Monday, August 24, 2020
Renewable Energy Consumption in the Future Research Paper
Sustainable power source Consumption in the Future - Research Paper Example At current utilization rates, we are left with 200 years of coal, 40 years of oil and 60 years of gas. Non-renewable energy sources, Nuclear, and hydroelectric force plants likewise represent a peril to the earth (Hargreaves, 2011). On the off chance that we are to address the issue of a dangerous atmospheric devation, achieved through carbon emanations, at that point we should utilize the correct vitality sources, and discard the waste created in our everyday lives in a powerful way. The utilization of sun powered boards is driving sustainable elective vitality source utilized internationally. Sun powered boards work by saddling the radiation from the sun and changing over it to power. Its principle advantage is the plenteous accessibility of the sunââ¬â¢s beams and boundless openness over the globe. Be that as it may, gracefully can be variable and discontinuous, contingent upon climate conditions and time spans. These elements would most likely underscore why the take-up of sun oriented boards has not been as across the board as would be normal. As per the Pew Center on Global Climate change (2010), sun oriented force just creates one percent of the vitality prerequisite of the entire world in 2008. As indicated by the United States Environmental Protection Agency (2010), Americans produced around 2.3 million tons of waste, in the year 2009. 53% of that waste was dumped, 33.8% reused and 11.9% consumed. This would appear to demonstrate that solitary a little bit of waste really gets reused. As per the grassroots reusing system (grrn.org), a significant number of the items that we believe are reused are really ââ¬Å"downcycledâ⬠. For instance, papers are transformed into low-esteem items like protection material and cow bedding. The issue with this sort of waste administration framework is that it prompts the persistent debasement of the earth, and exhaustion of regular assets likes backwoods. A colossal piece of the waste is comprised by paper items , and on the off chance that we are not cautious how we hotspot for more paper materials, we could wind up cutting more trees, and in this way further intensifying the nursery impact. The most ideal approach to accomplish the decrease of carbon emanations is by searching for better and increasingly feasible sustainable power sources and by using better reusing strategies. Improved Geothermal Systems This framework creates power by bridling the warmth normally produced by the earth (Blodgett and Slack, 2009). To achieve this, you have to delve into a stone situated in a chilly zone. The broke system is then improved to make a bowl into which strengthening wells are going be penetrated in. Crisp H2O is then spurted towards the wells, through the broke system, holding the warm temperature from the stone as streams into the stone. The final product is, steam is caught from the reemerging water, which is then used to control steam turbines. Thereafter, it is then diverted to the broke sy stem to rehash the entire cycle. This strategy for power age produces zero carbon emanations and is as of now being used at Copper Basin in Australia. Brilliant Grids A Smart Grid is a ââ¬Å"computerizedâ⬠power network. It includes including two-way advanced correspondence innovation gadgets to a power network (Williams et al, 2007). Each electronic gadget on the system can accumulate information, through sensors, in addition to two-way advanced correspondence between the field and the utilityââ¬â¢s organize activity focus. This availability would then be able to permit the administrator to change and control every individual gadget.
Saturday, August 22, 2020
Fusion of western musical elements with african traditional free essay sample
Fell Ampoule Cut was conceived on October 1 5,1938 to the group of Reverend Israel Ransoms Cut at Absolute In Gun State, Nigeria. At an early age, he was at that point presented to music by playing the Plano even from the composed score.He was an accomplished performer and a lobbyist. He contemplated music at the Truly College of Music London. Upon his arrival from abroad, he was presented to feature and Jazz and later on created hold back music. He kicked the bucket in Some of the outside and indigenous melodic components in abstain music of Fell Nikolas Kit are: JAZZ: This is a mix of components of western music and qualities discernible back to the music of west Africa. The basic in recognizing highlights of jazz depends on straightforward songs and complex cross-rhythms blended in with verbal slurs, vibrato and steady syncopation.Jazz music receives a significant part of the utilization of act of spontaneity and special timing. One of Fells explanations behind his appropriation of Jazz style into his music was on the grounds that jazz music had a great deal of social data that enhanced his psyche. We will compose a custom exposition test on Combination of western melodic components with african customary or then again any comparable theme explicitly for you Don't WasteYour Time Recruit WRITER Just 13.90/page This he said in a meeting with Walrus(1989). A few instances of Fells tunes that have a few components of jazz styles are: water, follow, route among others. BLUES: This rose up out of spirituals, work tunes, field hollers, yells and drones, and rhymed basic numbers in United States of America in the twentieth century. It later turned into the foundations of jazz, awesome, hip jump and other well known music forms.The basic example of the blues is a fundamental twelve-bar verse structure which is reflected by a standard symphonious movement of twelve bars, in 4/4 time. Slow blues are regularly played in 12/8 (beats per measure with 3 regions for each beat). In the agreement of blues, the utilization of symphonious seventh interim prevalently called blues seven Is a significant trademark. Another element of the blues Is the masterful Imitation of Instrumental sounds with their voices and to reproduce parts of the human voice with their Instruments. A few instances of fells melodies that have components of blues are: Paella, you no beyond words others.
Saturday, July 25, 2020
Financial Aid Filing Season
Financial Aid Filing Season As the start of the school year is quickly approaching, seniors should be keeping financial aid at the forefront of their thoughts. Financial aid is very important as itâs necessary for many students to be able to afford post-secondary opportunities. In order to be eligible to receive financial aid, the first step is completing the Free Application for Federal Student Aid (FAFSA). You can start filing for your FAFSA as early as October 1st, 2018. I encourage you to complete the application as quickly as possible because funding is available on the first come first serve basis, meaning if you wait too late, there might not be any funding available. Timely completion of your FAFSA is very essential if you plan on exploring any post-secondary opportunities. The FAFSA is the first step in the financial aid process. It is used to apply for federal student financial aid such as grants, loans and work study. In addition, post-secondary schools use information from the FAFSA to award non-federal financial aid. The application is available free of charge therefore, you should not be paying anything to complete this application. In order to begin the process, complete the FAFSA application using the link provided. Make sure that you are adding the schools youâre considering attending to your application by adding their school code. For example, if you are applying to Illinois, you must add our federal school code which is 001775. Next, you should ensure that all of your contact information is entered correctly on your application. In many cases, once a student completes their application, more information is needed from the student and our Office of Student Financial Aid (OSFA) will need to reach out to for further information. If OSFA is requesting additional information from you, they will reach out via paper mail and email. Itâs important that you provide this necessary information as quickly as possible in order to receive your award letter. Award letters start becoming available as early as February 15th. If you completed FAFSA and we are waiting for more information from you, you will not receive an award letter however, the funds allocated to you will still be available once you send the information needed. Please frequently check your emails and standard mail throughout your entire senior year as their might be very important matters pending. Seniors, I truly understand that you will be extremely busy this school year. You are expected to complete college applications, scholarship applications, maintain quality grades, engage in involvement and complete your FAFSA. Itâs important for you to understand that you are not alone in this process. Most high schools have college counselors available to assist you in the completion of your FAFSA and itâs important that you utilize them as your main resource this year. If your school doesnât provide assistance to you, there are other resources that are willing to assist you such as, The Illinois Student Assistance Commission. Additionally you may always contact OSFA for any assistance as well. If you have any questions or concerns, feel free to drop them below and I will get back to you! Good Luck! Chris Admissions Counselor I was born and raised on the south side of Chicago and graduated from Kenwood Academy High School. I hold a bachelorâs degree from Illinois in Urban Planning. I work in the Chicago Satellite Office, where I assist and recruit students who are interested in attending Illinois.
Friday, May 22, 2020
Textual Analysis The Flies - 1183 Words
Milca C. Altamirano ENG 101 Jon LaGuardia 7 September 2016 Textual Analysis You awake with a breeze twirling with the fragments of hair left on your scalp; a dance known only to friends of the oncoming light. You open your eyes only to see the endless ocean in the sky. You do not see your family, nor your friends. You demand your legs and arms to function, they do not. You beg them to work the one time you need them to, and in defiance to the groan of your bones, you stand. You begin to wonder if this is a dream, a nightmare. Itââ¬â¢s not real. I will see them when I wake up. They are fine. Itââ¬â¢s not real. The earth rises and in its presence is the rubble of your home, your brotherââ¬â¢s home, and your neighborââ¬â¢s home, scattered and utterly destroyed. With a horrible realization, you start screaming for the arms of your children and wife to wrap around you once again. You canââ¬â¢t hear yourself scream. You canââ¬â¢t hear anything except the deafening silence. You drop to our knees while your eyes are drowned in a river of sorrow. T hen, you feel the small hands of your children grasp yours with surprising fierceness. Though your wife is nowhere to be seen in the mist of dust, you have never been so relieved to bask in the mist of ruins and death. This is a devastating reality many are facing in the Middle East every day, some more grim than others. It is through a writerââ¬â¢s words, written or oral, or a photographerââ¬â¢s lens where we see our news, our history being captured. In thisShow MoreRelatedForrest Gump : Active Video Note Taking, Questions, And Analysis Paper1154 Words à |à 5 PagesActive Video Note-taking, Questions, and Analysis Paper Directions: Now that we have practiced, implemented, and analyzed the first two standards in the Common Core Reading for Literature 9-10, students will attempt to apply these skills to another medium: a film. The class will watch Forrest Gump, and when finished, compose a detailed analysis based on both of the skills or standards that were instructed: Standard 9-1: Cite textual evidence to support analysis of what the text says. Standard 9-2:Read MoreThe Kite Runner By Khaled Hosseini1574 Words à |à 7 Pagesexpressing his love in better terms through empathy. The following quote of Baba speaking to Amir after he graduates high school emphasizes this. ââ¬Å"ââ¬ËI am Moftakhar, Amir,ââ¬â¢ he said. Proudâ⬠(131). As shown by the quote, Baba is like a kite who tried to fly away from Amir due to their differences. But Amir hung onto the string of this kite. He loved Baba and Baba loved him, but they could not express this in Amirââ¬â¢s childhood because of their clashing personalities. When Baba comes to realization that AmirRead MoreSql Research Paper1334 Words à |à 6 PagesIntroduction Although many varieties of sophisticated software are available for database construction, they impose very little restriction on their implemented form. Indeed, it would fly in the face of database philosophy to impose the form of implementation, for this would not encourage features like responsiveness to new requests (Bailey, Creel, Grossman, Gutti, and Sivakumar, 55-57). Thus each operational database is unique, even if the software used in constructing it is an industry standardRead MoreCrash Essay2284 Words à |à 10 Pagesencounter. This scene summarizes Daniels character and his ability to help others or fix locks. As Farhad is left to ponder his actions, there is an overhead shot of a broken man and the American flag ââ¬â symbolizing liberty, equality and freedom ââ¬â flies poignantly in the background. Later a regretful Farhad is seen slumped on the floor. It is at this point that Farhad acknowledges he is not only a victim of racial abuse but a perpetrator. The audience is persuaded to feel empathically for DanielRead MoreImage Processing1392 Words à |à 6 PagesIntelligent systems with a high degree of recognition accuracy for most fonts are now common. Some systems are even capable of reproducing formatted output that closely approximates the original scanned page including images, columns and other non-textual components. The accurate recognition of Latin-script, typewritten text is now considered largely a solved problem. Typical accuracy rates exceed 99%, although certain applications demanding even higher accuracy require human review for errors. OtherRead More The Understated Narrator of The Masque of the Red Death Essay2052 Words à |à 9 Pagesmeans of its impossible narrator. We recognize that we cannot successfully imitate the narrators trick, for unlike him we are flesh and blood: time and death will not pause to see whether we remember their inevitability. The narrator is thus a fly in the soothing ointment of aesthetic distance, figuring and ridiculing both the authors and the readers hope of escape into art. à The irony of all this is that the cynical message of Red Death is at odds with its own power as a workRead MoreTextual Analysis Of Edgar Allen Poe s The Raven 1911 Words à |à 8 PagesTextual Analysis of Edgar Allen Poe ââ¬Å"The Ravenâ⬠Michelle Zaharek December 1, 2014 The Raven Edgar Allen Poe was a poet, author, editor, literary critic, and husband. His works have been pulled apart many times and the DNA of his words dissected by critics and literary analytical writers. He has been the center of attention, but he did not start off that way. Beneath his sad eyes is a story that rarely gets told. When people think of Poe, they think of a gothic horror writer, not necessarily an imaginativeRead MoreConfucianism in Journey to the West31834 Words à |à 128 PagesUniversity: University of Leiden 14 June 2012 Department: Language and Culture of China Course: Visual Political Communication (BA3) Semester: Summer Semester 2011/2012 Lecturer: Florian Schneider Journey to the West A Textual-Visual Discourse Analysis Name: Stefan Ruijsch (Student No. 0620203) Major: Chinese Studies, BA 3 E-mail: s.ruijsch@umail.leidenuniv.nl Phone: 06-48369645 Address: Vrijheidslaan 256, 2321 DP Leiden Word Count: 9,387 Table of Contents Read MoreWilliam Shakespeare s The Ghost 2757 Words à |à 12 Pagesinnocence is questionable. Is she simply a blameless victim seeking dependence upon a authoritative leader or is she a malicious woman hungry for power and capable of murder? The answer is somewhat unequivocal because we can never find any conclusive textual references. In the Ghostââ¬â¢s encounter with Hamlet, he calls his ex-wife his ââ¬Ëmost seeming virtuous queenââ¬â¢. Whatââ¬â¢s more, he bids Hamlet to ââ¬ËLeave her to Heaven/ And to those thorns that in her bosom lodge/ To prick and sting her.ââ¬â¢ Although these wordsRead MoreMiss Brill5112 Words à |à 21 PagesReview of European Studies December, 2009 A Stylistic Analysis of ââ¬Å"Miss Brillâ⬠by Katherine Mansfield Shenli Song College of Foreign Languages, Zhejiang Gongshang University Office of Foreign Language College at Zhejiang Gongshang University Xia Sha City-University-Town, Hangzhou 310018, Zhejiang, China E-mail: windyforever@gmail.com Abstract Katherine Mansfield, remembered as one of the finest writers of English short stories, enjoys enduring fame and a somewhat awesome literary status with
Friday, May 8, 2020
Oni Art- The Different Styles through the Ages - 1350 Words
Oni Art- The Different Styles through the ages Original- Hideous demonic ogre like creatures who just want feast on human flesh and to terrorize humankind. They can shapeshift and take human form because of their gruesome appearance reflects their evil disposition. They have horns on their heads and wear loincloths and have diabolical grimaces. They were feared because of their cravings for human flesh. Modern Oni have transformed over the years since its conception. They can look more eclectic than their ancestral cousins. They have been seen as benign and sometimes benevolent beings. They can still shapeshift but choose more sexually attractive females who are alluring and can also be naughty a child in some cases. The commercial interests that writers and artists face in the modern age has forced those changes to adapt to societies wants and views. Japanââ¬â¢s socio-economic evolution into one of the most industrialized nations in the world reflects the change in art. Utagawa Kuniyoshi born 1797 was one of the last great masters of the japanese ukiyo-e style woodblock prints and painting. Wood block printing is a technique that was originally chinese and then in the Edo period (1603-1867) was widely adopted by japan. Wood block art was aimed at the prosperous merchant class with images of beautiful women, historic events, kabuki actors, sumo wrestlers, folk tales, landscapes and beautiful flowers, and erotica. It would start off with aShow MoreRelatedThe Influence of Instructional Facilities on Studentsââ¬â¢ Academic Performance in Public Secondary Schools in Sapele Local Government Area of Delta State11042 Words à |à 45 PagesTherefore, the teacher has to use instructional material to make the teaching and learning process interesting. Facilities management is crucial in the enhancement of instruction. It is not in doubt that if performance must be enhanced through facilities, the management of the latter is highly indispensable. It is also regrettable that across Sapele Local Government Area of Delta State, that management of facilities is lamentable. A tour of the schools in the LGA reveals a commonRead MoreAn Impact Assessment of Science and Technology Policy on National Development of Nigeria61708 Words à |à 247 PagesPhilosophy in Management St. Clements University October, 2004 iii DECLARATION I declare that this Dissertation is an output of my own research endeavours. In pursuant of this research work, concerted efforts were made to duly acknowledge through bibliography, all sources of data and information used. However, in case of inadvertent omissions or incomplete referencing, I nevertheless, still express the acknowledgement of such sources. I accept full responsibilities for any shortcomingsRead MoreIgbo Dictionary129408 Words à |à 518 PagesDuring the 1990s, the manuscript was partly typed without alteration into a Word processor, originally an Apple-based system. This was transferred to an IBM system quite recently, but without any conversion of the character codes. It seems that two different systems of coding diacritics were used and more than two IPA phonetic fonts. Furthermore, for some reason, the typing of the grammar sketch which precedes the manuscript is incomplete. In order to make the manuscript available, I have therefore joined
Wednesday, May 6, 2020
Project Appraisal of Dairy Firm Free Essays
string(80) " is a commodity and mostly every one drink daily, we have a more customer base\." As the need for milk is constantly increasing, this gives easy access to the market. This milk is made available to the common people at a comparably low cost and also providing them with a good quality. As people are becoming health conscious, the need for vitaminzed milk is increasing. We will write a custom essay sample on Project Appraisal of Dairy Firm or any similar topic only for you Order Now Product proposed to be manufactured: Shrud is a milk dairy which is aimed to supply pure milk to the people at a comparably low cost. The following different types of milk are produced in the dairy. Standardized milk- This is made by combining buffalo milk and skimmed milk. The fat percentage is maintained at 4. 5%. Whole milk: Whole milk must contain at least 3. 25% milk fat and 8. 25% milk solids by weightââ¬âwhich means it derives about 50% of its calories from fat. Because of this relatively high fat content, whole milk is best used only for infants and young children up to age 2. Reduced-fat milk (2%): This milk contains 2% milk fat. The percentage of milk fat refers to the percentage of fat by weight, and much of milkââ¬â¢s weight is water. Once you subtract the water from 2% milk, for example, youââ¬â¢re left with a product that contains 20% fat by weight; such milk actually derives 35% of its calories from fat.Drinking 2% milk is a good way to wean oneself from whole milk at first, but is too high in fat as a permanent choice, unless your diet is otherwise very low in fat. Low-fat milk (1%): One-percent milk gets 23% of its calories from fat. Many people find low-fat milk more appealing and a good compromise. Skimmed milk/non-fat milk: This type of milk has as much fat removed as possible. It may not contain more than 0. 5% milk fat by weight, and usually contains less than 0. 5 gm of fat per cup, deriving just 5% of its calories from fat.Skimmed milk has about half the calories of whole milk. It is the best choice for adults, and is the only type of milk that should be consumed by people on strict low-fat diets. Unfortunately, skim milk has a very ââ¬Å"thinâ⬠flavor and an unappealing bluish cast. Vitaminized or Irradiated Milk Vitaminized milk is milk to which one or more vitamins are added. Irradiated milk is milk in which the vitamin D content has been increased by exposure to ultra violet rays. Addition of vitamins (and minerals) to milk is called fortification and such milk is called fortified milk.The vitamins and minerals may be added singly or in combination as multi-vitamin and mineral milk preparations. It also produces Curd but mainly concentrates on milk. As milk is a daily product and every one drink daily, every one who drinks milk are our customers. The main differentiated factor is the vitamin milk or multi vitamin milk which gives the company a competitive edge. Marketing will be the key for this company because there are many competitors from many years who have a strong foot fold in the state. So it is necessary for he company to show differentiation and the campaigning is very important. Flavored milk: By providing various kind of flavored milk like strawberry, vanilla etc Butter: Providing various kings of butter in the market like butter, low fat bread spread butter and cooking butter. Ghee: Naturally obtained ghee from the diary farm. ABOUT THE PROMOTERS OF THE PROJECT NAME OF THE PROMOTERSAGENET WORTH N. PADMANABARAO221000000 M. HARSHITHA221000000 VISHNUPRIYA221000000 SWATHI. V221000000 AISHWARYA. J221000000 2. MARKETING FEASIBILITY Market feasibilityMarket Feasibility Study typically involves testing geographic locations for a real estate development project, and usually involves parcels of real estate land. Developers often conduct market studies to determine the best location within a jurisdiction, and to test alternative land uses for given parcels. Jurisdictions often require developers to complete feasibility studies before they will approve a permit application for retail, commercial, industrial, manufacturing, housing, office or mixed-use project. Market Feasibility takes into account the importance of the business in the selected area.Market share: As per 2009 survey the population in around Rajahmundry is 15 lacs. According to the data, market share of vishaka is 22%, market share of Vijaya is 18%, market share of heritage is 6% and market share of jersey is 4% and local milk vendor are dominating the market by holding a market share of 40%. We can grab a market share of 0. 06% market share. Unit Market Share (%) =Unit Sales (#)/Total Market Unit Sales (#) = 10000/ 1500000 = 0. 06 There is a huge population of 15 lacs in and around Rajahmundry. So, we can easily sell the 10000 liters of milk every day.Itââ¬â¢s easy to grab the market. 2. 1 MARKETING PLAN: a) MAJOR CUSTOMERS: As milk is a commodity and mostly every one drink daily, we have a more customer base. You read "Project Appraisal of Dairy Firm" in category "Papers" As our capacity for the processing of milk is small we can serve only to Rajahmundry. b) Region: As we want to serve the market of Rajahmundry, we have located our plant close to it. There are benefits we can incur such as reduction in transportation cost, better availability etc. c) Major players already in the field: the market is presently dominate by key players like vishaka, jersey, heritage, and vijaya. ) Competitive advantage enjoyed by the proposed venture: Our main competitive edge is low pricing, easily availability. This can be achieved, as the plant is located at the centre of 40 villages and the milk can be easily procured. Another advantage is as the plant is near to the Rajahmundry we serve the market well, the cost can reduced in terms of transportation and we can offer at low price compared to competitors. e) Sales channels and methods: in this type of industry, distributors play a vital role. So we have selected this as a channel as it offers a good step into the market.This helps in penetration of market. As milk is a commodity and we are offering high margin for distributors we are not advertising or promoting the product. f) Market tie-up: A good tie up gives a competitive edge in this type of industry. As our business is completely of procuring the milk, processing and supplying to the customers, a trusted tie up with the villagers is very essential. So we are concentrating on building the relationships with the farmers , which will enhance the productivity and leads to better profits. 3. TECHNICAL FEASIBILITY 3. 1 RAW MATERIALS REQUIRED Raw MaterialsThe average composition of cowââ¬â¢s milk is 87. 2% water, 3. 7% milk fat, 3. 5% protein, 4. 9% lactose, and 0. 7% ash. This composition varies from cow to cow and breed to breed. For example, Jersey cows have an average of 85. 6% water and 5. 15% milk fat. These figures also vary by the season of the year, the animal feed content, and many other factors. Vitamin D concentrate may be added to milk in the amount of 400 international units (IU) per quart. Most low fat and skim milk also has 2,000 IU of Vitamin A added. a) Raw materials required: Milk and water in ratio 1:2 and packing materials ) Sources of supply: Local vendors Near by villages Own cattle farms c) Minimum purchase quantity, lead time, seasonality; Minimum purchase quantity from local vendor is 2 liters Lead time is 1 day Minimum Seasonality variations as milk is commonly used commodity at any period of time. d) Arrangements made for regular supply of the required quantity of raw materials Vans are provided at our cattle firm to transfer milk from firm to production place. Vans are provided at the morning times every day in the villages for collecting milk. 3. 2 Manufacturing ProcessMilk is a perishable commodity. For this reason, it is usually processed locally within a few hours of being collected. In the United States, there are several hundred thousand dairy farms and several thousand milk processing plants. Some plants produce only fluid milk, while others also produce butter, cheese, and other milk products. Dairy cows are milked twice a day using mechanical vacuum milking machines. The raw milk flows through stainless steel or glass pipes to a refrigerated bulk milk tank. Collecting * Dairy cows are milked twice a day using mechanical vacuum milking machines.The raw milk flows through stainless steel or glass pipes to a refrigerated bulk milk tank where it is cooled to about 40à ° F (4. 4à ° C). * A refrigerated bulk tank truck makes collections from dairy farms in the area within a few hours. Before pumping the milk from each farmââ¬â¢s tank, the driver collects a sample and checks the flavor and temperature and records the volume. * At the milk processing plant, the milk in the truck is weighed and is pumped into refrigerated tanks in the plant through flexible stainless steel or plastic hoses. Separating The cold raw milk passes through either a clarifier or a separator, which spins the milk through a series of conical disks inside an enclosure. A clarifier removes debris, some bacteria, and any sediment that may be present in the raw milk. A separator performs the same task, but also separates the heavier milk fat from the lighter milk to produce both cream and skim milk. Some processing plants use a standardizer-clarifier, which regulates the amount of milk fat content in the milk by removing only the excess fat. The excess milk fat is drawn off and processed into cream or butter. Fortifying Vitamins A and D may be added to the milk at this time by a peristaltic pump A clarifier removes debris, some bacteria, and any sediment that may be present in the raw milk. The milk is then fortified and pasteurized. which automatically dispenses the correct amount of vitamin concentrate into the flow of milk. Pasteurizing * The milkââ¬âeither whole milk, skim milk, or standardized milkââ¬âis piped into a pasteurizer to kill any bacteria. There are several methods used to pasteurize milk. The most common is called the high-temperature, short-time (HTST) process in which the milk is heated as it flows through the pasteurizer continuously. Whole milk, skim milk, and standardized milk must be heated to 161à ° F (72à ° C) for 15 seconds. Other milk products have different time and temperature requirements. The hot milk passes through a long pipe whose length and diameter is sized so that it takes the liquid exactly 15 seconds to pass from one end to the other. A temperature sensor at the end of the pipe diverts the milk back to the inlet for reprocessing if the temperature has fallen below the required standard. Homogenizing * Most milk is homogenized to reduce the size of the remaining milk fat particles.This prevents the milk fat from separating and floating to the surface as cream. It also ensures that the milk fat will be evenly distributed through the milk. The hot milk from the pasteurizer is pressurized to 2,500-3,000 psi (17,200-20,700 kPa) by a multiple-cylinder piston pump and is forced through very small passages in an adjustable valve. The shearing effect of being forced through the tiny openings breaks down the fat particles into the proper size. * The milk is then quickly cooled to 40à ° F (4. 4à ° C) to avoid harming its taste. Packaging * The milk is pumped into coated paper cartons or plastic bottles and is sealed.In the United States most milk destined for retail sale in grocery stores is packaged in one-gallon (3. 8-liter) plastic bottles. The bottles or cartons are stamped with a ââ¬Å"sell byâ⬠date to ensure that the retailers do not allow the milk to stay on their shelves longer than it can be safely stored. * The milk cartons or bottles are placed in protective shipping containers and kept refrigerated. They are shipped to distribution warehouses in refrigerated trailers and then on to the individual markets, where they are kept in refrigerated display cases.Cleaning * To ensure sanitary conditions, the inner surfaces of the process equipment and piping system are cleaned once a day. Almost all the equipment and piping used in the processing plant and on the farm are made from stainless steel. Highly automated clean-in-place systems are incorporated into this equipment that allows solvents to be run through the system and then flushed clean. This is done at a time between the normal influx of milk from the farms. Quality Control * The federal Food and Drug Administration (FDA) publishes the Grade AMilk Ordinance which sets sanitation standards for milk production in most states and for all interstate milk shippers. Testing of milk products includes tests for fat content, total solids, pasteurization efficiency, presence of antibiotics used to control cow disease, and many others. The Future The trend to low-fat dairy products over the last 20 years is expected to continue in the future. Sales of butter are expected to decline, while sales of low-fat yogurt and low-or reduced-fat milk are expected to increase. Overall consumption of liquid milk is expected to increase as the population increases. 3. PLANT CAPACITY: | 1st year(litres)| 2nd year(litres)| 3rd year(litres)| 4th year(litres)| Licensed capacity| 10000| 10000| 10000| 10000| Proposed capacity| 5000| 6000| 75000| 10000| 3. 4 LOCATION AND SITE: Procured 2 acres of land at korukonda which is 20 km away from Rajahmundry. LOCATIONAL ADVANTAGES OF THE PROPOSED LOCATION: Location is surrounded by 40 villages from which we can easily procure the milk. The connectivity to various places is easier. 3. 4 INFRASTRUCTURAL FACILITIES: a) Transport facilities: The vehicles required for procurement and distribution of milk depends on the quantity of milk to be handled.The number of vehicles required, source of supply, rental charges etc. need to be furnished. Depending upon the need, the requirement of vehicles may be considered in the project cost. Vehicles provided are vans. b) Utilities:- i)à Power: Normally a three phase electricity supply is required for milk processing plants. The power requirement depends upon the load to be connected and the necessary approval from SEB should be obtained for connection. Depending upon the position of power supply, standby generators may be considered for connecting the essential sections. ii)à Water:A milk processing plant requires the water in the ratio of 2:1 (2 liters of water for 1 liter of milk processed) for cleaning of equipment, cold storage and drinking purposes (source of water supply, quantity available and suitability for the purpose has to be mentioned). Accordingly, the size of the well is required to be designed and depends on the quality of water, the water softening plant may be considered. Easily availability of water as it is nearer to river Godavari. iii)à Steam: The steam requirement (kg/hr) depends upon the processes involved and the source of steam may be met by coal/oil/gas fired / electric boiler; iv)à Fuel:LDO/coal/gas requirement and the availability to be ascertained. v)à Compressed Air: It will be required for various pneumatic operations flow control operations as well as for cleaning purposes. The total requirement of compressed air and the capacity of the compressors is required to be furnished. vi)à Vehicles: The vehicles required for procurement and distribution of milk depends on the quantity of milk to be handled. The number of vehicles required, source of supply, rental charges etc. need to be furnished. Depending upon the need, the requirement of vehicles may be considered in the project cost. ii)à Other Services: Although a maintenance workshop is an integral part of milk processing for carrying out repairs and maintenance of equipment. 3. 6 SCHEDULE OF IMPLEMENTATION: ACTIVITYCOMMENCEDCOMPLETTED ACQUSITION OF LAND23rd august 201015th September 2010 Land development16th September 201025th September 2010 Construction of buildings26th September 201030st November 2010 Procurement of plant and machinery15th November 20105th December 2010 Erection of plant and machinery6th December 20109th December 2010 Trial production15th December 201018th December 2010Commercial production25th December 2010 MAN POWER REQUIREMENT Executive productionno of persons requiredcomments on availability Executives: Production :1 available Marketing :1 available Finance and accounting :1 available General management :1 available Procurement officer : 1 available Supervisory staff : 2 available Skilled worke rs : 5 available Administrative staff :3 available Unskilled workers :8 available Others (watch man) : 3 available Drivers :2 available 4. FINANCIAL FEASIBILITY: g) Fixed capital:Details of fixed assets required for the project: h) Land: Procurring 2 acres of land in korkunda 20kms from Rajahmundry, East Godvari District. Each acre cost 10lacs and the total cost incurred for procuring the land is 20lacs. i) Land Development: entire site should be fenced with barbed wire or compound wall should be constructed with gates. j) Buildings: Factory building: The civil works comprises of factory building, quarters, office, garages, security post etc. The factory building for the milk reception, quality control, processing, packing and storage of milk products should be as per the BIS.The total covered area depends on the processes involved, products manufactured, the quantity of milk handled and the equipment chosen for services and product manufacturing. About 4000 sq. ft. area of building is required for handling 10000 liters of milk. Cost incurred for construction is Rs 7 lack. * Finished stock godown: it is constructed near to plant. Cost incurred for construction is Rs 1 lack. * Office and administrative building: it is constructed nearer to plant. Cost incurred for construction is 2lacks. 4.. 1 Plant and machinery: )| PLANT AND MACHINERY| à Specification| Quantity| à Total cost (lacs)| i)| Can conveying and washing system| ââ¬â| ââ¬â| 2. 23| ii)| Weigh scale| 500 kg| 2| 2. 36| iii)| Dump tank and accessories| 1000 lts| 1| 0. 59| iv)| Detergent tank| ââ¬â| 1| 0. 31| v)| Milk chiller| 3000-5000lph| 1| 0. 97| vi)| Cream Separator| 2000-5000 lph| 1| 5. 7| vii)| Milk pasteurizer| 5000 lph| 1| 17. 82| viii)| Storage tanks| 10,000 lts| 2| 6. 38| ix)| S S tanks| 300 lts| 1| 0. 76| x)| Packaging machine amp; accessories| 2500 pph| 1| 3. 14| xi)| Ghee boiler| 500 kg| 1| 1. 76| xii)| Ghee storage tank| 1000 lts| 1| 0. 9| xiii)| Boiler amp; accessories| 300 kg/h| 1| 5. 46| xiv)| D. G. set| 62. 5KVA| 1| 5| xv)| Refrigeration equipment| ââ¬â| ââ¬â| 15. 21| xvi)| Electrical panels amp; cables| ââ¬â| 1 set| 3. 02| xvii)| Pumps| ââ¬â| 4| 1. 2| xviii)| S S pipes amp; fittings| ââ¬â| ââ¬â| 2| xix)| Erection amp; commissioning| ââ¬â| ââ¬â| 2. 5| | Total| à | à | 84. 38| 4. 2 Miscellaneous fixed assets MISC. FIXED ASSETS| à Particulars| à | No of units| à | i)| Furniture| ââ¬â| ââ¬â| 0. 3| ii)| Computer| Pentium| ââ¬â| 0. 3| iii)| Fire fighting equipment| ââ¬â| ââ¬â| 0. 2| iv)| Collection centre equipment| Centrifuge, butyr. 20| ââ¬â| 0. | v)| Work table| ââ¬â| ââ¬â| 0. 28| vi)| Milk cans| 40 lts (plastic)| 500| 3| vii)| Crate conveying system amp; trolleys| ââ¬â| ââ¬â| 0. 52| viii)| Lab equipment| ââ¬â| ââ¬â| 2. 5| ix)| Effluent treatment plant| ââ¬â| ââ¬â| 3. 25| x)| Water softener| ââ¬â| ââ¬â| 0. 2| | Total| à | à | 12. 35| E)| VEHICLES| à | à à à | à à | i)| Jeep Mahindra| à | 1| 3| ii)| Bajaj ct 100| à | 1| 0. 4| Sr. No. | Particulars| Unit cost| Period days| Years| à | à | à | à | (Rs. )| à | à | à | à | | à | à | à | I| II| III onwards 75%| | à | à | à | 50%| 60%| à | 1| Stock in progress| 7. 8| 1| 0. 39| 0. 46| 0. 585| 2| Packing material| 0. 4| 30| 0. 6| 0. 72| 0. | 3| Chemicals amp; detergents| 0. 07| 30| 0. 105| 0. 126| 0. 157| 4| Stores, spaces and fuel**| à | 30| 0. 399| 0. 408| 0. 405| 5| Finished goods| à | à | à | à | à | | Toned Milk| 15| 1| 0. 75| 0. 9| 1. 12| | Standard Milk| 16| 1| 0. 8| 0. 96| 1. 2| | Cream milk| 15| 1| 0. 75| 0. 9| 1. 12| | à | à | à | à | à | à | | Saleable Cream| 90| 10| 22. 5| 27| 33. 75| | Saleable Ghee| 100| 30| 67. 5| 81| 101. 2| 6| Receivables| à | 7| 3. 2| 3. 4| 4. 2| | Total ( 1 to 6)| à | à | 96. 244| 114. 974| 143. 517| à | Less sundry creditors (days)| à | 7| 10. 23| 13. 45| 15. 23| à | Total working capital required| à | à | 86. 14| 101. 524| 128. 287| à | Margin money @ 25% of working capital| à | à | 21. 5035| 25. 381| 32. 07175| à | Bank Cash credit| à | à | 64. 5105| 76. 143| 96. 21525| à | Interest on working capital @ 16%| à | à | 13. 76224| 16. 24384| 20. 52592| 4. 3 WORKING CAPITAL ASSESSMENT : (Rs. in lakhs) 4. 4 Preliminary amp; Preoperative Expenses Preliminary amp; Preoperative Expenses| à Particulars| à 1st year| à 2nd year| à 3rd year| à | i)| Incorporation of company| 0. 2| à 0| 0| à | ii)| Project preparation| 0. 25| à 0| 0| à | iii)| Market survey| 0. 3| à 0. 5| 0. 6| à | iv)| Establishment ( Salary amp; wages )| 4. 3| à 5. 75| 6. 54à | à | v)| Travelling| 0. 3| à 0. 5| 0. 65| à | vi)| Consultancy| 1| à 0| 0| à | vii)| Administrative expenses| 1| à 1. 5| 1. 8| à | viii)| Interest during construction| 2. 5| à 2. 5| 2. 5| à | à | Total| 9. 38| à 10. 75| à 12. 09| à | H)| CONTINGENCY ( @ 5% of cost of buildings, plant amp; machinery and misc. fixed assets )| à | à | à | à 4. 57| I)| MARGIN MONEY FOR WORKING CAPITAL( 25% of first yearââ¬â¢s requirement ââ¬â statement ââ¬â 2 )| à à | à | à | à 21. 57| 4. 5 PROJECT COST: Particulars| TOTAL COST(in lacs)| Land| 20| Land development| 3| Building| 10| Plant and machinery| 84| Tools and spare parts| 1|Miscellaneous fixed assets| 12. 75| Preliminary and pre operative expenses| 9. 38| Contingency| 4. 57| Margin money for working capital| 21. 23| 4. 6 MEANS OF FINANCING: PARTICULARS| TOTAL (in lacs)| promoters contribution| 50| term loan| 100| Margin money assistance| 25%| Unsecured loans| 0| Total| 150 | 4. 7 PROJECTED PROFITABILITY STATEMENT: INCOME PROJECTIONS| S. No| Particulars| Unit| à | Years| à | | à | à | I| II| III onwards| 1| Milk procured| litres/day| 5000| 6000| 7500| 2| Yield per day| à | à | à | à | i)| Toned milk ( 3% fat )| litres/day| 3250| 3750| 4145| ii)| Standard milk (4. % fat )| litres/day| 1750| 2250| 3355| iii)| Saleable cream ( 25% of iii approx. )| litres/day| 100| 115| 135| iv)| Ghee| kg/day| 142| 169| 206| 3| Income per day| à | à | à | à | i)| Toned milk (Rs. 24. 00 / litre )| Rs. Lakhs| 0. 72| 0. 84| 0. 9948| ii)| Standard milk ( Rs. 26. 00 / litre )| Rs. Lakhs| 0. 39| 0. 455| 0. 728| iii)| Cream ( Rs. 90. 00/ litre)| Rs. Lakhs| 0. 225| 0. 3375| 0. 24975| iv)| Ghee ( Rs. 110. 00/kg)| Rs. Lakhs| 0. 1562| 0. 1859| 0. 2266| 4| Total income/day| Rs. Lakhs| 1. 4912| 1. 8184| 2. 19915| 5| Income per year (1st year for 6 months i. e. 182 days)| Rs.In lakhs| 271. 3984| 330. 9488| 400. 2453| | | | | EXPENDITURE PROJECTIONS S. No| Particulars| Unit| à | YEARS| à | à | à | | I| II| III onwards| 1| Milk processing per year| Thousand litres/day| 5| 6| 7. 5| 2| Raw material ââ¬â milk| Rs. 18/litre| 90| 108| 135| 3| Commission on milk collection| Rs. 1. 0/litre| 5| 6| 7. 5| 4| Transportation charges| Rs. 0. 40. litre| 2| 2. 4| 3| 5| Power and fuel | -| 5. 351| 10. 804| 10. 841| 6| Packing material| Rs. 0. 50. litre| 2. 5| 3| 3. 75| 7| Chemicals ;amp; detergents| Rs. 0. 1. litre| 0. 5| 0. 6| 0. 75| 8| Salaries and wages| à | 17. 733| 19. 492| 23. 674| | Repairs ;amp; maintenance| Rs. 0. 1. litre| 0. 5| 0. 6| 0. 75| 10| Overheads| Rs. 0. 1. litre| 0. 5| 0. 6| 0. 75| 11| Milk distribution cost | ââ¬â| 19. 644| 23. 52| 28. 71| à 12| Total operational cost| Rs. lakhs| 148. 728| 181. 016| 222. 225| | | PROJECTED CASH FLOWS STATEMENT: Sr. No| Particulars| I| II| III| 1| Income (Statement 5)| 271. 3984| 330. 9488| 400. 2453| 2| Operational cost (Statement 6)| 148. 728| 181. 016| 222. 22| 3| Gross operating profit| 122. 6704| 149. 9328| 178. 0253| 4| Less| à | à | à | i)| Interest on term loan @ 16%| 16| 13. 44| 11. 2896| ii)| Interest working capital @ 16%| 13. 6224| 16. 24384| 20. 52592| Iii| Depr. On straight line method| à | à | à | | Land and building| 1. 452| 1. 307| 1. 176| | Plant and machinery| 16. 096| 12. 072| 9. 054| | Misc. fixed assets| 5. 263| 1. 15| 2. 362| iv. | Amortisation of preliminary and preoperative expenses| 0. 215| 0. 215| 0. 215| 5| Profit before tax| 69. 88216| 105. 50496| 133. 40278| 6| Tax at 35%| 24. 458756| 36. 926736| 46. 690973| 7| Net profit| 45. 423404| 68. 578224| 86. 711807| 8| Net income available (7+4)| 98. 211644| 113. 006064| 131. 334327| PROJECTED BALANCE SHEET ASSETS| à 2010| 2011| 2012| Current Assets| à | à | à |Cash| 6| 17| 14| Net accounts receivable| 3. 2| 3. 4| 4. 2| Inventory| 78| 113| 126| Prepaid expenses| 9. 38| 10. 75| 12. 09| Total Current Assets| 96. 58| 144. 15| 156. 29| Fixed Assets| à | à | à | Land and buildings| 33| 32. 6| 31. 3| Plant ;amp; equipment (net)| 84. 38| 68. 34| 56. 25| Miscellaneous fixed assets| 12. 75| 6. 34| 5. 2| Total Net Fixed Assets| 130. 13| 107. 28| 92. 75| TOTAL ASSETS| 226. 71| 251. 43| 249. 04| LIABILITIES| à | à | à | Current Liabilities| à | à | à | Accounts payable| 17. 23| 18. 45| 22. 23| short term loan| 69. 51| 58. 73| 42. 25| Total Current Liabilities| 86. 74| 77. 8| 64. 48| Long-term Liabilities| à | à | à | term loan| 100| 89| 76| Total Long-term Liabilities| 100| 89| 76| SHAREHOLDERSââ¬â¢ EQUITY| à | à | à | Capital stock| 40| 40| 40| Retained earnings| 0| 45. 23| 68. 57| Total Shareholdersââ¬â¢ Equity| 40| 85. 23| 108. 57| TOTAL LIABILITIES ;amp; EQUITY| 226. 74| 251. 41| 249. 05| FINANCIAL PARAMETERS: a) Promoters contribution: 0. 28% b) Debt service coverage ratio: DSCR = (Annual Net Income + Amortization/Depreciation + other non-cash and discretionary items (such as non-contractual management bonuses)) / (Principal Repayment + Interest payments + Lease payments)Debt Service Coverage Ratio = 1. 526209183 A DSCR of less than 1 would mean a negative cash flow. Typically, most commercial banks require the ratio of 1. 15 ââ¬â 1. 35 times (net operating income or NOI / annual debt service) to ensure cash flow sufficient to cover loan payments is available on an ongoing basis. c) Break even point: Break even point = fixed cost/ contribution Fixed Cost: Interest on term loan @ 16%| 16| Interest working capital @ 16%| 13. 76224| Depr. On straight line method| à | Land and building| 1. 452|Plant and machinery| 16. 096| Misc. fixed assets| 5. 263| Amortisation of preliminary and preoperative expenses| 0. 215| fixed cost| 52. 78824| Net income available (7+4)| 98. 21164| Break even point = (fixed cost/ fixed cost+ profit)*100 =(52. 78824/52. 78+45. 42)*100 =34. 95% d) Return on investment: Return on investment = net profit per year *100/ total investment =45. 42*100/ 140 = 32% Bibliography 1. Project management ââ¬â Samuel 2. Project Appraisal and financing ââ¬â K R Sharma 3. www. nabard. com How to cite Project Appraisal of Dairy Firm, Papers
Monday, April 27, 2020
Patient Confidentiality
The Issue It is the duty of healthcare providers to sustain the confidentiality of their patients. However, healthcare practitioners face a huge workload and sometimes find themselves taking part in discussions about their patients. The code of ethics for all healthcare practitioners prohibits any discussion on the healthcare of patients without their knowledge. Today, there are new technologies that enable people to engage in conversations without physically being close to one another.Advertising We will write a custom research paper sample on Patient Confidentiality specifically for you for only $16.05 $11/page Learn More Such technologies include social networking tools like Facebook and Twitter that allow two or more people to have a conversation and share multimedia content. The presence and ease of access of such social networking tools make it possible for healthcare practitioners to ease their workload pressures by instantly connecting to their s ocial circles. Unfortunately, the solution does not come without drawbacks. Leach (2009) reports in the Telegraph that out of 78 US medical schools, more than half had cases of students sharing information online in an unprofessional way. Moreover, the Telegraph report indicates that the number of guileless violations falls within the ratio of one for every ten students. The main online forums that medical students used to share content unprofessionally were blogs and the social networking site, Facebook. According to the article, violations reported were in the form of profanity and the use of discriminatory language while describing patients or their conditions. Additionally, the report notes that the medical students behaved in a conduct that could not be justified given the fact that they were training to become physicians. Impact Behaviors such as being frequently drunk and disorderly contributed largely to the violation of patientââ¬â¢s trust and public trust in the medical students and the healthcare profession in general. Most of the information posted online breached doctor-patient agreement or expectation on confidentiality. Because of the violations of patient confidentiality, students receive informal warnings and when the violations become serious, medical schools have no other choice but to dismiss the particular students. Arguments and Facts Used in the Article to Support Solution The article indicates that it is important to instill the discipline expected of a medical practitioner to students. Therefore, medical students need to know practically the disadvantages and consequences of being careless with the information they give out while contributing to social conversations. Additionally, students need to be extra careful when using online media to communicate because the internet exponentially increases the speed and access to information. The article indicates that a possible cause of the high number of student misconduct cases is a resul t of the lack of sound policies that cover engagements in social network and blogging services online (Leach, 2009).Advertising Looking for research paper on health medicine? Let's see if we can help you! Get your first paper with 15% OFF Learn More Ethical and legal issues reported The Telegraph article, discussed above, points out ethical misgivings that include the failure to ask for the patientââ¬â¢s permission before disclosing their status to other persons. Medical practitioners abide by the oath of Hippocrates that simply states that they should not speak of anything that they see or hear in the lives of their patients that is not acceptable. The US law protects a patientââ¬â¢s confidentially through the Health Insurance Portability and Accountability Act (HIPAA). Under this law, medical practitioners and mostly physicians have to abide by requirements that regulate the handling and disclosure of patientââ¬â¢s health information transactions and their confidentiality. Moreover, the law protects a patientââ¬â¢s data through a number of guidelines directly related to the daily workings of a physician. The human rights act also assures everyone of respect to their personal lives together with their homes and correspondence (The UK Ethics Network, n.d.). An Explanation of Managerial Responsibilities Physicians have a responsibility of using resources, supervising or leading teams and working in managed systems in various institutions. Practically, all practicing physicians act as managers in their respective capacities. Healthcare managers have the responsibility of raising concerns in public community risks only after they have done the same within their organizations without finding a solution. However, this does not absolve them of their responsibility of not breaching patient confidentiality. Therefore, it is important that practitioners keep abreast with new ethical and legal requirements regarding patient confidentiality. He althcare institutions have to manage patient confidentiality properly by using well-structured systems. The systems should follow the law requirements of storing, using and disclosing patient confidential information. Likewise, institutions need record managers with the adequate training needed to provide data protection. These record managers do not work in isolation; they need adequate support and cooperation that will allow them to perform as required. Other than record managers, staff having access to patient records should also have a proficient training on discretion and decent record keeping (General Medical Council, 2006). Lastly, staff contracts need to state explicitly the importance of respecting and maintaining patient confidentiality. Generally, a medical practitioner should listen to patients and respect their personal health views. In addition, patientââ¬â¢s descriptions handling should be serious and the feedback provided to the patient should be in an understanda ble way. When patients complain, they should receive a prompt answer form their physician. Additionally, the answer should be frank and beneficial. A proper way to manage patient information would be to make timely reports for the organization, which may be shared with other relevant bodies. This ensures that any blame arising shifts away from the practitioner after the resolution of the case.Advertising We will write a custom research paper sample on Patient Confidentiality specifically for you for only $16.05 $11/page Learn More Proposed Solutions A possible solution to the studentsââ¬â¢ case of breaching patient confidentiality would be to introduce safeguards on Clinical Data Management (CDM) systems to prevent leak of information. The law needs amending to include harsh penalties even for student doctors as a way to instill the discipline of respecting patient confidentiality. One major form, in which patient confidentiality breaches occur, is t hrough negligence of other structures necessary for guaranteeing it. One such case is on patient privacy. When patient privacy structures have a poor implementation record in an institution, likely due to lack of dedicated resources, then patient confidentiality tends to suffer (Manning, n.d.). In the studentsââ¬â¢ case, outlined in this essay, Leach (2009) reports that most of the medical schools covered in the study did not have any policy covering the use of blogging and social media networks online. This is an example of a case where the disregard of patientââ¬â¢s privacy has negative externalities to patient confidentiality. If the medical schools had policies protecting patient privacy by restricting the use of online media and other channels of communication, then incidences of student breach of patient confidentiality would not be as high as reported. It is important to strengthen warnings against breach of patient confidentiality by having robust systems. To sum up, p atient confidentiality is a fundamental requirement of patient-physician relationships. Medical practitioners have an ethical and legal obligation to adhere to patient confidentiality. Each practitioner assumes managerial responsibilities for their departments, teams or institutions. Having a well-structured system allows these practitioners to fulfill their responsibilities easily. References General Medical Council. (2006). Management for doctors ââ¬â guidance for doctors. Web. Leach, B. (2009, September 24). ââ¬ËTweetingââ¬â¢ breaches patient confidentiality. Web.Advertising Looking for research paper on health medicine? Let's see if we can help you! Get your first paper with 15% OFF Learn More Manning, W. L. (n.d.). Privacy and confidentiality in clinical data management systems: why you should guard the safe. Web. This research paper on Patient Confidentiality was written and submitted by user Jackal to help you with your own studies. You are free to use it for research and reference purposes in order to write your own paper; however, you must cite it accordingly. You can donate your paper here.
Thursday, March 19, 2020
The Science Behind Fog
The Science Behind Fog Fog is considered a low cloud that is either close to ground level or in contact with it. As such, it is made up of water droplets that are in the air like a cloud. Unlike a cloud, however, the water vapor in fog comes from sources close to the fog like a large water body or a moist ground. For example, fog usually forms over the city of San Francisco, California during the summer months and the moisture for that fog is produced by the cool ocean waters that are nearby. By contrast, moisture in a cloud is gathered from large distances that are not necessarily near where the cloud forms. Formation of Fog Like a cloud, fog forms when water evaporates from a surface or is added to the air. This evaporation can be from the ocean or another body of water or moist ground like a marsh or a farm field, depending on the type and location of the fog. As the water begins to evaporate from these sources and turn into water vapor it rises into the air. As the water vapor rises, it bonds with aerosols called ââ¬â¹condensation nuclei (i.e. small dust particles in the air) to form water droplets. These droplets then condense to form fog when the process occurs close to the ground. There are, however, several conditions that need to first occur before the process of fog formation can be complete. Fog usually develops when relative humidity is near 100% and when the air temperature and dew point temperature are close to one another or less than 4ÃÅ¡F (2.5ÃÅ¡C). When air reaches 100% relative humidity and its dew pointà it is said to be saturated and can thus hold no more water vapor. As a result, the water vapor condenses to form water droplets and fog. Types of Fog There are various types of fog that are categorized based on how they form. The two main types though are radiation fog and advection fog. According to the National Weather Service, radiation fog forms at night in areas with clear skies and calm winds. It is caused by the rapid loss of heat from the Earths surface at night after it was gathered during the day. As the Earths surface cools, a layer of moist air develops near the ground. Over time the relative humidity near the ground will reach 100% and fog, sometimes very dense forms. Radiation fog is common in valleys and often when the fog forms it remains for long periods when winds are calm. This is a common pattern seen in Californias Central Valley. Another major type of fog is advection fog. This type of fog is caused by the movement of moist warm over a cool surface like the ocean. Advection fog is common in San Francisco and it forms in the summer when warm air from the Central Valley moves out of the valley at night and over the cooler air over the San Francisco Bay. As this process occurs, the water vapor in the warm air condenses and forms fog. Other types of fog identified by the National Weather Service include upslope fog, ice fog, freezing fog,ââ¬â¹ and evaporation fog. Upslope fog occurs when warm moist air is pushed up a mountain to a place where the air is cooler, causing it to reach saturation and the water vapor to condense to form fog. Ice fog develops in the Arctic or Polar air masses where the air temperature is below freezing and is composed of ice crystals suspended in the air. Freezing fog forms when the water droplets in the air mass become supercooled. These drops remain liquid in the fog and immediately freeze if they come into contact with a surface. Finally, evaporation fog forms when large amounts of water vapor are added to the air through evaporation and mixes with cool, dry air to form fog. Foggy Locations Because certain conditions must be met for the fog to form, it does not occur everywhere, however, ââ¬â¹there are some locations where fog is very common. The San Francisco Bay Area and Central Valley in California are two such places, but the foggiest place in the world is near Newfoundland. Near Grand Banks, Newfoundland a cold ocean current, the Labrador Current, meets the warm Gulf Stream and fog develops as the cold air causes the water vapor in the moist air to condense and form fog. In addition, southern Europe and places like Ireland are foggy as is Argentina, the Pacific Northwest, and coastal Chile.
Tuesday, March 3, 2020
3 Top Tips for a Stand-Out Cornell Essay
3 Top Tips for a Stand-Out Cornell Essay SAT / ACT Prep Online Guides and Tips Cornell admits just under 12.5% of their total applicant pool every year. In order to be one of them, you need to write amazing Cornell essays as part of your Cornell University application. In this article, weââ¬â¢ll outline the different types of essays you need to write for your Cornell University application and teach you how to write a Cornell supplement essay that will help you stand out from the thousands of other applicants. What Are the Cornell Essay Prompts? You only have to answer one Cornell supplement essay prompt as part of your application. Yay! Donââ¬â¢t get too excited though, because this one essay carries a lot of weight. The word limit is on the longer side (650 words) and the topic depends on which school youââ¬â¢re applying to. Cornell University consists of many smaller colleges, each with their own required Cornell supplement essay example. Your Cornell essay prompt will correspond to the school that you plan to study at, so give your future as a Cornell student some thought before you start writing. Be sure to write about the subject or area of study that you are currently interested in, even if that may change when you get to college. As with all college admissions essays, authenticity is key. You may have myriad scholastic interests, but for this essay, stick with what you know best and are most passionate about. Your potential topic must correspond with the areas of study at the college, too. The Cornell essay prompts give ample space for you to express yourself and reveal a more complete portrait of who you are as a student and human simply because of the word limit. You can say a lot in 650 words - so take advantage of it! Want to get into Cornell or your personal top choice college? We can help. PrepScholar Admissions is the world's best admissions consulting service. We combine world-class admissions counselors with our data-driven, proprietary admissions strategies. We've overseen thousands of students get into their top choice schools, from state colleges to the Ivy League. Learn more about PrepScholar Admissions to maximize your chance of getting in. 2018-19 Cornell Supplement Essay Questions Here are the essays and instructions as shown on the Cornell University admissions website: College Interest Essays The primary focus of your college interest essay should be what you intend to study at Cornell. In the online Common Application Writing Supplement, please respond to the essay question below (maximum of 650 words) that corresponds to the undergraduate college or school to which you are applying. College of Agriculture and Life Sciences: Why are you drawn to studying the major you have selected? Please discuss how your interests and related experiences have influenced your choice. Specifically, how will an education from the College of Agriculture and Life Sciences (CALS) and Cornell University help you achieve your academic goals?â⬠¯ College of Architecture, Art, and Planning: What is your ââ¬Å"thingâ⬠? What energizes you or engages you so deeply that you lose track of time? Everyone has different passions, obsessions, quirks, inspirations. What are yours?â⬠College of Arts and Sciences: Students in Arts and Sciences embrace the opportunity to delve into their academic interests, discover new realms of intellectual inquiry, and chart their own path through the College. Tell us why the depth, breadth, and flexibility of our curriculum are ideally suited to exploring the areas of study that excite you. Cornell SC Johnson College of Business: Charles H. Dyson School of Applied Economics and Management: Affiliated with both the Cornell SC Johnson College of Business and the College of Agriculture and Life Sciences, The Charles H. Dyson School of Applied Economics and Management is unique by design. Explain how our approach to business education is the right fit for you, and how your interests, experiences or goals will contribute to the unique composition of the entering class. Cornell SC Johnson College of Business: School of Hotel Administration (SHA): The global hospitality industry includes hotel and foodservice management, real estate, finance, entrepreneurship, marketing, technology, and law. Describe what has influenced your decision to study business through the lens of hospitality. What personal qualities make you a good fit for SHA? College of Engineering: Cornell Engineering celebrates innovative problem-solving that helps people, communitiesâ⬠¦ the world. Consider your ideas and aspirations and describe how a Cornell Engineering education would allow you to leverage technological problem-solving to improve the world we live in. College of Human Ecology: How have your experiences influenced your decision to apply to the College of Human Ecology? How will your choice of major impact your goals and plans for the future? School of Industrial and Labor Relations: Tell us about your intellectual interests, how they sprung from your course, service, work or life experiences, and what makes them exciting to you. Describe how ILR is the right school for you to pursue these interests. Cornell Supplement Essays Analyzed In this section, weââ¬â¢ll take a look at each Cornell supplemental essay prompt in depth. Remember, you may only answer one prompt for your application. We'll also give tips for how to best approach answering the individual essay questions. Some tips will apply to all of the questions, but we will highlight the important differences for each program. College of Agriculture and Life Sciences Why are you drawn to studying the major you have selected? Please discuss how your interests and related experiences have influenced your choice. Specifically, how will an education from the College of Agriculture and Life Sciences (CALS) and Cornell University help you achieve your academic goals?â⬠¯ The College of Agriculture and Life Sciences asks you to have an idea of your major as you apply. In your essay, you should commit to one major and be specific about why it's important to you. Choose a topic of genuine interest to you and that you have a personal connection with, even if that personal connection consists solely of articles youââ¬â¢ve read and documentaries youââ¬â¢ve seen. Do your research about the topic and the school. Dedicate some time to reading about the Cornell College of Agriculture - its history, its current faculty and its notable alumni. Is there anyone from your research who you can relate to? Who you think of as inspiring? Are there professors whom you are looking forward to working with? Lean into the schoolââ¬â¢s reputation and choose something specific to write about that has a personal connection to you. For example, instead of writing about homesteading trends across the country, write about a local farm in your area that you visited as a child or how you got interested in food science. You could also write about your personal connection to a specific project of a professor who teaches in the Cornell School of Agriculture and Life Sciences. College of Architecture, Art, and Planning What is your ââ¬Å"thingâ⬠? What energizes you or engages you so deeply that you lose track of time? Everyone has different passions, obsessions, quirks, inspirations. What are yours? The essay from the College of Architecture, Art, and Planning offers a fun essay topic... so have fun with it! You don't have to feel limited to purely scholastics interests here. Think about what you learn about or engage with of your own volition, not just because you're required to. In other words, when you fall down an Internet rabbit hole, what are you often researching? Feel free to pull examples from pop culture, history, science, math... anything! Remember, the prompt asks about passions, as well as quirks. Don't feel embarrassed! Share something personal about yourself. Maybe you love watching old cinema or make your own pop-up cards for your family. Maybe you watch hundreds of hours of videos from YouTube photographers. Maybe you visit the City Hall of whatever new town you visit. Whatever you choose, make sure you elaborate on why you're interested in it and how its affected your life. College of Arts and Sciences Students in Arts and Sciences embrace the opportunity to delve into their academic interests, discover new realms of intellectual inquiry, and chart their own path through the College. Tell us why the depth, breadth, and flexibility of our curriculum are ideally suited to exploring the areas of study that excite you. The College of Arts and Sciences is the least specific school of study at Cornell University, and the admissions essay reflects that. If you know you love to learn, but arenââ¬â¢t sure what your career will look like after college, itââ¬â¢s likely youââ¬â¢ll be applying here. Donââ¬â¢t be fooled! Just because the question is broad, you donââ¬â¢t have to write a broad essay in response. Donââ¬â¢t feel like you have to demonstrate an interest in both Russian literature and molecular biology. Rather, describe your real intellectual pursuits with honesty and sincerity. You donââ¬â¢t have to have huge aspirations or a fancy reason for your intellectual pursuits. Stay true to yourself. If youââ¬â¢re interested in Elizabethan history because of some historical fiction novels you read as a child, thatââ¬â¢s fine! You can totally say that. Just be sure to tie it back to how Cornellââ¬â¢s academics let you study your passion. If you feel you have multiple areas of study that you are passionate about, you may write about them - but donââ¬â¢t write about more than two or three at the most. Otherwise, your essay will feel more like a list, rather than an in-depth exploration of your actual interests. If you do choose to write about multiple interests, be sure to connect them back to you and your individual experience as a Cornell student and community member. Cornell SC Johnson College of Business Charles H. Dyson School of Applied Economics and Management: Affiliated with both the Cornell SC Johnson College of Business and the College of Agriculture and Life Sciences, The Charles H. Dyson School of Applied Economics and Management is unique by design. Explain how our approach to business education is the right fit for you, and how your interests, experiences or goals will contribute to the unique composition of the entering class. This prompt is a gift: they are telling you exactly what to write. Do not guess here. Research the program so that you know exactly what their approach to business education is and how it differs from other programs. The question provides you with a thesis: explain why the program is the right fit for you and why you are a good fit for the program. Follow it! Your essay should indicate why you want to attend Cornellââ¬â¢s school of business, rather than any other. Do some research on what makes Cornellââ¬â¢s business college stand out from others. You can list specific classes youââ¬â¢d like to take or professors youââ¬â¢d like to study with. Doing so will show that youââ¬â¢re interested in Cornell, not just any old business school. Cornell School of Hotel Administration (SHA) The global hospitality industry includes hotel and foodservice management, real estate, finance, entrepreneurship, marketing, technology, and law. Describe what has influenced your decision to study business through the lens of hospitality. What personal qualities make you a good fit for SHA? The Johnson College of Business prompt may also seem broad and easy to answer in a general way - do not be fooled! As with all good college essays, it is crucial that you answer this prompt with as much specificity as you can muster. If youââ¬â¢re having trouble coming up with a topic, use the list of global hospitality industry topics as a jumping off point. Why are you interested in marketing? What experience do you have in hotel or foodservice management? Why do you care so much about these topics? When writing about your personal qualities that make you a good fit for the program, donââ¬â¢t describe yourself using only adjectives and generalizations. Instead, use stories, anecdotes and experiences from your life that actually happened and that show your personality traits. Follow that old grade school writing rule: show, donââ¬â¢t tell. Demonstrate your personal qualities through examples, rather than just stating them. College of Engineering Cornell Engineering celebrates innovative problem-solving that helps people, communitiesâ⬠¦ the world. Consider your ideas and aspirations and describe how a Cornell Engineering education would allow you to leverage technological problem-solving to improve the world we live in. This essay seeks to understand why you want to study engineering. Donââ¬â¢t just say that you want a steady job after graduation. Cornellââ¬â¢s College of Engineering wants to see that you have both ambition and interesting ideas. Consider how engineers solve challenges. What challenges do you care about in your community? In the world? How could your work as an engineer help solve these problems? Itââ¬â¢s important to write about issues that youââ¬â¢re passionate about. If you donââ¬â¢t care about climate change, donââ¬â¢t write about how you want to create clean energy solutions. Focus on issues that youââ¬â¢re truly interested in. Before you start writing, consider the prompt. That is not to say that you should garble your essay with too many topics to have a specific direction. Instead, pick a direction, a thesis, and use the various topics listed in the question as an outline for how to write your essay with appropriate supporting topics. College of Human Ecology How have your experiences influenced your decision to apply to the College of Human Ecology? How will your choice of major impact your goals and plans for the future? This essay prompt gives you lots of room for creativity. That being said, heed this caveat: donââ¬â¢t get carried away in stating your grandiose mission for solving the worldââ¬â¢s problems. As with the other essay prompts, specificity is key. Choose an example from your life to illustrate your answer to the question. Pick something that has truly been formative in your educational and professional goals, dive in deep, and write from the heart. For example, if youââ¬â¢re interested in studying Policy Analysis and Management, you could talk about how your experience with social welfare programs has affected your life. Or, if youââ¬â¢re looking to be part of the Fiber Science Apparel Design program, you could talk about why clothing has played such an important part in your life and your passion for fashion design. Be sure to include your future goals in your answer. The College of Human Ecology has a very specific focus - youââ¬â¢ll want to reflect that in what you write about. School of Industrial and Labor Relations Tell us about your intellectual interests, how they sprung from your course, service, work or life experiences, and what makes them exciting to you. Describe how ILR is the right school for you to pursue these interests. This essay is a great opportunity to show off your academic side. You get to write about your topics of study and describe how you will continue to make it a part of your life in your college career and beyond. You donââ¬â¢t have to limit your answer to school experiences. Academic pursuits can grow from hobbies, travels, or personal experiences. Do you take on leadership roles in your religious community? Have you had a particularly influential summer job? As long as you relate the experience back to academics you are golden. You should also specify what ILR is the right college at Cornell for you to pursue these interests. What can you study at ILR that you canââ¬â¢t study in Cornellââ¬â¢s other colleges, such as the College of Arts and Sciences? It can be helpful to list specific courses or tracks of study at ILR that reflect your intellectual interests. Remember, the prompt specifically asks why ILR is your Cornell college of choice. How to Write a Great Cornell Essay Regardless of which Cornell essay prompt youââ¬â¢re responding to, you should keep in mind the following tips for how to write a great Cornell essay. #1: Use Your Own Voice The point of a college essay is for the admissions committee to have the chance to get to know you beyond your test scores, grades, and honors. Your admissions essays are your opportunity to make yourself come alive for the essay readers and to present yourself as a fully fleshed out person. You should, then, make sure that the person youââ¬â¢re presenting in your college essays is yourself. Donââ¬â¢t try to emulate what you think the committee wants to hear or try to act like someone youââ¬â¢re not. If you lie or exaggerate, your essay will come across as insincere, which will diminish its effectiveness. Stick to telling real stories about the person you really are, not who you think Cornell wants you to be. #2: Avoid Cliches and Overused Phrases When writing your Cornell essay, try to avoid using cliches or overused quotes or phrases. These include quotations that have been quoted to death and phrases or idioms that are overused in daily life. The college admissions committee has probably seen numerous essays from students who have grand plans to change the world. Only talk about changing the world if you have legitimate interests to back it up. Strive for originality and avoid using cliches, which take away from the strength and sincerity of your work. #3: Check Your Work It should almost go without saying, but you want to make sure your Cornell essay is the strongest example of your work possible. Before you turn in your Cornell application, make sure to edit and proofread your essays. Your work should be free of spelling and grammar errors. Make sure to run your essays through a spelling and grammar check before you submit. Itââ¬â¢s a good idea to have someone else read your Cornell essay, too. You can seek a second opinion on your work from a parent, teacher, or friend. Ask them whether your work represents you as a student and person. Have them check and make sure you havenââ¬â¢t missed any small writing errors. Having a second opinion will help your work be the best it possibly can be. Recap: Writing a Stellar Cornell Essay The Cornell essay prompts give you a chance to really show the admissions committee who you are. Regardless of the question youââ¬â¢re answering, remember to follow these basic dos and donââ¬â¢ts as youââ¬â¢re writing: DO Be authentic and honest. Be specific when citing people, places and things. Strive for brevity and clarity; less is more! Be yourself, and do your research - both will shine through in your essays! DONââ¬â¢T Base your essays on what you think the Cornell application committee wants to hear. Use cliches or broad sweeping statements. Try too hard to be funny and original. Be genuine and your positive attributes will be visible to the committee. Whatââ¬â¢s Next? Are youworking onthe Common App essayas part of your application? Read ourbreakdown of the Common App promptsand our guide topicking the best prompt for you. If you'replanning to take the SAT or ACT as part of your application, try out some of our famous test prep guides, like"How to Get a Perfect Score on the SAT"and"15 Key ACT Test Day Tips." Want to write the perfect college application essay? Get professional help from PrepScholar. Your dedicated PrepScholar Admissions counselor will craft your perfect college essay, from the ground up. We'll learn your background and interests, brainstorm essay topics, and walk you through the essay drafting process, step-by-step. At the end, you'll have a unique essay that you'll proudly submit to your top choice colleges. Don't leave your college application to chance. Find out more about PrepScholar Admissions now:
Sunday, February 16, 2020
Assessment Essay Example | Topics and Well Written Essays - 500 words - 9
Assessment - Essay Example Frustrating sights from yellow leaves bring disbelieve as pest and disease had invaded the some trees and spreading to others. With time, the leaves wither and fall forming a carpet of dry and crusty leaves as some trees succumb and dry up. Additionally, gusty whirlwinds introduce flames of withering serenity while carrying everything to the sky. My choice for this description paper is Pillsbury Crossing. It was with joy that I wrote about this amazing place that offered numerous positives and negatives and a mix of numerous first impressions. Whereas peacefulness and calmness were striking features of the floodplain, the nature parkââ¬â¢s beauty is under threat from human activities (Stokes n.p). My first sentence explained the mood of the entire paragraph. The sentence ââ¬Ënatureââ¬â¢s language whispers in my earsââ¬â¢ emphasize the calmness and quietness one finds in this place. Amidst the quietness is harmony from water, birds, and the wind working in inadvertent harmony. Contrasting this harmony is ââ¬Å"grief has had her way hereâ⬠. The introduction of grief presents an unpleasant tone. However, without the grief the nature would lose its relevance. Defining the tone was a daunting task, but with the tone defined, I identified and chose the right words to use. I was careful to adhere to the intended mood of the description. I defined the atmosphere as filled with ââ¬Å"gentle harmonious tunes making it pleasant. For a person who has never been to Pillsbury Crossing, the words are compelling and it would prompt plans for a visit. However, the ââ¬Å"frustrating sightsâ⬠from my negative description reveal the ambiance as under attack by harmful and cruel elements. I also describe leaves. The positive description acknowledges them for their ââ¬Å"attractive amber, crimson, gold, and ochre hues.â⬠Conversely, the leaves die after ââ¬Å"fallingâ⬠to form a leave carpet on the ground. Similes and metaphors satisfactorily created numerous
Sunday, February 2, 2020
Law for Accounting coursework question Essay Example | Topics and Well Written Essays - 4000 words
Law for Accounting coursework question - Essay Example Moreover, Serenaââ¬â¢s offer had indicated that only bids over ?20,000 would be accepted. The first issue is whether there was an offer and acceptance. Serena made the offer, however, Eric, by stating that he would buy the Galileo at ?19,500 instead of the ?20,000 that Serena was asking for, effectively made a counteroffer.1 The reason for this is the ââ¬Å"mirror image rule.â⬠This rule states that an unequivocal acceptance must mirror the offer exactly ââ¬â any deviation made by the offeree to the offeror would therefore be considered to be a counteroffer. At this point, therefore, it was up to Serena to accept Ericââ¬â¢s offer, as Eric did not offer an unequivocal, mirror image acceptance of Serenaââ¬â¢s terms. However, one can state that Serena was not really making a valid offer with her advertisement, as she indicated that she would consider all offers higher than ?20,000. She did not state that the highest bid would be the winner, so to speak, but, rather, o nly indicated that she would consider any and all bids above the threshold number. The courts would state that this was not really an offer at all, but an invitation to treat. An invitation to treat is an invitation for bids. This is similar to the case of Spencer v. Harding (1870) LR 5 CP 561. This case involved the following offer: ââ¬Å"28, King Street, Cheapside, May 17th, 1869. ... Milk Street, up to Thursday, the 20th instant, on which day, at 12 o'clock at noon precisely, the tenders will be received and opened at our offices. Should you tender and not attend the sale, please address to us sealed and inclosed, 'Tender for Eilbeck's stock.' Stock-books may be had at our offices on Tuesday morning. Honey, Humphreys, & Co.â⬠2 The court held that this was not a valid offer, but, rather, an invitation for bids. The wording in the offer in Spencer is similar to the wording in the case at bar, therefore, there probably was not a valid offer made by Serena for the Galileo. That said, when Eric made his statement on the answering machine, this would be an offer. As indicated above, when Eric made his statement on the answering machine, the ball was effectively in Serenaââ¬â¢s court, and she could either accept Ericââ¬â¢s offer or not. The question is whether Serena did accept the offer. She finally called Eric in January, after having made the original offe r in December, and Eric had made the counteroffer in that same month. Both parties knew that Eric wanted the dress for his girlfriendââ¬â¢s birthday. Serena might have known when Ericââ¬â¢s girlfriendââ¬â¢s birthday was, as Eric is her brother. Regardless, when Ericââ¬â¢s girlfriendââ¬â¢s birthday came and went, the doctrine of frustration of purpose might apply here. Frustration of purpose is ââ¬Å"Where, after a contract is made, a party's principal purpose is substantially frustrated without his fault by the occurrence of an event the non-occurrence of which was a basic assumption on which the contract was made, his remaining duties to render performance are discharged, unless the language or circumstances [of the contract] indicate the contrary.â⬠3 The leading case in English law is that of Krell v Henry [1903]
Saturday, January 25, 2020
The Benefits Of A Pacemaker
The Benefits Of A Pacemaker What is a Pacemaker? An artificial pacemaker is an electronic medical device which is used to treat abnormalities in the rhythm of the human heart. These devices are used internally inside the body, are usually small and implanted into the chest. The pacemaker provides electrical impulses that allow the heart to beat at its normal rate, if the heart were not able to do so by itself. Reason for the need of a pacemaker A pacemaker is used to treat arrhythmias. Arrhythmias are problems or abnormalities in the rhythm of the heartbeat. These problems or abnormalities include an irregular heartbeat, the rate of the heartbeat being too slow or the rate of the heartbeat being too fast. Arrhythmias are a severe condition which causes shortness of breath, fatigue and fainting. It can also lead to serious damage of bodily organs or even death if not treated properly. However these problems can easily be solved with the implementation of a pacemaker. A pacemaker can allow a person with these problems to lead a normal and active lifestyle relieving them of fatigue and fainting. How an artificial pacemaker functions The pacemaker is run on batteries and delivers electrical impulses through electrodes, which are connected to the cardiac muscle to regulate the beat of the heart. These electrical impulses regulate the heart beat and maintain the correct rhythm of the heart. The leads which connected between the pacemaker and the heart send electrical signals back and forth and sense when the heart needs some sort of treatment. When it requires treatment, the heart will receive an impulse from the device to correct the problem. Human Pacemaker Within the cardiovascular system there are electrical events which cause the contraction and relaxation of the muscles in the heart. The cells of cardiac muscle can be classified as either non-pacemaker cells or pacemaker cells in terms of electrical activity. It is the pacemaker cells that create the impulses and control the heart rate. The pacemaker cells lie within the sinoatrial (SA) node. This node can be found in the wall of the right atrium. These pacemaker cells cause spontaneous depolarizations which generate action potentials that determine the heart rate under normal physical conditions. Pacemaker cells can also be found at the atrioventricular (AV) node, which lies within the ventricular walls. It is the SA node that generally generates the hearts electrical impulses and is the reason it is usually called the pacemaker, but if the SA node were not to function or if it was blocked on its path, it would be the AV node that would generate the heart beat and become the new pacemaker. The failure of the function of these cells results in irregular and abnormal heartbeats which require correction. The artificial pacemaker can provide this correction with its own electrical impulses. Diseases Related to pacemaker Arrhythmias Arrhythmias or cardiac dysrhythmia is the condition in which the electrical activity in the heart is abnormal. The pacemaker is used to treat this condition if the heart is beating too fast, too slow or if the heart is beating irregularly. The heart normally beats between 60 to 100 beats per minute, however different types of arrhythmias can cause the heart to beat below or above this rate. Bradyarrhythmias causes the heart to beat below 60 beats per minute, tachyarrhythmias causes the heart to beat above 100 beats per minute. Causes of Arrhythmias There are many causes of arrhythmias occurring, which include: Injury caused by a heart attack. Injury during healing after heart surgery. Coronary artery disease. A change in the cardiac muscle in the heart. An imbalance of sodium or potassium in the blood which causes electrolyte imbalances. Symptoms of Arrhythmias Many symptoms can arise because of arrhythmias. Chest pains, shortness of breath, dizziness, fainting, fatigue, and palpitations of the heart are all common problems associated with arrhythmias, but if left untreated the problems may become much more severe and may even lead to death. However an arrhythmia may also be silent and a patient may be unaware of this condition as none of the symptoms listed may have occurred. A doctor can detect an arrhythmia with a regular physical examination using an electrocardiogram which measures the pulse of the heart. Any complications in the rhythm of the heart will become apparent and will indicate if a pacemaker is required. Types of Arrhythmias As mentioned already arrhythmias can be described as either bradyarrhythmias (heart rate too slow) or tachyarrhythmias (heart rate too fast). Bradyarrhythmias results in a heart rate lower than 60 beats per minute, the different types include sinus node dysfunction and heart blocks. Sinus node dysfunction results in slow rhythm as the heart beats because of an abnormal sinus node (SA). Heart block results in delaying or blocking the electrical impulses which travel from the sinus node to the ventricles. A pacemaker can be used to treat both of the these conditions Tachyarrhythmias results in a heart rate higher than 100 beats per minute, the different types of this condition include atrial premature beats, atrial flutter, paroxysmal tachycardias, ventricular premature beats, ventricular tachycardia, and ventricular fibrillation. Atrial premature beats are earlier than expected extra beats which come from the atria. These do not require treatment. Atrial flutter is rapid appearing atrial activity. This can cause rates of 250 300 bpm and is most common after heart surgery. Atrial fibrillation is a common irregular heart rhythm. It causes the atria to contract abnormally. Paroxysmal tachycardis results in a rapid heart rate between 140 and 250 bpm originating from above the ventricles. Ventricular premature beats are unexpected beats from the ventricles. Ventricular tachycardia is a series of three or more ventricular premature beats in a row. Ventricular fribrillation is the most life threatening type of arrhythmia which results in disorded erratic impulses of the ventricles because the ventricles are unable to contract. Invention of the Pacemaker Who invented the first pacemaker? The first artificial pacemaker to be used in aiding the rhythm of the heart was invented by John Hopps. John Alexander Hopps was born in Winnipeg, Manitoba, Canada in 1919. He attended the University of Manitoba and in 1941 achieved a B.Sc.Eng degree in electrical engineering. In 1942 Hopps became a member of the National Research Council of Canada. Hopps did not produce the first pacemaker with all his own work but had help from both Dr. Wilfred Bigelow, a Canadian heart surgeon and Dr. John Callaghan, a cardiac surgeon also from Canada. In 1949 the first work began with this trio in inventing the first external artificial pacemaker. The research and development for their project was undertaken at the Banting Institute in the University of Toronto with the finishing touches completed in 1951. With both Dr. Bigelow and Dr. Callaghans vast knowledge of the human heart, and Hopps degree in electrical engineering the first successful pacemaker was invented which lead the way to improve treatment of arrhythmias. Artificial Pacemaker How does it work? The modern implantable artificial cardiac pacemaker consists of two parts, the pacemaker device which generates the impulses and the insulated leads which are connected to the heart via electrodes. The pacemaker generator device (pulse generator) is run by the use of batteries; these batteries must store enough energy to provide electrical impulses to maintain the rhythm of the heart, they are recharged when required and send electrical signals back and forth to the heart through the leads. This device is relatively small and is implanted into the chest. The pacemaker leads which are insulated are also implanted into the body. These leads are very thin and are connected to both the heart wall and the pacemaker generator device. The electrical signals which are produced by the pulse generator send small amounts of electrical energy through the leads which prompt the device to send impulses to the heart if the rhythm of the heartbeat is incorrect. Method of Pacing The methods of pacing the rhythm of the heart include percussive pacing, transcutaneous pacing, epicardial pacing, and transvenous pacing. However these methods of pacing are only used temporarily in conjunction with an external pacemaker or in an emergency. The method used in the implantable pacemaker is permanent pacing. Permanent pacing involves placing one or more pacing leads (electrodes) in the chamber/chambers of the heart. The electrode lead is inserted and passed through a vein until it reaches the heart valve, the lead continues to pass through the valve and is placed inside the chamber of the heart. Once the surgeon is pleased with the position of the electrode in heart chamber the opposite end of the lead is connected to pacemaker generator device. The generator device is also implanted into the chest of the body. Different types of Pacemakers There are now many different types of pacemakers which assist in treating other heart conditions as well such as combining pacemakers and defibrillators in one device. Some devices only use one electrode while others make use of many electrodes to regulate different positions of the heart. The three basic types of implantable pacemakers which use permanent pacing include: Single-chamber pacemakers, this type of pacemaker only uses one pacing lead. The pacing lead is placed in only one chamber, either the atrium or the ventricle. Dual-chamber pacemakers, this type of pacemaker uses two pacing leads. The pacing leads are placed in two chambers of the heart, with one pacing the ventricle and the other pacing the atrium. Rate-responsive pacemakers, this type of pacemaker includes a sensor that automatically adjusts due to a change in the activity of the human body. Materials Used The materials used for producing the pacemaker generator and electrodes are inert, nontoxic, biocompatible and all function within the body. The casing of the pacemaker generator is made of stainless steel, titanium or a titanium alloy. The battery requires storing a large amount of energy but cannot be too big because of the small size of the device, for this a lithium battery is used. The electrodes are made from platinum or platinum-iridium alloy but insulated with polyurethane. Sealing of the casing or any other parts is done using silicon rubber or polypropylene. Methods of production Pacemaker devices are produced by biomedical engineering companies such as Boston Scientific. There are three main components which must be produced to make a pacemaker. The main battery used for a pacemaker device is a lithium/iodine cell. The iodine and a polymer are mixed and heated together first. The liquid iodine/polymer solidifies to form the cathode with the lithium forming the anode. Moisture is prevented from entering the battery by hermetically sealing it. The wires in the leads are produced using a method of extrusion. The wires are bundled together and insulated with polyurethane. One end is shaped to fit the pacemaker and the other to be placed in the heart. The motherboard used in the pacemaker includes semiconductors, resistors and capacitors which are combined together on a single circuit using hybridization. Once these components are produced they can all be put together in the casing of titanium or stainless steel, and sealed using the polypropylene or silicon rubber. Improvements and the future There have been many improvements in the technology of pacemakers. They have been reduced in size for the comfort of patients, the lithium batteries used have vastly improved the multiyear life spans of the device, better leads and wires along with improved electronics have reduced power consumption, and now the device can treat various types of arrhythmias. Increasing numbers of patients requiring pacemakers will mean more will have to be produced. Further research will be carried out to improve the existing devices. Future improvements may include longer lasting batteries with the use of radioactive isotopes, smaller devices, and an application of cardiac pace making technology to the brain.
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