French Revolutionary and Napoleonic Wars

Great-West Health Care Gets Great Ratings 2019

Great-West Health Care provides service to two million members enrolled in its health plan, and 401 (k) benefits to another 449,000. It has 90 locations across the country and employs 6,200 people. Its 2017 revenues were $2.6 billion and its assets totaled $37.1 billion. Those numbers indicate an extremely healthy business that appears to be managed well. Great-West offers a full range of health care plans, life and disability insurance, annuities and retirement savings plan and services. The healthcare sector includes Preferred Provider Organizations and HMO plans, COBRA services, health care management services and physician, hospital and preferred pharmacy networks. Other benefits are group dental and vision plans, and flexible benefit plans. The financial services sector offers retirement services such as employer- sponsored retirement savings plans and services, defined contribution plans, enrollment and education services for employer-sponsored plans as well as administration and record keeping services. .u1c0d2dd1d9ab5455b008ab902a74805e { padding:0px; margin: 0; padding-top:1em!important; padding-bottom:1em!important; width:100%; display: block; font-weight:bold; background-color:#eaeaea; border:0!important; border-left:4px solid #34495E!important; box-shadow: 0 1px 2px rgba(0, 0, 0, 0.17); -moz-box-shadow: 0 1px 2px rgba(0, 0, 0, 0.17); -o-box-shadow: 0 1px 2px rgba(0, 0, 0, 0.17); -webkit-box-shadow: 0 1px 2px rgba(0, 0, 0, 0.17); text-decoration:none; } .u1c0d2dd1d9ab5455b008ab902a74805e:active, .u1c0d2dd1d9ab5455b008ab902a74805e:hover { opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; text-decoration:none; } .u1c0d2dd1d9ab5455b008ab902a74805e { transition: background-color 250ms; webkit-transition: background-color 250ms; opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; } .u1c0d2dd1d9ab5455b008ab902a74805e .ctaText { font-weight:bold; color:inherit; text-decoration:none; font-size: 16px; } .u1c0d2dd1d9ab5455b008ab902a74805e .post Title { color:#000000; text-decoration: underline!important; font-size: 16px; } .u1c0d2dd1d9ab5455b008ab902a74805e:hover .postTitle { text-decoration: underline!important; } READ Find Arts and Humanitites Degree ProgramsThe company maintains a website called My Great West which allows plan participants to register and sign up for a myriad of services. A member can use the site to find a doctor in the network of facilities and medical professionals, view current and past claims, view benefits information, request or print ID cards, access planning tools and ask questions directly to the company. This website also provides secure e-mail for each member of a family insured at Great-West. An offshoot of the Great-West standard health care plan is the Great-West Healthcare/Healthyroads Complementary Alternative Care Plan. This plan offers alternative treatments such as chiropractic care, acupuncture, massage therapy and dietetic services. Great-West has had long-term success by maintaining focus on customer needs, and attention to detail. This has resulted in appropriate products, claims-paying ability and operating performance. One of the best vehicles to measure a health care plan is the rating it receives from nationally recognized rating agencies. The ratings represent the financial strength of a company and its ability to meet ongoing obligations to its members. .u2ff31f4280c5c9ea242fe53925c00a0a { padding:0px; margin: 0; padding-top:1em!important; padding-bottom:1em!important; width:100%; display: block; font-weight:bold; background-color:#eaeaea; border:0!important; border-left:4px solid #34495E!important; box-shadow: 0 1px 2px rgba(0, 0, 0, 0.17); -moz-box-shadow: 0 1px 2px rgba(0, 0, 0, 0.17); -o-box-shadow: 0 1px 2px rgba(0, 0, 0, 0.17); -webkit-box-shadow: 0 1px 2px rgba(0, 0, 0, 0.17); text-decoration:none; } .u2ff31f4280c5c9ea242fe53925c00a0a:active, .u2ff31f4280c5c9ea242fe53925c00a0a:hover { opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; text-decoration:none; } .u2ff31f4280c5c9ea242fe53925c00a0a { transition: background-color 250ms; webkit-transition: background-color 250ms; opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; } .u2ff31f4280c5c9ea242fe53925c00a0a .ctaText { font-weight:bold; color:inherit; text-decoration:none; font-size: 16px; } .u2ff31f4280c5c9ea242fe53925c00a0a .post Title { color:#000000; text-decoration: underline!important; font-size: 16px; } .u2ff31f4280c5c9ea242fe53925c00a0a:hover .postTitle { text-decoration: underline!important; } READ Rhode Island Colleges and Universities Pursuing Online and Campus Based Education in Rhode IslandA.M. Best Company, Inc. gives Great-West a superior rating, Fitch Ratings provides a rating of very strong, Moodys Investors Services rates Great-West as excellent, and Standard and Poors Rating Service judge the company as very strong. These ratings indicate that Great-West is performing excellent service to its members and maintaining a strong asset base. There is a myriad of health care providers from which to choose. It makes sense to investigate a company, find out about its asset base, the way in which it operates, and how ratings companies compare it to other plans. Great-West appears to take pride in the strength of its portfolio and adherence to sound investment principles, while maintaining long-term relationships with its members. This company appears to be one worth investigating when health care or financial planning benefits are needed and a company that deserves to have great in its corporate name. .ucfc5c1c2f210ce3a89292da12f3f945a { padding:0px; margin: 0; padding-top:1em!important; padding-bottom:1em!important; width:100%; display: block; font-weight:bold; background-color:#eaeaea; border:0!important; border-left:4px solid #34495E!important; box-shadow: 0 1px 2px rgba(0, 0, 0, 0.17); -moz-box-shadow: 0 1px 2px rgba(0, 0, 0, 0.17); -o-box-shadow: 0 1px 2px rgba(0, 0, 0, 0.17); -webkit-box-shadow: 0 1px 2px rgba(0, 0, 0, 0.17); text-decoration:none; } .ucfc5c1c2f210ce3a89292da12f3f945a:active, .ucfc5c1c2f210ce3a89292da12f3f945a:hover { opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; text-decoration:none; } .ucfc5c1c2f210ce3a89292da12f3f945a { transition: background-color 250ms; webkit-transition: background-color 250ms; opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; } .ucfc5c1c2f210ce3a89292da12f3f945a .ctaText { font-weight:bold; color:inherit; text-decoration:none; font-size: 16px; } .ucfc5c1c2f210ce3a89292da12f3f945a .post Title { color:#000000; text-decoration: underline!important; font-size: 16px; } .ucfc5c1c2f210ce3a89292da12f3f945a:hover .postTitle { text-decoration: underline!important; } READ Computer Science Career Options Related ArticlesWant To Work As A Health Care ProviderWest Virginia Colleges and Universities Pursuing Online and Campus Based EducationLets Thank IT For Our Health Care AdvancesHealth Care Management College DegreesWith a Psychology Degree, Coalition Fights for Expanded Scope of Practice for Healthcare ProfessionalsOnline Education Options in Healthcare

The Deepwater Horizon Oil Spill - 1886 Words

Samuel Goodman GEO- 215 / M001 Professor Read November 2014 The Deepwater Horizon oil spill, also known as the BP oil spill was located in the Gulf of Mexico in April 2010. This was the largest due to the impact it had on the environment. The oil company British Petroleum, chartered a mobile drilling rig that was drilling a deep exploratory well thousands of feet below the sea level. The rig was located in the Macondo Prospect in the Mississippi Canyon. The spill was first discovered when large amounts of oil were starting to spread around the rig site. This leak is considered to be one of the worst human inflicted disasters to have ever taken place. It has been an important topic in both political and economic discussions and an extremely costly event. BP has taken the blame for the spill, but a problem with the rig was what initiated the disaster when methane from the well rose into the rig and ignited it. This could have been avoided if there were more safety regulations in place and a better security net. Both the government and oil compa nies should ensure their equipment and drilling methods are completely safe before putting the environment at such risk. Professor David Valentine from the University of California, Santa Barbara is a prominent oil spill researcher and has spent months researching the Deepwater Horizon oil spill and attempting to figure out what really happened. He is the director of the Valentine lab at the university, which focuses on theShow MoreRelatedDeepwater Horizon Oil Spill1102 Words   |  5 PagesElizalde Exam Essay 1 The Deepwater Horizon oil spill was an oil spill in the Gulf of Mexico which flowed for three months in 2010. This spill had a catastrophic on the environment causing extensive damage to marine and wildlife habitats as well as killing 11 workers and injuring 17 others. 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At the time of the disaster the regulators of the oil industry in the United States was theRead MoreThe Deepwater Horizon Oil Spill Essay2353 Words   |  10 PagesThe e Deepwater Horizon oil spill at the Macondo well began on April 20, 2010, in the Gulf of Mexico on the BP-operated Macondo Prospect. An explosion on the Deepwater Horizon drilling rig on 20 April 2010 killed 11 people and caused almost 5 million barrels of oil to flow into the Gulf of Mexico. The spill covered 68,000 square miles of land and sea and triggered a response effort involving the use of nearly 2 million gallons of dispersant chemicals (Pallardy). Considered the largest accidentalRead MoreThe Deepwater Horizon Oil Spill2180 Words   |  9 PagesThe Deepwater Horizon Oil Spill occurred on April 20, 2010 in the Gulf of Mexico. This oil spill was the largest spill in history in front of the Exxon Valdez oil spill of 1989. This oil spill released about 4.9 million barrels of oil into the ocean. 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USDC (2012) reports that on April 20, 2010 examinations of the world concentrated on an oil platform in the Gulf, around 50 milesRead MoreBp The Deepwater Horizon Oil Spill Of 2010758 Words   |  4 PagesPrior to the Deepwater Horizon oil spill of 2010, BP had a positive reputation for promoting corporate sustainability and creating sustainable energy. In the wake of the oil spill, however, BP proved that it was not on the right track despite the proclamation to its constituents of the exact opposite. There is a popular adage â€Å"almost doesn’t count.† BP’s investment in research directed toward minimizing negative environmental impact while conducting business and accomplishing major undertakingsRead More Impact of the Deepwater Horizon Oil Spill on the Environment1549 Words   |  7 PagesThe Deepwater Horizon spill occurred on 20 April 2010 and was caused by an explosion on the Deepwater Horizon drilling rig that killed 11 workers and injured 17 more. The drilling rig, located 66 kilometers southeast of the Louisiana coast, left an oil gusher that was finally capped on July 15, almost 2 months later. This was the largest accidental marine oil spill in history and the largest offshore environmental disaster in the United States (Telegraph, New York Times, BBC News). It is estimatedRead MoreDeepwater Horizon Oil Spill: the Bp Disaster2305 Words   |  10 PagesAP Environmental Science Deepwater Horizon Oil Spill: The BP Disaster The Deepwater Horizon oil spill in the Gulf of Mexico was one of the most infamous industrial environmental disasters ever. On April 20, 2010, a marine oil-drilling dig called the Deepwater Horizon exploded, releasing hundreds of millions of gallons of oil into the Gulf of Mexico. This explosion resulted in the loss of human life, massive environmental damage, and widespread damage to the livelihood of people living along the

Essay on Chapter 2 Solutions for Int. Accounting...

CHAPTER 2 SOLUTIONS TO B EXERCISES EXERCISE 2-1B (15–20 minutes) (a) True. (b) False – General-purpose financial reports helps users who lack the ability to demand all the financial information they need from an entity and therefore must rely, at least partly, on the information in financial reports. (c) False – Standard-setting that is based on personal conceptual frameworks will lead to different conclusions about identical or similar issues. As a result, standards will not be consistent with one another, and past decisions may not be indicative of future ones. (d) False – Information that is decision-useful to capital providers may also be useful to other users of financial reporting, who are not capital providers. (e)†¦show more content†¦(c) Comparability requires that disclosure of changes in accounting principles be made in the financial statements. To do otherwise would result in financial statements that are misleading. Financial statements are more useful if they can be compared with similar reports for prior years. (d) The proper accounting for this situation is to report the equipment as an asset and the notes payable as a liability on the balance sheet. Offsetting is permitted in only limited situations where certain assets are contractually committed to pay off liabilities. (e) It is well established in accounting that revenues and cost of goods sold must be disclosed in the reporting of an income statement. It might be noted to students that such was not always the case. At one time, only net income was reported but over time we have evolved to the present reporting format. E2-9B (15–20 minutes) (a) Probably the company is too conservative in its accounting for this transaction. The expense recognition principle indicates that expenses should be allocated to the appropriate periods involved. In this case, there appears to be a high uncertainty that the company will have to pay. FASB ASC 450-20-25 requires that a loss should be accrued only (1) when it is probable that the company would lose the suit

Baltimore (Maryland) As A Transportation Network And Sea Port Free Essays

string(106) " large tracks of warehouses, that is, over 23 million square feet and cold storage space \(Starr, 1991\)\." Baltimore is located in North central part of Maryland state, on the Patapsco River, 40 miles (60 Km) North East of Washington D. C. and 75 miles (125 km) South West of Philadelphia (Holcomb, 2005). We will write a custom essay sample on Baltimore (Maryland) As A Transportation Network And Sea Port or any similar topic only for you Order Now The city lies in a humid sub-tropical climate zone and experiences very high humid summers around July and warm winters around January (Ogle, 1996). Baltimore towns were founded in the 17th Century as commercial ports. The town was established on July 30, 1729 and was named after the first proprietary governor of Maryland province Lord Baltimore (Holcomb, 2005). Baltimore grew rapidly from â€Å"mid to late 18th century as a granary for sugar-producing colonies in the Caribbean† (Ibid, 2005). Since the distance of Baltimore from the Caribbean is shorter as compared to other large ports such as New York City port and Boston, it was popularly used because it reduced transportation time as well as reduced spoilage of goods (Starr, 1991). After the British forces had burnt down Washington DC, they invaded Baltimore in 1812 but the US forces won in that war (Ogle, 1996). Afterwards, development grew explosively due to increase commerce in America and abroad. This lead to construction of federally-funded National road, privately-funded Baltimore and Ohio railroad (Oslon, 1997). This boasted Baltimore as a major shipping and manufacturing centre (Ibid, 1997). On February 7, 1904, great Baltimore fire gutted down more than 1,500 buildings in about 30 year and brought down city to ruin (Ogle, 1996). But two years later, through the help of city council the buildings were set back. The city grew in area as more suburbs were founded (Higham, 2004). From late 1970s, the Inner Harbor was revitalized in a bid to modernize the port to increase the capacity and make it more competitive (Ogle, 1996). In 1979 the Baltimore convention centre was opened (Higham, 2004). In 1990s it was revamped and expanded as it became a major tourist destination. In the 21st century there has been development of Inner Harbor with sites like sport centre, ESPN Zone and Baltimore World Trade Centre (Martin, 2003). During the 19th and 20th centuries, Baltimore served as a ship building and transportation hub for the Mid Atlantic states due to its large natural harbor. In the 20th century, the city competed vigorously with New York and Philadelphia in developing and maintaining large port facilities to attract merchants (Oslon, 1997). Baltimore port which was originally developed to â€Å"transport crops, today the port moves more than 30. 6 million tons of cargo annually from automobiles to zinc† (Anuta, 1983). This port has a major economic impact on Maryland state and neighboring states like Virginia, Washington DC and New York (Starr, 1991). The state is an industrious town with motor manufacturing and steel processing forming its economic base and backbone (Ogle, 1996). Nevertheless, shipping and transportation is a major economic engagement due to its strategic location as well as its developed and networked transportation system. Baltimore city has a number of interstate highways. These federally-funded state highways link Baltimore with other states (Robert, 2005). There are also two tunnels that pass through Baltimore harbor within the city. These are the four bore Fort McHenry Tunnel and two-bore Harbor tunnel (Ibid, 2005). Baltimore is well served with passenger rail. Amtruk’s trains serve between Baltimore and major cities in US, for example, just outside the city Baltimore/Washington International Thurgood Marshall Airport Rails Station is a renowned traveler’s stop (Oslon, 1997). Besides, MARC commuter rail services connect Baltimore’s two intercity rail stations; the Camden Station and Penn Station with Washington DC’s Union station and stops in between (Robert, 2005). Maryland Transit Administration provides people in Baltimore city with public transit. The bus network in the city is comprehensive and efficient. Baltimore-Washington International Thurgood Marshall Airport (BWI) and Martin State airport serves Baltimore with air transport services (Anuta, 1983). Baltimore is a preferred transport hub and sea port that is very important to Maryland State as well as neighboring states like New York and Virginia (Higham, 2004). This is because it has a well-defined road network that gives it great comparative advantage. Its deep water port facilities are modernized and handle bulk goods conveniently. There are various advantages of Baltimore port as compared to other ports around that region. These include geographical advantage. Baltimore has interconnected multi-model system of transport and it offers one of the low cost shipping and transportation services (Starr, 1991). It also has well-maintained state roads connect Baltimore to the rest of the US. Baltimore Beltway surrounds the city and other interstate highways connect Baltimore to all directions (Robert, 2005). People can easily make across Baltimore metropolitan area through the city’s extensive local road system. Due to its central location in the densely populated North West corridor of US, Maryland state and Baltimore in particular has geographical advantage over other ports as a distribution centre (Holcomb, 2005). Baltimore can be accessed by overnight tracks that haul goods to major markets of North East, South East and Mid West due to the strategic location (Ibid, 2005). According to Maryland Distribution Council (http://www. mdc. org) the consumer market that is within overnight reach of Maryland state represents a whooping 80 million people (32% of US population), $1. 2 trillion in effective buying income (35% of the US total) and $566. 2 billion in retail sales (33% of US total) (Anuta, 1983). According to MDC the private haulers number over 5,000, common and contract carriers that serve within Maryland and its environ (Ogle, 1996). Baltimore port handles in the ranges of 30. 6 million tons of cargo every year and it is ranked number one in Poll-on Roll off cargo in the East coast (Starr, 1991). Another comparative advantage is the technological advances in the port that has computerized its operations. The port boasts the use of Electronic Data Interchange (EDI), hand held computers, computerized gate computers and scanners which in a great way have had a positive impact on the efficiency and effectiveness of the port (Ogle, 1996). Economically, Baltimore has large skilled labor force that is important in running of its vibrant economy. It has large tracks of warehouses, that is, over 23 million square feet and cold storage space (Starr, 1991). You read "Baltimore (Maryland) As A Transportation Network And Sea Port" in category "Papers" It has developed in service industry and has comprehensive international banking services (Robert, 2005). Baltimore still has other comparative advantages over other ports surrounding it. These include excellent inter-model connections by water, rail and tunnel, rail service that is on-dock at all terminals provided by CSX and Norfolk Southern, is rated as one of the safest and most secure ports in the world, presence of advanced and electronic cargo data system which makes the process of clearing and forwarding efficient and time-saving, cargo consolidation, export parking and crating services. It also has excellent tracking services whether it is a local dray or a long haul (Robert, 2005). Baltimore harbor’s importance to neighboring states like New York City and Virginia are numerous. With the well-maintained interstate highways one can drive to Baltimore from New York City for only two hours, and less than one hour from Washington DC (Higham, 2004). There are also options to use trains or fly into the city. The city offers exciting tourist destination. Ellicott City is a charming village with restored historical sites with art galleries, quaint shops, gift shops and restaurants (Ibid, 2004). Baltimore offers a great investment destiny for businessmen and businessmen have identified the city for investment. Investors from New York and neighboring states are investing in hotels, transport and other services (Ogle, 1996). The Baltimore port ahs become a magnet for development that has spread outside the city to nearby states like Virginia (Oslon, 1997). This is because of the ability to handle large bulk of goods that are shipped into these states for development and also serving as exporting port to these states economies (Starr, 1991). The Baltimore port has contributed to growth of nearby regions such as Virginia and Philadelphia through provision of jobs. Direct related jobs, induced and indirect jobs have increased due to increased cargo movement in the port (Holcomb, 2005). Out of these 16,500 are direct jobs and about 34,000 induced and indirect jobs and other jobs that are directly related to activities at the port in nearby states are in hundreds of thousands (Anuta, 1983). Through taxes paid by businesses that engage in shipping, handling, transporting, importing and exporting goods, Maryland State and neighboring regional states, get tax revenues that greatly help them fund their budgets (Higham, 2004). Baltimore port has enabled growth of service sectors in Maryland state and other states (Oslon, 1997). These sectors that developed include banking, insurance, admiralty, law, maritime services, consignee service and surface transport (Ibid, 1997). This has impacted an increased business income of participants like national trucking firms, freight forwarders and bankers. The value of the port of Baltimore to neighboring states has increased due to increased due to increased cargo moving via the port into these states (Martin, 2003). Through the port goods are exported and imported into these states that generate about $50 billion of their economic activities in 2007 (Ibid, 2003). Some of the challenges that Baltimore port faces is environment degradation due to material waste disposal (Starr, 1991). However, legislation was passed to control waste of dredge materials. Environment Trust Fund was set up to fund building of a site for the disposal of the material dredged from the shipping channels leading to Baltimore harbor (Anuta, 1983). Environment impact statement was prepared after public hearing, where citizens proposed provision of commercial shipping by maintaining channels approaching Baltimore port, which in turn saw an outright prohibition to open water disposal and recycling of waste for agricultural and other purposes (Robert, 2005). Traffic congestion is another challenge that faces the city and Maryland state in general. There was a bill that proposed state local and regional transportation plans to reduce vehicle mileage by at least 10% by 2020; however the US senate rejected the proposal (Holcomb, 2005). The assembly has approved removal of the annual state sidewalk funding capital which amounts to about 2 million dollars which will see increased funding of state in sidewalks that will manage transport in the city streets (Oslon, 1997). Crime situation in the state is a major challenge to this city port (Anuta, 1983). The crime statistics for 2005 revealed approximately 269 homicides which is about seven times the normal rate (Starr, 1991). Generally overall crime rate have worked hard to reduce crime activities and give the city a safe environment (Martin, 2003). Conclusion Baltimore port is a very important not only to the Maryland state but to the whole region. This port serves as a major entry and exit point of goods and people from Atlantic to Mid West and the whole of United State. Its strategic geographic location has given it a comparative advantage over rival ports. Many of businesses around the region use these ports to export or import their goods as it is cheaper considering the short distance to the coast. Increased activities this port has translated to economic growth in the region. The impact of the use of the Baltimore ports on the regional economies can be identified in sectors such as, tourism sectors, transport and haulage sectors, banking and other financial service sectors as well as public sector. More service industries are developed in Maryland and nearby estates to support the growth brought by enhanced use of this port. Despite these positive influences the use of ports has on the region there are some negative impacts that can be identified as having came out of the use of the ports. Drug importation through these ports has been a challenge not only to this state but to the whole nation. Drug barons use this as sea entry point to US market. They disguise their consignment as legal trade goods to get clearance and access to their intended markets. Maryland Port Authority has stepped up and taken measures like use of scanners to scan contents in containers and use of drug detectors. The state security forces together with federal security agents should help reduce crime in the city. Insecurity has been recognized as a major force that can greatly decelerate the rate of development in the city. Investors flee areas that they know their investments are not safe. Maryland Port Authority should implement ways of improving harbor management and services for instance, ensuring that there is sufficient safety from hazards like fire, theft, accidents in the work place as well as ensuring that information technology system is up-to-date and fully functioning. In turn, this will radically enhance Baltimore harbor transportation network, thus reducing obstacles such as delayed transportation, drug trafficking and traffic congestion. References Anuta, Michael J. (1983). Ships of our Ancestors. Baltimore: Genealogical Publishing Co. , Inc. Higham, Eileen. (2004). Tuscany-Canterbury: A Baltimore Neighborhood History. Baltimore: Maryland Historical Society. Holcomb, Eric L. (2005). The City as Suburb: A History of Northeast Baltimore since 1660. Santa Fe, N. M. : Center for American Places. Martin L. Millspaugh. (2003). The Inner Harbor Story. The Urban Land Institute. Washington, D. C. Ogle, Maureen. (1996). All the Modern Civilization Baltimore. Johns Hopkins University Press. Olson, Sherry H. (1997). Baltimore: The Building of an American City. Baltimore: Johns Hopkins University Press. Robert C. Keith (2005). Baltimore Harbor: A Pictorial History. Third Edition. The Johns Hopkins University Press. Baltimore and London. Starr, J. (1991). The Port of Baltimore: Off the Beaten Track? Maritime Policy and Management 18, 171-181. http://www. mdc. org How to cite Baltimore (Maryland) As A Transportation Network And Sea Port, Papers

Clinical Reasoning for Anaesthesia & Intensive - myassignmenthelp

Question: Write about theClinical Reasoning for Anaesthesia Intensive Care. Answer: Introduction: Clinical reasoning cycle is a methodical procedure which is followed by nurses in their practices as it helps them to collect information about the patients and thereby come to an understanding about the problem or the situation of the patient. This cycle then helps the nurses to plan and implement interventions necessary for the patients and then helps in proper evaluation of the outcomes of the interventions on the patients. The entire situation would then be reflected by the nurses so that they can learn from any mistakes that they have made or they can promote their practices for betterment. In the following case study, a patients named MR Amari had been admitted and the nurse would follow a proper clinical reasoning skill to develop ideas about the interventions that she would take. Patients situations: The first step of the clinical reasoning cycle is considering the patient situations. The patient who has been shifted from the emergency department to the medical department is called Mrs. Amari. She is an indigenous New Zealand citizen belong to the Maori tribe. She is living with her son and daughter in law and with two grandchildren. However, she is a patient of hypertension as well as hypercholestemia and these had been the major contributors of the present condition she is suffering from which is transient ischemic attack. Actually, her tribal customs had made her take tobacco for almost years which might have had a very bad impact on her health. Although he had quitted smoking, but the after effects had stayed with her as many researchers suggest that smoking leads to strokes and heart disorders (Miller et al. 2016). Moreover, she has a positive family history of heart diseases and therefore she is also within the vulnerable zone of being affected by heart disorders. Therefore following her family history, it becomes evident that her heredity might have also played an important part in her present condition. After the death of her husband, she had to move in with her son to Australia as he was not being able to cope up with the financial crisis and had been staying in Australia and lives heavily as a carer for her grandchildren. Collection of cues: The second step of the clinical reasoning cycle mainly incorporates the activity of the nurses for collection of cues as well as information about the patients condition, giving a detailed explanation of the various details which the nurse should incorporate in her time of critical reasoning so that she can perform the next step properly. Review: When the patient was admitted to the hospital it was seen that the patient had a facial droop and her mouth was diverted to the right side. She had numbness in the right side of her face and also in the right arm. However she did not show any acute signs of stroke like weakness and were easily able to swallow and had a steady gait. She was also able to move her extremities and was able to follow commands. Moreover she did not have a headache and also denied nausea, vomiting, chest pain, diaphoresis as well as visual complaints. She was alert and oriented. Therefore, it helped nursing professionals to come to a conclusion that she was not a stroke patient but rather suffered from TIA (Beltowski 2014). When the nurse of the next shift came, she was handed a document which stated that all the symptoms of the patient had resolved. However, she witnessed an entirely different case. She saw that her condition was again deteriorating as her speech had become slurred again and the right side of the mouth is drooping. Gather: When the nurse of the next morning shift took her vital signs, they did not good results and the nurses understood that the patient is not absolutely in the best health. When the vital signs were taken, it showed that Blood pressure: was 175/98 which was considered to be very high as the normal blood pressure of the individuals should be 120/80 mmHg. Her Pulse was however 9 which was within the range of 60 to 100 betas and considered normal. Her Respiratory rate: 13 which is also between the normal range of 12 to 18 breaths per minute, Oxygen saturation which was also normal was 92%. The glucose level was found to be high as the blood glucose level was 6.6 mol much higher than the mean value of 5.5 mmol/L, Glasgow Coma Scale was 11/15. Recall: In most cases it is seen that TIA of the patients often exposes the patients to a stroke within 48 hours and therefore the nurse should take this point in her consideration. Usually, in the case of TIA, blood flow to the brain usually get blocked or reduced usually by blood clots or due to the formation of plaques in the arterial vessels. This often gives rise to stroke like symptoms (Mellon et al. 2016). Usually within a short time, when the blood flows again, the symptoms go away. They do not cause any brain cell damage or permanent disability. As a result of these, the tests which were conducted did not provide any information of such occurrences in the brain like formation of clots and others. However, this disorder often provides an early sign or warning of the occurrences of stroke as researchers suggest that every 1 in 3 TIA patients have stroke. Therefore the nurse should first take into consideration about the patients chance of having a stroke when the symptoms of facial dr opping and slurring of speech occurs again (Catangui et al. 2015). For this the nurse should at first provide her with medication to remove any plaques or fatty deposits from the vessel or to prevent blood clots in the arteries that supply blood to the brain and immediately perform diagnostic tests to confirm whether she is having another attack of TIA or is having a stroke. The neurological assessment that would mainly be conducted by the nurse is the FAST assessment which mainly checks the face, arm, speech and time test. The score of the test would help her o understand the seriousness of the issue. She can also conduct the Rosier scale test to check the occurrence of stroke possibility (Howard 2016). She should perform magnetic resonance imaging called MIR scan, computerized topography scan to test for TIA. For the diagnosis of stroke, she should perform tests like carotid ultrasound, cerebral angiogram, echocardiogram. The results of the tests have to be verified in order to ch eck whether she is having another TIA or stroke. The next step of the clinical reasoning cycle is processing of the information that the nurse usually collects by handling the case effectively. Interpret: The next step of the clinical reasoning cycle is processing of the information that the nurse usually collects by handling the case effectively. The first step is the interpretation steps where the nurses need to assess the result of the steps that she had conducted. In this case, the nurses need to conduct the FAST tool assessment as well as the ROSIER assessment. In the FAST assessment, the nurse should check whether the Face has drooped, whether the patient can lift both the arms, has their speech slurred and if all the three things are present there is an emergency and suggests that the Time is critical for the patients (Wang et al. 2013). Moreover form the rosier scale assessment; if the marks are greater than or equal to +1, then the nurse may become sure of the attack of stroke (Jiang et al. 2014). Source: (Jiang et al. 2014) Discriminate: Besides, the different diagnostic tests should also be done in order to confirm the results of the neurological assessment made about the patients symptoms. Slurring of speech identified in the assessment shows that either of the sides of the brain has been affected which mainly governs the speech of a patient (Fothergill et al. 2013). This gives the idea to the nurse that a part of the brain is affected by the stroke which is affecting his speech. If the assessment catches the patient having drooping down of the mouth, then the nurse may also consider the brain being affected for which messages are not sent properly. Besides, arms of the patients should also be asked to lift which will help in finalizing the attack (Crapo et al. 2014). Besides, diagnostic tests should be immediately done to be sure that whether any blood clots or abnormality is found in the brain of the patient and whether the patient is suffering from stroke or TIA again. The change of the GCS scale from 15 to 11 showed that the patients should be immediately taken to the emergency wards for treatment as her condition was found to be deteriorating. Nerve damage was the main reason that were resulting in the slurring of voice and face droop. Oxygen saturation decrease was giving clues that her vital organs are having less oxygen which could have caused her in loss of consciousness and adults. Infer and relate: The next part would be to infer and relate the patients assessment results with the main rationale hat has resulted in the occurrence of the symptoms. The vital signs show that the patient has high blood pressure than normal. The patient is already seen to suffer from hypertension. When the pressure of blood is high, it can lead to stroke by the damaging as well as the weakening of the brains blood vessels (Miller et al., 2016). This causes them to be narrow or even leads to rupture and leak. High blood pressure can also lead to form blood clots in the arteries which lead to brain that blocks the blood flow and causes stroke. She is also a patient of hypercholestemia for which cholesterol which is a fatty substance in the blood can increase in number and high cholesterol in the arteries block the normal flow of blood to brain causing stroke (Jatuzis 2015). All these might have occurred in the patient and therefore the patient is suffering from symptoms of stroke or TIA. Conclusion: Therefore the nurse who has to handle a patient showing symptoms of stroke or TIA has first have to conduct a vital sign analysis and neurological assessments of the patient. These tests would be finalized by the performing of important diagnostic tests like MIR, CT scan and others. Then the nurse should try to relate the patient history with the biological rational of the occurrence of the attacks. These would help her to develop interventions based on the management of the causing factors. References: Be?towski, J. 2014. Priority paper evaluation: Reverse epidemiology in ischemic stroke: High cholesterol as a predictor of improved survival in stroke patients.Clinical Lipidology,9(2), 135-139. Catangui, E.J., 2015. Thrombolysis for patients with acute ischaemic stroke.Nursing Standard,30(8), pp.40-44. Howard, R.S., 2016. The management of ischaemic stroke.Anaesthesia Intensive Care Medicine,17(12), pp.591-595. Jatuzis, D., 2015. Ongoing Discussions on Reliability of Diagnosis of Transient Ischemic Attack.Neuroepidemiology,45(2), pp.111-112. Mellon, L., Doyle, F., Williams, D., Brewer, L., Hall, P., and Hickey, A. 2016. Patient behaviour at the time of stroke onset: a cross-sectional survey of patient response to stroke symptoms.Emerg Med J, emermed-2015. Miller, A. P., Navar, A. M., Roubin, G. S., Oparil, S. (2016). Cardiovascular care for older adults: hypertension and stroke in the older adult.Journal of geriatric cardiology: JGC,13(5), 373. Wang, Y., Wang, Y., Zhao, X., Liu, L., Wang, D., Wang, C., Wang, C., Li, H., Meng, X., Cui, L. and Jia, J., 2013. Clopidogrel with aspirin in acute minor stroke or transient ischemic attack.New England Journal of Medicine,369(1), pp.11-19. Jiang, H.L., Chan, C.P.Y., Leung, Y.K., Li, Y.M., Graham, C.A. and Rainer, T.H., 2014. Evaluation of the Recognition of Stroke in the Emergency Room (ROSIER) scale in Chinese patients in Hong Kong.PloS one,9(10), p.e109762. Fothergill, R.T., Williams, J., Edwards, M.J., Russell, I.T. and Gompertz, P., 2013. Does use of the recognition of stroke in the emergency room stroke assessment tool enhance stroke recognition by ambulance clinicians?.Stroke,44(11), pp.3007-3012. Crapo, S.A., Wooten, J.M. and Brice, J.H., 2014. Stroke and transient ischemic attack.Prehospital Care of Neurologic Emergencies, p.63.

History of the American Film Industry Essay Example For Students

History of the American Film Industry Essay America, being at the forefront of film in our current society, has come a long way with regards to the industry of film. Rising from 1894, when the worlds first commercial motion picture exhibition was given in New York (Ref library book), Americas film industry has become increasingly more advanced and entertaining to countries all over the world. This essay will take a deeper look into the history of the American film industry and investigate the various accomplishments and discoveries that led to the establishment of what we now call Hollywood. The Beginning of the Film The motion pictures did not originate as art but as a machine. ? (Ref the American Film Industry p27). In the very beginning of the American film industry, a device dubbed the ?magic lantern was introduced which consisted of pictures that had been painted on glass were placed in front of a lantern in a dark room and these images would appear on the opposite wall (Ref Bib Book p3). This, some would say, was the ex periment that spurred on the desire to begin the search of new ways into viewing pictures, and later on, the search to create the possibility of moving pictures. The zoopraxiscope ?, exhibited by Eadweard Muybridge in 1893 began the widespread discussion of the possibility of moving pictures (Ref Bib Book p5). The thought of the illusion of motion first became possible with the invention of the Kinetoscope, created by Thomas Edison and William Dickson in 1889, was used (REF Bib Book p7). A kinetoscope refers to a device that creates the illusion of movement by means of a perforated strip of film showing a sequence of images over a light source and a high-speed shutter (Figure 1)(Reference from some book). Although only able to be viewed by one person at a time and the films only being as long as a minute, this device formed the beginning of the entire basis of the film industry. Branching off from Edisons kinetoscope was the mutoscope ?, which was a peep-show cabinet, and Henry Marvins biograph ?, which were both invented in order to create more money making opportunities in the soon-to-be film industry (Ref Bib Book p8). From the kinetoscope came the system of projection, created by C. Francis Jenkins and Thomas Armat in 1893, which allowed more than one individual to view a film at a time (ref from The American film industry). As technology in this area advanced, so did the entire film industry along with its fan base. Pictures of life in action attracted more attention and produced more entertainment than sounds transmitted through ear-pieces ? (REF Bib Book p8). The Rise of Cinema In order to create more opportunities to gain money, bigger cinemas needed to be created in order to accommodate more people. In this way, a new and profitable entertainment field was discovered by introducing the invention of a projection machine (Ref Bib Book p9). The first two that were invented were the panopticon? and the vitascope?, both invented in 1895 (Ref Bib Book p10). The panopticon, produced by the Lambda Company, displayed a motion picture of a prize fight all of which lasted five minutes (Ref Bib Book p10). The vitascope, on the other hand, was produced by Thomas Armat and C. Francis Jenkins. As these motion pictures became more widely recognised and advanced, so the ways of viewing these motion pictures needed to become more advanced as well. In order to accommodate the growing amount of people interested in these motion pictures, parlours were joined up with store-rooms of which doors and windows were removed to create a wider entrance (Ref Bib Book p9). This was believed to invite pedestrians to enter and be intrigued by the motion pictures that they viewed, and this worked (Ref Bib Book p9). The entrance would be decorated with circus-like posters and (Figure 2)(Reference). These opened up store-rooms and parlours became known as show-shops and later became known as penny-arcades due to the fact that pennys was what were used as form of payment for entering the show-shop. Eventually, these penny-arcades became known as cinemas. LumiAre, a Parisian and one of the men who had made a peep-show cabinet and camera (like Edisons kinetoscope), called his device the cinematograph ? and from that day forward, cinema ? was used to describe motion pictures. Cinemas were usually placed in upper class urban areas as exhibitors aimed at attracting an affluent middle class audience (Ref the American Film Industry p19). These cinemas, over time, gradually took new and different forms. As they grew more and more popular, more space was needed in order to accommodate the new crowd. The Dewey Theatre was one of the first major theatres to arise during this period. Converted from a church into a cinema by William Fox, it had the capacity to seat up to a thousand individuals (figure 3)(Ref the American Film Industry p19). Multiple shows would be presented that lasted for two hours, and uniformed ushers would greet the viewers and show them to their seats (Ref the American Film Industry p19). This radically altered the nature of going to the movies, as evident in todays society when viewing a film at the cinema. Cinemas soon became designed to make the patron feel more at home, by increasing the comfortableness of the patrons experience as well as providing snacks and refreshments (Ref the American Film Industry p62). One cinema that was established in New York was especially hospitable. Created by E. F. Proctor, the Pleasure Palace ? included a main auditorium as well as a roof garden, German cafAÂ ©, smaller auditorium, Turkish bath, and stands selling various goods (Ref the American Film Industry p62). Patrons were asked to pay a small fee before entering but were then given free rein to enjoy the pleasures of the Pleasure Palace for the day (Ref the American Film Industry p62). The Establishment of Hollywood Roger Ebert on Finding Nemo EssayDue to the rapid growth and development of the American film industry, Hollywood has become bigger and better. Mass amounts of individuals flock to Hollywood in order to chase their dreams and become one of these well-known stars. It is therefore apparent that, in the past, Hollywood was much more elite, whereas nowadays Hollywood has become a sea of competition with regards to starring in films. It is interesting to note how, during the early stages of Hollywood, the stars that were made famous became iconic figures and role models for many people across America and across the world. However, in present-day Hollywood, although various stars of Hollywood have become role models to different youth, they are nowhere near the iconic status as the stars of previous Hollywood, such as Chaplin, Monroe, and Dean. It is also easier to make ones way into the American film industry in present times compared to previous decades, as there are much more genres being used, as well as the fact that the scale at which movies have been made has drastically increased. Hollywood Then and Now Talk about how genres have changed and how genres are intermingled. How that making of movies have changed. From the very beginning of the American film industry, genres have been an important aspect in producing films. The use of genres has been used in order to direct a films attention to specifics group of people and have been used in many different manners. A genre refers to a ?type or ?kind (Ref Genre and Hollywood by Steve Neale no page). Some examples of the types of genres that have made its way into the American film industry are horror films, comedies, romance, western, and many more. During the early stages of Hollywood, however, types of genres were very limited. The most evident of genres were that of western films (Thomas Edisons The Great Train Robbery being the first film ever made), and comedies (as seen in the many films that Charlie Chaplin starred in during the silent era). However, as the film industry in America developed, producers began playing around with different types of genres. It became noticeable as well as to which genres proved to be most popular, and these would become mass produced. In other words, cinema began shifting its focus on mainstream, commercial films and this was most evident with regards to Hollywood films (Ref Genre and Hollywood by Steve Neale no page). Barry Keith Grant, a professor, states that genre movies are those commercial feature films which, through repetition and variation, tell familiar stories with familiar characters in familiar situations. ? (Ref Genre and Hollywood by Steve Neale no page). This was especially evident with Romantic Comedies where similar stories occurred with minor differences: boy and girl meet, fall in love, a conflict or misunderstanding between the two occur, they sort it out and the film ends with the two happily in love. As time passed and the industry further developed, genres were further discovered and experimented with. These discoveries gave birth to sub-genres and also to the possibility of intermingling between genres. From the simple little kinetoscope only being able to be viewed by one person at a time, to the invention of the projector, the American film industry has not only grown in audience, but grown in technology too. The making of movies has become more and more complex with regards to the equipment used in the production of a film. Since the late 1980s, the equipment used began developing at a fast rate. The use of digitization of sounds and special effects pushed the American film industry even further than it had ever been before (Ref American film in the digital age by Robert Sickels p11). The American Film Industry vs. the Rest of the Worlds Film Industries Therefore, it is widely evident that the American film industry has become the biggest and most popular film industry in the world. Although foreign films are occasionally distributed across the world, the amount of American films distributed and displayed in most parts of the world are a vast majority higher than those nationally made films (excluding America of course) (Ref American film in the digital age by Robert Sickels p2). Robert Sickels elaborates on this in his book American Film in the Digital Age, asking the question When is the last time you saw Nollywood/ Bollywood/ Iranian/ name-the-country, etc. , film in an American theatre or on American television? ? (Ref American film in the digital age by Robert Sickels p2). This indicates that America has dominated the film industry over the years and continues to do so; creating bigger and better films each year and making billions off of the viewers that support these films. Being the first country to introduce the possibility of moving pictures into the world, America has continued to impress the rest of the world with its increasingly high standards in the production of movies. It can also be said that the film industry has not only altered technology with regards to computerised and digitized effects in films and other media, but it has also had a vast effect on social change. Bibliography: Figure 4: http://www.google.co.za/imgres?q=Charlie+Chaplin+making+a+living+1914um=1hl=ensa=Nbiw=1920bih=883tbm=ischtbnid=4o3YTNa8uRhUZM:imgrefurl=http://www.rlsbb.com/making-a-living-1914-dvdrip-xvid-8ballrips/docid=0lCW444x8oM5AMimgurl=http://img.rlsb