Tuesday, September 15, 2020

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Friday, September 11, 2020

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Wednesday, September 2, 2020

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Essay Writing Service At $7

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Friday, August 28, 2020

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Wednesday, August 26, 2020

Essay Writing Service Hire An Online Essay Writer 24

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Essay Writing Service Hire An Online Essay Writer 24

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Saturday, August 1, 2020

Wallace, Henry Agard

Wallace, Henry Agard Wallace, Henry Agard, 1888â€"1965, vice president of the United States (1941â€"45), b. Adair co., Iowa; grad. Iowa State Univ. He was (1910â€"24) associate editor of Wallaces' Farmer, an influential agricultural periodical run by his family, and when his father, Henry Cantwell Wallace , died in 1924, he became editor. Henry A. Wallace had developed several strains of hybrid corn that were to be used extensively by farmers of the American Corn Belt, and his writings on farm economics and plant genetics quickly won him recognition as an agrarian authority. A Republican until 1928, Wallace helped swing Iowa to the Democratic party in the 1932 election. In 1933 he was appointed secretary of agriculture by President Franklin Delano Roosevelt and soon led the reorganization of the Dept. of Agriculture and the supervision of the Agricultural Adjustment Administration . He became a highly regarded leader in the New Deal , and was Roosevelt's running mate in the 1940 election. As vice p resident, he went on several missions to Latin America and Asia and served (1942â€"43) as head of the Board of Economic Warfare. Plagued by accusations that he was too friendly toward the Soviet Union, Wallace failed to receive the vice presidential nomination in 1944. In 1945, shortly before Roosevelt's death, he became secretary of commerce. He held that position until Sept., 1946, when he was forced to resign because of his open opposition to President Truman's foreign policy. He then edited (1946â€"48) The New Republic. In 1948, Wallace helped launch the new Progressive party, which charged the Truman administration with primary responsibility for the cold war. As its presidential candidate that year he polled some 1,150,000 votes (mostly in New York state), but won no electoral votes. Wallace left the party in 1950 after it had repudiated his endorsement of the U.S.-UN intervention in Korea. Retiring from politics, he denounced Soviet communism and returned to the Republican party. Wallace's numerous books on agricultural problems and politics include Agricultural Prices (1920), New Frontiers (1934), The Century of the Common Man (1943), Toward World Peace (1948), and The Long Look Ahead (1960). With E. N. Bressman he wrote Corn and Corn Growing (1923), and with W. L. Brown he wrote Corn and Its Early Fathers (1956). See biographies by D. Macdonald (1948), E. L. Schapsmeier (2 vol., 1968â€"70), and J. C. Culver and J. Hyde (2000); R. Lord, The Wallaces of Iowa (1947); K. M. Schmidt, Henry Wallace: Quixotic Crusade, 1948 (1960); J. S. Walker, Henry A. Wallace and American Foreign Policy (1976); T. W. Devine, Henry Wallace's 1948 Presidential Campaign and the Future of Postwar Liberalism (2013). The Columbia Electronic Encyclopedia, 6th ed. Copyright © 2012, Columbia University Press. All rights reserved. See more Encyclopedia articles on: U.S. History: Biographies

Friday, May 22, 2020

Pros And Cons Of A Balanced Budget - 1397 Words

Tristan Santos Andrew Jalil Economics 351: History of Macroeconomic Policy 4/21/17 Pros and Cons of a Balanced Budget In 1995, US Congressional lawmakers introduced an amendment to the United States Constitution that would restrict federal spending to the sum of its collected revenues in any given fiscal year. The â€Å"Balanced Budget Amendment† would’ve taken full effect in 2002, guaranteeing a balanced federal budget unless a budgetary deficit was approved by two thirds of the Senate . The proposed amendment passed the House of Representatives but came up one vote short in the senate. More than two decades later, the US budget remains an incendiary topic; Total federal debt exceeds $15 Trillion dollars and the Federal Budget Deficit†¦show more content†¦It is pertinent that the US address its growing budget deficit, and an amendment to the constitution forcing the start of that process would provide long term benefits to the US economy. In 2017, at 77 percent, government debt held by the public comprises its largest share of GDP since the end of the second world war (SOURCE ). As more and more funds are allocated to the growing costs of health and social services dedicated to the US’s aging population (SOURCE), analysts expect government debt should continue to grow. The Congressional Budget Office estimates that, should trends in federal spending continue, (IMAGE) total US Federal debt owed to the public will exceed gross domestic product by 2033, and by 2035 will exceed the post war peak of 106% of GDP. The rate at which the US accumulates this debt will be even more accelerated should the current administration honor its two trillion-dollar commitment aimed to improve the US infrastructure. (SOURCE) While these figures are just estimates, should they prove true they would have dramatic effects on the US economy; as the ratio of public held debt to GDP grows, investors of US held assets will demand a larger interest rate in order to negate the assumed higher risk that comes from US holding larger amount of debt. The increasedShow MoreRelatedBo eing1310 Words   |  6 Pagesstandardized operations. Although, the 4 divisions were still autonomous – they executed their own work, reported the same measuring criteria in financial dollars, project performance and product quality terms, as well as range of other measures for the BAL balanced scorecard. 2. Systems Architecture Issues The information systems architecture encompassed 12 different BAL sites, which were strategically located close to major BAL customers. And at multiple sites the numerous programs and application were usedRead MoreThe United States Congress Often Comes Across Issues That2017 Words   |  9 Pagesshould do everything in our power to make sure that we are a truly free and well represented society. The mandatory balanced budget is another topic that is thrown around in Congress. According to Wikipedia, every state with the exception of Vermont contains some sort of a balanced budget. Our Federal Government does not. Our Federal Government is not required to have a balanced budget. With that being said, that means that as long as the bill is passed, they are allowed to spend as they please. NoRead MoreI Want to Be a Physical Therapist1409 Words   |  6 Pagesfor hurt in order to help it recover to its full range of motion. The career I want to pursue is physical therapy, in order to understand this profession you need to learn about the work environment, education needed, earnings, outlook, and the pros and cons of this career. Physical therapy unlike most occupations has a variety of work environments. As a physical therapist you can work in hospitals, nursing homes, clinics, and private offices. In 2012 the top 2 industries to employ physical therapistRead MoreDifference Between Cognitive Knowledge And Behavioral Skills1686 Words   |  7 Pagesis to make us they go through the process to get the organization classified a tax exempt. Some functional responsibilities of the board of directors are to establish a code of ethics, to make sure the employees abide by them, and approve program budgets. 9. Name and explain two positive and two negative consequences of power in a public or nonprofit organization. Provide examples of each that a manager might encounter. Power can has a positive and negative effect on an organization. When you useRead MoreMontefiore Medical Center Case Analsisy1308 Words   |  6 Pages1. Evaluate the strengths and weaknesses of the balanced scorecard in this type of an organization. Brief summary of Montefiore Medical Center: * MMC started off in 1884 as a home for the chronically ill that other hospitals couldn’t help, dedicated in honor of Sir Moses Montefiore. * In 1963, Montefiore agreed to operate the patient care facility of the Hospital of the Albert Einstein College of Medicine. Both hospitals remained as distinct entities with separate administrations for theRead MoreIntel: Stock and Capital Structure704 Words   |  3 Pages2. Describe briefly Intel’s current capital structure. Discuss whether in your view this capital structure is optimal for Intel, with particular emphasis on the pros and cons of Intel’s substantial cash holdings. Articulate and defend a â€Å"target† capital structure for Intel. Cee Capital Structure As shown in the financial income statement (Exhibit3), Intel Corp. (INTC) has a capital structure consisting most of equity. Intel has very little debt in its capital structure and the cost of debtRead MoreAvoiding the Alignment Trap in Intormation Technology Essay1696 Words   |  7 Pagesto be effective. They are being measured based on the ineffectiveness as far as completing projects on time and on budget, and the ineffectiveness of alignment to an important business objective. The first of these quadrants is â€Å"alignment trap†. Despite being highly aligned, the companies within this group are less effective in completing budgets on time and within the budget. Charles Schwab Co. is currently in this position and as a result, continues to spend money on projects and seeingRead MoreTenure Of The K 12 School Systems884 Words   |  4 Pagesmust be balanced, listing occurrences of sub-par performance as well as instances of satisfactory performance. The teacher must be allowed a hearing that is fair and timely; allowing the teacher a chance to challenge charges and allegations of poor performance. Teachers who have been in the system for a substantial period of time and are experienced feel like they need tenure to have job security. The threat of firing has increased in recent years as many school districts are faced with budget cutsRead MoreThe On The Healthy Hunger Free Kids Act1554 Words   |  7 Pageshealthy choices at home as a reinforcement. Alternative Policy Analysis criteria: 1. Educate and inform primary stakeholders, which includes parents, students, the community about the essential information on the nutritional facts and standards. Pro: Parents and teachers are primary stakeholders, who instill healthy nutrition habits in their children and students; parents influence their children by serving role models and applying all the appropriate dietary guidelines at home and provide healthyRead MoreMGMT 479 UNDER ARMOUR Powerpoint Group Essay1065 Words   |  5 Pagesgoals, adding timelines and budget plans would enhance company performance. Analysis of Strategic Factors *See note section for more details ïÆ'‘ International Marketing: Focus on product quality and appeal to global market sports outside of American Football. ïÆ'“ ïÆ'“ ïÆ'‘ Pros: Brand awareness to more consumers. Cons: Temporary Decrease in company profits. Competitive Pricing: Reevaluate pricing strategies against competitors ïÆ'“ ïÆ'“ Pros: Increase competitive advantage. Cons: Sales expectations unmet,

Sunday, May 10, 2020

Psychology Behavior and Mental Process - 1100 Words

Psychology is the study of the behavior of individuals and their mental processes. (Gerrig page 2). I think the field of psychology is divided into several parts: Research, counseling, perspectives, goals, and careers. Research has played a vital role in the psychology. It has identified and helped us to understand how and why people feel, act, and think. Implementing the scientific method enables the results to be both reliable and valid. By employing this precise method, psychologists are able to collect data and make reasonable conclusions based upon the facts collected. Counseling explores human thoughts and behaviors. Psychologists utilize theories to explain why these actions and thoughts occur. Aristotle, Plato, Wundt, and Freud†¦show more content†¦Biological is the basic need for food, water, and shelter. Safety includes security, comfort, and absence of fear. Attachment refers to the need to be loved (Gerrig pg. 302). Overall, business use ploys to appear to every person’s needs, wants, fears, and even desires. Individuals applied psychological principles in their interactions with others. Some people do not realize which approach they are using. Their actions are a conscience effort to obtain the desired results. This is evident at a very young age. Two preschoolers want the same toy. At first, the interaction is very civil. One child will ask the other child for the toy. In some cases the interaction ceases at this point when the child hands over the toy. In most cases the conversation continues with a negotiation. Child A indicates if he received the toy now, then Child B can have it later. However, more often than not, the interaction erupts in to the two children fighting for the toy. Eventually, one child will get hit harder than the other and relinquish the toy out of fear for further harm. After conducting some research, I have identified two areas of psychology which are of interests to me. The first area is genetic counseling. According to the Dictionary of Occupational Titles the main function of a genetic counselor is to study inheritance and variation of characteristics in forms of life and performs experiments to determine laws, mechanisms, and environmental factors inShow MoreRelatedEssay about Psychology: The Study of Behavior and Mental Process1347 Words   |  6 PagesPsychology is the study of behavior and the mental process. The mental process is the steps the mind takes to think, feel, etc., while behavior is just simply how one acts. In the beginning, philosophers such as Plato and Aristotle wrote about the relationship of the body and the soul. Psychologists and medical doctors wondered about the connection between the body and the brain whereas philosophers tried to explain the connections between the mind and the body. Psychologists study the process ofRead MoreFour Goals of Psychology Essay793 Words   |  4 Pagesof Psychology Amanda K Farias 12/17/2010 Four Goals of Psychology What are the four goals of psychology? To understand the four goals of psychology, you must first understand that psychology is based off of its findings from scientific research and critical thinking. The four goals of psychology are to describe, understand, predict, and control behavior and the mental process. These goals were set to help psychologists to better understand what factors cause different types of behavior andRead MoreFoundation of Psychology773 Words   |  4 PagesFoundation of Psychology Psychology is the study of human behavior and mind. According to Psychology: The Study of Mental Processes and Behavior defined psychology as the scientific investigation of mental processes (thinking, remembering, feeling, etc.) and behavior. Psychology alone has more than one basic foundation. Psychology can be as broad as biology and as detailed as philosophy, because it includes humans who are very complex in nature. Psychology involves more than how people act;Read MoreResearch Paper on William James and Functionalism1230 Words   |  5 PagesIntroduction William James (January 11, 1842 – August 26, 1910) was an American philosopher and psychologist who had trained as a physician. He was the first educator to offer a psychology course in the United States. James wrote influential books on pragmatism, psychology, educational psychology, the psychology of religious experience, and mysticism. He was the brother of novelist Henry James and of diarist Alice James. In the summer of 1878, William James married Alice Gibbens. WilliamRead MorePerspectives of Psychology1141 Words   |  5 PagesPerspectives of Psychology Psychology can be defined as the systematic study of mental processes, couple with behaviors, and experiences (Kalat, 2011). There are many ways in examining, mental processes and behaviors among people, and therefore psychologist uses different perspectives to understand how human beings, think, act, and behave. Some psychologist uses one perspective to analyze behaviors, and other uses a multidimensional approach. Carter Seifert (2013) identified 7 major perspectivesRead MorePsychology and Its Importance1295 Words   |  6 PagesArticle Psychology and Its Importance Psychology What psychology means? What’s the function of psychology? Is it important? What’s the importance of it then? What do you call a person who studies psychology? There are a lot of questions concerning psychology and as you continue reading this article many of those queries will get answered accordingly. Psychology means a theoretical, educational and applied science connecting the scientific study of mental operations and behavior or performanceRead MoreThe Question in the Origins of Psychology is What Drives Us and Why722 Words   |  3 Pageswas considered as its own scientific discipline. Psychology began in 1879 when a man named Wilhelm Wundt set up a psychology laboratory in Leipzig, Germany. This laboratory would be considered the birth place of experimental psychology. Within the laboratory, Wundt independently trained over 180 students. Over 100 of these students came from other countries, and then returned to their native countries with the knowledge of experimental psychology. Of the one-hundred, Edward Titchener returned toRead MoreHow Psychology Is The Scientific Study Of Behavior And Mental Processes849 Words   |  4 PagesWhat is psychology? The definition of psychology is the scientific study of behavior and mental processes. There are three key terms in the definition of psychology – science, behavior, and mental process. Psychology uses systematic methods to observe human behavior and draw conclusions. Behavior is anything that we do that is visible by another person, and mental processes are the thoughts and feelings that we experience but that are not noticeable by another person. For thousands of years, peopleRead MoreThe Diverse Nature Of Psychology1200 Words   |  5 Pages The Diverse Nature of Psychology Name Institution The Diverse Nature of Psychology Introduction Psychology consists of a wide collection of diverse concepts, which influence its precise nature that includes the study of behavior and mind in different organisms. Ideally, these organisms range from the most complex to the most primitive. In essence, diversity involves recognizing the variability of characteristics, which make people unique such as their physical appearance, partnered/maritalRead MoreSchool of Thought1108 Words   |  5 PagesPage1 When psychology was first established as a science it separated from biology and philosophy, the debate over how to describe and explain the human mind and behavior began. The first school of thought, structuralism, was advocated by the founder of the first psychology lab, Wilhelm Wundt. Almost immediately, other theories began to emerge and vie for dominance in psychology. The following are some of the major thought that have influenced our knowledge and understanding of psychology: Structuralism

Wednesday, May 6, 2020

New Worlds for AllIndians, Europeans and the Remaking of Early America Free Essays

Collin G. Calloway’s â€Å"New Worlds for All† is a wonderfully written look into the relationship between the indiginious people and the Europeans who came to America. His work takes a different path than those of other historians. We will write a custom essay sample on New Worlds for All:Indians, Europeans and the Remaking of Early America or any similar topic only for you Order Now There is a creative genius in how he explores the historical facts and insight into the history of the two different people’s lives. It is a helpful look at the lineage of the time and brings a new insight into the historical facts of our time. Covering events from the Revolutionary war in his introduction where our fore fathers asked the Indians to not stand at their side but remain passive in the fight for freedom in the introduction. Quoting several of our fore fathers, the tact they used in their bid to get the native people to think that they were all one and that they stood together with them. Each of the ten chapters covers a wide range of subject matter from the interactions with the Europeans and the Natives, to the warfare of the Natives against each other as well as against the invading Europeans. We take a walk through the Seven years war as well as all the wars that came before and after. It takes a look at the way the Europeans arrived in North America and wanted to build societies much like the ones they had left behind in Europe. It also goes on to explain that while they thought they were superior they found that the Native people were in some cases more advanced and superior than their own culture. How their arrival changed not only the workings of the native communities but the very land they lived on with the cutting down of trees for homes and the over hunting of their lands for food making it harder for them to feed their own families. The chapter on disease and healing was an amazing look at how the European disease affected the natives. It also looked at how the natives dealt with healing as not so much healing as conflict as they were complementary. Calloway goes on to say that while Native America people were not completely disease free the magnitude of their diseases were actually rather simple, from aches and pains to snake bites. Medicine men had a vast knowledge of herbs and plants that could be used for medicinal purposes. He covers the decimation of entire tribes by disease some of them brought by the Europeans and others brought by the natives themselves as they traded in foreign lands. There were several ceremonial aspects to the trade with the natives that the Europeans tried to integrate into their own trades. The Stuff of life in chapter three goes into depth about the interactions of the native people and the Europeans as they not only struggled to coexist as well as integrate the bits and pieces of each other’s cultures into their lives. Learning how to do something’s differently like hunting for food and even the diets and clothing they wore took on the differences of what they learned from each other. In the next chapter Calloway talks about the integration of religious beliefs of the different people the Christians that brought with them their beliefs in one God and his word, it brought many of the natives into a new religious arena where they learned about bibles, churches, missions, priest and ministers. Indian religions tended to be less exclusive and intolerant than that of the Christians. It is an interesting look at the way they handled the integration of the Christians not only into their culture but into their lives and how their own beliefs were shaped outside of what the Christians believed. Chapter five takes a look at the ways the Europeans affected the Indians in their warfare not only against the Europeans but also against other natives. The face of the way war was fought not only between warring tribes. The turning point in the tribal warfare changed on one Instance, 1609 when the Algonkin and the Montagnais Indians, the use of guns made this an uneventful war and short lived but it opened the door way to the Indian people to guerrilla warfare as well as the use of guns. The introduction of guns made the native weapons basically useless. Chapter Six, the diplomacy and Foreign affairs of the Europeans and the Indians were at times bloody and deadly, fighting to preserve their own lands the Indians had to adapt to the foreigners as they invaded and the Europeans were after more land and more land, always fighting with the Europeans trying to maintain the balance between the two worlds was difficult one side or the other was always violating the treaties that they signed. As more Europeans moved into the new world and more warfare and diseases ravaged the lands the Indians were forced to move from place to place and rebuild their world and lives often in environments that were not their own and dealing with people that they knew nothing about, this often created tension and conflicts. As well as the need for the Indians were forced to adapt to the world around them. There is a lot of great information in this book, and a fresh perspective that takes the reader weather a professional historian or just the average reader into the lives of people from different worlds. It is a new look at the world that was created around us and the people who inhabited it, their lives and the changes that were caused by each interaction with the other. Mr. Calloway takes us on a journey through old and new in an enlightening way, exploring the world as it is new and discovering the different effects of the changes in cultures, beliefs, politics and life as the people of two different cultures learned, adjusted, and tried to build the world we now see around us. A great read for anyone interested in the history of America and the people in it.    How to cite New Worlds for All:Indians, Europeans and the Remaking of Early America, Essay examples

Wednesday, April 29, 2020

Starbucks Coffee Company Research Paper Example

Starbucks Coffee Company Paper Starbucks had a humble beginning with one small store front in 1971 at the famous Pike’s Place in Seattle, Washington. The inspiration for Starbucks came from Peet’s Coffee and Tea who started importing fine Arabica beans from around the world (Arthur, 1999). At that time Starbucks had a simple mission of providing the world’s finest fresh roasted coffee to its customers, and it worked. A decade later in 1981, Howard Schultz, now Chairman, President and CEO, had entered Starbucks and was instantly captivated. For over a year, Howard pursued employment at Starbucks, wanting the job far more than Starbucks wanted him. Eventually, he convinced the three partners to take him on as head of marketing. He soon hung up his high profile New York City position and moved to Seattle. He quickly gained acceptance, knowledge and experience in all aspect of the coffee business. Howard’s trip to Italy a year later would change that one small store into the global corporation it has become today. He was be taken by the warmth and connectivity local Italians shared at their coffee bars, and wanted to combine the great coffee with the closeness of the community. After having a cafe latte, he concluded it was the perfect drink and no one in America knows about it. Upon returning, he had growing frustration as the owners did not want to leave the retail business for the beverage business. A year later, once the sixth store was open did Howard get his espresso bar? It was a huge success, but he could not convince the owners to expand the beverage business to the other stores. He left Starbucks to create his own coffee shop il Giornale with the financial help of Jerry Baldwin. He used Starbuck’s coffee to brew espresso and coffee beverages. We will write a custom essay sample on Starbucks Coffee Company specifically for you for only $16.38 $13.9/page Order now We will write a custom essay sample on Starbucks Coffee Company specifically for you FOR ONLY $16.38 $13.9/page Hire Writer We will write a custom essay sample on Starbucks Coffee Company specifically for you FOR ONLY $16.38 $13.9/page Hire Writer Soon II Giornale’s three stores had annual sales of $1. 5 Million. In 1987, Jerry Baldwin and Gordon Bowker decided it was time to sell Starbucks and Howard knew this was his opportunity. He was able to obtain the $3. 8 Million in capital to purchase Starbucks. This acquisition started the chain of quick expansion for Starbucks. By the late 1980’s, Starbucks had a few years of unprofitability as the stock market had crashed in October of 87. Howard relentlessly pushed forward, battling with his board to better the company and continue expansion. By 1991, the financial performance had improved and Starbucks went on to introduce their â€Å"bean stock. † This was an employee stock option plan that all employees working more than 20 hours per week were granted 12 percent of their base pay with stock options (Arthur, 1999). These generous fringe and higher than average pay allowed for Starbucks to retain highly motivated and talented baristas. In 1992 Starbucks went public with one of the most successful IPOs of the year. This allowed for Starbucks to pursue their three year geographic expansion plan. They achieved their plan by opening a large store in a major city that acted as a hub. A team of professionals were located in the â€Å"hub† and were task with the opening, support, and development of 20 or more stores around the hub store (Arthur, 1999). To grow internationally, Starbucks sought out license agreements with local companies. In 1996, they made their first international expansion into Japan and Singapore. They identify reputable companies that had experience in retailing and strong local knowledge. Through their aggressive expansion strategy combined with their model to be a connected member of the neighborhood, they have stores in 61 countries and 18,066 shops. They have successful just launched the acquisition into India with the first stores opened in Mumbai in 2012. Starbucks has a diverse beverage product line. Their core business is fresh roasted Arabica coffee, and espresso beverages. From this base, Starbucks continue to innovate their beverage offering based on consumer’s wants where they offer a range of smoothies, teas and chocolate beverages. With tea being a substitute for coffee, they had acquired Tazo Tea and most recently Teavanna. They have expanded their food offering in every store with an emphasis on healthy options. Through a partnership with Pepsi bottling, Starbucks entered the soft drink retail business with bottled Frappuccino and other coffee drinks. The entered the instant home brewing market with the launch of the Starbucks K-Cups. They continue to grow their merchandising and equipment business. Starbucks have a diverse line of merchandise from coffee accessories to music that is played in the stores. They retail all the equipment necessary to properly brew coffee from home, and sell their fresh roasted coffee. Not just a coffee shop and retailer, Starbucks realized its strength and advantage came from motivated baristas who would positively engage customers. The baristas are the face of Starbucks, and to cultivate the Italian espresso bar image, Starbucks had to develop engaged employees. Starbucks is very committed to quality and the image of Starbucks that is why Starbucks does not operate any franchises. At the end of 2012, Starbucks had a total of 18,066 stores of which 9,405 were company owned and 8,661 were licensed stores. The mix of company owned stores and licensed stores allow Starbucks to retain authority while accessing difficult markets and reducing costs. Starbucks classifies its stores into a three-region structure which includes: 1) Americas; 2) Europe, Middle East, and Africa; and 3) China/Asia Pacific. As of September 30, 2012, Starbucks had 7,857; 882; and 666 stores opened in each region respectfully. Under their licensed agreements, Starbucks had 5,046; 987; and 2,628 stores respectfully in each region (Form 10k). Overall the licensed agreements accounted for 9 percent of total revenue in 2012. Since 2009, Starbucks have seen a rapid and steady increase in their stock price. From the low of $8. 45 per share to the recent value of $65. 11 per share as of June 24th, Starbucks is trading just under its 52 week high. Starbucks is financial sound, producing steady cash from operations indicating steady demand and innovation. Consolidated revenues for 201 were $13. 3 billion which is an increase of 13. 7 percent from 2012 revenues of $11. 7 billion. From the $13. 3 billion, company-owned stores contributed 79. 2%; licensed stores – 9. %; and CPG food serveries contributed 11. 7% (Form 10K). Starbucks has been making financial improvements to its operating income which is up 40% since 2010. Their net income is also up 46% since 2010. With this increase only brings marginal performance increase. The operating margin for 2012 was 15% up from 13% in 2010. This has only seen slight improvements due to the volatility in the commodity markets and high costs of operating the stores. Starbucks has been steadily improving and that have estimated a revenue increase of 10 to 13 percent for 2013. They continue to develop and expand their channel development line which includes K-Cups and bottled coffee and tea drinks. They will see a steady increase in revenue from their licensed stores as-well-as their company owned stores. Their stock is estimated to appreciate into the low $70 per share range for 2013. Starbucks faces extensive competition on their coffee beverage business from quick-service restaurants and specialty coffee shops. As more local coffee shops open, they pressure the sales of existing Starbucks. Dunkin Donuts has set its sight on Starbucks, and has rebranded them a beverage company. By 2015 they plan to have opened 15,000 stores west of the Mississippi with a large portion of those stores operating in California (O’Connor, 2013). In distribution and sale of coffee and premade coffee products, Starbucks faces completion from nationwide coffee manufacturers. Kraft Foods is the supplier of Maxwell house and Procter and Gamble is the parent company of Folgers brand coffee. Recently Starbucks had a deal fall through with Kraft over the distribution of coffee to supermarkets. Schultz’s vision to create a company with soul derived the basis of Starbucks competitive advantage. Schultz’s dream to treat every employee with respect and to do better for the community became a way of life for Starbucks through good and bad financial times. Through extensive employee training and involvement, Starbucks developed actively engaged baristas that exceeds customers’ expectations of their coffee shops. Every new hire receives 24 hours of training within the first two to four weeks. They learn how to address and engage the customer, brew the perfect cup, and properly handle the coffee. Starbucks coffee line is hand chosen from around the world. Starbucks strives for the highest standard in the coffee industry and bypasses the coffee commodity market. They enter into fix-price contracts to secure their supply. This also allows Starbucks to exert considerable power of farmers to rely on the accuracy of the fair trade agreements. The stores ambiance of Starbucks is critically important to driving the culture and experiences at the coffee shop. Starbucks developed their own internal team of architects and designers to ensure that each store would convey the right image and character (Arthur, 1999). The company went to great lengths to make sure the store fixtures, the merchandise displays, the colors, the artwork, the banners, the music, and the aromas all blended to create a consistent, inviting, stimulating environment that evoked the romance of coffee, that signaled the companys passion for coffee, and that rewarded customers with ceremony, stories, and surprise (Arthur, 1999). Soon the cost of opening a new store became highly undesirable. Starbucks responded by centralizing buying which allowed them to realize a discount of 20 to 30 percent on orders from vendors. They focused on the equipment that was absolutely necessary for a successful new launch and employed a just in time management system on materials. This significantly cut costs and lowered store development time from 24 to 18 weeks. Through innovation Starbucks continues to remain competitive. Schultz’s built a company where employees can freely, without repercussions, submit ideas and comments about any aspect of the business. Through technological change, Starbucks have captured and stayed true to their promise of coffee and connectedness. Through digital applications, customers can pay for their order by using their phone to enhance the experience of their 14. 6 million loyalty card members. They adapt to consumer preferences and delivered Starbucks K-cups, a lighter roast coffee, and Starbucks refreshers. A constant problem that Starbucks faces is the increased competition from specialty coffee shops around the country. These shops possess a great threat to Starbucks because they specialize in fair trade organic coffee, but have a reputation of being the small business. Starbucks have been able to maintain a competitive edge over the small local coffee shop through their support of the â€Å"hub† system, high traffic locations, and Starbucks mission. The â€Å"hub† system allows for a highly talented team to quickly react to changes in the local market and satisfy consumers. The highly visible and high traffic locations make for convenience when consumers are in a rush on their daily routine. Starbucks involvement in the community through their extensive corporate social responsibility programs makes Starbucks seem like the local coffee shop. Starbucks Coffee Company (Starbucks) has five major stakeholder groups: customers, partners (employees), community / â€Å"neighbors,† suppliers and shareholders. Customers – Starbucks is incredibly dedicated to its customer base and emphasizes the human connection. Starbucks aims to, â€Å"connect with, laugh with, and uplift† (Starbucks mission statement) its customers, even though the customer interaction time is short. Partners (employees) – Starbucks does not simply call its employees, ‘employees,’ but rather partners because it is not just a job, but a passion (mission statement). Everyone within the organization â€Å"treats each other with respect and dignity. † All partners can feel comfortable being themselves because Starbucks is a place that embraces everyone’s individuality. Community / â€Å"Neighbors† – Starbucks has an extensive program around social responsibility and corporate citizenship. Starbucks believe that it should â€Å"have a positive impact on the communities it serves, one person, one cup and one neighborhood at a time. † (http://www. starbucks. com/responsibility) Suppliers – As part of its community and neighbor focus, Starbucks is passionate about ethically sourcing its coffee beans and â€Å"improving the ives of people who grow them. † (Mission Statement). Starbucks also makes it a point to work with suppliers that share the same vision of social responsibility. If a supplier is not meeting expectations, Starbucks will work with that supplier to make the necessary changes. Shareholders – Starbucks believes that if it can deliver in all of the above mentioned areas that it will be successful and be able to reward its shareholders. It wants its shareholder to â€Å"endure and thrive† (mission statement). Conflict among stakeholders can arise during changing economic conditions, specifically when suppliers are forced to raise prices. This increase in expense for Starbucks can translate into charging higher prices for its products. Customers may be turned off and change their habits and purchase their morning coffee from a competitor. This in turn will affect the financial success of the company and negatively impact the return to shareholders. (Annual report) However, interestingly enough coffee prices are actually falling but Starbucks has decided to increase its prices for certain products, as much as 10 cents. The shareholders will benefit from the extra money to the bottom line, but customers will be unhappy and may feel as though they are being taken advantage of. Table 1 (below), displays Starbucks’ top-management hierarchy, much in the same way the Jones text does in Figure 2. 1 (Jones, p. 38). Starbucks is a publically traded company so its shareholders are the legal owners of the organization. To oversee its governance structure, Starbucks’ Board of Directors adopted governance principles, committee charters and policies that guide the company to stay committed to its mission and maintain its uncompromising principles as it grows (corporate governance). The Board of Directors is also accountable for monitoring and evaluating the corporate-level management team that is responsible for Starbuck’s overall vision, strategic planning and goal-setting. Starbucks’ executive team is led by company founder and CEO, Howard Shultz. Schultz’s top-management team is made up of 14 executives that set strategy and oversee specific geographic areas (Americas, Asia, Africa, etc. ) and company functions like marketing, public affairs, community involvement, digital business, global strategy, and global coffee. Following down the chain of command are managers in line roles that are specifically responsible for the production of coffee in six roasting plants, and managers in staff roles that are responsible for overseeing specific organizational functions like communications, design, engineering finance, green coffee and tea management ,marketing, operations, procurement, quality, research and development, sales, social responsibility and supply chain management. Beyond the central functions are the divisional and functional management teams that oversee Starbucks’ 18,066 (annual report) company-operated and licensed stores throughout the world. In succession, regional directors oversee district managers that oversee store managers that supervise assistant store managers that supervise assistant store managers that oversee shift supervisors and baristas. Each position has its own responsibilities for meeting financial, management and customer service goals. One of the most important positions is probably that of the barista, as those partners are the face of Starbucks interacting with customers and create that personalized and unique customer experience.

Friday, March 20, 2020

Prolonged Preservation of the Heart Prior to Trans Essays

Prolonged Preservation of the Heart Prior to Trans Essays Prolonged Preservation of the Heart Prior to Transplantation Biochemistry Prolonged Preservation of the Heart Prior to Transplantation Picture this. A man is involved in a severe car crash in Florida which has left him brain-dead with no hope for any kind of recovery. The majority of his vital organs are still functional and the man has designated that his organs be donated to a needy person upon his untimely death. Meanwhile, upon checking with the donor registry board, it is discovered that the best match for receiving the heart of the Florida man is a male in Oregon who is in desperate need of a heart transplant. Without the transplant, the man will most certainly die within 48 hours. The second man's tissues match up perfectly with the brain-dead man's in Florida. This seems like an excellent opportunity for a heart transplant. However, a transplant is currently not a viable option for the Oregon man since he is separated by such a vast geographic distance from the organ. Scientists and doctors are currently only able to keep a donor heart viable for four hours before the tissues become irreversibly damaged. Because of this preservation restriction, the donor heart is ultimately given to someone whose tissues do not match up as well, so there is a greatly increased chance for rejection of the organ by the recipient. As far as the man in Oregon goes, he will probably not receive a donor heart before his own expires. Currently, when a heart is being prepared for transplantation, it is simply submerged in an isotonic saline ice bath in an attempt to stop all metabolic activity of that heart. This cold submersion technique is adequate for only four hours. However, if the heart is perfused with the proper media, it can remain viable for up to 24 hours. The technique of perfusion is based on intrinsically simple principles. What occurs is a physician carefully excises the heart from the donor. He then accurately trims the vessels of the heart so they can be easily attached to the perfusion apparatus. After trimming, a cannula is inserted into the superior vena cava. Through this cannula, the preservation media can be pumped in. What if this scenario were different? What if doctors were able to preserve the donor heart and keep it viable outside the body for up to 24 hours instead of only four hours? If this were possible, the heart in Florida could have been transported across the country to Oregon where the perfect recipient waited. The biochemical composition of the preservation media for hearts during the transplant delay is drastically important for prolonging the viability of the organ. If a media can be developed that could preserve the heart for longer periods of time, many lives could be saved as a result. Another benefit of this increase in time is that it would allow doctors the time to better prepare themselves for the lengthy operation. The accidents that render people brain-dead often occur at night or in the early morning. Presently, as soon as a donor organ becomes available, doctors must immediately go to work at transplanting it. This extremely intricate and intense operation takes a long time to complete. If the transplanting doctor is exhausted from working a long day, the increase in duration would allow him enough time to get some much needed rest so he can perform the operation under the best possible circumstances. Experiments have been conducted that studied the effects of preserving excised hearts by adding several compounds to the media in which the organ is being stored. The most successful of these compounds are pyruvate and a pyruvate containing compound known as perfluoroperhydrophenanthrene-egg yolk phospholipid (APE-LM). It was determined that adding pyruvate to the media improved postpreservation cardiac function while adding glucose had little or no effect. To test the function of these two intermediates, rabbit hearts were excised and preserved for an average of 24.5 1 0.2 hours on a preservation apparatus before they were transplanted back into a recipient rabbit. While attached to the preservation apparatus, samples of the media output of the heart were taken every 2 hours and were assayed for their content. If the compound

Wednesday, March 4, 2020

Order Professional Help Annotated Bibliography Examples

Order Professional Help Annotated Bibliography Examples Annotated bibliography is a combination of the research materials citations and their summaries. It is one of the elements of a good APA, MLA or Chicago style paper. If you are searching for the examples of annotated bibliography here is a collection of samples of annotated bibliography: Chicago Style, MLA, APA. If you dont have time to write it on your own, you may read: HOW TO BUY ANNOTATED BIBLIOGRAPHY ONLINE What is an Annotated Bibliography? An annotated bibliography is a list of research materials - books, articles, and documents  - presented both as citations  and as a summary of their value. The description acts to evaluate the source as a credible document. The purpose of the annotated bibliography is to inform the reader of the relevance, accuracy, and quality of the sources cited. Annotated bibliographies are different from abstracts, the latter being purely descriptive summaries found at the beginning of scholarly journal articles, while annotations are descriptive and require critical thinking. They may take into account the authors point of view, authority, and the place and time of their piece. How to Write an Annotated Bibliography Step 1.  Choose works that provide a balanced perspective on your topic. Step 2.  Locate and cite the books, periodicals, and documents about your topic. Step 3.  Cite the source using the appropriate style for your paper: MLA, APA or Chicago Manual Style. Step 4.  Write a concise annotation that summarizes the central theme and scope of the book or article. Include one or more sentences that accomplish one of the following: qualify the authority of the author; comment on who might gain from reading this source; compare the work to other work being cited; or, explain how this work enlightened you on your topic. Step 5.  Sign up today for the annotated bibliography writing service that will change the way you finish your school assignments. Sample MLA Annotation Greene, Robert. The 48 Laws of Power. Penguin Books, 2000. Greene offers honest advice on how to conduct ones life, according to the lessons we have learned from history, its rulers and their failures. Taking a sometimes fantastical approach to the realities of societal rules and norms, the chapters in Greenes book are wry and anecdotal and offer advice on everything from avoid the unhappy and the unlucky and mastering the art of timing. In the process, Greene includes interpretations of each law and examples of when the law was carried out in reverse to someones detriment. Greene offers sober, although harsh, advice for those struggling with ones imperfect journey with flawed peers, unfair laws, and conniving rivals. Rather than a practical handbook to how to live ones life, this text takes an honest perspective with advice that only those who truly need power will end up being able to implement in their life. However, there is still some useful tips that us every man and every woman can take. Chapters in this text lend themselves to being studied out of order, or as they become necessary in the readers life. Some of the chapters would even do well as part of a history course, or a section of a course, where students were learning about the human spirit and human folly. See also: MLA Essay Format with Example Sample APA Annotation Camron, J. (1992). The Artists Way. New York: Tarcher Putnam. In this workbook of nonfiction based on the writers creative journey, Cameron attempts to guide readers through the stages of reclaiming their inner artist and bringing more art into their lives. She does so by implementing the discipline of writing morning pages each day and by answering open-ended questions throughout to help the reader gauge where and why they may be stuck creatively. An experienced writer, Cameron is aware of the limitations of her experiment, and thats why she uses this book in tandem with live talks and workshops and encouraging fans of her work to meet where they live and help each other operate more like artists. The author is forthcoming about her past struggles with alcohol and the frustrations in her shortcomings as a poet to help ease the pretense that artists are artists and those who are not yet artists are on the outside looking in. Camerons book is completely inclusive and seems to embrace all who dare to discover their dormant inner artist. See also: APA Citation Machine Referencing Format Tool Sample Chicago Style Annotated Bibliography Schwabs book provides a thorough examination of the current state of Africas countries, communities, wars, resources, and leaders and how things came to be, from colonization until the new millennium. The author discusses relevant topics, such as war, cross-border conflict, ethnic conflict, despotic leadership, predatory regimes, and economic health. The book includes chapters on the slave trade, AIDS and poverty, globalization, and a question that asks if the continent will survive. This book could be read as part of a course but it appears the intention of the writer was to create a book for the interested layman to get a brief and terrifying history lesson. See also: Chicago Style Format with Example We hope, youve found these annotated bibliography samples helpful. Use them as the examples when composing your annotated bibliography. If you have no time for writing your APA annotated bibliography or MLA annotated bibliography, etc., you may order it online.  Place an order for annotated bibliography writing help, saying write me annotated bibliography, and we will deliver to you an expertly-presented piece. If you need any other writing services, feel free to contact our writers for assistance.

Monday, February 17, 2020

The Conflict in Ukraine (2014-ongoing) Essay Example | Topics and Well Written Essays - 1500 words

The Conflict in Ukraine (2014-ongoing) - Essay Example The Conflict in Ukraine (2014-ongoing) is the greatest example of where the rule of the people cannot be respected by the running government. The government instead goes to the point compelling the people with the leadership they rejected (Lauren, Viola& Kathleen, 2015). Ukraine came back to full-scale war or conflict is very saddening. The fight begun in the 2014 April and has since raged numerous months to the eventual stage when the separatists and the Ukrainian government came to a ceasefire. The ceasefire has been used to prepare and reigniting of the fight mainly entailed capturing of the Donetsk airport that is a strategic symbol and asset from the government forces. The government troops have pulled out of the town that is the key transport hub as a new truce was established on 12 February in attempts to stage mediation process. The war has placed a cost of close to 5600 lives. The violence has placed up debilitating effects to the country as many civilians have been killed by rockets on the rebel side in the cities like Luhansk and Donetsk. Approximately thirty people were killed in the Maripaul, which is a port city under artillery attack. Rebels have since then besieged main roads and rail hub in areas of Debaltseve, which is the region i n which most Ukrainian military troops have their base. The Ukranian problem is equally shared in various other parts of the globe where poor electoral and leadership have resulted in rebels and mass killings. In the past few months thousands of Bangladesh workers died in one of the greatest workplace safety tragedy in ever recorded in memorable history. Nigeria, Iran, Russia and many other countries close to 80 countries have created a discriminatory environment for the LGBT persons. This case has been created by the design of policies and laws that deny the LGBT their human rights and respect to human dignity. The condition has created a

Monday, February 3, 2020

Critical Evaluation Of The Three Approaches To IHR Essay

Critical Evaluation Of The Three Approaches To IHR - Essay Example Thus, â€Å"globalization is a process of interaction and integration among the companies as well as the people of different nations, a process which is mainly process driven by international trade and investment for the benefit of the investor as well as the host country† (Herbig 2008, p.6). Thus, in a way the globalisation from the last decade of the 20th century has optimized the opportunities for the companies, particularly the Multinational Companies (MNCs) to enter foreign countries, give employment to the local population as well as sell their products or services at competitive prices. In addition, firms cannot keep on operating in a saturated home market to achieve success. They have to break geographical boundaries as well as their economical limits to tap those opportunities in the foreign markets or countries, by following the process of internationalisation. Thus, internationalisation is a happening concept which is being used by many firms to expand their reach g lobally. â€Å"As the global economy expands, as more products and services compete on a global basis and as more and more firms operate outside their countries of origin, the impact on various business functions becomes more pronounced† (Briscoe and Schuler 2004, p. 20).... ing, researching, applying and revising all human resource activities in their internal and external contexts as they impact the process of managing human resources in enterprises throughout the global environment† (Briscoe and Schuler 2004, p. 20). When this management of human resources or employees in the international context is focused, it can be categorized into three approaches: cross-cultural management; comparative human resource management; and multinational perspective in human resource management. The first approach of cross-cultural management focuses on understanding the cultural differences and similarities that may exist between the entering firm or the home country and the local employees or the host country. Each country will have distinct and unique cultural traditions, and so the employees will also imbue it in them and exhibit during the organizational processes. Thus, these cross-cultures of the firms as well as employees have to be managed under the auspi ces of IHRM approach of cross-cultural management. As Cieri, Fenwick and Hutchings (2005, p.588) states, cross-cultural management focuses on â€Å"identifying the likely impact of cross-culturally similar and different human behaviour on the functional elements of HRM, including recruitment and selection, training and development, performance management and reward management.† Even before the foreign firms enter new countries, the employees in those firms will not be all similar, as they could come from different background. Those employees could have been made into a unit through the formation of common organizational culture and other strategies. When these firms with their employees enter new countries, it will be more challenging for them. Most of the countries around the world will have

Sunday, January 26, 2020

Analysis of Sickle Cell Disease

Analysis of Sickle Cell Disease Safiullah Barat Melissa Parker Canada is becoming more multicultural as individuals from developing countries are making Canada their home. As the rate of immigrants in Canada is rising, diseases that were uncommon are becoming more prevalent. For instance, disorders such as sickle cell disease are increasing in all regions in Canada (Neglected Conditions, 2014). Sickle cell disease is genetic disorder that causes undesired effects which decreases an individual’s quality of life. The purpose of this paper is to analyze the pathophysiology of sickle cell disease, and to research evidence based practice such as management and prevention measures. To begin, a brief explanation of the search strategy used will be discussed, followed by details on the epidemiology of sickle cell disease. Furthermore, aspects of the disorder will be discussed in the following order: risk factors, clinical manifestations, diagnostic tests, complications, evidence based treatment, and different levels of preventive measures. Accord ing to RNAO, â€Å"knowledge provides the basis for professional practice and, is a central aspect of professionalism† (Professionalism in nursing, pg. 28). It is evident that nurses need to critically analyze disorders, such as sickle cell disease, in order to apply and provide competent care. Search Strategy To help retrieve the most up to date, recent and peer reviewed articles, different search strategies have been used. Nursing databases such as ProQuest, CINHAL and MEDLINE were used to find the appropriate journal articles. After doing so, search limiters were used to narrow down the search. Peer reviewed, full text and published dates set from 2009 to 2014 were selected, as well as the availability of references was included. Boolean operators, â€Å"and† and â€Å"or†, were commonly used ; furthermore, search term â€Å"sickle cell disease† and Boolean phrases including â€Å"complications†, â€Å"treatment†, â€Å"diagnostic test†, â€Å"pediatrics†, â€Å"prevention†, â€Å"etiology†, and â€Å"Canada† were combined to narrow the search. Epidemiology Sickle cell disease is prevalent in areas where malaria is common. This includes area such as the Caribbean, Nigeria, Middle East, Mediterranean, Indian sub-continent, Greek, Turkey, India, Pakistan, Ghana, and Far East China (Brown, M. 2012). A study conducted by Lanzkron et al (2013) took a look at mortality rates with individuals who had sickle cell disease over a time frame of thirty years. Over the course of thirty years, 16, 654 sickle cell-related deaths had occurred with a mortality rate of 0.7% each year (Lanzkron et al, 2013). In Canada, one in every 2500 babies will be born with sickle cell disease, and have a one in four chance (25%) of having sickle cell disease. Furthermore, they have a one in two chance (50%) of being a carrier for sickle cell disease (Sickle Cell Disease Association of Canada, 2013). Etiology/Risk Factors Sickle cell disease is an inherited autosomal recessive condition that causes an abnormal formation of hemoglobin. Different types of sickle cell disease includes sickle cell anemia (HbSS), sickle hemoglobin-c disease (HbSC), and sickle cell thalassemia (HbS) ( Brown, M. 2012).However, the most common is sickle cell anemia (Lewis, 2014). This inheritance occurs when both the mother and father pass on the defective gene to their child (Brown, M. 2012). Therefore, being a carrier of the sickle cell trail is a major risk factor. Individuals have an increased risk of developing sickle cell disease if residing in areas where malaria is endemic. Sickle cell disease puts individuals at risk whose ancestors came from West Africa, southern Italy, northern Greece, South and Central America, Middle East, Central India, southeast coast of Turkey and Mediterranean in Sicily (Pack-Mabian, A Haynes, J.r. 2009). Clinical Manifestations Although, each individual will display different signs and symptoms of sickle cell disease, they all display one similar characteristic: when exposed to factors that decrease oxygen, the hemoglobin forms into a sickle-shaped red blood cell which blocks the flow of blood. As a result, clinical manifestations often show anemia, jaundice and severe pain (Addis, G. 2010). Often, patients are asymptomatic except when experiencing a sickling episode (Lewis, 2014). An individual with sickle cell disease may develop anemia due to the complete destruction of red blood cells or hemolysis (Addis, G. 2010). Normally, red blood cells live for 120 days in our body but sickle cells usually die within ten to twenty days (Addis, G. 2010). As a result, the body’s organs are not receiving enough oxygen. The body compensates as it increase heart rate, increase blood pressure to allow the oxygenated hemoglobin to reach the necessary organs. Furthermore, individuals will display signs and symptoms of SNS or fight or flight response. Increase pupil dilation, diaphoresis and tachypnea are evident in patients with sickle cell crisis (Tortora Derrickson, 2012). In addition, the constant breakdown of hemoglobin produces bilirubin, a byproduct of hemoglobin, which cannot be processed by the liver. As a result, the bilirubin gets stored in the blood and connective tissue which results in yellowing of the eyes and the skin (Addis, G. 2010). However, the most common manifestation individuals with sickle cell disease experience are pain as a result of vaso-occlusive crises, also known as sickle cell crisis. Pain related to sickle cell disease accounts for ninety percent of hospital admissions (Musumadi, L. et al. 2012). This is mainly due to episodes of sickling that prevents oxygenated blood reaching organs, which results in ischemia and gradual deterioration of tissue and organ function (Musumadi, L. et al., 2012). Diagnostic Tests Diagnostic tests to diagnose sickle cell disease involve blood work. Often, individuals who have sickle cell disease are best diagnosed with the use of a peripheral blood smear test which reveals sickle cells (Lewis, 2014). In addition, sickle hemoglobin tests involve taking red blood cells, and expose them to factors that deoxygenate the blood, and determines if there is hemolysis (Lewis, 2014). Furthermore, a test known as the hemoglobin electrophoresis helps to differentiate sickle cell trait between sickle cell disease. It works by identifying various types of hemoglobin within a blood specimen to confirm the diagnosis of sickle cell disease (Randolph Wheelhouse, 2012). Additionally, secondary diagnostic tests could be used to diagnose complications that arise with sickle cell disease. Individuals may require a chest x-ray, skeletal x-ray, magnetic resonance imaging (MRI), and a Doppler ultrasound (Lewis, 2014). Skeletal x-rays are used to determine bone and joint deformities whereas chest x-rays are used to diagnose chest infection (pneumonia). MRIs are used to aid in the diagnosis of a stroke caused by blocked blood vessels from sickled cells Likewise, a Doppler ultrasound may be used to diagnose deep vein thrombosis (DVT) (Lewis, 2014). Course of the disease and complications Sickle cell disease causes a wide range of complications that begin at infancy and worsen with age when not controlled. Complications develop when sickling episodes causes vaso-occlusion which leads infarction of body tissues and organs (Lewis et al., 2010), and with increasing age, causes end-organ complications (Miller Meier, 2012). At age 2, children begin to experience dactylitis, pain in small bones of hands and feet (Miller Meier, 2012). Vaso-occlusive pain involving the back, chest, abdomen, or extremities continues to occur throughout the lifespan of an individual with sickle-cell disease (Pack-Mabien, 2009). Furthermore, both pediatrics and adults encounter the difficulty of anemia as it leads to other complications such as bone marrow suppression, renal insufficiency, and splenic or hepatic sequestration (Pack-Mabien, 2009). The infarction of the spleen can begin in infancy and causes another major complication: infection. The dysfunction of the spleen and its inability t o phagocytize foreign objects can cause major infection in both children and adults â€Å"and is the leading cause of morbidity and mortality in patients with sickle cell disease† (Miller Meier, 2012). Additionally, sickling episodes can affect the pulmonary system in all affected age groups and causes acute chest syndrome, a disorder that includes pulmonary complications such as pneumonia, fat embolism, systemic infection, pulmonary infarction, and if not treated, can lead to respiratory failure (Miller Andrew, 2012). Unfortunately, children and adults are also at risk for stroke due to cerebral infarction (Miller Meier, 2012). Other complications include gallstones, kidney failure, priapism or involuntary erection, delayed sexual development, delayed growth, bone necrosis, and leg ulcers (Brown, M. 2012). Treatments The treatment of sickle cell disease involves the reduction of symptoms and complications. Treatment includes pain management involving opioid or non-opioid analgesics, anti-inflammatory drugs, and NSAIDS (Addis, 2010). Also, cognitive behavioural therapy and non-pharmacological approaches can benefit patients with chronic or acute pain (Addis, 2010). Another treatment includes RBC transfusion and is required â€Å"as an emergency measure or to prevent short or long-term complications.† (Addis, 2010). Furthermore, a medication called hydroxyurea is a major advancement in the management of sickle cell disease and is available in Canada (Canadian Association of Sickle cell†¦). Hydroxyurea increases the level of fetal hemoglobin that results in an overall decrease in circulating sickle cells (Smith et al., 2011). A clinical study conducted by Smith et al (2011), has proven a decrease in pain intensity in patients undergoing hydroxyurea therapy, as well as a decrease in analg esic use and a significantly lower reduction in crisis and mortality. Moreover, multiple studies have shown bone marrow transplant as a potential cure of sickle cell disease; however, further studies are needed for this treatment to be recommended as a standard treatment for sickle cell disease (Thompson, 2012). Preventive Measures Primary Preventive Measures Although genetic risk factors are non-modifiable, there is a preventive measure for sickle cell disease: genetic counselling. Genetic counselling should be encouraged in patients with the sickle cell trait especially when planning to have a child. This preventive measure helps patients understand and adapt to the implications of genetic contributions to the disease and offers â€Å"counselling to promote informed choices and adaptation to the risk or condition† (Lewis, 2014. p. 787). A 6-year study in Saudi Arabia, a country of high prevalence of sickle cell disease, showed a significant decrease in the genetic disease through the use a genetic counselling program as it decreased the number of at-risk marriages (Memish, 2011). Secondary Preventive Measures Prevention measures in the secondary level focuses on diagnostic tests and screening for sickle cell disease. Newborn screening is the earliest way to detect whether the child has sickle cell disease in time to prevent serious complications from occurring (Newborn Screening Ontario, 2013). According to the Newborn Screening Ontario (2013), newborn screening can prevent â€Å"infection and sepsis, growth delay, painful sickle crisis, tissue ischemia and organ damage.† Secondary preventive measures also involve previously stated diagnostic testing for complications such MRI for stroke, the use of x-rays for chest infections, etc. Also, pain is a major complication in both adults and pediatrics and should be diagnosed; however, it is challenging to detect pain in unresponsive clients such as neonates. Registered Nurses Association of Ontario recommends the use of a validated pain assessment tool for neonates called Neonatal Infant Pain Scale (NIPS) due its evidence of reliability and validity. This tool includes components such as facial express, cry, breathing patterns, arms, legs, and state of arousal component (Assessment and Management of Pain, 2013). Tertiary Preventive Measures Tertiary preventive measures involve treatments that aid in regaining patient’s functional ability and the elimination of the disease. For individuals with sickle cell disease, preventive measures at this level include medical interventions to prevent and control symptoms and complications. For example, interventions are pain management, hydroxyurea, and transfusion therapies as mentioned earlier. Furthermore, penicillin can be given to children starting at 2 months of age, and vaccinations against pneumococcal infections, flu, meningitis, and hepatitis are important to prevent infections and early death (Addis, 2010). Conclusion In conclusion, sickle cell disease is one that affects the quality of life of affected individuals. The analysis focused on different aspects of sickle cell disease such as the epidemiology in which prevalence is high in areas where Malaria is predominant. Also, due to increasing immigration, the incidence of the disease is increasing in Canada. Furthermore, known risk factors have been identified such as genetic and environmental factors. In addition, the main clinical symptoms with sickle cell disease include pain as well as symptoms of anemia. Furthermore, a variety of tests which include blood work are the determinants of the presence of sickle cell disease. Sickle cell disease potentiates of a variety of complications, most commonly vaso-occlusive pain, acute chest syndrome, anemia and other major organ complications. Unfortunately, treatment only aids in controlling the complications and does not provide a cure for the disease. It is evident that the need for further research i n stem cell transplant as a potential cure is highly needed. Lastly, genetic counseling, neonatal screening, diagnostic tests, and current evidence based treatment such as pain management, hydroxyuria and transfusion therapy, are all preventive measures of symptoms and complications of the disease. The findings in this analysis are significant for nurses to apply when having encountered a patient with sickle cell disease. Certainly, it is important for nurses to acknowledge the increasing diversity in Canada and to continue competency by constantly seeking new pertinent information to apply to everyday practice. References Addis, G. (2010). Sickle cell disease, part 1: understanding the condition. British Journal Of School Nursing, 5(5), 231-234. Brown, M. (2012). Managing the acutely ill adult with sickle cell disease.British Journal Of Nursing,21(2), 90-96. Lanzkron, S., Carroll, C., Haywood Jr., C. (2013). Mortality Rates and Age at Death from Sickle Cell Disease: U.S., 1979-2005. Public Health Reports, 128(2), 110-116. Lewis, S. M. (2010). Medical-surgical nursing in Canada: assessment and management of clinical problems (2nd Canadian ed.). Toronto: Mosby Elsevier Canada. Memish, Z., Saeedi, M. (2011). Six-year outcome of the national premarital screening and genetic counseling program for sickle cell disease and [beta]-thalassemia in Saudi Arabia. Annals Of Saudi Medicine, 31(3), 229-235. doi:10.4103/0256-4947.81527 Miller, Andrew C., and Mark T. Gladwin. (2012) Pulmonary Complications of Sickle Cell Disease.American Journal of Respiratory and Critical Care Medicine185.11 (2012): 1154-65.. Miller, J. L., Meier, E. (2012). Sickle Cell Disease in Children. Drugs, 72(7), 895-906. doi:10.2165/11632890-000000000-00000 Musumadi, L., Westerdale, N., Appleby, H. (2012). An overview of the effects of sickle cell disease in adolescents. Nursing Standard, 26(26), 35-40 Neglected conditions. (2014). Canadian Medical Association.Journal, 186(6), 452-453. Newborn Screening Ontario. (2013). Newborn screening manual: a guide for newborn care providers. Retrieved from http://www.newbornscreening.on.ca/data/1/rec_docs/795_CHO0093-NSM-Web.pdf Pack-Mabien, A., Haynes, J. r. (2009). A primary care providers guide to preventive and acute care management of adults and children with sickle cell disease. Journal Of The American Academy Of Nurse Practitioners, 21(5), 250-257. doi:10.1111/j.1745-7599.2009.00401.x Randolph, T. R., Wheelhouse, J. (2012). Novel test method (sickle confirm) to differentiate sickle cell anemia from sickle cell trait for potential use in developing countries. Clinical Laboratory Science, 25(1), 26-34. Registered Nurses’ Association of Ontario. (2013). Nursing Best Practice Guidelines: Assessment and Management of Pain. Retrieved from http://rnao.ca/ Registered Nurses’ Association of Ontario. (2007). Nursing Best Practice Guidelines: Professionalism in Nursing. Retrieved from http://rnao.ca Sickle Cell Disease Association (2013). Reterieved from http://www.sicklecelldisease.ca/ Smith, W. R., Ballas, S. K., McCarthy, W. F., Bauserman, R. L., Swerdlow, P. S., Steinberg, M. H., Waclawiw, M. A. (2011). The Association Between Hydroxyurea Treatment and Pain Intensity, Analgesic Use, and Utilization in Ambulatory Sickle Cell Anemia Patients. Pain Medicine, 12(5), 697-705. doi:10.1111/j.1526-4637.2011.01096.x Tortora, G. J., Derrickson, B. (2012). ANS Neurotransmitters and Receptors. Anatomy Physiology: Princples of Anatomy. Danvers, MA: JOHN WILEY.