, â€Å"We have to ask ourselves whether medicine is to remain a humanitarian and respected profession or a new but depersonalized science in the service of prolonging life rather than diminishing human suffering.† In the health care field there are many roles that balance each other. Whether it is the doctor, patient, or medical assistant all play a vital role in the care of others. The purpose of this paper is to compare the differences in communication between the different roles in the hospital. This paper will also be providing an appropriate solution for the scenario provided. The scenario provided is about a young Asian girl named Lena. She was taken to the emergency room by her friend Susie after she fainted in class. Raised in a culture, which has made Lena independent, She verbally attacks her friend yelling about how she is not weak. When she tries to leave, Susie retrieves the medical assistant. The medical assistant restrains Lena and is then sent away by the doctor. The doctor tries to reason with Lena and explain why she is there, but gets no response from her. Finally, the doctor leaves to care for other patients. For this scenario I will be examining the role of the doctor first. From the perspective of the doctor, Lena is very stubborn. This doctor has to see dozens of patients a day and does not have time to argue with one patient who does not want to be there. A doctors time is precious, especially in the emergency room. Although the doctor sees many cases which are easy, such as a runny nose or a broken finger, there are many emergencies that require immediate attention. If there was a call for a doctor to assist in a patient from a major auto accident , this doctor may choose to put a fainting girl on the sideline to assist with the trauma. On the other hand, the doctor should still attempt to treat the patient to the best of his or her abilities in the short time allowed. There are other ways to gain  information regarding Lenas situation, which will be discussed later. The medical assistant was the first medical professional to confront Lena after she woke up. From the tone of voice portrayed in the scenario, the medical assistant wanted to help the patient. The assistant rushed to the patients side, knowing she was very sick and needed medical attention. Unfortunately, Lena could not be reasoned with between the time the medical assistant arrived and the time the doctor walked in. The medical assistant was not given enough time to calm the patient or explain the situation. Susie seems concerned for her best friends health and safety. Even though Susie knows her friend has an independent attitude, there has to be a reason she brought Lena to the emergency room. Unless Lena had been sick for a while or had fainted before, there would be no cause for Susie to rush her to the hospital. Susie also shows her concern for Lena by rushing to get the attention of the medical assistant when Lena tries to leave. Susie must believe that Lenas health is important enough to bring her to a place where she can get the medical help she needs to get better. Finally, there is Lena, the patient. Lena was brought up to be independent and strong. Many residents raised in Southeast Asia that find it hard to conform to western medicine. Even though Lena has lived in the United States for 10 years, which means she has spent the majority of life around the medicinal practices of her parents and her culture. As an example, if Lena is from Vietnam her knowledge of medicine would be vastly different (Schultz, 1980). In most areas of Vietnam, residents and medical practitioners steer away from prescription medicine and favor herbs instead. Eastern medicine relies heavily on the spiritual element in the human body as much as western medicine relies on the chemical makeup (Vietnam National Administration Of Tourism, 2010). If Lena was used to Vietnamese eastern medicine her reaction to being in the hospital is not surprising. Her idea of medicine may come in the form of a root instead of a bottle. Within the scenario are many complications with the communication between individuals. First, there is the confrontation between Lena and Susie. Lena  instantly blames Susie for taking her to the hospital. While Susie is her best friend and is the one sitting in the room with her, it may not have been Susies choice to send Lena to the emergency room. Because Lena fainted in class, it would be the responsibility of her instructor to make sure she was taken care of. The instructors reaction may have been to call the paramedics to make sure the student received proper medical attention. There would have been nothing Susie could have said to prevent the paramedics and medical professionals from making the decision to take Lena to see a doctor. Once at the hospital, Susie could have worked to calm her friend down before rushing to find the medical assistant to restrain her. She could have also provided some insight, to the doctor, regarding Lenas recent medical problems leading to the fainting. This may have softened the doctors approach to Lenas silence. While the medical professional was doing her job by keeping the patient in the hospital, extra empathy should have been given. The initial approach was rough and direct. Each patient should be given the same consideration regardless of the circumstances. Instead of verbally attacking Lena, the medical assistant should have approached Lena in a different manner. Being too direct will put the patient in a defensive position rather than a position to listen. When the medical assistant states she doesnt have time to deal with Lena, it lowers the value of the patients worth as someone who needs care. It is like saying the person with a bloody nose should take priority over someone who has fainted and may have a serious underlying condition. Admonishing a patient and telling them they are sick is worthless. Lena knows she is sick. She just wants to prove she can cure herself without the interference of doctors. Had the medical assistant shown more empathy and expressed her understanding of Lenas situation it may have diffused the angry encounter. Many communication conflicts with the doctor in regard to everyone else in the room. First is the treatment of the medical assistant by the doctor. From the scenario we can see that the doctor was close behind the assistant as she came through the door. The medical assistant did not have enough time to do her job before the doctor told her to leave the room. Had the doctor  allowed the medical assistant to stay in the room it may have had a positive effect on the patient. If the doctor is a male, Lena may have felt uncomfortable around him and the presence of a female assistant may ease the worry. The doctor could have gained immeasurable information about Lenas condition from Susie. Had the doctor questioned the best friend it could have revealed how long this had been going on and what other symptoms Lena had been exhibiting. Instead the doctor completely ignores Susie and turns attention to Lena. When the doctor tells Lena what is going on he does not pay attention to how, she is reacting, only that she is not answering the questions. The doctor makes the assumption that Lena is quite on purpose and leaves to go treat other patients. In the scenario are a few key points that the doctor missed and misinterpreted. Just like with the medical assistant, more care should have been given to calming Lena down instead of becoming defensive. By being understanding, the doctor would have caught the signs of something more serious going on with Lenas health. The blank look on her face may not have given much away, depending on her age. Many people who look blank or vacant when someone is telling him or her about a topic they know little about. However, her eyes may have helped the doctor realize something serious was happening. A blank look may mean nothing, but a glassy eyed stare could mean something. Lena had started to sweat profusely. Most hospitals keep the complex cooler than normal to help stave off nausea and fever in most patients. The sweating, blank stare, and non-responsiveness could have signaled the doctor there was something worse than just fainting in Lenas condition. With just the few symptoms exhibited in the scenario, Lena could be suffering anything from heat exhaustion to a deadly pulmonary embolism (WebMD, LLC, 2010). Last, there is the patient, Lena. Her lack of communication is born from family traditions that go back hundreds of years. Even so, Lena has lived in the United States for 10 years. It would be impossible for her to live in this country and go to school here without seeing a western medicine doctor. She could be used to smaller clinics; however, her reaction to the emergency room is unwarranted. The scenario made it seem as if Lena did not want to  talk to the doctor because she resented being in the hospital. Her outburst upon waking, and her non-responsiveness to the doctor, may have been a part of her illness. She might not have been aware of where she was by the time the doctor was through explaining her condition. An appropriate solution for the situation should be patience and empathy. The medical assistant and the doctor should have been more understanding toward the patient. There should have been compassion toward a young girl who was upset and confused. More attention to detail was needed by the doctor. Susie should have spoken up when Lena could not. Her information could help her friend from getting worse. Lena, having lived in the United States for 10 years, should have been willing to hear what the doctor had found before making the decision to leave. I have been in the customer service field for 13 years. From Banking, to telecommunication, to healthcare, the only factor that changes is the service provided. There will always be someone else who needs the attention of the representative. The key to communicating to a customer is empathy. Allowing a person to realize you understand their situation and showing a willingness to help, makes the difference. When you have a patient who is screaming and upset, you cannot take it personally. They are hurt, confused, and afraid. A caregiver cannot treat patients the same if they take everything personally. Lena was not yelling because she hated the assistant or the doctor. She was yelling because she did not think she was as sick as the doctor did. Both the doctor and the assistant treated Lena as if she were wasting their time, instead of looking at the situation rationally. In conclusion, communication all comes down to how a person handles customer service. Each role in this scenario is a tough one to have. First, the patient, who is full of fear and has been raised to think differently. Next, the best friend, who is afraid of losing her friend to illness but is too scared to speak up. Third, the assistant, who has many other patients to see. Last, the doctor, who is skilled in what he does, but fails to see the obvious signs of something worse. All of these roles are true, from day to day. They are in every hospital, clinic, and emergency room. There should be  more classes within medical schooling that teach caregivers how to show empathy and understanding to their patients. There should also be continuing education for all caregivers to refresh what they have been taught. References WebMD, LLC. (2010). WebMD Symptom Checker. Retrieved from http://symptoms.webmd.com/symptomchecker Vietnam National Administration Of Tourism. (2010). Vietnam Traditional Medicine. Retrieved from http://www.vietvisiontravel.com/vietnam/travel-guide/Traditional_medicine/ Schultz, S. L. (1980, August). Southeast Asian Health Beliefs and Practices. Education Resources Information Center

Self-improvement througth Frost Essay -- essays research papers

â€Å"The unexamined life is not worth living† â€Å"Know thyself† The great philosopher Socrates stated these ideas and made it his duty to fulfill his own reasoning. He knew that as human beings, we are a complex system of nature’s product that is still very enigmatic to our selves. Thus in order to fully comprehend one self as an individual, one must look inward and seek the cause and function of one’s own natural condition. Many methods are effective in one’s search, and this fact holds evident to our own differences, some use social interaction as a form of investigation, while others may find solitary confinement as a more productive approach. Through my own personal path to clarity and understanding, it has proved invaluable to myself that the reading of literature and poetry has a profound effect upon fulfillment. By associating oneself into the thoughts and theories of the writer, one can gain an insight into their personal condition. In particular, Robert Frost includes much thought and examples into his own behavior a s well as others. Through the analysis of Robert Frost’s poetry, one attains an insight into oneself, and a deeper perspective of the human condition. Poems such as â€Å"The Death of a Hired Man†, â€Å"The Road Not Taken†, and â€Å"Stopping by Woods on a Snowy Evening† all are incorporated with his thoughts of the natural human condition, and delve into his own definitive bearing. Poetry, he wrote, was â€Å"one step backward taken,† resisting time-a â€Å"momentary stay against confusion.†(Baym 1116) The confusion that Frost recalls is the chaos that is included in the search for oneself, and poetry to him was an elapse from the confusion. It gave him comfort to read and write of his thoughts, emotions, and beliefs, and analyze them in a humanistic nature that many could relate to and enjoy. In the 1930s when writers tended to be political activists, he was scene as one whose old-fashioned values were inappropriate, even dangerous, in modern times. Frost deeply resented this criticism, and responded with a new hortatory, didactic kind of poetry. (Baym1116) This style of poetry created an atmosphere that urged the reader to generate perception into the moral subject and envision the meaning behind them. Frost shared with Thoreau and Emerson the belief that everybody is a separate individuality and that collective enterprise could do nothing but weaken the self. (... ... own idea of their balance and enforce the idea that the importance of such is invaluable, thus aiding in the search for oneself as an individual. Scientists say that the human race is the most complex and sophisticated race of all. They say that the full understanding of such an entity is far from attainable. Robert Frost is a man and a poet who knew himself, a person who will continue to fulfill his needs as a human. His work as a poet is all the evidence that is needed to prove this thought. One may greatly benefit in the study and thought of his work, a teacher for all to learn if the mind is open. The human condition is continuously brought up in his poetry as a force to be made comfortable and understanding to. Listen to your inner condition and learn as Frost has of its great power to enrich the individual to a higher plain. Search into yourself as a book always being rewritten, ready for tuning, open for improvement. Work Cited Baym, Nina. The Notron Anthology of American Literature. Fifth edition, vol 2. Ed. Juliae Reidhead. Unites States of America, 1998 Self Improvement through the poetry of Robert Frost

Week 1 Assignment

Working for a big company, there is always something new to learn and new work that comes our way. There are many different personalities. We were always training and learning new material and tools to use to make our work more effective and productive. We would have meetings that were hours long so everyone can train on the new work and tools we had coming our way. Most of the people were struggling to learn the new tools. I was taking a class in which we were learning about peoples’ different learning styles. I thought all the training we were doing would be a great project for the class I was taking.I brought it to my bosses’ attention that I think that people are not learning because everyone has a different learning style. She was convinced that people were just tired and busy that’s why they could not understand the material. I wanted to test this theory. I suggested if we can give the employees on our team a learning test to see which way they better leane d. The results were exactly what I thought they were. Everyone had different learning styles. It turns out that most of the people on our team learned best Hands-On. Others were visual and the rest learned best by reading the material.This type of research method is best described as Correlation Research (positive correlation) because I was determining if two sets of variables are associated and if the variables increase or decrease. In this case when people used a learning method that fit best for them, they had better results for learning. When they were using a learning method that was not best for them, they were not learning the material. If I could have done anything different it would have been to test peoples’ personalities to determine if certain personalities learned a certain way. This would have gone more in depth as to why people learn the way they do.

Life of Quaid E Azam

ACCF/AHA Pocket Guideline Adapted from the 2011 ACCF/AHA Guideline for the Diagnosis and Treatment of Hypertrophic Cardiomyopathy November 2011 Developed in Collaboration With the American Association for Thoracic Surgery, American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Failure Society of America, Heart Rhythm Society, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons  © 2011 by the American College of Cardiology Foundation and the American Heart Association, Inc.The following material was adapted from the 2011 ACCF/AHA Guidelines for the Diagnosis and Treatment of Hypertrophic Cardiomyopathy (J Am Coll Cardiol 2011;XX:XX–XX). This pocket guideline is available on the World Wide Web sites of the American College of Cardiology (www. cardiosource. org) and the American Heart Association (my. americanheart. org). For copies of this document, please contact Elsevier Inc. Reprint Department, e-mail: [ema il  protected] com; phone: 212-633-3813; fax: 212-633-3820.Permissions: Multiple copies, modification, alteration, enhancement, and/ ordistribution of this document are not permitted without the express permission of the American College of Cardiology Foundation. Please contact Elsevier’s permission department at [email  protected] com. Contents 1. Introduction †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. 3 2. Clinical Definition †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. †¦ 6 3. Genetic Testing Strategies/Family Screening †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. 4. Genotype-Positive/Phenotype-Negative Patients †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. 9 5. Echocardiography †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ 10 6. Stress Testing †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. 14 7. Cardiac Magnetic Resonance †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ 15 8. Detection of Concomitant Coronary Disease †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. 17 9. Asymptomatic Patients †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ 19 10.Pharmacologic Management†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. 21 11. Invasive Therapies †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ 26 12. Pacing †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. 29 13. Sudden Cardiac Death Risk Stratification †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. 30 14. Selection of Patients for Implantable Cardioverter-Defibrillators †¦ 32 15. Participation in Competitive or Recreational Sports and Physical Activity †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â ‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. 6 16. Management of Atrial Fibrillation †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. 38 17. Pregnancy/Delivery †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ 41 2 1. Introduction The impetus for the guidelines is based on an appreciation of the frequency of this clinical entity and a realization that many aspects of clinical management, including the use of diagnostic modalities, genetic testing, utilization of implantable cardioverter-defibrillators (ICDs), and therapies for refractory symptoms lack consensus.The discussion and recommendations about the various diagnostic modalities apply to patients with established HCM and to a variable extent to patients with a high index of suspicion of the disease. Classification of Recommendations The ACCF/AHA classifications of recommendations and levels of evidence are utilized, and described in more detail in Table 1. 3 Applying Classification of Recommendations and LevelRecommendations and Level of Evidence Table 1. Applying Classification of of Evidence Table 1. Applying Classification of Recommendations and Level of Evidence S i z e Class I Benefit >>> Risk f T r e a T m eSni T ee f ffe c T e a T z o Tr Class IIb Class IIa Benefit >>> Risk Benefit Risk Additional studies with broad Additional studies with objectives objectives needed focused needed; additional registryreasonable to perIt Is data would be helpful Class IIa Class I Benefit >> RiskRisk Benefit >>> Additional studies with Procedure/Treatment focused objectives needed should be performed/ Procedure/Treatment should be performed/ administered It administered Is reasonable to perform procedure/administer treatment n Recommendation favor n Recommendation in thatProcedure/Treatment form procedure/administer may be ConsIdered treatment n n Rec ommendation Recommendation’s eSTimaTe of cerTainTy (PreciSion) of TreaTmenT effecT a populations d* ived from multiple zed clinical trials analyses Recommendation that level a procedure or treatment Multiple populations is useful/effective evaluated* n Sufficient evidence from Data randomized multiple multiplederived from trials randomized clinical trials or meta-analyses or meta-analyses n of procedure or procedure treatment treatment is useful/effective being useful/effective n Sufficient evidence from n Some conflicting evidence n favor usefulness/efficacy less of treatment or procedure well established being useful/effective conflicting evidence evidence from multiple from multiple randomized randomized trials or trials or meta-analyses meta-analyses in favor of treatment or procedure usefulness/efficacy less being useful/effective well established conflicting evidence from single evidence from single randomized trial randomized trial oror nonrandomized studies nonrandomi zed studies in favor usefulness/efficacy less of treatment or procedure well established being useful/effective opinion, case studies, or opinion, case studies, standard of care care or standard of may/might be considered is reasonable may/might be reasonable can be useful/effective/beneficial usefulness/effectiveness is is probably recommended unknown/unclear/uncertain or indicated or not well established n n Some Greater multiple randomized trials from multiple randomized or or meta-analyses trialsmeta-analyses b populations d* ived from a ndomized trial ndomized studiesRecommendation that level b procedure or treatment Limited populations is useful/effective evaluated* n Evidence from single Data derived or randomized trialfrom a single randomized trial nonrandomized studies or nonrandomized studies n n Recommendation in that n Recommendation favor n n Recommendation Recommendation’s of procedure or procedure treatment treatment being useful/effective is useful/effective n Some conflicting single n Evidence from n n Some Greater evidence from trial or randomized single randomized trial or nonrandomized studies nonrandomized studies n Recommendation favor n Recommendation in that C ited populations d* sensus opinion ts, case studies, ard of careRecommendation that level C procedure or treatment is Very limited populations useful/effective evaluated* n Only expert opinion, case Only consensus opinion studies, or standard of care of experts, case studies, or standard of care n n n Recommendation Recommendation’s of procedure or procedure is treatment treatment useful/effective being useful/effective n Only expert expert n Only divergingopinion, case studies, or studies, opinion, casestandard of care or standard of care is reasonable should can be useful/effective/beneficial is recommended is probably recommended is indicated oris useful/effective/beneficial indicated n n Only diverging expert Only diverging expert d phrases for commendations shou ld Suggested phrases for writing recommendations is recommended is ndicated is useful/effective/beneficial s treatment/strategy A is Comparative recommended/indicated in effectiveness phrases†  preference to treatment B treatment/strategy A is probably treatment/strategy A is recommended/indicated in in recommended/indicated preference to to treatment B preference treatment B it is reasonableshould be chosen treatment A to choose treatment A over treatment B over treatment B treatment/strategy A is probably recommended/indicated in preference to treatment B it is reasonable to choose treatment A over treatment B ive ess phrases†  4 treatment A should be chosen over treatment B e T menT e ffe c T A recommendation with Level of Evidence B or CClass IIIIIb Benefit Class No orBenefit > Risk Class III Harm Procedure/ Additional studies with broad test treatment objectives needed; additional Cor III: Not No Proven be helpful noregistry data would Benefit benefit Helpful Class II I No Benefit or Class III Harm Procedure/ test Cor III: Not no benefit Helpful Cor III: harm treatment No Proven Benefit does not imply that the recommendation is weak. Many important clinical questions addressed in the guidelines do not lend themselves to clinical trials. Although randomized trials are unavailable, there may be a very clear clinical consensus that a particular test or therapy is useful or effective. Procedure/Treatment Cor III: Excess Cost Harmful harm be w/o Benefit to Patients may ConsIdered or Harmful n n Recommendation’s Recommendation that Excess Cost Harmful w/o Benefit to Patients or Harmful Data available from clinical trials or registries about the usefulness/efficacy in different subpopulations, such as sex, age, history of diabetes, history of prior myocardial infarction, history of heart failure, and prior aspirin use. †  For comparative effectiveness recommendations (Class I and IIa; Level of Evidence A and B only), studies that support the use of comparator verbs should involve direct comparisons of the treatments or strategies being evaluated. n procedure or treatment is usefulness/efficacy less not useful/effective and may well established be harmful conflicting n Greater n evidence from multiple Sufficient evidence fromRecommendation that procedure or treatment is not useful/effective and may be harmful Sufficient evidence from multiple randomized trials or meta-analyses Recommendation that procedure or treatment is not useful/effective and may be harmful Evidence from single randomized trial or nonrandomized studies Recommendation that procedure or treatment is not useful/effective and may be harmful Only expert opinion, case studies, or standard of care COR III: Harm potentially harmful causes harm associated with excess morbidity/mortality should not be performed/ be done administered/ other n multiple randomizedor randomized trials trials or meta-analyses meta-analyses n n Recommendation’s Recommendatio n that n sefulness/efficacy less procedure or treatment is well established not useful/effective and may be harmful conflicting n Greater n evidence from single Evidence from single randomized trial randomized trial oror nonrandomized studies nonrandomized studies n Recommendation’s Recommendation that usefulness/efficacy less procedure or treatment is well established not useful/effective and may n Only diverging expert be harmful opinion, case studies, or n Only expert opinion, case standard of care studies, or standard of care n n n n COR III: COR III: may/might be considered Nomay/might be reasonable Benefit Harm usefulness/effectiveness is is not potentially unknown/unclear/uncertain recommended harmful or indicated not well established harm is not causes associated with excess morbidity/mortality should not be done COR III: No Benefit is not recommended is not indicated should not be performed/ be done administered/ is not useful/ other beneficial/ is not useful/ effect ive bene? cial/ effective should not be done s not useful/ beneficial/ effective 5 2. Clinical Definition The generally accepted definition of hypertrophic cardiomyopathy (HCM), is a disease state characterized by unexplained left ventricular (LV) hypertrophy associated with nondilated ventricular chambers in the absence of another cardiac or systemic disease that itself would be capable of producing the magnitude of hypertrophy evident in a given patient. Clinically, HCM is usually recognized by maximal LV wall thickness ? 15 mm, with wall thickness of 13 to 14 mm considered borderline, particularly in the presence of other compelling information (e. g. , family history of HCM), based on echocardiography.In terms of LV wall-thickness measurements, the literature has been largely focused on echocardiography, although cardiovascular magnetic resonance (CMR) is now used with increasing frequency in HCM. In the case of children, increased LV wall thickness is defined as wall thickness ? 2 standard deviations above the mean (z score ? 2) for age, sex, or body size. However, it should be underscored that in principle, any degree of wall thickness is compatible with the presence of the HCM genetic substrate and that an emerging subgroup within the broad clinical spectrum is composed of family members with disease-causing sarcomere mutations but without evidence of the disease phenotype (i. e. , LV hypertrophy). 6 3. Genetic Testing Strategies/Family Screening Class I 1.Evaluation of familial inheritance and genetic counseling is recommended as part of the assessment of patients with HCM. (Level of Evidence: B) 2. Patients who undergo genetic testing should also undergo counseling by someone knowledgeable in the genetics of cardiovascular disease so that results and their clinical significance can be appropriately reviewed with the patient. (Level of Evidence: B) 3. Screening (clinical, with or without genetic testing) is recommended in first-degree relatives of pati ents with HCM. (Level of Evidence: B) 4. Genetic testing for HCM and other genetic causes of unexplained cardiac hypertrophy is recommended in patients with an typical clinical presentation of HCM or when another genetic condition is suspected to be the cause. (Level of Evidence: B) 7 Class IIa 1. Genetic testing is reasonable in the index patient to facilitate the identification of first-degree family members at risk for developing HCM. (Level of Evidence: B) Class IIb 1. The usefulness of genetic testing in the assessment of risk of sudden cardiac death (SCD) in HCM is uncertain. (Level of Evidence: B) Class III: 1. Genetic testing is not indicated in relatives when pathogenic mutation. (Level of Evidence: B) 2. Ongoing clinical screening is not indicated in genotype-negative relatives in families with HCM. Level of Evidence: B) No Benefit the index patient does not have a definitive 8 4. Genotype-Positive/Phenotype-Negative Patients Class I 1. In individuals with pathogenic mutat ions who do not express the HCM phenotype, it is recommended to perform serial electrocardiogram, transthoracic echocardiogram (TTE), and clinical assessment at periodic intervals (12 to 18 months in children and adolescents and about every 5 years in adults), based on the patient’s age and change in clinical status. (Level of Evidence: B) 9 5. Echocardiography Class I 1. A TTE is recommended in the initial evaluation of all patients with suspected HCM. (Level of Evidence: B) 2.A TTE is recommended as a component of the screening algorithm for family members of patients with HCM unless the family member is genotype negative in a family with known definitive mutations. (Level of Evidence: B) 3. Periodic (12 to 18 months) TTE screening is recommended for children of patients with HCM, starting by age 12 or earlier if a growth spurt or signs of puberty are evident and/or when there are plans for engaging in intense competitive sports or there is a family history of SCD. (Level o f Evidence: C) 4. Repeat TTE is recommended for the evaluation of patients with HCM with a change in clinical status or new cardiovascular event. (Level of Evidence: B) 5. A transesophageal echocardiogram (TEE) is recommended for the intraoperative guidance of surgical myectomy. (Level of Evidence: B) 10 6.TTE or TEE with intracoronary contrast injection of the candidate’s septal perforator(s) is recommended for the intraprocedural guidance of alcohol septal ablation. (Level of Evidence: B) 7. TTE should be used to evaluate the effects of surgical myectomy or alcohol septal ablation for obstructive HCM. (Level of Evidence: C) Class IIa 1. TTE studies performed every 1 to 2 years can be useful in the serial evaluation of symptomatically stable patients with HCM to assess the degree of myocardial hypertrophy, dynamic obstruction, and myocardial function. (Level of Evidence: C) 2. Exercise TTE can be useful in the detection and quantification of dynamic left ventricular outflow tract (LVOT) obstruction in the absence of resting outflow tract obstruction in patients with HCM. (Level of Evidence: B) 11 3.TEE can be useful if TTE is inconclusive for clinical decision making about medical therapy and in situations such as planning for myectomy, exclusion of subaortic membrane or mitral regurgitation secondary to structural abnormalities of the mitral valve apparatus, or in assessment for the feasibility of alcohol septal ablation. (Level of Evidence: C) 4. TTE combined with the injection of an intravenous contrast agent is reasonable if the diagnosis of apical HCM or apical infarction or severity of hypertrophy is in doubt, particularly when other imaging modalities such as CMR are not readily available, not diagnostic, or contraindicated. (Level of Evidence: C) 5.Serial TTE studies are reasonable for clinically unaffected patients who have a first-degree relative with HCM when genetic status is unknown. Such follow-up may be considered every 12 to 18 months f or children or adolescents from high-risk families and every 5 years for adult family members. (Level of Evidence: C) 12 Class III: 1. TTE studies should not be performed more HCM when it is unlikely that any changes have occurred that would have an impact on clinical decision making. (Level of Evidence: C) 2. Routine TEE and/or contrast echocardiography is not recommended when TTE images are diagnostic of HCM and/or there is no suspicion of fixed obstruction or intrinsic mitral valve pathology. (Level of Evidence: C)No Benefit frequently than every 12 months in patients with 13 6. Stress Testing Class IIa 1. Treadmill exercise testing is reasonable to determine functional capacity and response to therapy in patients with HCM. (Level of Evidence: C) 2. Treadmill testing with monitoring of an electrocardiogram and blood pressure is reasonable for SCD risk stratification in patients with HCM. (Level of Evidence: B) 3. In patients with HCM who do not have a resting peak instantaneous g radient of greater than or equal to 50 mm Hg, exercise echocardiography is reasonable for the detection and quantification of exercise-induced dynamic LVOT obstruction. (Level of Evidence: B) 14 7. Cardiac Magnetic Resonance Class I 1.CMR imaging is indicated in patients with suspected HCM when echocardiography is inconclusive for diagnosis. (Level of Evidence: B) 2. CMR imaging is indicated in patients with known HCM when additional information that may have an impact on management or decision making regarding invasive management, such as magnitude and distribution of hypertrophy or anatomy of the mitral valve apparatus or papillary muscles, is not adequately defined with echocardiography. (Level of Evidence: B) Class IIa 1. CMR imaging is reasonable in patients with HCM to define apical hypertrophy and/or aneurysm if echocardiography is inconclusive. (Level of Evidence: B) 15 Class IIb 1.In selected patients with known HCM, when SCD risk stratification is inconclusive after docume ntation of the conventional risk factors, CMR imaging with assessment of late gadolinium enhancement may be considered in resolving clinical decision making. (Level of Evidence: C) 2. CMR imaging may be considered in patients with LV hypertrophy and the suspicion of alternative diagnoses to HCM, including cardiac amyloidosis, Fabry disease, and genetic phenocopies such as LAMP2 cardiomyopathy. (Level of Evidence: C) 16 8. Detection of Concomitant Coronary Disease Class I 1. Coronary arteriography (invasive or computed tomographic imaging) is indicated in patients with HCM with chest discomfort who have an intermediate to high likelihood of coronary artery disease (CAD) when the identification of concomitant CAD will change management strategies. (Level of Evidence: C) Class IIa 1.Assessment of coronary anatomy with computed tomographic angiography is reasonable for patients with HCM with chest discomfort and a low likelihood of CAD to assess for possible concomitant CAD. (Level of E vidence: C) 2. Assessment of ischemia or perfusion abnormalities suggestive of CAD with single-photon emission computed tomography or positron emission tomography myocardial perfusion imaging (because of excellent negative predictive value) is reasonable in patients with HCM with chest discomfort and a low likelihood of CAD to rule out possible concomitant CAD. (Level of Evidence: C) 17 Class III: 1. Routine single-photon emission computed echocardiography is not indicated for detection of â€Å"silent† CAD-related ischemia in patients with HCM who are asymptomatic. (Level of Evidence: C) 2.Assessment for the presence of blunted flow reserve (microvascular ischemia) using quantitative myocardial blood flow measurements by positron emission tomography is not indicated for the assessment of prognosis in patients with HCM. (Level of Evidence: C) No Benefit tomography myocardial perfussion imaging or stress 18 9. Asymptomatic Patients Class I 1. For patients with HCM, it is recom mended that comorbidities that may contribute to cardiovascular disease (e. g. , hypertension, diabetes, hyperlipidemia, obesity) be treated in compliance with relevant existing guidelines. (Level of Evidence: C) Class IIa 1. Low-intensity aerobic exercise is reasonable as part of a healthy lifestyle for patients with HCM. (Level of Evidence: C) Class IIb 1.The usefulness of beta blockade and calcium channel blockers to alter clinical outcome is not well established for the management of asymptomatic patients with HCM with or without obstruction. (Level of Evidence: C) Class III: Harm 1. Septal reduction therapy should not be performed for asymptomatic adult and pediatric patients with HCM with normal effort tolerance regardless of the severity of obstruction. (Level of Evidence: C) 2. In patients with HCM with resting or provocable outflow tract obstruction, regardless of symptom status, pure vasodilators and high-dose diuretics are potentially harmful. (Level of Evidence: C) 19 Fi gure 1. Treatment Algorithm HCM PatientsACE indicates angiotensin-converting enzyme; ARB, angiotensin receptor blocker; DM, diabetes mellitus; EF, ejection fraction; GL, guidelines; HCM, hypertrophic cardiomyopathy; HTN, hypertension; and LV, left ventricular. Treat comorbidities according to GL [HTN, Lipids, DM] Obstructive Physiology No Heart Failure Symptoms or Angina No Yes Yes Avoid vasodilator therapy and highdose diuretics Systolic Function Annual clinical evaluation No Heart Failure Symptoms or Angina LV EF 50 mm Hg) for whom standard medical therapy has failed. (Level of Evidence: C) 4.When surgery is contraindicated or the risk is considered unacceptable because of serious comorbidities or advanced age, alcohol septal ablation, when performed in experienced centers, can be beneficial in eligible adult patients with HCM with LVOT obstruction and severe drug-refractory symptoms (usually New York Heart Association functional classes III or IV). (Level of Evidence: B) 26 Class IIb 1. Alcohol septal ablation, when performed in experienced centers, may be considered as an alternative to surgical myectomy for eligible adult patients with HCM with severe drug-refractory symptoms and LVOT obstruction when, after a balanced and thorough discussion, the patient expresses a preference for septal ablation. (Level of Evidence: B) 2. The effectiveness of alcohol septal ablation is uncertain in patients with HCM with marked (i. e. , >30 mm) septal hypertrophy, and therefore the procedure is generally discouraged in such patients. (Level of Evidence: C) Class III: Harm 1.Septal reduction therapy should not be done for adult patients with HCM who are asymptomatic with normal exercise tolerance or whose symptoms are controlled or minimized on optimal medical therapy. (Level of Evidence: C) 2. Septal reduction therapy should not be done unless performed as part of a program dedicated to the longitudinal and multidisciplinary care of patients with HCM. (Level of Evidence : C) 27 3. Mitral valve replacement for relief of LVOT obstruction should not be performed in patients with HCM in whom septal reduction therapy is an option. (Level of Evidence: C) 4. Alcohol septal ablation should not be done in patients with HCM with concomitant disease that independently warrants surgical correction (e. g. coronary artery bypass grafting for CAD, mitral valve repair for ruptured chordae) in whom surgical myectomy can be performed as part of the operation. (Level of Evidence: C) 5. Alcohol septal ablation should not be done in patients with HCM who are less than 21 years of age and is discouraged in adults less than 40 years of age if myectomy is a viable option. (Level of Evidence: C) 28 12. Pacing Class IIa 1. In patients with HCM who have had a dualchamber device implanted for non-HCM indications, it is reasonable to consider a trial of dual-chamber atrial-ventricular pacing (from the right ventricular apex) for the relief of symptoms attributable to LVOT obst ruction. (Level of Evidence: B) Class IIb 1.Permanent pacing may be considered in medically refractory symptomatic patients with obstructive HCM who are suboptimal candidates for septal reduction therapy. (Level of Evidence: B) Class III: 1. Permanent pacemaker implantation for the performed in patients with HCM who are asymptomatic or whose symptoms are medically controlled. (Level of Evidence: C) 2. Permanent pacemaker implantation should not be performed as a first-line therapy to relieve symptoms in medically refractory symptomatic patients with HCM and LVOT obstruction in patients who are candidates for septal reduction. (Level of Evidence: B) No Benefit purpose of reducing gradient should not be 29 13. Sudden Cardiac Death Risk Stratification Class I 1.All patients with HCM should undergo comprehensive SCD risk stratification at initial evaluation to determine the presence of: (Level of Evidence: B) a. A personal history for ventricular fibrillation, sustained ventricular tach ycardia, or SCD events, including appropriate ICD therapy for ventricular tachyarrhythmias. * b. A family history for SCD events, including appropriate ICD therapy for ventricular tachyarrhythmias. * c. Unexplained syncope. d. Documented nonsustained ventricular tachycardia (NSVT) defined as 3 or more beats at greater than or equal to120 bpm on ambulatory (Holter) electrocardiogram. e. Maximal LV wall thickness greater than or equal to 30 mm. Appropriate ICD discharge is defined as ICD therapy triggered by VT or ventricular fibrillation, documented by stored intracardiac electrogram or cycle-length data, in conjunction with the patient’s symptoms immediately before and after device discharge. 30 Class IIa 1. It is reasonable to assess blood pressure response during exercise as part of SCD risk stratification in patients with HCM. (Level of Evidence: B) 2. SCD risk stratification is reasonable on a periodic basis (every 12 to 24 months) for patients with HCM who have not under gone ICD implantation but would otherwise be eligible in the event that risk factors are identified (12 to 24 months). (Level of Evidence: C)Class IIb 1. The usefulness of the following potential SCD risk modifiers is unclear but might be considered in selected patients with HCM for whom risk remains borderline after documentation of conventional risk factors: a. CMR imaging with late gadolinium enhacement. (Level of Evidence: C) b. Double and compound mutations (i. e. , >1). (Level of Evidence: C) c. Marked LVOT obstruction. (Level of Evidence: B) Class III: Harm 1. Invasive electrophysiologic testing as routine SCD risk stratification in patients with HCM should not be performed. (Level of Evidence: C) 31 14. Selection of Patients for Implantable Cardioverter-Defibrillators Class I 1.The decision to place an ICD in patients with HCM should include application of individual clinical judgment, as well as a thorough discussion of the strength of evidence, benefits, and risks to allow the informed patient’s active participation in decision making. (Level of Evidence: C) 2. ICD placement is recommended for patients with HCM with prior documented cardiac arrest, ventricular fibrillation, or hemodynamically significant ventricular tachycardia. (Level of Evidence: B) Class IIa 1. It is reasonable to recommend an ICD for patients with HCM with: a. Sudden death presumably caused by HCM in 1 or more first-degree relatives. (Level of Evidence: C) b. A maximum LV wall thickness greater than or equal to 30 mm. (Level of Evidence: C) c. One or more recent, unexplained syncopal episodes. (Level of Evidence: C) 2.An ICD can be useful in select patients with NSVT (particularly those 30 mm or Recent unexplained syncope No Yes ICD reasonable Nonsustained VT or Abnormal BP response Yes Other SCD Risk Modifiers* Present? Yes No ICD can be useful Legend Class I Class IIa No ICD not recommended Class IIb Class III Role of ICD uncertainRegardless of the level of recommendatio n put forth in these guidelines, the decision for placement of an ICD must involve prudent application of individual clinical judgment, thorough discussions of the strength of evidence, the benefits, and the risks (including but not limited to inappropriate discharges, lead and procedural complications) to allow active participation of the fully informed patient in ultimate decision making. BP indicates blood pressure; ICD, implantable cardioverter-defibrillator; LV, left ventricular; SCD, sudden cardiac death; SD, sudden death; and VT, ventricular tachycardia. 35 15. Participation in Competitive or Recreational Sports and Physical ActivityClass IIa 1. It is reasonable for patients with HCM to participate in low-intensity competitive sports (e. g. , golf and bowling). (Level of Evidence: C) 2. It is reasonable for patients with HCM to participate in a range of recreational sporting activities as outlined in Table 2. (Level of Evidence: C) Class III: Harm 1. Patients with HCM should not participate in intense competitive sports regardless of age, sex, race, presence or absence of LVOT obstruction, prior septal reduction therapy, or implantation of a cardioverterdefibrillator for high-risk status. (Level of Evidence: C) 36 Table 2. Recommendations for the Acceptability of Recreational Noncompetitive) Sports Activities and Exercise in Patients With HCM* Intensity Level High Basketball (full court) Basketball (half court) Body building†¡ Gymnastics Ice hockey†¡ Racquetball/squash Rock climbing†¡ Running (sprinting) Skiing Soccer Tennis (singles) Touch (flag) football Windsurfing § Moderate Baseball/softball Biking Modest hiking Motorcycling†¡ Jogging Sailing § Surfing § Swimming (laps) § Tennis (doubles) Treadmill/stationary bicycle Weightlifting (free weights)†¡|| Hiking 2 4 4 3 3 3 2 5 4 5 1 3 (downhill)†¡ Skiing (cross-country) 0 0 1 2 0 0 1 0 2 2 0 0 1 1 Eligibility Scale for HCM†  Intensity Level Low Bowling Golf Hor seback riding†¡ Scuba diving § Skating ¶ Snorkeling § Weights (nonfree weights) Brisk walking 5 5 3 0 5 5 4 5 Eligibility Scale for HCM†  *Recreational sports are categorized according to high, moderate, and low levels of exercise and graded on a relative scale (from 0 to 5) for eligibility, with 0 to 1 indicating generally not advised or strongly discouraged; 4 to 5, probably permitted; and 2 to 3, intermediate and to be assessed clinically on an individual basis. The designations of high, moderate, and low levels of exercise are equivalent to an estimated >6, 4 to 6, and

Criminal Justice Essays - Searches And Seizures, Warrants

Criminal Justice Essays - Searches And Seizures, Warrants Criminal Justice Reason to Search The two vehicle stops were made for different reasons. The first vehicle, the white Toyota Camry, was stopped because it fit the description of a vehicle that was just used in a bank robbery. This gives the police probable cause that the vehicle contains evidence of criminal activity. According to Carroll v. United States that is sufficient reasoning for a stop (211). The second vehicle had the drivers side brake light out. This is sufficient cause to pull the vehicle over because that is a traffic violation. In Whren v. United States, the Supreme Court ruled that the true motivation of police officers in making traffic stops was irrelevant as long as they had probable cause to believe that a traffic law had been broken (211). I feel that both stops were justified and neither violated the rights of the suspects. Fitting the description of suspects and being in the general vicinity of the crime is adequate evidence to pull a vehicle over and check out the situation. The second stop was made because the driver had violated a traffic code. Since the vehicle is breaking this law the police have the right to pull over that vehicle. The officers even took the vehicle to the station to obtain a search warrant when the suspect objected. Both stops were done in a legal manner. The warrant less search of the white Toyota Camry was justified because the suspect did not say no when the officer asked to search the vehicle. The officer did not come right out and ask if he could search the trunk, but the suspect never objected. Instead the suspect begins to not cooperate which leads to more suspicion. The behavior of the suspects and the fact that neither suspects objected to the search is reason enough to for a warrant less search. If the suspects in the white Toyota Camry had been advised of their Miranda rights before the search of their vehicle then the police would have had to obtain a search warrant. But by denying the police the right to search your vehicle is almost implying guilt in itself. I think the only difference getting a search warrant would have done is prolonged the police finding the evidence in the trunk. Either way I think the situation would result in the police finding the rifle and the suspects getting arrested. If the officers had opened the trunk and found no evidence of the robbery then I think they could only take the suspects in for questioning. Since this questioning would be in an accusatory manner then the suspects would need to be advised of their Miranda rights. If the suspects exercised their right to an attorney then they would be advised to keep their mouths shut. Without evidence to incriminate the suspects then the suspects would be released and probably questioned again later. With the only basis for charging being that the suspects and their vehicle fit the description of those in a robbery then in all likelihood the suspects would not be charged.

Whats the ACT Score Range

What's the ACT Score Range SAT / ACT Prep Online Guides and Tips You can’t study effectively for the ACT if you don’t know what score to aim for, and you won’t know what score to aim for if you don’t know how the ACT is scored! In this post, I’ll start off with some important background info on the ACT before getting to the good stuff- the ACT score range and what you should know about it. For example, what do these scores mean? What counts as a good ACT score? Read on to find out! ACT: The Basics Although it wasn’t the original college entrance exam, the ACT is now accepted everywhere that the SAT is. In fact,more people take the ACT every year than the SAT. The ACT (or the SAT, if you so choose) will be an important part of your college applications. Admissions officers consider your scores as a measure of academic preparedness- the higher your scores, the stronger your application. Higher-ranking schools have higher expectations when it comes to ACT scores, so if you want to be a top applicant, it's important to know what scores you should be aiming for (don't worry, we'll get to that shortly)! The ACT Score Range The ACT is scored out of a total of 36 points- this is known as the composite, or total, score. The lowest possible composite score is 1. This score is calculatedby averaging all the ACT sections. There are four sections, or tests, within the ACT. Each test is scored out of 36 points, with the lowest possible score of 1- just like the composite score. Here's some information about what to expect for each ACT section (click the links to read more about each topic): English–75 total questions Math–60 total questions Reading–40 total questions Science–40 total questions There’s also the option to take the ACT with a writing section. Some colleges require you take the ACT with Writing. This doesn’t affect your composite score, but your writing section will be sent to colleges in addition to the scores above. There have been some changes to the ACT Writing section this year, so be sure to check out our guide for more info. A Better Understanding of ACT Scores Here's where we start to make sense of this score range. A score range of 1-36 isn’t necessarily easy to wrap your head around, unlike a standard test scored out of 100 points. While it’s helpful to know about the maximum and minimum scores, the range doesn’t really tell you what’s average or normal for a student like you. Lucky for us, millions of students take the ACT every year, and we have access to information about how they’ve scored. National ACT Performance Here's what we know about the ACT score distribution on a national level: The average composite score is 21 points, out of a possible 36. The 75th percentile score is 24. This means that students who score 24 points had higher composite scores than 75% of all other test takers. Scores of 24+ are generally considered excellent,at least on a national level. The 25th percentile score is 16. This means that students who score 16 points had lower composite scores than 75% of all other test takers. Scores at or below 16 points are generally considered low, at least on a national level. If you want more detailed information on national ACT score distribution, check out this percentile chart. High School and Target College ACT Performance Although looking at national ACT performance is helpful, it can only get you so far. People who take the ACT come from vastly different backgroundsand have vastly different goals- you go to one particular high school in one particular area, and you're probably looking at a specific set of colleges, right? You won't be applying to every single school in the country. You'll want to aim for goal scores that are appropriate considering both your educational background and your future goals. The first steps in this process involve learning how your peers perform on the ACT, and learning how students at your target schools perform on the ACT. To learn what your peers tend to score on the test: Google "[Your high school name] ACT score report" See your guidance counselor Ask your friends Read our guide to understanding ACT scores for more detailed instructions To learn what students at your target colleges score on the ACT (remember, you want your scores to look like theirs): Google "[school name] PrepScholar admissions requirements" to get information on 25th and 75th percentile ACT scores Read our guide to setting appropriate goal scores for more information What's Next? Now that you know all about the ACT score range, you can start learning all you can about the test's content. Check out how to prepare for the ACT English, math, reading, and science sections. If you're particularly ambitious and want to aim for some of those top schools I mentioned earlier, learn how to score a perfect 36 on the ACT. Disappointed with your ACT scores? Want to improve your ACT score by 4+ points? Download our free guide to the top 5 strategies you need in your prep to improve your ACT score dramatically.

UNIT 4 DISCUSSION BOARD Essay Example | Topics and Well Written Essays - 500 words - 4

UNIT 4 DISCUSSION BOARD - Essay Example Though Medicare and Medicaid are federally operated programs, they rely on private providers that are regulated and financed through a variety of different agencies and corporations. In contrast, the VA and military are health care systems that are run directly by the government. This difference has allowed the VA to concentrate on quality rather than quantity of services. In addition, the VA manages the system to hold regional and area managers directly responsible for the performance of the system. The private sector providers have little incentive to invest in quality such as the VAs commitment to, "purchases of health IT to track adherence to clinical guidelines or spending on education and training to improve compliance with safety protocols" (Veterans Administration, 2007, p.14). In addition, the VA has implemented the Veterans Equitable Resource Allocation (VERA) system to monitor resources and assure that they are being adequately distributed. This has developed into a highly refined system of patient classification, regional cost analysis, and produces a level of care that the private sector could benefit from to control costs while assuring quality care (National Defense Research Institute, 2005, p.3). The US Department of Defense (DoD) operates the largest health system in the US and provides medical care for active military, retirees, and civilian employees. A key difference between the DoD and the private sector is the ability to enact policies that affect their participants health while saving money. The military is able to vaccinate their members in greater numbers for diseases such as polio, measles, mumps, influenza, and varicella (Kruzel). The military policy views this as a health maintenance (and cost saving) measure, while the private sector sees this as a cost. Because the DoD operates on a fixed budget from year to year, they are forced to control costs, while the private sector is often prompted to accelerate costs to

Khatem Al Shaklah Essay Example | Topics and Well Written Essays - 2000 words

Khatem Al Shaklah - Essay Example A strategic plan has been formulated with vision, mission and product development, and communication and media strategies are being established. At the end, an impact analysis has been done to review the sustainability of the project in the long run. Location Audit Khatem al Shaklah is an upcoming area located in the city of Al Ain. Al Ain is one of the developed cities in the state of UAE. It is also the second largest city in Emirates. The place is located near the border of Oman and connected by highways to big cities like Abu Dhabi and Dubai. The rainfall is average in the place and humidity is low, which makes it a favourite destination for holidays, especially during the summers. The place also boasts presence of many green forests and gardens, because of which the city is often termed as Garden city. Khatem al Shaklah is located on the central part of the city and is properly connected to the rest of the city with well built highways. The city of Al Ain is a popular destinatio n for tourist attraction. As most of the other cities in UAE are located in the coastal areas, the humidity is high. Dry weather of the Al Ain city makes it a favourable place for outing and spending holidays. Al Ain has become a major destination for commerce and service industry. This rise of tourists and people settling here from other countries makes it a favourable market for services industry. The city has currently three established malls and shopping centres (Atiyyah, 1997). Apart from the weather, the place is also famous for its historical legacy. The rich culture of Arab has been preserved in many historical and archaeological sites in the city (Nikam, et al, 2004). All the above features make the place an attractive destination for setting up a new heritage site. SWOT Analysis To find out the opportunities and areas of concern, a SWOT analysis has been done for the chosen place. The goal of SWOT analysis is to find out the strengths, weaknesses, opportunities and threats associated with the chosen location and strategies to overcome the weaknesses and threats (Piercy and Giles, 1989). Strengths- The major strengths associated with the location are the weather and the historic legacy associated with it (Carlsen and Andersson, 2011). With a normal temperature and rainfall and a lower humidity especially during the summers, the area becomes a major destination place for tourists. The place has also many gardens and green spots which further attract tourists in the desert area. Another strength of the location is the infrastructure, the place is in the central part of the state and is connected with major cities such as Abu Dhabi and Dubai through highways as well as air transport. This makes it easy for the tourists and travellers and ensures a smooth and enjoyable experience for them. Weakness - The weakness of the location can be associated with the political, geographical and variable weather conditions. Even though the place is better than most of the cities of the Emirates in terms of weather, the climate is constantly changing. Sudden sand storms and cold nights are the major issues which tourists face. Also the area is not well promoted as a holiday destination which can be a hindering factor for any new projects in this