What the In-Crowd Wont Tell You About Short Essay Writing Samples Bdsm

What the In-Crowd Won't Tell You About Short Essay Writing Samples Bdsm Essay writing can be rather a challenge. On our website, you are going to come across competent essay writers who will aid you with your assignments whatever they may be. Check your review to make certain that it follows the assignment. The conclusion can be composed of a couple of sentences. You may use the samples as a foundation for working out how to write in the suitable style. Something besides your goods is competing for the prospective client's money. Every individual has the right to comprehend how that food will impact their physique. No paper written for a different client is used for a different customer. Any documents containing confidential info or that were written with the help of others are no-gos. Avoid sending 10-15 page research paper even when you received an excellent grade. Academic papers play an incredibly important part in your academic success. Short Essay Writing Samples Bdsm - Is it a Scam? When you compose a brief essay, you have to bear in mind that there aren't any elements to be sacrificed. The body is fundamentally the center of your essay or composition. When you have finished with your composition, it is very important you take an instant and read over what you have written. You may want to choose pieces that show your entire scope of talents. Essays are extremely personalized. A literature review discusses information in a specific subject which has been published. Mind is the principal weapon in any volatile circumstance and is the big element of Self defense training. When it regards an expository essay, bear in mind that it's aimed at an estimation of the subject from your standpoint. If you would like to send a sample of a bigger document, pick a 2-5 page section and introduce it using a paragraph that puts the selection into the suitable context. There are specific things you should do before you compose a literature review. The narrower your topic is, the simpler it is going to be to limit the variety of sources you require in order to go through to find a superb survey of the material. A terrific conclusion will summarize all data that has happened in the short article and use it in order to give one final reason why you ought to join our side. Having us to address any of the problems which you may face when coming up with scholarship essay topics will be recommended for you. There are 10 basic kinds of essay that are widespread in the sphere of academic writing. For instance, if you're writing an essay on How Global Warming can be lo wered, it'll be a great idea you take a minute to define what global warming is about in your introductory paragraph. If you're working with prose, do something similar. Writing good compositions is extremely important in the English Language in the feeling that it permits the student to have the ability to express what is in her or his mind regarding a specific matter. Our writers are specially vetted and trained to make certain they work diligently to fulfill all your requirements. Even if you believe you're a bad writer today, you can learn to take your simple essay and transform it into something far more effective. In truth, it is more comfortable to write about something you understand well and something you're sure about than digging into the info that was received from another person. Your mind believes something is correct, therefore it makes sure it will become true. The first thing you're likely to have to do is to choose a topic that has more than one clear side. With us, it doesn't matter what your reason is, you might not have enough time, knowledge, skills or another reason that may not permit you to compose the paper.

Theory Based Health And The Prevention Of Hiv And Stds

Theory Based Health Interventions applying Health Belief Model and Theory of Planned Behavior/Reasoned Action to the prevention of HIV and STDs HED 525: Health Behavior and Health Education 11/17/2014 Theories: As a health educator, developing theory-based health behavior change interventions is an integral part of promoting health in the community. The theories chosen for this topic have been frequently applied to the prevention of HIV and STDs in various countries and various target populations. The research presented on this topic will provide evidence on how well the Health Belief Model and the Theory of Planed Behavior/Reasoned Action were applied in each situation in regards to the prevention of HIV and STDS. According to Glanz, Rimer, and Viswanath (2008) the Health Belief Model attempts to explain why people do or do not engage in specific health behaviors such as taking action to prevent, screen for, or to control illness conditions through concepts including susceptibility, seriousness, benefits and barriers to a behavior, cues to action, and self-efficacy. Perceived susceptibility is defined as a person’s beliefs about the likelihood of getting a disease or condition. Perceived severity is defined as a person’s feelings about the seriousness of contracting an illness or of leaving it untreated. Perceived benefits are described as influencing whether a person’s perceived susceptibility will lead to behavior change. Perceived Barriers are described asShow MoreRelated Improving the Effectiveness of Sex Education in Schools Essay980 Words   |  4 PagesThe question is no longer should sex education be taught, but rather how should it be taught. Over 93% of all pub lic high schools currently offer courses on sexuality or HIV. More than 510 junior and senior high schools have school-linked health clinics, and more than 300 schools make condoms available on campus. The question now is, are these programs effective, and if not, how can we make them better? Kids need the right information to help protect them-selves. The US has more than doubleRead MoreUse of Social Marketing to Control the STDs Pandemic Essay1945 Words   |  8 Pagescentury has seen a pandemic that is wrecking just as much havoc on the globe- Sexually Transmitted Diseases (STDs) and one in particular- HIV and AIDs. The focus of this paper will explore past interventions using social marketing and Social Network Theory as their foundation to encourage condom usage to prevent the spread of STDs. Public Health Concern In modern times, STDs (such as HIV and AIDs) have wrecked such havoc upon the globe with more than 35.3 million being affected in 2012 (UNAIDSRead MoreReduction Of Stds And Hiv Essay2038 Words   |  9 PagesReduction of STDs and HIV in Adolescent Women An Analysis of the Reduction Program: Sisters Saving Sisters Ashley Reid CPH 330: Human Sexuality Dr. Mary Koss THE PROBLEM The aim of the intervention program Sisters Saving Sisters (SSS) is to help prevent and reduce HIV and other STDs rates in young African American and Hispanic women. Sisters Saving Sisters aims to reduce the overall number of sexual partners adolescent women have to decrease their risk of contracting HIV or otherRead MoreSociological Perspectives On Sexual Activity1544 Words   |  7 Pagesphysically and emotionally and although engaging in sexual activity is a personal decision, taking risks can certainly have outside influences. Psychologist Urie Bronfenbreener’s ecological perspective theory posits that a child’s development is formed through interconnected influences with their environment based on a layered system. These systems include: microsystem (direct connection to groups or institutions), mesosystem (the interconnection between microsystem components), exosystem (social settingsRead MoreCost Effectiveness Of Daily Oral Prep For Msm1401 Words   |  6 Pag esJuusola et al. (2012) added to this literature with a study of the cost-effectiveness of daily oral PrEP for MSM. Using a detailed economic analysis combined with the dynamic progression and transmission of HIV/AIDS model, the researchers assessed PrEP cost-effectiveness (based on clinical trials showing a 44 percent reduction in infection) in the general MSM population, and among high-risk MSM. The results indicate that initiating PrEP in 20 percent of U.S. MSM over 20 years would yield a 13 percentRead More African Americans, HIV and AIDA Essay2302 Words   |  10 Pagesepidemic proportions. According to the Centers for Disease Control and Prevention (CDC) in Atlanta, there are an estimated 1 million Americans infected with AIDS and 40,000-80,000 new infections with Human Immunodeficiency Virus (HIV) each year. There are few people who do not know someone who has died of AIDS, and it is estimated that, early in the new millennium, some forty million people worldwide will be infected with HIV, and ten million of them will develop AIDS. Research and statistics revealsRead MoreCore Functions Of Public Health993 Words   |  4 Pagesfunctions of Public health are: †¢ Assessment: Monitoring the health needs of a community along with investigating and analyzing the health hazards. This helps in diagnosing the extent of a health issue and hence aids in the development of health interventions. Assessment helps in accumulating information on the status of a public health problem within a community using approaches such a statistics, epidemiologic studies etc. †¢ Policy Development: This is required to address the health needs of a communityRead MoreThe Human Immunodeficiency Virus ( Hiv )1653 Words   |  7 Pagesfew diseases have been as antagonistic as the human immunodeficiency virus (HIV). The global transmission of this disease has been perpetuated by the ease of long distance travel and immigration (Magis-Rodriguez, 2004; Xu et al., 2014). Throughout the past 35 years the course of HIV and other sexually transmitted infections (STIs), as well as patterns of immigration, have changed immensely. Given the increase in both HIV and immigration, specifically in North Carolina (NC), this dissertation willRead MoreThe Center For Disease Control And Prevention2231 Words   |  9 PagesThe Center for Disease Control and Prevention (2012) states that more than a million people in the United States alone are living with, and dying from Human Immunodeficiency Virus infection or Acquired Immune Deficiency Syndrome (HIV/AIDS), and almos t one in seven people are unaware of their HIV infection status. Over the past decade, the number of people living with HIV has increased, while the annual number of new HIV infections worldwide has remained relatively high. The trend of new infectionsRead MoreRisk on Studen Prostitute in Zamboanga City4811 Words   |  20 Pagesboyfriend, or whether one is in college and needs to pay for next semester’s tuition and one works at a strip club behind glass where men never actually touch you – all these forms of prostitution hurt the women in it. (Melissa Farley,. 1-28-2000) HEALTH PROBLEM In the Philippines student prostitute working in club or bars and school keep and entertaining their customer as they can give. Nearly all student prostitutes can be fine and taken from anywhere they agree for having a short time and long

Ethical Decision Making and Information Technology

Question: Discuss about the Ethical Decision Making and Information Technology. Answer: Introduction: Business ethics states the application of ethical values like integrity, respect and openness in the behavior of the business (Ferrell and Fraedrich 2015). It is important to look around how people perform to carry out their respective roles. The paper discusses the ethical dilemma associated with the workplace at ACE Inc. Ethical dilemma: The ethical dilemma arises in the organization when it was found that Harry, a network programmer developed a program and released it under the name Safe-T under the name of Lock Smith. Jill, the manager of Harry did not trust on the program designed by Harry and later on discovering the fact that the program has been launch on the internet under the pseudo name Lock Smith, immediately took the decision to fire him. In addition to this, Brockley Smetherton, Jills manager did not cross check the situation and just nodded with the decision made by Jill and fired him. However, Ima, the owner of the Company on hearing good feedback by an independent head-hunter about the innovative program, asked Brockley to offer Lock Smith a position of the expertise at ACE Inc. Here lies the ethical dilemma upon Brockley whether to hire Harry again or not. According to the Code of Ethics, it falls under professionalism to uphold and advance the honor, dignity and the effectiveness of the professionals of the information technology. It is indeed important to be honest and loyal towards the community and keep high standards of competence and ethical conduct. Ethical analysis and decision making process Understanding the situation: Brockley is under a situation of ethical dilemma because he himself did not clarify the issue all by himself and depending on the decision of Jill at the time of firing Harry. It has to be understood that Jill had recognized certain faults in the program designed by Harry. The ACS framework put forwarded the framework that the employer is responsible for serving the interest of employees and the colleagues working in an organization. However, the approach was not found at the time of dealing with the situation of Harry. Again, at a certain point of time, it can be said that Jill also conducted an unethical approach by directly firing Harry. Another important issue has been highlighted here that Harry, even working at the Pvt. Firm, has developed a program and published the same in the internet under the pseudo name Lock Smith. Isolating the major ethical dilemma: Among the ethical dilemmas identified above, it can be said that the central ethical dilemma was related to the approach made by Brockley by firing Harry without investigating the situation by him (Shapiro and Gross 2013). This approach can be considered to hinder the ACS codes of ethics. It can be said that Brockley had utilized its power and the authority of being at a higher position and fired Harry without even thinking about the situation of Harry after getting fired. Ethical analysis Consequentialism: As stated by Sverdlik (2016), Consequentialism holds the consequences of ones conduct states the ultimate basis of any judgment based on the rightness or the wrongness of the specific conduct. If the case of Harry in the case study is considered, it can be easily said that there remained certain faults from the end of the management in deciding the firing process of Harry (Pettit 2016). Rights and duties: People at the higher authority in an organization posses certain rights as well as duties. Ethical actions should not be performed out of ones personal inclination but on the basis of moral and ethical approach (Kallman and Grillo 1996). The situation can be easily inclined with the situation of Harry. It has to be said that Harry utilizes his talent of creating the particular program and publish the same in the website. This can be considered as an unethical approach from the end of Harry. On the other hand, the way Harry was treated and terminated from the job was another unethical approach taken by his manager, Jill. Kants Categorical Imperative: According to the deontological or the duty based ethics, the actions done by an individual cannot be justified by showing the consequence of the thing done. As commented by Sverdlik (2016), there are certain acts that can be considered as good acts for the duty based ethics but the result can be non-fruitful. For instance, it has been evident that Jill had fired Harry due to the mal practices conducted by him but ultimately it was observed that the program was fruitful for the organization (Peterson 2013). Thus, there were certain approaches that were taken against Harry unethically. Discussion: From the above analysis it can be said that the major ethical dilemma lies on the part of Brockley. He is supposed to come up with the decision of rehiring Harry to the Company. On one hand, it has been found that Harry under the pseudo name has come up certain practices that are not ethical and this was the reason when Jill fired him. However, the final decision of firing Harry had remained with Brockley. It was in his part to investigate the situation and then come to a conclusion, but the same approach was lacking from his side that has created the most ethical dilemma in the whole consequence. However, the present situation has demanded the presence of Harry in the organization as a program analyst that has to be fulfilling because of the demand of the higher authority. Making a decision: In case of making a right decision on the part of Brockley, it is important to identify the stakeholders involved in the complete scenario. It has been understood that the major stakeholders involved in the complete scenario are the employees and the people at the higher authority (Shaw and Barry 2015). Therefore, any kind of decision that has to be made must be following the perspective of the stakeholders. Here, Ima can be regarded as the most important person whose decision matter the most in the organization. It is true that Brockley had faced a situation where he had to think of his decision on firing Harry for the approach that has been highlighted by Jill. There is no doubt that Brockley is under such a situation where an intense ethical dilemma is present. In order to cope with the situation, it is expected that Brockley would examine the situation well and go through the complete program that had been designed by him (Weiss 2014). In the first place, Brockley should not have reached to a conclusion and made judgment on firing Harry. In this respect, the role of Jill will also be highlighted because Brockley fired Harry on the recommendation of Jill. Therefore, in case of rehiring Harry, there might raise the situation where Jill would have to suffer because the main decision was made by her. Therefore, it is expected that Brockley will investigate the complete situation and make a proper report to his higher authority, Ima and make effort to improve the situation where the ethical dilemma has raised. Conclusion: A detailed analysis of the situation has been made and it has been understood that at the first place Brockley had conducted unethical approaches by not evaluating the situation and directly coming to a conclusion. In order to deal with the situation, it is important to follow the entire discourse and coming down to a conclusion that is both ethical as well as beneficial to the Organization. References: Baker, K., 2016. The Consequences of Accepting Consequentialism.Philosophy Now,115, pp.38-40. Ferrell, O.C. and Fraedrich, J., 2015.Business ethics: Ethical decision making cases. Nelson Education. Kallman, E.A. and Grillo, J.P. 1996, Ethical Decision Making and Information Technology, McGraw-Hill, Ch. 3 Peterson, M., 2013.The dimensions of consequentialism: Ethics, equality and risk. Cambridge University Press. Pettit, P., 2016. Non-consequentialism and political philosophy.Enfoques,18(1-2), pp.27-49. Rothman, J.C., 2013.From the front lines: Student cases in social work ethics. Pearson Higher Ed. Shapiro, J.P. and Gross, S.J., 2013.Ethical educational leadership in turbulent times:(Re) solving moral dilemmas. Routledge. Shaw, W.H. and Barry, V., 2015.Moral issues in business. Cengage Learning. Slade, S. and Prinsloo, P., 2013. Learning analytics ethical issues and dilemmas.American Behavioral Scientist,57(10), pp.1510-1529. Sverdlik, S., 2016. Consequentialism, Moral Motivation, and the Deontic Relevance of Motives.Moral Motivation: A History, p.259. Weiss, J.W., 2014.Business ethics: A stakeholder and issues management approach. Berrett-Koehler Publishers.

Quicken In Singapore free essay sample

Analyzes the prospect of introducing the software utility tool into the city-states market. Discusses competition, price, promotion and economics. Includes a chart. Introduction Innovations in transportation and communications during the twentieth century have resulted in the ability of goods and services to move among nations with greater ease than at any other time in history. International business is no longer the exclusive realm of the large multinational corporation; small businesses are creating marketing niches for themselves in particular product or service areas. When considering international marketing, companies must take into account their own internal structure, the role of the governments of the countries considered, and the way in which the company would operate in the foreign nation (whether directly, as part of a joint venture, or through some licensing effort). Political situations must be considered, and the labor situation in the foreign country (as well

The Good and Bad of a School Principal Job

The Good and Bad of a School Principal Job I love being a principal of a school. There is nothing else that I want be doing at this point in my life. This does not mean that I enjoy every aspect of my job. There are certainly aspects that I could do without, but the positives far outweigh the negatives for me. This is my dream job. Being the principal of a school is demanding, but it is also rewarding. You must be thick skinned, hard working, diligent, flexible, and creative to be a good principal. It is not a job for just anyone. There are days that I question my decision to become a principal. However, I always bounce back knowing that the reasons I love being a principal are more powerful than the reasons I hate it. Reasons I Love Being a Principal of a School I love making a difference. It is fulfilling to see the aspects that I have a direct hand in making a positive impact on students, teachers, and the school as a whole. I love collaborating with teachers, offering feedback, and seeing them grow and improve in their classroom from day to day and year to year. I enjoy investing time in a difficult student and seeing them mature and grow to the point that they lose that label. I am proud when a program I helped create flourishes and evolves into a significant component of the school. I love having a larger impact. As a teacher, I made a positive impact on the students I taught. As a principal, I have made a positive impact on the entire school. I am involved with every aspect of the school in some way. Hiring new teachers, evaluating teachers, writing school policy, and establishing programs to meet school-wide needs all impact the school as a whole. These things likely will go unnoticed by others when I make the right decision, but it is satisfying to see others being positively impacted by a decision I made. I love working with people. I love working with the different groups of people that I am able to as a principal. This includes other administrators, teachers, support staff, students, parents, and community members. Each sub-group requires me to approach them differently, but I enjoy the collaboration with all of them. I realized early on that I work with people as opposed to against them. This has helped shape my overall educational leadership philosophy. I enjoy building and maintaining healthy relationships with the constituents of my school. I love being a problem solver. Every day brings about a different set of challenges as a principal. I have to be adept at problem solving to get through each day. I love coming up with creative solutions, which are often outside the box. Teachers, parents, and students come to me on a daily basis seeking answers. I must be able to provide them with quality solutions that will satisfy the problems they have. I love motivating students. I enjoy finding entertaining and unusual ways to motivate my students. Over the years, I’ve spent a cold November night on the roof of the school, jumped out of an airplane, dressed like a woman, and sang Karaoke to Carly Rae Jepsen’s Call Me Maybe in front of the entire school. It has generated a lot of buzz and the students absolutely love it. I know that I look crazy while I am doing these things, but I want my students to be excited about coming to school, reading books, etc. and these things have been effective motivational tools. I love the pay check. My gross salary was $24,000 the first year I taught. It is hard for me to fathom how I survived. Luckily, I was single at the time, or it would have been difficult. The money is certainly better now. I am not a principal for the pay check, but I cannot deny that making more money is an enormous benefit to becoming an administrator. I work extremely hard for the money that I make, but my family is able to live comfortably with some extras that my parents were never able to afford when I was a kid. Reasons I Hate Being a Principal of a School I hate playing politics. Unfortunately, there are many aspects of public education that is political. In my opinion, politics dilutes education. As a principal, I understand that it is necessary to be political in many cases. There are many times that I want to call parents out on when they come to my office and blow smoke about how they are going to handle their child. I refrain from this because I know that it is not in the school’s best interest to do so. It is not always easy to bite your tongue, but sometimes it is best. I hate dealing with the negative. I deal with complaints on a daily basis. It is a large part of my job, but there are days when it becomes overwhelming. Teachers, students, and parents like to gripe and moan about each other continuously. I feel confident in my ability to handle and smooth things over. I am not one of those that sweep things under the rug. I spend the necessary time to investigate any complaint, but these investigations can be time daunting and time consuming. I hate being the bad guy. My family and I recently went on vacation to Florida. We were watching a street performer when he picked me to help him with a part of his act. He asked me my name and what I did. When I told him I was a principal, I got booed by the audience. It is sad that being a principal has such a negative stigma associated to it. I have to make difficult decisions every day, but they are often based on mistakes of others. I hate standardized testing. I loathe standardized testing. I believe that standardized tests should not be the end all evaluation tool for schools, administrators, teachers, and students. At the same time, I understand that we live in an era with an overemphasis of standardized testing. As a principal, I feel that I am forced to push that overemphasis of standardized testing on my teachers and on my students. I feel like a hypocrite for doing so, but I understand that current academic success is measured by testing performance whether I believe it is right or not. I hate telling teachers no because of a budget. Education is an investment. It is an unfortunate reality that many schools do not have the technology, curriculum, or teachers necessary to maximize learning opportunities for students due to a budget shortfall. Most teachers spend a significant amount of their own money to buy things for their classroom when the district tells them no. I have had to tell teachers no, when I knew they had a fantastic idea, but our budget just would not cover the expense. I have a hard time doing that at the expense of our students. I hate the time it takes away from my family. A good principal spends a lot of time in his office when no one else is in the building. They are often the first one to arrive and the last to leave. They attend almost every extra curricular event. I know that my job requires a significant investment of time. This investment of time takes time away from my family. My wife and boys understand, and I am appreciative of that. It is not always easy, but I try to ensure a balance of my time between work and family.

Overview of 12th Grade Math Curriculum

Overview of 12th Grade Math Curriculum By the time students graduate high school, they are expected to have a firm understanding of certain core mathematics concepts from their completed course of study in classes like Algebra II, Calculus, and Statistics. From understanding the basic properties of functions and being able to graph ellipses and hyperbolas in given equations to comprehending the concepts of limits, continuity, and differentiation in Calculus assignments, students are expected to fully grasp these core concepts in order to continue their studies in college courses. The following provides you with the basic concepts that should be attained by the end of the school year where mastery of the concepts of the previous grade is already assumed. Algebra II Concepts In terms of studying Algebra, Algebra II is the highest level high school students will be expected to complete and should grasp all core concepts of this field of study by the time they graduate. Although this class is not always available depending on the jurisdiction of the school district, the topics are also included in precalculus and other math classes students would have to take if Algebra II were not offered. Students should understand the properties of functions, the algebra of functions, matrices, and systems of equations as well as be able to identify functions as either linear, quadratic, exponential, logarithmic, polynomial or rational functions. They should also be able to identify and work with radical expressions and exponents as well as the binomial theorem. In-depth graphing should also be understood including the ability to graph ellipses and hyperbolas of given equations as well as  systems of linear equations and inequalities, quadratics functions and equations. This can often include probability and statistics by using standard deviation measures to compare the scatter of sets of real-world data as well as permutations and combinations. Calculus  and Pre-Calculus Concepts For advanced math students who take a more challenging course load throughout their high school educations, understanding Calculus is essential to finishing off their mathematics curriculums. For other students on a slower learning track, Precalculus is also available. In Calculus, students should be able to successfully review polynomial, algebraic, and transcendental functions as well as be able to define functions, graphs, and limits.  Continuity, differentiation, integration, and applications using problem-solving as the context  will also be a required skill for those expecting to graduate with a Calculus credit. Understanding the  derivatives of functions and real-life applications of derivatives will help students to investigate the relationship between the derivative of a function and the key features of its graph as well as understand the rates of change and their applications. Precalculus students, on the other hand, will be required to understand more basic concepts of the field of study including being able to identify the properties of functions, logarithms, sequences and series, vectors polar coordinates, and complex numbers, and conic sections. Finite Math and Statistics Concepts Some curricula also include an introduction to Finite Math, which combines many of the outcomes listed in other courses with topics which include finance, sets, permutations of n objects known as combinatorics, probability, statistics, matrix algebra, and linear equations. Although this course is typically offered in 11th grade, remedial students may only need to understand the concepts of Finite Math if they take the class their senior year. Similarly, Statistics is offered in the 11th and 12th grades but contains a bit more specific data that students should familiarize themselves with before graduating high school, which include statistical analysis and summarizing and interpreting the data in meaningful ways. Other core concepts of Statistics include probability, linear and non-linear regression, hypothesis testing using binomial, normal, Student-t, and Chi-square distributions, and the use of the fundamental counting principle, permutations, and combinations. Additionally, students should be able to interpret and apply normal and binomial probability distributions as well as transformations to statistical data. Understanding and using the  Central Limit Theorem  and normal distribution patterns are also essential to fully comprehend the field of Statistics.

Reponse to Phase 1 Essay Example | Topics and Well Written Essays - 500 words

Reponse to Phase 1 - Essay Example Select sellers; in this phase we will select vendor that will supply the product or service. The project team may make the final an ultimate choice, though normally inside an overall procedure that is owned by the purchasing department. Project procurement activities and contracting activities through out the project management lifecycle will facilitate us in a number of ways like we will have some standardized and single tool for the whole organization. And implementation of some web-based solution seems likely to be the most successful tool. This unites all the departments and also provides the signal platform for the overall working. If we implement web based system then we can take the advantage of overall connectivity means systems are attached to a single online system, so that some immediate change or development can easily be shared and resolved. The main advantage we can visualize is the facility to share experience, data, information and also the secluding planes among all departments and PMs. There are lots of negative factors those can be happen by continuing as usual. The main negative factor is the lack of the standardization. Each PM has its own scheduling software that makes the oval united working difficult and become irritating. There is also lack of communication between PMs is also negative a negative point. The intended developed product will ensure the overall online communication among all project managers. Here also the main negative point against this existing system is the lack of sharing of information among PMs and project teams, so this intended system will also facilitate this feature also. Plan contracting process involves the stages2 of request seller responses, select sellers, contract administration and contract finality. These phases will facilitate us by offering more enhanced and standardized process for the gathering the best and most diverse supplier information, this information will outline to deal

Global Environmental Change Assignment Example | Topics and Well Written Essays - 250 words

Global Environmental Change - Assignment Example hauls it to a centralized facility where workers or a machinery separate the wastes for recycling may found in understanding the characteristics and application of the 2nd Law of Thermodynamics, also known as the entropy law. What is Entropy? Requadt defines to Entropy as the amount of energy that cannot be converted into mechanical work. (Requadt, 2010). The term entropy is a measure of the degree to which energy has lost the capacity to perform useful work. Energy quality: According to the first energy law, energy can neither be created nor destroyed, one might think there will always be enough energy. Yet when you fill a cars tank with gasoline and drive around something is lost. If it isnt energy, then, what is it? The second law of energy, also known as the second law of thermodynamics provides the answer to this question. Energy varies in its quality or ability to do useful work. For useful work to occur energy must move or flow from a level of high-quality (more concentrated) energy to a level of lower-quality (less concentrated) energy like manifestation of the Second Law can be stated quite simply: Heat always flows spontaneously from hot (high-quality energy) to cold (low-quality energy). Heat energy will not flow from a cooler to a warmer body. It would be foolish to try to warm our hands on a block of ice although there is considerable heat in the ice. If we compare the heat of ice with the heat of liquid hydrogen, ice would appear to be very hot, indeed. It would be easy to build a machine that runs on the heat differential between the cold block of ice and the much colder liquid hydrogen. However, since the heat in the ice is at a much lower level than the heat in our body, heat cannot flow from the ice to our hands. We cannot warm our hands by immersing them in ice. We have always known this fact. Now we know why we cannot warm our hand by touching a block of ice. Any time work of any kind is done some energy is lost. In every mechanical

Victoria’s Motorcycle Licensing Program Essay Example for Free

Victoria’s Motorcycle Licensing Program Essay Within the past year, there have been 332 fatalities in Victoria; fourteen percent of this number is composed of motorcyclists, of which only seven percent carry a motorcycle driver’s license, according to the Transport Accident Commission’s most recent annual road toll (2008). The same source lists the following as the most usual causes of motorcycle crash accidents; drunk driving, driver fatigue, and speeding which are violations to the fairly basic road safety regulations that drivers are expected to know before being given a driver’s license. However, in this case, it appears that there is a need to re-assess Victoria’s current licensing program to answer the question: Is the current process for obtaining a motorcycle driver’s license in Victoria effective in promoting road safety? This proposal will be presented according to an Evaluation Plan template (Educational Psychology and Instructional Technology, n. d. ) which lists the following elements necessary in a successful program evaluation: a background of the program; a specification of the evaluation’s purpose; an outline of the limitations, ethical considerations, and decisions which the evaluation would affect; a list of evaluation questions expanding on the research question; and lastly a rationale of the methodology and sampling techniques that will be used. Background In 1938, the rising road toll in Victoria spurred the state to form a separate entity which would govern road safety management it was set back because of WWII but was picked up afterwards. This eventually led to the formation of VicRoads in 1989. At present, VicRoads is in charge of â€Å"Victoria’s arterial road network, implement road safety strategies and programs and provide vehicle registration† and providing the state with a driver licensing service (VicRoads, 2008). According to their website, the following requirements need to be fulfilled in order to qualify for a motorcycle license: 1. must be at least 18 years old 2. has a current learner’s permit for at least 3 months 3. has passed the eyesight test, motorcycle license skills assessment, and hazard perception test VicRoads currently employs 2700 people overseeing these functions. Purpose For the purpose of assessing the efficiency of Victoria’s current motorcycle licensing program a process-based evaluation â€Å"geared to fully understanding how it [program] works† (McNamaran, n. d. ), is the most logical choice. According to Rossi (1999): â€Å"Program process evaluation is a form of evaluation designed to describe how a program is operating and assess how well it performs its intended functions. It builds on program process theory which identifies the critical components, functions, and relationships assumed necessary for the program to be effective (p. 89). † Michael Quinn Patton’s Utilization Focused Evaluation Checklist (2002) would also be used as a guideline for program assessment, evaluator assessment, and identification of users which would also determine respondent sampling. The aim for this evaluation is to address the need for improving the licensing program as a tool for eliminating road risks caused by preventable human errors like driving under the influence coupled with or resulting in speeding and lack of physical control over vehicles. By delving into the process of licensing, program strengths and weaknesses may be specified. Limitations It is recognized that there are other factors contributing to the dangers associated with motorcycle driving. Assessing the licensing program merely gives us a place to start since the responsibility for determining who is fit to be behind the wheel on Victorian roads falls on license evaluators and service providers like VicRoads. It would also be difficult to achieve a completely objective assessment of the program since the methods suggested in the gathering of data will primarily be from observation and survey or interview questions which are largely subject to interpretation. Gathering a sample pool consisting of license test takers, evaluators, and licensed drivers would also be a challenge given the area of Victoria, the number of licensing centers, and the mobility of test takers. It will be of great importance to preserve an objective and unbiased perspective while conducting the evaluation to ensure the greatest reliability and validity possible. A method for data gathering would also be designed to allow other evaluators who wish to test the resulting data to replicate the exact methodology used. Ethics All participants in the evaluation would be promptly informed of the purposes of the evaluation. They would also have the option for anonymity if they wish to opt for such. Personal information would be kept under strict confidentiality. If a respondent wishes to discontinue or terminate participation at any time during the process evaluation, they have every right to do so as well. Details of the methods, expected results, and projected date of completion would be provided to all respondents. Before any interview, survey, or observation takes place, a consent form would be reviewed and signed by the respondent first. Permission for observation and data gathering would also be secured from VicRoads. Process evaluators would be instructed to keep all information VicRoads wishes to keep private confidential and would not be released to the public without written permission and consent from VicRoads. Decisions That Might Be Affected by This Evaluation’s Results Revisions to the current processes might result if the evaluation findings point to inefficiencies to the current processes and procedures or if an apparent dissatisfaction with the program is discovered. Both favorable and unfavorable outcomes are expected. For example, stricter implementations for restricting drivers with debilitating medical conditions might be taken by the community as a discrimination against disabled residents but educating the community against its possible dangers will most probably be taken reasonably. Explaining that an old man with poor eyesight poses a risk to pedestrians and other motorists when given license to drive on the road should be fairly easy to comprehend. It will also be a good venue for researchers and product developers to look into redesigning vehicles which more are forgiving to drivers would certain medical conditions and would enable them to continue driving without risking themselves or the community. Perhaps more frequent license renewal or application for ex-drink drivers and speeders who previously already had their license suspended or revoked should reduce the state’s problems with drink driving and speeding by making it particularly tedious or expensive to regain their right to driving on the road. This should of course be in collaboration with the states penalties for violators who drive without licenses. Evaluation Questions To give more definition to our research question about the effectiveness and efficiency of Victoria’s motorcycle licensing program, more specific questions have been listed below. The process evaluation aims to answer the following questions: 1. Since the implementation of Victoria’s motorcycle licensing program, has the number of the states motorcycle fatalities been lowered? 2. Do the tests and requirements for getting a motorcycle driver’s license prepare prospective drivers for Victorian roads by educating them of the state’s road regulations and road safety rules? 3. Are the current tests enough in screening a driver’s road competency? 4. The current tests are mostly skills assessment, shouldn’t there be a test designed to predict a driver’s emotional and intellectual stability that would screen out would-be drink drivers and speeders? How would license test takers react? 5. Are the tests objective, reliable, valid, and consistent? How does the current process prevent bias from affecting results? Are the same procedures followed for all centers and applied for each individual? 6. Do license test takers view the program as necessary? Do they approve of the process or are there improvements they would like to see made? Methodology Given the nature of the evaluation, the following methods will be used in the collection and gathering of data: acquiring statistical figures, implementing surveys and questionnaires, interviews, and first-hand observation. Acquiring statistical data about the number of motorcycle fatalities since 1989 when the licensing program was first implemented would be interpreted to determine if the program has been effective in lowering the states road toll. It would also determine what percentage of said fatalities is attributable to lack of education or human error. Surveys and questionnaires would be used for gathering personal information from license test takers especially on their opinions of the program’s relevance and effectiveness. It would also be used to ask for suggestions for improvement from the program’s end users. Interviews with the license evaluator in each of VicRoads’ licensing facilities would be done to acquire more insight to the actual process from the clients’ point of view. It also aims to get the license evaluator’s personal experiences and opinions regarding the licensing process. Lastly, on-site observations would be implemented to see the program in action first-hand. It will be used to evaluate the program’s reliability, validity, consistency, and objectivity. It will determine if there are differences in the practice between centers which would greatly affect a license test takers results. It would also try to measure effectiveness and see if the process is implemented as intended. Sample Choosing respondents would be done randomly for the test takers and licensed drivers. For license evaluators, however, since their number is relatively smaller than that of the license takers and drivers, the aim is to correspond with each evaluator in all of the licensing centers or if this is not possible, to interview with as many evaluators as permitted by the resources. Letters will be sent out to randomly selected licensed drivers with survey questionnaires attached. Instructions for sending responses back would also be detailed in the letter. For survey questions where the respondent’s answers are vague or unspecified, a call would be made for clarification. The aim for the sample population of license test takers should at least be thirty percent of the total number of test takers in the same time it takes to complete an application for a license up to the actual claiming of a motorcycle driver’s license. These respondents should be a healthy representation of each stage of the process: those who are about to apply for a license, those who are in the process of acquiring a license, and those who are there claiming their actual license. Survey Questions for Both License Test Takers and Licensed Drivers Not all questions need to be answered. Respondents would be asked to answer only questions which apply to them. 1. How do you rate the requirements needed for licensing? Do you think they are necessary and reasonable? 2. With the preparation you’ve been given before, after, and during the test, would you say you are confident with your driving competency? 3. Were you properly educated of the state’s road regulations and safety rules? 4. How would you react if the state required you to undergo psychological testing to measure your emotional and intellectual stability before granting you a motorcycle license? 5. Do you believe the test is fair and unbiased? If not, what led you to say so? 6. Is the licensing program contributing to the decrease in the number of crash fatalities? What would you suggest for improvements? Interview Questions for License Evaluators 1. How would you rate the program’s effectiveness? Is there anything you wish to improve? 2. How do you make sure that your basis for approving or denying an individual his motorcycle driver’s license is free from bias and is reliable and valid? Follow-up questions depending on the respondent’s answers would also be used to gain depth in the answer. Observation Guidelines 1. Compare the processes from center to center. Enumerate the steps and determine if there are delineations from the prescribed process. 2. Compare the implementation of tests for each individual test taker. Is everyone undergoing identical tests and procedures? 3. Pay attention to the interaction between the test taker and the evaluator. Does their relationship affect the license test result? Timeline The projected completion date for this process evaluation is six months, enough to cover all centers and complete the data gathering. Within the said time frame an analysis of data would be passed along with a prescription for action. The timeline should go as follows: †¢ Definition of evaluation plan and design †¢ State permission and random sample pool †¢ Simultaneous interviews, surveys, and observations †¢ Analysis of data †¢ Prescription for a plan of action References Davidson, E. J. (2004. ) Evaluation methodology basics: The nuts and bolts of sound evaluation. Sage. Retrieved on September 1, 2008 from the World Wide Web: http://books. google. com/books? id=ePfuba9tDbECprintsec=frontcoverdq=evaluation+methodologysig=ACfU3U2xBnA9EO2s1nLt8by60FdZmv3y1g#PPR7,M1 Educational Psychology and Instructional Technology. (n. d. ) Evaluation plan template. Retrieved on September 1, 2008 from the World Wide Web: http://it. coe. uga. edu ~treeves/edit8350/EPT. html Mcnamara, C. (n. d. ). Basic guide to program evaluation. Free Management Library. Retrieved on September 1, 2008 from the World Wide Web: http://www. managementhelp. org/ evaluatn/fnl_eval. htm#anchor1575679 Patton, M. Q. (2002). Utilization-focused evaluations checklist. Evaluation Checklist Project. Retrieved on September 1, 2008 from the World Wide Web: http://www. wmich. edu/ evalctr/checklists/ufe. pdf Rossi, P. H. , H. E. Freeman, et al. (1999). Evaluation: a systematic approach (6th ed. ). Thousand Oaks, Calif, Sage Publications Chapter 6

Rome Essay -- History, Architecture

Early Rome was an architecturally diverse place. For the first centuries after its founding all the people of Rome lived in very simple huts devoid of any significant meaning. But during the rule under the Etruscans, they learned how to build more complex structures with specific purposes such as a sacred place where a god can be thought to dwell. Etruscan buildings cannot be seen though without Greek architectures’ indelible mark. Through the Etruscans, Rome learned how to build huge and complex structures where before that knowledge did not exist. This period of Roman architecture can be defined along with Rome’s governmental development. Republican Rome began in 509 B.C. and with it entered the beginning of Rome’s architectural greatness. â€Å"With the expulsion of the Etruscan kings Rome was free to shape her own destinies† (Sear 14). Since Rome was not restrained because of its conquerors it was free to create whatever they wished, however they wanted. While there was still a heavy Greek influence, a style developed that was distinctly Roman, but as Rome conquered nations across the Mediterranean Sea it absorbed their styles of building and it was shown in the buildings of their capital. Imperial Rome saw the highest and lowest point in Rome’s history. But during this time an enormous number of innovative and massive structures were built that defined Rome as the dominant power in the ancient world. During this time Rome reworked its earlier principles to be used in the government and religious buildings. Cement also played an important role in the ability to construct complex domes and ornate arches. Another major change that occurred was the extensive use of marble in construction, unlike earlier brick buildings.... ...ed the small farming village on the banks of the Tiber into a thriving city. Throughout the Republic of Rome, advances were made in complexity and design alongside the introductions to new cultures during Rome’s conquests. These conquests gave Rome the wealth and inspiration needed to create its massive buildings. All through the Empire, magnificent and colossal buildings were built which reflected the height of Roman power and wealth. â€Å"It is said of Augustus that he found Rome a city built of bricks but left it a city built of marble† (Clayton 22). This is very true of how Rome was rebuilt during its time as an empire and the dominant power in the world. From beginning to end, the Roman concept of architecture was based on shaping matter around space, and this only changed in complexity and in meaning, but never changed the foundation upon which it was built.

Independent Employer Essay

An independent contractor is the worker whose taxes are not withheld or paid by the employer. Joshua is an independent contractor not an employee. Elements such as behavioral, financial and type of employment relationship will help us in determining who Joshua is. First, the Ark Bark has no full control over what Joshua does. This is evident from the point that he still deals with the other business enterprises as the sales person and even the VP of the company Fred Flood accepts the fact the Joshua makes his own decisions about his work in the company. Schneir and James (1999) view a person whose duties are not controlled by the company as an independent contractor. Dealing with the financial issue, we can vividly see that the business aspects of Joshua’s job are not fully controlled by the Ark Bark. Though, there is a bit of confusion in this area because Ark Bark chipped in to foot the travel expenses, business cards among others. These are just minor expenses. If he was an employee, he could have not incurred the greater business expenses, instead the employer could. The type of employment relationship also confirms that Joshua is an independent contractor. First there is no written contract for the contract between the two parties. Broadhurst Emily holds that, even though one can enter into a contract with the employee even minus a written document, it is mandatory that the person be provided with the staff handbook. Joshua’s claim that he was still winding up with the former companies was illogical for an employee. For one to be an employee, the contract between the employee and the employer is never gradual. Therefore, the fact that he accepted the contract while still holding onto the other jobs indicates that he was an independent contractor, who is not under any obligation of Ark Bark. What the company could do to make Joshua an independent contractor. If the company had an intention of making Joshua an independent contractor, they ought to have laid a better business contract for him. It was the duty of the company to keep to the employment Act of 1963 (passed in 1972 Act). This Act defines employees must be given written evidence on the major issues related to terms of employment, this include the mode of payment. This could have saved the controversies erupting over with the $2,500 was a salary or commission The company could as well fill the form SS-8 (PDF) with IRS to be certain about the work status of Joshua for the purposes of taxation. According to Barry and Jeffrey (1992), the form critically reviews the workers status based on the circumstances of employment. It was unnecessary for the company to provide other services like paying for printed stationery and business cards and travel expenses, when they intended to make him an independent contractor. Doing this creates some confusion since for an independent contractor; the company should not provide any tool of operation for the worker. This kind of confusion is tackled in Philip Inman’s (1999) scheme regarding payment between contractors and the employers. Are there ethical issues in the company’s action? No, there are no ethical issues involved. The way the company is trying to treat the man is unethical, according George Richard’s (1999) opinion on business ethics, even if the contract was made orally, it was better for the business to provide a staff handbook or any other written material indicating the terms of employment. The company breached law of a fair employment contract. Actually, if the intention of the company was to have Joshua as an independent contractor, what was the need of terminating his services when he claimed that he was winding down his links with the former companies? This is ethically unaccepted because it leads to harassment. According to Bowie, Norma (1999), business should not be accompanied with harassment. It is not very clear that why Joshua was terminated. But the obvious reason is due to the poor relationship between him and the company. Broadhurst Emily (2005) argues that such an act is unlawful since the law provides protection against unfair dismissal. Other than terminating his services, the company could have embarked on solving grievances at the work place as described by Broadhurst Emily. This could better their relationship instead. Is there room to alter the relationship? Yes there is room to make things different, but very limited. I say very limited because, Joshua is already out of Ark Bark company. If he was still a worker in the company, the company could simply revise the relationship bit, translate the contract in writing and forward details to the IRS. This could justify whether Joshua is an independent contractor or not. At the same time, I say that there is limited room since there are no legal issues preventing Joshua from re-applying to be an employer of the company. The success or failure of the re-union lies with the two parties.

Development from conception to age 16 years Essay

E1. 0-3 – Social and Emotional. Babies around the age of 0-3 will learn how to make eye contact, smile and laugh at others, this will get adults attention and start to form good bonds between the baby and mother. Within social development children learn to make friends and understand the importance of social development skills which will help them success in their personal and professional lives. Babies start to socialise and from bond attachments with people who they normally see the most such as their parents and other family members. Children start to understand all different kinds of social skills. For example, babies and young toddlers will learn to share and take turns during activities and normal everyday routines. Babies need a lot of stimulation in order for their brain to develop and to make opportunities to physically use their body. As babies gradually get older and get to the age of 2, you will realise that they start to change and feel a lot more emotions in themselves, such as temper tantrums. 0-3 – Language and Communication. Babies around the age of 0-3 will experience how to communicate well and understand how communication works. They will start to recognise people’s voices such as their parents and other family members. By being able to recognise their voices will help babies realise who they are and who they should turn to. As babies start growing up they can understand different words and sounds that come from their parents in order to start saying things themselves, such as ‘mama’ or ‘dada’. You will find that babies often talk to themselves but as a parent it may be difficult to try understand what they are saying or trying to say. E2. 3-7 – Social and Emotional. Children at the age of 3-7 will have much more of an understanding of their social and emotional development than when they were a baby. Children react differently and will have gained a lot more understanding of what social development is all about. For example children at this age will know a lot more about sharing and taking turns during activities. For example they will realise that sharing and taking turns is important as they will begin school and there will be many more children in which they will be involved in. Most children at this age enjoy playing and working with others but the very few may like to work and play on their own. Socialising is how children learn to relate to other people and follow what is normal in their society. E.g. Manners and toilet training. Children at this age range can have many mixtures of emotions. This aspect helps children how to learn to express their feelings and how to control and manage them. 3-7 – Language and Communication. During the age of 3-4 children are able to use language well and fairly grammatically although there will be some speech immaturity. Children at this age are able to form good sentences and start to ask question such as ‘why?’ and are able to understand what kind of answers adults feedback to them. At the age of 5-7 children are more likely to understand how to do things on their own. For example they can say their own name, how old they are and be able to recognise different information about themselves. At this age children will also have a good interest in reading and writing. This is important for children as it helps them benefit a lot with their language and communication. They are able to recognise and understand bigger words which they won’t have heard before. (Meggitt C (2006) Page what†¦ E3. Explain two theoretical perspectives relevant to the areas of development. Lev Vygotsky. – Vygotsky believed that children understand language and communication by having good interaction skills between themselves and other people. Vygotsky thought that by the age of 2-3 children should use language to control their behaviour and thoughts. This would explain their feelings by talking out loud. Vygotsky also believed that children develop different communication, expressions and explanation by children playing and interacting with other children either at home or in school. Therefore in schools he said that play was significant for learning and children should help each other through play, this will help children understand the importance of socialising. Children use facial expressions and body language in order to understand what has been said to them. Vygotsky suggested that thought and language began as two different activities. When a baby babbles the baby is not using babbling as a way of thinking, therefore the baby is learning to talk. Jerome Bruner. – Bruner believed that all children learn by having to make their own choices and having the change to have different opportunities in able for them to learn. Independence comes into this theory as independence is a massive impact on children as they should learn to do things for themselves instead of asking an adult. Bruner believed that children learn through different activities such as reading, writing and drawing. He felt that adults should guide and support children during activities like these so he or she could reach their potential. Adults guiding and supporting children is called â€Å"scaffolding†, which helps children to develop their knowledge and understanding. E4. Include three observations as appendices. E5. Written Narrative Observation – Narrative Observations is a lot of detailed information about what the child is doing and what you see. Time Sampling Observation – Observing what happens in a short period of time. Tick List Observation – A list of things an observer looks at when observing children. E6/C1. When you work in childcare settings you are always working with young children, their families and other professionals. You should know that confidentiality is a massive impact when working in childcare settings. Confidential information concerning children or their families should never be discussed with anyone, or written down anywhere as confidentiality is the right of every child and parent whether the information is spoken, written down or on a computer. When working on observations it is also important that you maintain confidentiality. When observing children it is important that you write down all correct information about the child and not write anything that is unnecessary. After observing children you should make sure that all information on observations should be stored away properly which means in a safe and secure place. This is so nobody is able to see what has been written down about the particular child except the person who is responsible for the child, for example the child’s name. It is also important that the name of the setting should stay confidentiality as it could be passed on to people who it may not concern. D1/D2. The observations I carried out showed that child A was confident as she showed she could play alongside her friends, by sharing and taking turns within playing with the babies. Child A was acting out different roles such as mum, dad, brothers and sisters and dressing up. Child A showed that she was being independent by different equipment herself which she needed. For example, she decided she wanted to feed her baby therefore she got out the feeding equipment herself and fed her baby independently. Child A showed that she was particularly interested in playing in the home corner as she stuck to this for a long period of time and didn’t change to a different activity. She showed love and affection to the baby treating it as a real human and looked after her. As child A was playing in the home corner she made sure she was including each of her friends by letting them join in with her and playing nicely. By playing in the home corner it supports children’s needs by helping them with their gross and fine motor skills, such as children will try out new thing containing gross and fine motor skills. B1. When you are working on observations it is important that you plan everything before you start the observation in order for you to look back on the planning and know what you are able to do, and follow everything when it comes to doing them. Talk about working alongside with other parents and professionals†¦ Make sure you are doing the correct observations†¦ Knowing if the observation has gone good or bad? Evaluate and reflect on them†¦ A. There are 4 key components of attachment which are Safe Haven, Secure Base, Proximity Maintenance and Separation Distress. John Bowlby used the word attachment so children could experience bonding with more than one person. He was one of the first people to recognise the needs of babies and young children and a strong relationship with their careers. Attachment is about parents being available to meet their child’s needs and being aware of security within their children. He said that bonds which are formed at a young age have a huge impact on children throughout their lives. Babies and young children who do not have bonds or find it difficult creating bond with other people may find it hard to form relationships in their later life, but he suggested that is was important for babies and young children to have some form of attachment or bond with their mother Mary Ainsworth also looked at attachment working alongside with John Bowlby. She is also a theorist who also looks at attachment in young children. Mary Ainsworth looked at how babies reacted when they were left with a complete stranger then being back with their parents again. This links in with behaviour attachment.

Initial Marketing Plan Essay

Initial Marketing Plan Essay Initial Marketing Plan Essay Initial Marketing Plan MCS*1000 Gazelle Chike Inoma 0759596 Jack Battagalia 0888873 Marie Pineault 0876871 Lauren Murphy 0872759 February 13, 15 At Gazelle, we make computers that appeal to the average individual. Computers today can be expensive, and majority of the working population are unable to buy one. Our main objective is to deliver quality computers with an affordable price tag. By focusing our efforts primarily on the computer’s internal components, we guarantee that our computer’s potential can be fully maximized by our customers. For this vision to occur, we came up with different strategies for production. Firstly, we hired few employees to reduce costs and stationed our head office in Shanghai. This allows us to reach a large portion of our target market, while saving on costs. However, we’ve also made plans to expand our offices in order to reach out to a larger target market and increase demand of the â€Å"Gazelle One†. We will eventually branch off into the Chicago office in an attempt to capitalize on the greater demand that is associated with opening two sales offices. With the larger market, it is easier to produce our computers in bulk and reduce the major production costs. After completing this expansion into Chicago, we plan on training and hiring more employees to give our customers the best possible customer service. As this shift occurs, we’ll continuously come up with new ideas to improve our computers features. To do this, we will adjust how funds are allocated within the business. By allocating funds towards improving our computer’s design, it would give us the opportunity to service a different target market, while keeping our core market satisfied with functioning internal components. This leaves a lot of room f or growth and gives us a larger potential then we had in the past. Secondly, our main marketing strategy was to create an ad that highlighted the following mission statements; Gazelle Computers aims to fulfill the needs of the everyday employee. We want to provide these working consumers with an easy-to-use, user-friendly computer while still providing them with the best experience possible. We offer our customers efficient computers at a low cost. It is capable of running the best quality software programs while maintaining a large amount of data storage. We recognize that our working target market is not interested in a computer for leisure or luxury, but rather for getting the job done. As a result, affordable quality is crucial to our company. We firmly believe in offering the best quality products at the best prices possible. Gazelle Computers has focused its efforts on making the internal components of the computer the most valuable part. However, we did want our computer to look as good on the outside as it operates on the inside; therefore we designed our computer with a sleek and simple exterior, offering a unique and distinct look. At Gazelle Computers, our only operating brand is the Gazelle One. At this time we are solely focused on getting our worker oriented desktop computer into the market but hope to expand in the near future. We have priced our product at $2500, matching what the average consumer is willing to pay for their computer. Currently our office headquarters are located in Shanghai. We strategically chose this specific location as it contained the highest demand for worker-orientated computers. This location also offered us the lowest office expense costs allowing or our company to better invest the extra money further into our product. With this ad, we have been able to generate a large deal of recognition and business. We plan in the future to expand our marketing capabilities in order to showcase our product to more consumers. Showing the internal and external factors that could affect our company’s success can summarize our company’s competitive environment. The internal factors of our company, with emphasis on the strengths are our marketing

Using Facebook for Entry-Level and Advanced Writing Jobs

Using Facebook for Entry-Level and Advanced Writing Jobs Want entry-level writing jobs almost sure to accept you? Trawl Facebook. It was Facebook that handed me my first portfolio samples, including a gig on tasers and guns. The proprietor of that store taught me how to defend myself ( More recently and unknown to most Facebook also shoved off its very first Jobs for Facebook whose ads target more experienced writers. So, if you’re looking for a gig at either end of the spectrum, Facebook’s the place for you! Facebook for entry-level freelancers   Visit Facebook to locate the following: entry-level writing jobs, evergreen writing gigs, and writing jobs that average three to seven cents per word. To date, Facebook has more than 2.27 billion monthly active users, and, occasionally, one of these users mentions their need for a writer. You can be first on their rosters with the following steps: 1. Type your search words into Facebook’s search tab. My favorite words include hiring writers, â€Å"looking for writers, writer† + (your niche), â€Å"seeking writers†. Also try â€Å"looking for content/ marketing writers/ bloggers† and synonyms like â€Å"contract† and â€Å"remote†. I avoid the popular â€Å"writers wanted† and â€Å"writers needed†, since these tend to spit up spam or bulk ads from sites like Upwork. 2. Next, see â€Å"Posts† in the upper margin? Run down and select the following: Posts From (Anyone) Post Type† (All Posts) â€Å"Posted in Group† (Any Group) â€Å"Tagged Locations (Anywhere). Date Posted Toggle the arrow option at â€Å"Choose a Date.† In contrast to regular listed jobs that get snatched fast, job mentions on Facebook tend to linger, so I backtrack my search 3. As an alternative, I try Date Posted (Any Date) with search words that include the word â€Å"always.† Example: always looking for writers (content producers) (bloggers) etc. This prods a stream of great evergreen jobs. Middle to advanced freelance writers. Summer 2017, Facebook launched a new option for personnel recruiters, called Jobs on Facebook.   Here’s where you find job openings from entities like marketing and PR agencies, publishing outlets and B2B or B2C companies. Just as LinkedIn has its job postings, these are those of Facebook. Apparently, Facebook refused to design this site with freelancers in mind, but I’ve found a way around it. 1. Go to Jobs on Facebook, and type in synonyms for writer in the Jobs on Facebook search tab. (Note: don’t use the search tab on the top of page; it redirects you to your FB homepage). I tend to use terms like â€Å"writer,† freelance writer, content strategist, marketing strategist, and SEO content writer. Forget synonyms like â€Å"looking for,† â€Å"hiring,† and the like. 2. Fill in â€Å"Location† in the box underneath the search function. Here’s where it gets tricky if you want to trawl the globe, or, at least, America. My solution? Track where your clients tend to come from and experiment. Most of my U.S. clients come from New York, Los Angeles, San Francisco, and Chicago, so I type in the names of each of those regions and browse respective results. Jobs on Facebook, also, has major UK cities and several Canadian provinces but expect little more for countries outside North America. 3. As your last step, select the Contract button under â€Å"Job Type.† This is   my substitute for â€Å"freelancer.† After becoming more familiar with Jobs on Facebook, you’ll notice most positions want in-site writers or are managerial and executive. Some of the search results, too, are wacky. Evidently, the platform’s still got a way to go. Still, here and there, you find some gems, like this delectable one I found today. (Just look at that pay!) Your turn!

Exam about research class Essay Example | Topics and Well Written Essays - 500 words

Exam about research class - Essay Example Examples of these variables can be given as the socio-economic backgrounds of children and family ethics. Unlike longitudinal research, cross sectional researches do not look at variables over long periods of time but rather conduct observations into a given phenomenon within a set time frame. For instance there could be the study of child delinquency events the causative factors associated with them in modern times rather than looking at the relationship that has existed between the rate of child delinquency and rate of school drop out. Cross sectional researches are therefore often directed towards finding solutions to an occurring problem whiles longitudinal research would want to establish reasons and facts surrounding a child delinquency over a period of time. If the topic of child delinquency is taken from a cohort research perspective, it would be more of combining the advantages and merits of the first two forms of research study discussed. However, one transformational trait about the cohort research in relation to child delinquency would be that the cohort research would look into specific cases of child delinquency and correlate previous events and happenings to come out with substantive conclusions. It is in this direction that Shuttleworth (2009) writes that â€Å"a cohort study is a research program investigating a particular group with a certain trait, and observes over a period of time.† There is a highly technical issue with this scenario. As a matter of fact, the technicality of the issue reduces the decision to be taken by the thesis student to one thing and that complying with research ethics. In the absence of research ethics, the issue could have been described as a typical dilemma but once there is the issue of research ethics, there could be a straight forward option for the researcher. The straight forward

An Accounting Career Research Paper Example | Topics and Well Written Essays - 750 words

An Accounting Career - Research Paper Example It also looks at the salary scale, with emphasis on the average annual entry level salary as well as the salaries paid to persons who hold the CPA qualification in the state of Mississippi. Introduction Choosing a career is one of the most important decisions that a person will ever make in a lifetime. It is not uncommon for students to start college without any thought or knowledge of what it is that they would like to do as a career. This is so despite the number of career fairs that are held in high school and the resources available on the web and in school libraries. The most important aspects of the accounting profession are the skills required, duties performed and the salary it offers. These represent major considerations when making a decision on career choices. Skills Accounting is a very demanding career. Therefore, in addition to knowledge and qualifications the accountant is required to have a variety of skills. They include but are not limited to communication, presenta tion, information technology, analytical, computation, and critical thinking skills. Good communication skills are very important especially when a job function requires dealing with people at all levels inside and outside the organization. The accountant has to deal with the staff below the position held as well as those in authority. It is a reporting position so at all times reports of one kind or another have to be prepared. These have to be properly communicated both orally and in writing. According to Career Infonet (2011) active listening and speaking skills are required. Active listening involves giving total attention to what others are saying and taking time out to understand what is being said and asking the appropriate questions and interrupting only when appropriate (Career Infonet 2011). Information has to presented properly present so that others can understand. Information technology will also be required to aid in presentations to management as well as to input, pro cessing and summarizing information. In terms of presenting information accountants can use PowerPoint presentation. In terms of summarizing ability to use one or more accounting software packages as well as a spreadsheet is important. Accountants are required to analyze and evaluate accounting and other information. They need to be able to indicate reasons why figures change from one year to the other so that they can make proper recommendations on how to reduce expenses and so increase profitability. The ability to carry out basic computations is very important. All accountant jobs involve figures and there accuracy is key to becoming a good accountant. Critical thinking skills are very important. The accountant is required to use logic and reasoning in identifying the strengths and weakness that may arise from various alternatives relating to the solution of a problem. Duties Accountants perform a wide range of tasks some of which are specific to the profession and some of which are generalized work activities. Completing these tasks play a major role in getting a job done properly. According to Career Infonet (2011) the accounting specific tasks include advising clients in various areas such as compensation, health benefits, design of data processing systems as well as tax planning. They prepare tax computations as well as ensure that organizations that use their services or to which they are employed comply with the requirements of the tax authorities. Additionally, accountants develop, maintain and analyze budgets for clients with the use of information technology. They also prepare financial statements which indicate the financial position and financial performance of organizations including their as well as cash flow statements. Some general duties

Marijuana and students Research Paper Example | Topics and Well Written Essays - 1250 words

Marijuana and students - Research Paper Example My comments are on the use of punctuation and absence of thesis of the paper. A thesis will provide the supporting claims for the paper. I also suggest creating better transition sentences, where it is clear what the claims are. Marijuana is the top illegal drug of choice for students in the United States and other nations, such as Ireland, Belgium, Czech Republic, and the United Kingdom (Duarte, Escario, and Molina 90). Johnston et al. (2005) discover in their 2005 survey that the average incidences of cannabis use in the U.S. â€Å"for eighth, tenth and twelfth graders [were] 16.4%, 34.1% and 44.8%, respectively† (qtd. in Duarte, Escario, and Molina 90). At present, some people are lobbying to legalize marijuana beyond its medicinal uses. This paper believes that marijuana should not be legalized for all purposes, because of its diverse negative effects on students, especially on their health and academic success. Adolescents are particularly at risk, because cannabis use has been connected to the development of psychotic symptoms (Skinner, Conlon, Gibbons, and McDonald 1). Legalizing marijuana can encourage increased recreational use of marijuana among students, which can have negative effects on their health and academic status. One of the effects of legalizing marijuana is that it can lead to its widespread recreational use, which can result to a greater prevalence of risky behaviors among students. In â€Å"Sending the Wrong Message: Did Medical Marijuana Legalization in California Change Attitudes about and Use of Marijuana?† Khatapoush and Hallfors studied the impact of the legalization of medical marijuana on drug-related attitudes and use among youth in several communities in California and other ten states. They used telephone survey data that included beliefs and experiences related to marijuana use. Findings showed that legalizing marijuana did not encourage more drug use among

Accuracy of Rectal Water Contrast Transvaginal Ultrasound

Accuracy of Rectal Water Contrast Transvaginal Ultrasound Abstract Objectives:  To compare the accuracy of rectal water contrast transvaginal ultrasound (RWC-TVS) and double-contrast barium enema (DCBE) in assessing the presence and extent of bowel endometriosis. Methods:  This prospective study included 198 patients of reproductive age with suspicion of bowel endometriosis. RWC-TVS and DCBE were performed before operative laparoscopy by two groups of physicians specialized in endometriosis, each blinded to the results of the other groups. Findings of RWC-TVS and DCBE were compared with histological results. The severity of pain experienced during RWC-TVS and DCBE was measured by a 10 cm visual analog scale. Results:  In total, 110 of the 198 women had bowel endometriosis nodules confirmed at laparoscopy and histopathology patients. For the diagnosis of bowel endometriosis DCBE and RWC-TVS had a sensitivity of 96.4% and 88.2%, specificity of 100% and 97.3%, positive predictive value of 100% and 98.0%, negative predictive value of 98.0% and 88.0% and accuracy of 98.0% and 92.4% respectively. DCBE was associated with more intense pain than was RWC-TVS. Conclusions: RWC-TVS and DCBE have similar accuracy in the diagnosis of bowel endometriosis, but patients tolerate RWC-TVS better than they do DCBE. Keywords: double-contrast barium enema; rectal water contrast transvaginal ultrasound; bowel endometriosis; diagnosis Introduction Bowel endometriosis affects between 4-37% of patients with endometriosis1. Intestinal endometriosis lesions may have variable size2. Small endometriosis nodules located on the serosal surface of the bowel rarely cause symptoms and, therefore, do not require treatment2. Larger endometriosis nodules infiltrate the bowel wall and may cause various gastrointestinal complaints such as dyschezia, diarrhea, constipation, abdominal bloating and intestinal cramping1, 3. These symptoms may mimic irritable bowel syndrome. Symptoms caused by bowel endometriosis are nonspecific, often resulting in misdiagnosis or delay in diagnosis4. Physical examination may suggest the presence of rectovaginal endometriosis; however, it has poor accuracy in diagnosing rectosigmoid nodules5, 6. Until recently, the ultrasonic diagnosis of endometriosis was limited to patients with ovarian endometriomas and other imaging techniques were used for the assessment of bowel endometriosis including rectal endoscopic ultrasound, transvaginal ultrasound (TVS), double-contrast barium enema (DCBE), magnetic resonance imaging (MRI), multidetector computerized tomography enema (MDCT-e) and virtual colonoscopy7-10. TVS is a reliable non-invasive method to assess the presence and the extent of bowel endometriosis11. Injecting saline through a catheter into the rectum during TVS (rectal-water contrast TVS, RWC-TVS) may facilitate the identification of rectosigmoid nodules, the assessment of the depth of infiltration of endometriosis in the intestinal wall and estimation of the degree of stenosis of the bowel lumen. However, no previous study compared the accuracy of DCBE and RWC-TVS in the diagnosis of rectosigmoid endometriosis4, 12, 13. A preoperative diagnosis of the presence and extent of bowel endometriosis is necessary to determine whether surgery is required and to plan the surgical procedure with the colorectal surgeon14. Knowing before surgery the size and number of intestinal endometriosis nodules, the depth of infiltration of the nodules in the intestinal wall and the degree of stenosis of the bowel lumen allows determining whether surgery is required and may allow the surgeons to choose between nodulectomy and bowel segmental resection15, 16. In addition, determining before surgery the extent of bowel endometriosis allows the surgeon to inform the patient about the potential benefits and complications of the surgical procedure that will be performed. In fact, postoperative complications and evolution of digestive symptoms after surgery may differ between patients undergoing nodulectomy and those undergoing segmental resection, with a higher incidence of bladder-voiding dysfunction and postoperative constipation in patients undergoing the latter procedure. In this study, we compared the accuracy of DCBE and RWC-TVS in assessing the presence and extent of bowel endometriosis. Methods Study population This prospective study was performed between May 2012 and Aug 2016. Participants were recruited among patients of reproductive age scheduled for laparoscopy with strong suspicion of intestinal endometriosis based on symptoms and clinical examination. During this period, the imaging workup required that both DCBE and RWC-TVS were performed in patients with suspicion of bowel endometriosis. Institutional review board approval was obtained before initiating the study. Patients participating in the study signed a written consent form. Inclusion criteria for the study were: reproductive age and suspicion of deep pelvic endometriosis; presence of gastrointestinal symptoms that might be caused by bowel endometriosis; and desire to undergo complete surgical excision of the endometriosis. Patients were excluded from the study if they had previous bilateral ovariectomy; previous barium radiological examination or radiological diagnosis of bowel endometriosis; previous colorectal surgery; previ ous episodes suggestive of intolerance to iodinated contrast medium; renal or hepatic failure; refusal to undergo DCBE and psychiatric disorders. Symptoms were systematically investigated during the study period and they were recorded in a database. The presence of dysmenorrheal, deep dyspareunia, non-menstrual pelvic pain and dyschezia was investigated and the intensity of their symptoms was assessed in all patients on a 10 cm visual analog scale (VAS), on which the left extremity represented absence of pain and the right extremity indicated maximum intensity of pain. The presence of the following gastrointestinal symptoms was assessed: diarrhea-predominant irritable bowel syndrome; constipation-predominant irritable bowel syndrome; passage of mucus in the stools; rectal bleeding; intestinal cramping; and abdominal bloating. A symptom analogue scale questionnaire was used to estimate the severity of each gastrointestinal symptom. DCBE and RWC-TVS results were compared with surgical and pathologic findings. The radiologists performing DCBE and the gynecologists performing TVS were each blinded to the others results. They were blinded to the clinical data and knew only that the presence of intestinal endometriosis was suspected. All patients underwent laparoscopy within 1 month from the completion of the diagnostic investigations. Intestinal endometriosis was defined as the disease infiltrating at least the muscularis propria. Endometriosis foci located on the bowel serosa were considered peritoneal and not bowel endometriosis. The present study determined the accuracy of DCBE and RWC-TVS in assessing the presence of bowel endometriosis, estimating the size and the number of bowel endometriosis nodules and determining the presence of peritoneal endometriosis infiltrating only the intestinal serosa. Rectal water contrast transvaginal ultrasound technique Two physicians performed all the examinations according to a standardized procedure. RWC-TVS was performed by using a Voluson E6 machine connected to a transvaginal transducer. After the transducer had been introduced into the vagina, an assistant inserted a 6-mm flexible catheter through the anus into the rectal lumen up to a 15 cm distance from the anus. A gel infused with lidocaine was used to facilitate passage of the catheter. A 50 mL syringe was connected to the catheter and warm sterile saline solution was injected inside the rectum and the sigmoid under ultrasonic control. The amount of saline solution needed to show the rectosigmoid ranged between 100 and 350 mL, depending on the distensibility of the intestinal wall. One hundred milliliters of saline solution were continuously and slowly infused at the beginning of the procedure; the rest of the solution was infused when requested by the ultrasound. During ultrasound, when saline solution was not being infused, backflow through the catheter was prevented by placing a Klemmer forceps on the catheter. There w as no significant leakage of saline solution into the space between the catheter and the anus. Images were obtained before, during and after saline injection. Bowel endometriosis appears ultrasonographically as a nodular, solid, hypoechoic lesion, adjacent to and/or penetrating the intestinal wall. Hyperechoic foci may sometimes be present within the lesion. Intestinal distension allows defining the limits of the intestinal nodules and in particular the various layers of the rectal wall in order to estimate the depth of infiltration. The intestinal serosa is hyperechoic; the two layers of the muscularis propria appear as hypoechoic strips separated by a fine hyperechoic line; the submucosa is hyperechoic; the muscularis mucosa is hypoechoic and the interface between the lumen and the mucosal layer is hyperechoic. Rectal endometriosis infiltration is demonstrated by the fact that the hypoechoic nodule penetrates the intestinal wall and, in general, it thickens the muscularis mucosa. Two different ultrasonic signs are commonly used to describe this condition. Double-contrast barium enema All DCBE procedures were carried out using a motorized tilting table for fluoroscopic and radiological examination. In preparation, patients maintained a low-residue diet for 1 day prior to the examination in order to keep the enteric content fluid. The examination was performed after intramuscular administration of 20 mg (1 ampoule) Scopolamine in order to induce colonic hypotonia. The presence of bowel endometriosis was diagnosed on DCBE when the bowel lumen was narrowed at any level from the sigmoid to the anus in association with crenulation of the mucosa and/or speculation of contour. Tolerability of the examinations Immediately after each examination patients were asked to rate the discomfort encountered during DCBE and RWC-TVS by means of a 10 cm visual analogue scale (VAS), mild pain was defined as a VAS score of 5. Surgery and histological evaluation The surgeons examined the reports and the images of DCBE and RWC-TVS prior to laparoscopy. Although the diagnosis of recto-sigmoid endometriosis and its treatment were based on laparoscopic findings. All surgical procedures were performed laparoscope by a team of gynecological and colorectal surgeons with extensive experience in the treatment of pelvic and bowel endometriosis. In all cases, after adequate adhesiolysis, the sigmoid colon and rectum were systematically examined to verify the presence of endometriosis lesions. Bowel endometriosis lesions were removed by intestinal resection in cases of a single lesion >3 cm in diameter, a single lesion infiltrating at least 50% of the circumference of the intestinal wall or three or more lesions infiltrating the muscular layer. In all other cases of bowel endometriosis partial- or full-thickness disk resection was performed. Intestinal lesions infiltrating only the serosal layer of the bowel wall were excised by shaving. All visible les ions suspected to be endometriosis were excised and sent for histological examination in agreement with our clinical protocol. The surgical specimens were evaluated by histological; the depth of infiltration of the endometriosis nodules in the bowel wall was assessed. In cases of nodulectomy the specimens were macroscopically oriented along the intestinal wall (from the serosa towards the mucosa) and cut into macro sections of 2 mm thickness. From each macrosection tissue blocks of 1.5 cm length were obtained in variable numbers according to the size of the lesion, and from each tissue block a 5  µm section was obtained for microscopically evaluation. In cases of bowel resection the specimen was opened longitudinally through its entire length and 2mm longitudinal bands of bowel wall, reaching the two resection margins and passing through all macroscopically visible lesions, were cut. These bands were sampled in tissue blocks and 5  µm sections were obtained for microscopic evaluation. Statistical analysis Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated for both DCBE and RWC-TVS. The diagnostic value of each test was also assessed using positive likelihood ratio (LR+) and negative likelihood ratio (LR-). Efficacy parameters were calculated with 95% confidence intervals (CIs). McNemars test with the Yates continuity correction was used to compare the accuracy of DCBE and RWC-TVS in the diagnosis of intestinal endometriosis. McNemars test was used to compare the number of patients in which the number of rectosigmoid nodules was correctly identified by DCBE and RWC-TVS. The accuracy of the measurement of nodule size by imaging techniques was estimated by subtracting the size of the nodule as measured by the techniques from the size of the nodules measured at histology. The nonparametric Mann-Whitney test was used to compare the intensity of pain experienced by patients during DCBE and RWC-TVS, the chi-square test was used to co mpare the type of pain (mild, moderate or severe) and Spearmans rank correlation coefficient was used to determine whether there was a correlation between the intensity of pain experienced by patients during the two techniques. Data were analyzed using the SPSS software. p Results Study population A total of 198 patients were enrolled in the study and all underwent surgery were included in this study (Figure 1). The main demographic characteristics of the study are demonstrated in Table 1. The intensity of pain and gastrointestinal symptoms are presented in Table 2. Surgery and histology demonstrated that 110 patients (55.6%) had bowel endometriosis nodules. The endometriosis lesions infiltrating the intestinal serosa in 28 patients. The remaining 82 patients had only pelvic endometriosis with no evidence of intestinal lesions. The largest intestinal endometriosis nodule was found locate on the sigmoid colon in 53 patients, on the rectum in 30 patients, at the rectosigmoid junction in 20 patients, on the ileum in 5 patients and on the caecum in 2 patients. The endometriosis lesions infiltrating only the intestinal serosa were located on the sigmoid colon in 15 cases, on the rectum in 5cases and at the rectosigmoid junction in 3 cases. The mean ( ±SD) length of the resected bowel segment was 12.2  ± 3.6 cm. The diagnosis of endometriosis was confirmed in all the excised nodules by histological exam. Furthermore, it demonstrated that the deepest endometriosis nodule infiltrated the muscularis propria in 62 patients (56.4 %), the submucosa in 3 1 patients (28.2%) and the mucosa in 17 patients (15.5%). Accuracy of RWC-TVS and DCBE in the diagnosis of bowel endometriosis The accuracy, sensitivity, specificity, PPV, NPV, LR+ and LR- of DCBE and RWC-TVS in the diagnosis of bowel endometriosis are described in Table 3. DCBE identified 106 of 110 patients with bowel endometriosis (96.4%). In 4 patients endometriosis nodules infiltrating the muscularis propria of the rectum were not identified, which were excised by partial-thickness nodulectomy. RWC-TVS identified 97 of 110 patients with intestinal endometriosis (88.2%). RWC-TVS did not identify 4 ileal lesions, 2 cecal lesions, 4 sigmoid nodules and 3 rectal nodules infiltrating the muscularis propria. Furthermore, we identified 4 of these patients had large bilateral endometriosis ovarian cysts, which may have hampered the identification of intestinal nodules. There was 2 false positive on RWC-TVS-a rectovaginal endometriosis nodule that was judged to infiltrate the muscularis of the rectum. Surgery confirmed the presence of the rectovaginal nodule but did not reveal infiltration of the rectal muscularis. The sensitivity, specificity, PPV, NPV, LR+, LR- and accuracy of the two techniques in the diagnosis of intestinal endometriosis were shown in Table 3. McNemars test showed that there was no significant difference in the accuracy of the two techniques in the diagnosis of bowel endometriosis (P=0.109). Histology examination demonstrated that endometriosis infiltrated the submucosa or mucosa of the rectosigmoid colon in 53 patients. DCBE correctly identified the depth of infiltration in 27 of these patients (50.9%), while RWC-TVS correctly identified the depth of infiltration in 20 of them (37.7%) (P=0.126). All the other nodules that were seen to infiltrate the submucosa or mucosa at histology were judged to reach only the muscularis at DCBE and RWC-TVS. Both techniques had no cases of false-positive diagnosis of submucosal or mucosal infiltration. Both DCBE and RWC-TVS underestimated the size of the endometriosis nodules; however, the underestimation was greater for RWC-TVS than for DCBE (Table 4). In addition, in both imaging techniques the underestimation was greater for nodules with diameter≠¥30 mm. Tolerability of DCBE and RWC-TVS DCBE was safely performed in all the patients. During both the examinations all patients tolerated intestinal distension and in no patient was it necessary to interrupt the procedure. However, the intensity of pain experienced during DCBE was significantly higher than the intensity of pain experienced during RWC-TVS (Table 5). A positive correlation was observed between the intensity of pain experienced by the patients during the two examinations (Spearman correlation coefficient=0.575; p Discussion To the best of our knowledge, this is the first study demonstrated that DCBE and RWC-TVS have similar accuracy in the diagnosis of bowel endometriosis. Both RWC-TVS and DCBE underestimated the size of bowel endometriosis nodules, but under estimation was greater for RWC-TVS than for DCBE, particularly when the nodules had largest diameter ≠¥ 30 mm (Table 4). The choice of the ultrasonic technique is often based on the experience of the ultrasonographers rather than on evidence of superiority of one technique compared to the others. In fact, TVS must be performed by highly skilled, it has been recently estimated that the learning curve for an accurate diagnosis of deep pelvic endometriosis by TVS requires performing about 40 cases17. Therefore, it may be difficult to achieve such experience for ultrasonographers working in small hospital. The main advantage of DCBE could be that, with a retrograde distension of the entire colon, this technique may provide a complete overview of t he whole colon18. In the current study, the distension was targeted to the rectosigmoid because the aim of the study was the comparison with RWC-TVS and endometriosis lesions of the right colon are beyond the field of view of a transvaginal approach. Furthermore, we did not compare the accuracy of RWC-TVS with TVS alone, which was the objective of a previous study. RWC-TVS was chosen for the comparison with DCBE because of the personal experience of the authors and of the common criterion of bowel distension with fluid. The usefulness of this technique was subsequently confirmed by the same authors in larger series. Furthermore, other authors confirmed that intestinal distension and opacification using ultrasound gel helps to visualize rectosigmoid endometriosis nodules19, 20. Previous studies have suggested that TVS could reliably diagnose rectosigmoid endometriosis. The sensitivity of TVS for detecting rectosigmoid endometriosis is between 91 and 98%, the specificity between 97 and 100%, the PPV between 97 and 100% and the NPV between 87 and 98%21-24. Recently, RWC-TVS has been developed to facilitate identification of intestinal lesions in patients with rectovaginal endometriosis and to determine the depth of infiltration of endometriosis in the intestinal wall25. TVS has been extensively used in patients with bowel endometriosis; while only little data is available on the use of DCBE in these patients. This study demonstrated that DCBE and RWC-TVS have similar accuracy in the diagnosis of bowel endometriosis. Both techniques precisely estimated the length of the rectosigmoid nodules, but DCBE was more precise than RWC-TVS in assessing the distance between the endometriosis nodule and the anal verge9. Obviously, the extensive experience of the radiologi st and the gynecologist in DCBE and RWCTVS, respectively, may have influenced the accuracy of these techniques in diagnosing bowel endometriosis24, 26. The findings may be explained by the fact that when performing imaging techniques, particularly RWC-TVS, it might be difficult to choose the plane in which the irregular endometriosis nodule has the largest diameter. However, the difference between the estimated size of the nodule and the largest diameter as measured on histopathology was quite small and, in most cases, it seems unlikely that this difference would affect the choice of nodulectomy or bowel resection as treatment27. Importantly, patients tolerated RWC-TVS better than they did DCBE. These findings are in line with those of previous studies demonstrating the accuracy of TVS in the diagnosis of bowel endometriosis and comparing TVS with other techniques such as MRI and rectal endoscopic ultrasound11, 28-30. The potential benefits of introducing aqueous contrast medium into the rectum during TVS have been questioned. TVS is an operator-dependent procedure and it is possible that the differences observed in the accuracy of this technique are determined by the experience of the ultrasonographer carrying out the procedure31. However, adding intestinal aqueous contrast to TVS may facilitate the identification of rectosigmoid lesions. Other techniques have been proposed for improving the accuracy of TVS in the detection of deep endometriosis, such as sonovaginography or the use of large quantities of ultrasound transmission gel (12 mL) in the probe cover32. Up to now, no study has established whether any one of these ultrasonic techniques is superior to the others in the diagnosis of deep endometriosis. TVS should be considered the first-line investigation in patients with deep endometriosis, and allows the diagnosis of intestinal lesions24. Other investigations such as RWC-TVS, MDCT-e, MRI, rectal endoscopic ultrasound and DCBE may be used to determine the characteristics of intestinal endometriosis, such as the size and number of nodules, the depth of infiltration of the nodules in the intestinal wall and the degree of stenosis of the bowel lumen33-35. RWC-TVS has several advantages over the other techniques. It is less expensive than MDCT-e and MRI and the equipment required to perform the procedure is commonly available to gynecologists, who are usually involved in the management of patients with endometriosis. A recent study has shown that RWC-TVS allows estimation of the degree of stenosis of the intestinal lumen caused by endometriosis36. Unfortunately, this parameter was not examined in the current study- the major limitation of our investigation. Theoretically, RWC-TVS may also allow determination of the extent of the disease along the longitudinal intestinal axis. Obviously, RWC-TVS cannot determine the presence of intestinal nodules located proximally to the sigmoid because these lesions are beyond the field of TVS. This study had several limitations. First, the experience of the ultrasonographer in RWC-TVS may influence the accuracy of these techniques in diagnosing bowel endometriosis. Second, the surgeons were aware of the findings of DCBE and RWC-TVS. Although in an ideal prospective study the surgeons should be blinded to the findings of the preoperative investigations, this theoretical study design appears unethical in clinical practice because diagnostic imaging may facilitate the identification of intestinal endometriosis nodules during surgery. Furthermore, the knowledge of the findings of the preoperative investigations may only help the surgeons in identifying endometriosis nodules that were actually present. Third, RWC-TVS and DCBE did not estimate the percentage of the circumference of the intestinal wall infiltrated by endometriosis, a criterion used to choose between nodulectomy and bowel resection. Therefore, patients scheduled for nodulectomy on the basis of DCBE and RWC-TVS fin dings should be informed that bowel resection might be required for the complete excision of intestinal endometriosis. Future studies should examine whether DCBE and RWC-TVS can reliably estimate what percentage of intestinal circumference is infiltrated by endometriosis. DCBE may still have a role in the diagnostic workup of patients with suspected bowel endometriosis. When TVS or RWC-TVS demonstrates large intestinal nodules infiltrating the bowel muscularis, bowel resection can probably be performed without further investigation unless the surgeon wants to exclude intestinal lesions located proximally to the sigmoid. In contrast, when ultrasound demonstrates a single bowel nodule that may be excised by nodulectomy, DCBE should be used to exclude the presence of other intestinal nodules and, thus, to adequately plan the surgical procedure with the colorectal surgeon and the patient. Conclusions This study showed that RWC-TVS is a reliable technique for determining the presence and extent of bowel endometriosis and that it has an accuracy similar to that of DCBE. However, RWC-TVS may sometimes underestimate the presence of multiple bowel nodules and can be performed easily in an ambulatory setting and it is better tolerated by patients. It may be hypothesized to combine TVS and DCBE to achieve a complete preoperative assessment of the bowel in order to offer to the patients an adequate counseling and the most appropriate one-step surgical treatment.