Bill Gates Speech Essay Example for Free

Bill Gates Speech Essay William B. Gates, also known as Bill Gates was welcomed on October 28th, 1955 by his father William Gates II and his mother Mary Gates. Gates attended a public school and also the private Lakeside School. There, he discovered his interest in software and began programming computers at age 13. Today I would like to inform you about William B. Gates the founder of Microsoft, his life before Microsoft, his career, and his accomplishments. As a child, Bill Gates was very competitive, curious and a deep thinker, that is when his parents decided to enroll him in the private preparation school lakeside, where he soon excelled. Bill Gates was surrounded by historical events at a young age, like when Apolo eleven took men to the moon, this event inspired him because a huge computer was involved. When Bill Gates was in high school he would spend hours upon hours in the computer room. He graduated in 1973 from Lakeside and was accepted by the prestigious university of Harvard, where he had no definite career plan. He loved to stay up all day and night, he spent more time in the computer lab then he did in the classroom, that was his true craze. Soon he met Steve Balmer, who lived down the hall from him at Harvard. Balmer is now Microsoft’s chief executive officer. While at Harvard Gates developed a programing language called BASIC, for the first microcomputer. In his junior year gates left Harvard to devote his energies to Microsoft, a company he begun in 1975 with his childhood friend Paul Alan. His belief was the computer would be a valuable tool on every office desk and in every home. So they began developing software for personal computers. Gates foresight and vision was the success of Microsoft and the software industry. Under gates leadership Microsoft’s mission has been to improve software technology and to make it easier, cost effective and more enjoyable for people to use computers. In 1999 gates wrote business @ the speed of thought, the book was published in 25 languages and available in more than 60 countries. Was on the bestseller list of new york times, USA today, the wall street journal and amazon. com. Gates has donated the proceeds of the book to a nonprofit organization that support the use of technology and education and skills development. William Bill Gates is chairman of Microsoft Corporation the world wide leader in software, services and solutions that help people and buisnesses realizes their full potential. In 2008 Bill Gates transitioned out of a day to day role in the company to spend more time on his global health and education work at the Bill and Malinda Gates foundation. Gates Continues to serve as Microsoft s chairman and advisor on key development projects. In conclusion William B. Gates is considered a role model to many people, in many different ways. He has many accomplishments that have made him into the successful businessman he is today. Bill gates changed the way the world operates and functions, he made life easier for humans to live in. In 4 seconds he earns $250, in 24 hours he earns 20 million, and in a year he earns 7. 8 billion dollars. All this due to his co-founding the multi-billion dollar company that is Microsoft today. And as bill gates once said â€Å" be nice to nerds, because youll probably be working for one. †

Risks of noncompliance in corporate governance

Risks of noncompliance in corporate governance In Management, the aspect of compliance is one of the most important element in most businesses whether service or product. It involves the transformation of inputs of production and operation into outputs that, when distributed, have the needs satisfying abilities to the consumers. The concept of compliance refers to a state of being in accordance to certain rules and regulations. The process compliance involves the application of independent factors but mainly focuses on the overall corporate function of the organization. In corporate world we tend to associate compliance with leadership and decision making. The concept of Leadership is referred to as the progression of social influence which an individual can sign up in aid and support of others in the accomplishment of a common task. Leadership as a tool of effective management and compliance remains as one of the most pertinent aspects of the organizational context (Bicheno Elliot, 1997). When individuals are put in leadership positions, they are effectively authorized to comply with certain rules and regulations on of other people. They are expected to make wise decisions that serve the interests of the people that elected them, their organizations, state or country. Since compliance involves making tough decisions, its only leaders in involved in corporate governance who are in position to pass authority and influence other people. Good compliance technique is an indispensable skill for success and successful leadership. In the business world, many organizations especially those involved in financial services have compliance workforce whose function entails the idea of making sure the company comply with the laid down rules and regulations (Sparrow, 2000). Relationship of the cost of compliance against the degree of risk of noncompliance Corporate governance refers to a system by in which corporates or organizations are managed. It entails building of relationships between the management, committees of the Board, and employees. Effective corporate governance structure maximizes value and proficiency. Since compliance involves certification to do a particular task, it enables organizations to fulfill its goals and objectives for the reason that its functions are not delayed down by risks of non compliance. Organizations should concentrate on issues relating to compliance to ensure they fulfill their functions. There are numerous problems associated with failing to comply with certain regulations. Technically, the extent of risks found in organizations differs from one compliance element to another.  Ã‚   Regardless of issues involved, the cost of compliance is much smaller than the risks emerging out from noncompliance. In observing business ethics, the funds involved in compliance assist states and governments to c reate jobs and improve social status of its citizens. By enlarge; compliance is beneficial in that it makes corporate bodies to fulfill their social obligations to members of the public. Some of these costs also involve aspects of direct expenditures made by organizations to comply with safety issues, when complied; these regulations ensure consumers obtain high quality goods and services. Though high in some cases, the costs of compliance ensure fair trade and allow productions of goods and services that meet consumer requirements, needs and wants (Wong, 2001). The major risks of non compliance are the ability of the government to sue the organizations for compliance violations. This in the part of the organizations mostly its more expensive than the initial cost of complying with the required rules and regulations. For any organization to function well and achieve its goals and objectives, it must comply with all laid down rules and regulations to avoid risks of loss of clients resulting from closures, to avoid stiff penalties from regulatory bodies which are at times more costly that the cost of compliance and finally to avoid losing consumer confidence. To be effective in compliance matters, organization should do Self-Assessments of their functions and identify their risks. (Bicheno Elliot, 1997). Organization that uses committees within their corporate governance structure Organizations that implement the use of committees in their corporate governance structures have shown to be very effective, efficient and successful, and have shown potential to operate with utmost accountability and independence. this Committees perform duties on behalf of the organization management and shareholders and with efficient delegation of duties , they build stronger capital rights ,increase production and sales and increase the organization profitability ensuring they comply with necessary corporate rules and regulations . One of the most well recognized organization that uses committees with their corporate governance structure is PepsiCo. This company is found in beverage industry and its committee charters are very definitive and its purpose well structured. The organization consists of internal and external audit committees which guide the organization management in regulating quality and efficiency, financial position and organization compliance to regulatory bodys requirement and wants. Use of committees by McBride to mitigate noncompliance issues Like PepsiCo, McBride financial company should use the committees to mitigate the risks associated with noncompliance. The concept of compliance is a very significant issue for any organization. In the case of McBride Financial Services, the knowledge and execution of appropriate rules and regulations are ominous to the organization potential growth and development. Recommendations involving Self-Assessments and identification of risks should be used to mitigate issues of noncompliance in the company. McBride financial company should conduct self-assessment of their program in time before the time the regulators come knocking on their doors. The company should use internal committees to develop a risk-based compliance approach that include identification of risks of non-compliance and the factors required to ensure compliance. The committee analyzes the organization risks and assists the company come to a decision of which risks to focus on. When established, committees serve the fun ction of determining negative consequences of noncompliance. Committees perform quantitative analysis of the company performance and gives guidelines of what to do in order to achieve the companys goals and objectives (Causey, 2008). Conclusion Its a general business objective for most successful organizations in the world today to strategies on ways of improving their productivity, quality of products and services so as to satisfy the needs of their consumers as well as retaining their hare of the market. The success of the organization in the long-term requires that the organization considers the dynamism of management trends in their operations and comply with necessary rules and regulations. In conclusion we can say that concepts of compliance in corporate governance and s Management is one of the most important aspects of most businesses whether service or product. Compliance promotes creation of products that satisfies basic wants of customers and regulatory bodies. Happy customers promote productivity of a company in that the management produces more to be at level with their requirements. More production leads to increased yields and high profits.

Full Kinetic Chain Manipulative Therapy on the Knee

Full Kinetic Chain Manipulative Therapy on the Knee The relative effectiveness of full kinetic chain manipulative therapy and full kinetic chain rehabilitation in the treatment of osteoarthritis of the knee. Brief Synopsis of the Research Therefore in this study we aim to establish the effect of the KFC manipulative therapy alone, FKC rehabilitation alone and the combination of the two interventions on osteoarthritis of the knee. This will be done by means of a quantitative randomised comparative clinical trial. 60 patients will have been diagnosed with osteoarthritis of the knee according to the inclusion and exclusion criteria, and will be randomly divided into 3 groups. The first group will receive 6 treatments using FKC manipulative therapy alone, the second will receive 6 treatments using FKC rehabilitation alone, and the third group will receive 6 treatments using FKC manipulative therapy combined with FKC rehabilitation. Subjective (Beck Depression Inventory, McMaster Overall Therapy Effectiveness Tool, Western Ontario and McMaster Universities Osteoarthritis Index and Berg Balance Scale) and objective (Inclinometer) measures will be taken at baseline, 1 week and 1 month follow up. These results will be recorded and the data analysed using SPSS statistical package at a 95% confidence interval. Section B: To be typed in Arial 12-point font in one and half line spacing (expand sections to fit contents, but keep within the specified maximum lengths) 1. Field of Research and Provisional Title The relative effectiveness of full kinetic chain manipulative therapy and rehabilitation in the treatment of osteoarthritis of the knee. 2. Context of the Research 1. Osteoarthritis is a very common condition, affects 9.6% of men and 18% of women aged >60 years worldwide (Woolf and Pfleger, 2003). 2. Although multi-factorial, falls cause nearly two-thirds of all non-intentional injury related deaths in older adults (Hawk et al., 2006). One of the causative factors is loss of hip and knee proprioception secondary to increased joint degeneration, thus by addressing these problems with the rehabilitation and/or adjustment there may be a decreased risk of fall. 3. There is research to suggest that applying manipulative therapy and rehabilitation to the full kinetic chain yields greater benefits for KOA patients than at home rehabilitation alone (Deyle et al., 2005), however this combination of treatments has never been compared against full kinetic chain manipulative therapy alone. 4. KOA stiffness, pain and dysfunction was shown by Deyle et al., (2000) and Deyle et al., (2005) to improve better when adding manipulative therapy to a rehabilitation program as compared to placebo and exercise alone, respectively. 3. Research Problem and Aims Aim: The relative effectiveness of full kinetic chain manipulative therapy and rehabilitation in the treatment of osteoarthritis of the knee. Objectives: i) To determine whether manipulative therapy alone is effective in the short term treatment of KOA in terms of subjective and objective measurements. ii) To determine whether manipulative therapy alone is effective in the intermediate term treatment of KOA in terms of subjective and objective measurements. iii) To determine whether rehabilitation alone is effective in the short term treatment of KOA in terms of subjective and objective measurements. iv) To determine whether rehabilitation alone is effective in the intermediate term treatment of KOA in terms of subjective and objective measurements. v) To determine whether manipulative therapy combined with rehabilitation is effective in the short term treatment of KOA in terms of subjective and objective measurements. vi) To determine whether manipulative therapy combined with rehabilitation is effective in the intermediate term treatment of KOA in terms of subjective and objective measurements. vii) To compare short term results and intermediate results, respectively. viii) To determine whether manipulative therapy combined with rehabilitation is effective in decreasing the risk of fall according to the Berg Balance Scale. ix) To determine whether rehabilitation alone is effective in decreasing the risk of fall according to the Berg Balance Scale. x) To determine which treatment method is more effective in decreasing the risk of fall according to the Berg Balance Scale. 4. Literature review Osteoarthritis is a chronic degenerative disorder with a complex aetiology (Felson, 2000). It is characterized by focal loss of articular cartilage within synovial joints, associated with hypertrophy of bone (osteophytes and subchondral bone sclerosis) and thickening of the capsule, resulting in alterations in biomechanical properties (Woolf and Pfleger, 2003). It is a very common joint disorder, affecting mostly those above the age of 60 and can occur in any joint but is most common in the hip; knee; and the joints of the hand, foot, and spine (Symmons, Mathers and Pfleger, 2003). As many as 40% of people over the age of 65 suffering symptoms associated with knee or hip OA (Zhang et al., 2008), resulting in OA becoming the fourth leading cause of disability in the years 2000 (Symmons, Mathers and Pfleger, 2003). Although no cure exists, a number of treatment options exist to provide symptomatic relief as well as improvement of joint function. Amongst these are non-pharmacological in terventions, such as rehabilitation, manual therapies, acupuncture and electromodalities, as well as pharmacological measures such as oral medication and intra-articular injections. In severe cases, where nonsurgical interventions have failed, more invasive approaches may be needed (Scher and Pillinger, 2007). McCarthy (2004) compared the effectiveness of an at home exercise program on its own or when supplemented with a class-based exercise program. There was found to be a greater improvement in WOMAC score in the class-based exercise group (20.6%) than the at home group (8.8%). These relatively modest effects may be owed to inability of exercise to address a number of factors that prevent patients from maximising results from their exercise program. Fitzgerald (2005) identified quadriceps inhibition or activation failure, obesity, passive knee laxity, knee misalignment, fear or physical activity and self-efficacy as examples of such factors. The necessity for additional interventions to address these factors therefore becomes apparent. Tucker et al. (2003) compared the relative effectiveness of knee joint manipulation versus a non-steroidal anti-inflammatory drug (NSAID), and found manipulation to be just as effective as NSAIDs in the treatment on KOA. Fish et al., (2008) had similar results when comparing the effectiveness of knee joint mobilisation against Topical Capsaicin Cream. Capsaicin has been previously demonstrated superior to placebo in many painful disorders including knee and general osteoarthritis. Pollard, Ward, Hoskins and Hardy (2008) applied a manipulative therapy protocol, consisting of soft tissue mobilisation and an impulse thrust to the symptomatic knee joint complex. This was found to have a statistically significant improvement in knee pain, mobility, crepitus and function when compared to the control group (interferential current set at zero). Pollard et al. (2008) also noted that knee treatment had a significant improvement in hip movement of those in the intervention group compared to the control group. This may be owing to the effect that treatment to a single joint may have on the full kinetic chain (hereafter FKC). A number of studies have been conducted on various joints of the full kinetic chain of the lower extremity to determine their effect on the knee. Cliborne et al., (2004) aimed to determine the short-term effect of hip mobilization on pain and range of motion (ROM) measurement in patient with knee osteoarthritis (OA). It was demonstrated that the presence of hip pain and pain on squatting, restricted hip flexion and/or a positive scouring test predicts a better knee OA outcome. Currier et al., (2007) suggest that pain over the hip, groin or anterior thigh; limitations in passive knee flexion and internal rotation of the hip; as well as pain with hip distraction predicts a favourable short-term response to hip mobilizations. In fact it was found that, based on the presence of one variable, the probability of a successful response was 92% at 48-hour follow-up, which increased to 97% if 2 variables were present. Iverson et al., (2008) suggest that the strongest predictor of whether adjus ting the lumbopelvic spine will decrease knee pain (in patellofemoral pain syndrome) is if there is a side-to-side difference in hip internal rotation greater than 14 °. The presence of this variable increased the likelihood of a successful outcome from 45% to 80%. These studies collectively show that correcting the various dysfunctions within the kinetic chain will have a favourable effect on knee joint dysfunction. However, there has yet to be a study that seeks to improve knee osteoarthritis by treating all indicated joints in the full kinetic chain. Few studies have looked at what effect combining manipulation and rehabilitation would have in the treatment of KOA. Deyle et al., (2000) applied manual therapy to the knee as well as to the lumber spine, hip and ankle as required. Additionally patients where given to knee exercise program to perform in the clinic on treatment days and at home. WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) scores are used to detect changes in the patients perception of function and quality of life, specifically related to the disease process. In this study, there was a 55.8% improvement in the treatment group as compared to a 14.6% improvement in those patients receiving placebo (subtherapeutic ultrasound), thus proving the effectiveness of combining manipulation and rehabilitation. Using similar methodologies, Deyle et al., (2005) compared an at home versus in clinic physical therapy program. Those being treated in clinic received supervised exercise, manual therapy to the F KC and a home exercise program, while a second group received at home exercise only. Significant improvements where seen in both groups, however the clinic treatment group had an improvement in WOMAC scores of 52% and only a 26% improvement was seen in the home exercise group. The author attributed this difference between groups to the application of manual therapy to the full kinetic chain. However, the clinic group performed the exercises under supervision and where corrected where necessary while the home group were largely unsupervised and may have performed the exercises incorrectly as a result, thus decreasing the benefit such exercises would have. One should therefore not consider the difference in group performance to be solely due to the addition of manual therapy. To date there is no study which compares the effect of manual therapy alone versus the above mentioned treatment combinations. Therefore there is a need for a study to determine whether FKC manual therapy combined with a standardised rehabilitation program is more effective than either intervention alone in the treatment of osteoarthritis of the knee. 5. Research Methodology Design type: Quantitative comparative clinical trial conducted at the Durban University of Technology Chiropractic Day Clinic (hereafter DUT CDC). Advertising: [Appendix A] Old age homes and retirement villages throughout the greater Durban region will be approached, as well as advertisements placed on notice boards of DUT, community halls, shopping centres and places of worship. Sampling procedure: A sample size of 60 (n=60) will be selected by means of convenience sampling (Brink, 2006). Those individuals responding to the advertisements will be screened and accepted based on the inclusion and exclusion criteria. Telephonic interview: Patients are required to contact the DUT CDC telephonically to determine whether they meet the requirements of the study. This will be determined by asking the patient the following questions; * Are you between the ages of 38 and 80? * Have you had knee pain for longer than 1 year? * Do you have a history of trauma or surgery to the lumbar spine or lower limb? * Are you able to stand and walk on your own, with minimal need and/or without significant dependence on canes and walkers? * Do you suffer from a chronic medical condition that would require you to take regular medication? * Would you be prepared to have radiographs taken of your lower limb? If the patient meets the criteria for the study, a consultation will be made, at which they will be presented with a letter of information and informed consent form [Appendix B], which they will be required to sign. The following inclusion and exclusion criteria will be assess using a case history [Appendix C]; physical exam [Appendix D]; lumbar and pelvis [Appendix E]; hip [Appendix F]; knee[Appendix G] and; ankle and foot [Appendix H] regional examinations. Inclusion Criteria: A. Criteria, as developed by Altman (1991), requires a minimum of one of the first three clinical criteria below (#1, 2 or 3) for diagnosis of KOA (sensitivity 89 % and specificity 88%). 1. Knee pain and crepitus with active motion and morning stiffness ≠¤ 30 min (with age 38 ≠¤ 80 years of age). 2. Knee pain and crepitus with active motion and morning stiffness >30 minutes and bony enlargement (with age 38 ≠¤ 80 years of age). 3. Knee pain and no crepitus and bony enlargement (with age 38 ≠¤ 80 years of age). B. The following 4 criteria are all required: 4. Knee pain of ≠¥ 1 year duration and able to stand and walk without severe varus/valgus deformity and/or severe instability (Kellgren and Lawrence, 1957). 5. Diagnosis of concurrent subluxation/or joint dysfunction (S/JD) complex: a. Diagnosis of S/JD will be supported throughout using the PART(S) system. 6. A patient must have a score of ≠¥720 mm (≠¥30%) on the WOMAC scale to be included (Tubach et al., 2005). 7. No history of meniscal or other knee surgery in the past 6 months (Pollard et al., 2008). 8. A diary will be kept to monitor whether medication consumption is increased, decreased or stays the same. Exclusion Criteria: 1. Significant visual disorders, severe vestibular disorders, neurological and peripheral sensory disorders which may be a contra-indication to exercise 2. History of knee or hip joint replacement, severe varus or valgus deformity, instability, fracture and severe osteoporosis, Rheumatoid arthritis, or frank avascular necrosis with or without moderate or severe deformity, 3. History of significant lumbar herniated disc injury with sequela, 4. Severe balance and proprioception problems (i.e. inability to stand with and/or without marked spinal or hip deformity) 5. Symptoms of moderate to severe osteoarthritis in both knees and/or hips: Note: both knees can be treated if there is KOA or joint dysfunction in the opposite knee and otherwise no other severe complications as noted above. However, only data collected from the worst knee will be used for the purpose of the study. 6. Long term chronicity combined with multiple treatment failure especially multiple failure with previous physical treatment (≠¥ 3), with and/or long term severe pain, and/or a severely complicated or complex disorder (such as multiple co-morbidities combined with KOA such as a mix of: knee, hip and lumbosacral OA, and/or cardiovascular and/or auto-immune disease), or a severely disabled and/or a patient with severe and decreased functional ability and/or a severe clinical depression, may lead on a case by case basis, to exclusion. A basic guide for #6 to be used on a case by case basis: I. Pain: The patient gives a history that can be interpreted as having stayed constantly or chronically at a high level of an estimated verbal analogue score (VAS) of ≠¥ 7 or WOMAC score of 1680-1920mm (70-80%) (out of a maximum worst score of 2400mm) for 3 to 5 years or longer. II. Complicated or complex: 3 or more disorders at one time in the same patient (with KOA) as listed from #1-5 above. III. Severely disabled: dependent on a cane, brace or walker 75 to 100% of the time when ambulating; severe cardiovascular disease; severe instability in the knee or other joints or possibly less than, or markedly less than half the normal ROM. IV. Clinically depressed: determined by history and use the Beck Depression Inventory (BDI). The BDI has been validated for measuring depression in clinical and nonclinical settings (Beck et al., 1961). Radiological analysis: Although diagnosis of KOA will be made primarily through clinical examination, knee x-rays will be taken on patients who qualify and consent to participate in the clinical trial. The purpose is to determine the grade of osteoarthritic change (according to the Kellgren-Lawrence scale (reference)), to confirm suspicions of contra-indications to treatment, or to rule out a pathology outside of OA. Additionally, the subjects history and physical examination may indicate the need for lumbosacral/pelvic, hip, ankle and/or foot x-rays (see exclusion criteria below). Procedure: Time Baseline 2 weeks 4 weeks 6 weeks 1 week F/U 1 month F/U # Rx 2 2 2 Outcome measurement WOMAC ROM BBS BDI WOMAC OTE ROM BBS BDI WOMAC OTE ROM BBS BDI Once accepted into the study, patients will be randomly allocated into 3 (three) groups using a randomised allocation chart (reference). Interventions: Group A will be treated with only manipulative therapy of the FKC. Group B will be treated with only rehabilitation of the FKC. Group C will be treated with manipulative therapy combined with rehabilitation of the FKC. Manipulative therapy: [Appendix I] FKC manipulative therapy (manipulative therapy to the knee, and any indicated axial or appendicular joint dysfunction, such as to the spine, hip, ankle, and foot) for KOA has been hypothesized as superior to localised manipulative therapy (Deyle et al., 2005). Treatment will focus on carefully restoring knee flexion and extension by lesser grades of mobilization as recommended by Deyle et al., (2005) and Fish et al., (2008), and patellar mobilization as per Pollard et al., (2008), along with careful high velocity low amplitude axial elongation of the knee joint as per Fish et al., (2008). Additionally, manipulative therapy will be applied where needed to the full kinetic chain using other diversified techniques, such as HVLA manipulation or mobilization as outlined in Shafer and Faye (1990), and/or Peterson and Bergman (2002). Also, the hip technique, as outlined by Hoeksma et al., (2004) and the use of HVLA knee manipulation methods from Tucker et al., (2005) will also be utilized when indicated. The particular joint dysfunction also known as the subluxation complex or manipulable lesion will be chosen based upon findings in the regional examinations. Rehabilitation: [Appendix J] Rehabilitative therapy will include exercises, focused soft tissue treatment and stretch to the knee and elsewhere along the full kinetic chain where needed based upon functional assessment (Deyle et al., 2005). Also included in rehabilitation will be patient advice, education and home exercise recommendations for managing their KOA. The rehabilitation protocol will be standardised across groups B and C, with minor case by case variations. Intervention frequency: All patient will receive: 6 treatments in the first three (3) weeks (2x treatments/week). Training in a rehabilitation program, to be completed daily. Regular telephonic communication (every 1-2 weeks) following the completion of the 6th treatment. All groups will be required to return to the clinic no more than one (1) week after the 6th treatment and at the one (1) month follow up to have readings taken. Measurement Tools: All data will be collected previsit 1, no more than 1 week after 6th treatment and at 1 month follow up, with the exception of OTE which will not be collected at previsit 1. Subjective data will b obtained by means of; Beck Depression Inventory [Appendix K] The McMaster Overall Therapy Effectiveness (OTE) Tool [Appendix L] will be used to assess patient satisfaction and general improvement. o The OTE is a valid and reliable questionnaire that allows the patient to classify the change in their health status: whether their KOA symptoms, or overall quality of life has improved, remained the same, or worsened since the last visit (Chan et al., 2006) The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) [Appendix M] detects change in function and quality of life in patients suffering from KOA using multiple questions with the visual analogy scale (VAS). o The WOMAC is valid and reliable for KOA, and has a long history of being broadly and frequently utilized to assess knee and hip OA, thus allowing comparison to a large number of studies and trials (Bellamy et al., 1988). Berg Balance Scale (BBS) questionnaire [Appendix N] is a predictor of fall risk and will be delivered if the one legged standing test is failed (Hawk et al., 2006)). KOA patients who are +ve for the Berg Balance Scale (BBS) will be monitored as a subgroup (with a + OLST and BBS) at all clinic assessments Objective data will be obtained by means of: Inclinometer [Appendix O] readings for knee flexion and extension only to evaluate the patients range of motion (ROM) (reference). Statistics: The latest version of SPSS will be used to analyse the data. 6. Plan of Research Activities Provide a summarised work plan for each year of the project giving information for each research activity per year, under the following headings: Activity Timeframes (target dates for the duration of the project) 7. Structure of Dissertation / Thesis Chapters 1. Introduction 2. Review of the related literature 3. Subjects and methods 4. Results 5. Discussion 6. Recommendations and conclusions 7. References 8. Potential Outputs  § Provide details on envisaged measurable outputs (e.g. publications, patents, students, etc.);  § Expected national and/or international acclaim for the research and contribution of research outputs to building the knowledge base;  § Exploitability of outputs, e.g. applicability to community development, improved products, processes, services in SA, region and/or continent;  § Expected effects of research results. 9. Key References Brink, H. 2006. Fundamentals of research methodologies for health care professional. 2nd edition. Juta and co. Cape Town. Cliborne, A., Wainner, R., Rhon, D., Judd, C., Fee, T., Matekel, R., and Whiteman, J. 2004. Clinical hip tests and a functional squat test in patients with knee osteoarthritis: reliability, prevalence of positive test findings, and short-term response to hip mobilization. Journal of Orthopaedic Sports Physical Therapy, November; 34(11): 676-685. Currier, L., Froehlich, P., Carow, S., McAndrew, R., Cliborne, A, Boyles, R., Mansfield, L., and Wainner, R. 2007. Development of a clinical prediction rule to identify patients with knee pain and clinical evidence of knee osteoarthritis who demonstrate a favourable short-term response to hip mobilization. Physical Therapy, September; 87(9): 1106-1119. Deyle, G., Allison, S., Matekel, R., Ryder, M., Stang, J., Gohdes,D., Hutton, J., Henderson, N., and Garber, M. 2005. Physical Therapy Treatment Effectiveness for Osteoarthritis of the Knee: A Randomised Comparison of Supervised Clinical Exercise and Manual Therapy Procedures versus a Home Exercise Program. Physical Therapy, 85(12): 1301-1317. Deyle, G., Henderson, N., Matekel, R., Ryder, M., Garber, M., and Allison, S. 2000. Effectiveness of Manual Physical Therapies and Exercise in Osteoarthritis of the Knee. Annals of Internal Medicine, 132(3): 173-181. Felson, D. 2000.Osteoarthritis: New Insights Part 2: Treatment Approaches. In: National Iinstitute of Health Conference, Annals of Internal Medicine; 133: 726-737. Hawk, C., Hyland, J.K., Rupert, R., Colonvega, M. and Hall, S. 2006. Assessment of balance and risk for falls in a sample of community-dwelling adults aged 65 and older. Chiropractic and Osteopathy, 14(3). Haynes, S. and Gemmell, H. 2007. Topical treatments for osteoarthritis of the knee. Clinical Chiropractic; 10: 126-138. Iverson. C., Sutlive, T., Crowell, M., Morrell, R., Perkins, M., Garber, M., Moore, J., and Wainner, R. 2008. Lumbopelvic manipulation for the treatment of patients with patellofemoral pain syndrome: development of a clinical prediction rule. Journal of Orthopaedic Sports Physical Therapy, June; 38(6): 297-312. McCarthy, C., Mills, P., Pullen, R., Roberts, C., Silman, A., and Oldman, J. 2004. Supplementing a home exercise programme with a class-based exercise programme is more effective than home exercise alone in the treatment of knee osteoarthritis. Rheumatology; 43: 880-886. Pollard, H., Ward, G., Hoskins, W. and Hardy, K. 2008. The effect of a manual therapy knee protocol on osteoarthritic knee pain: a randomised controlled trial. Journal of the Canadian Chiropractic Association, December; 52(4): 229-242. Symmons D, Mathers C, Pfleger B. 2003. Global burden of osteoarthritis in the year 2000 [online]. Geneva: World Health Organization. Available at: URL: http://www3.who.int/whosis/menu.cfm?path=evidence,burden,burden_gbd2000docslanguage=english Tucker, M., Brantingham, J., Myburg, C. 2003. Relative effectiveness of a non-steroidal anti-inflammatory medication (Meloxicam) versus manipulation in the treatment of osteo-arthritis of the knee. European Journal of Chiropractic, 50: 163-183. Woolf, A.D. and Pfleger, B. 2003. Burden of major musculoskeletal conditions. Bulletin of the World Health Organization, 81 (9). Zhang, W., Moskowitz, R. W., Nuki, G., Abramson, S., Altman, R. D., Arden, N., Bierma-Zeinstra, S., Brandt, K. D., Croft, P., Doherty, M., Dougados, M., Hochberg, M., Hunter, D. J., Kwoh, K., Lohmander, L. S. and Tugwell, P. 2008. OARSI recommendations for the management of hip and knee osteoarthritis, Part II: OARSI evidence-based, expert consensus guidelines. Osteoarthritis and Cartilage, 16:137-162. Appendix L The McMaster Overall Therapy Effectiveness (OTE) Tool (for general improvement and patient satisfaction) Patient No.â‚ ¬Ã…’â‚ ¬Ã…’â‚ ¬Ã…’â‚ ¬Ã…’ Visit No. Page No. . Overall Treatment Evaluation KOA We would like to find out if there are any changes in the way you have been feeling since treatment started: after 6 treatments, and also at the 1st week and 1st month follow ups. Since treatment started, has there been any change in your ACTIVITY LIMITATION, SYMPTOMS AND/OR FEELINGS related to your knee osteoarthritis? Please indicate if there has been any change by checking ONE of the three boxes below (Better/About the same/Worse): Better About the Same Worse ⇓ ⇓ If you have checked ABOUT THE SAME, ⇓ Please stop here. ⇓ If you have checked the box If you have checked the box BETTER: WORSE: How much BETTER would you say How much WORSE would you say your ACTIVITY LIMITATION, your ACTIVITY LIMITATION, SYMPTOMS AND/OR FEELINGS SYMPTOMS AND/OR FEELINGS have been since treatment started? Have been since treatment started? Please choose ONE of the options Please choose ONE of the options below: below: Almost the same, hardly better at all Almost the same, hardly worse at all A little better A little worse Somewhat better Somewhat worse Moderately better Moderately worse A good deal better A good deal worse A great deal better A great deal worse A very great deal better A very great deal worse Patient No.â‚ ¬Ã…’â‚ ¬Ã…’â‚ ¬Ã…’â‚ ¬Ã…’ Visit No. Page No. . Overall Treatment Effect CHF, continued Answer the following question whether or not you answered BETTER or WORSE and what your response was. Note if you have improved, the change will be important since you likely will be able to carry out your responsibilities with greater ease and comfort compared to before the study. If on the other hand you are worse, then you will have more difficulty carrying out your responsibilities; this will also be important for you as you have more difficulty with your activities. Is this change (BETTER/WORSE) important to you in carrying out your daily activities? Not important Slightly important Somewhat important Moderately important Important Very important Extremely important THANKS FOR YOUR COOPERATION! Description of scales and how they will be assessed: * Pages one and two are graded separately. * Page one is graded on a 15 point scale. Scored from +7 to -7 * If the answer to the first question is Better then you have a + integer * If the answer to the first question is About the Same the score is 0 * If the answer to the first question is Worse then you have a integer * With a + or integer, the answers below the better or worse response are numbered sequentially from top to bottom. Almost the same, hardly better is a 1 and A very great deal better is a 7. * Page two is graded on a 7 point scale. Scored from 1 to 7 * The answers are numbered sequentially from top to bottom. Not important is a 1 and Extremely important is a 7 Later we will dichotomize the scores on page one between scores > 1 (improved) and Appendix M The WOMAC Western Ontario and McMaster Universities osteoarthritis index KNEE OSTEOARTHRITIS Name:_________________________________________________ Date:___/___/______DOB:___/___/_____ In Sections A, B and C questions will be asked in the following format and you should give your answers by putting a straight vertical (up-and-down) mark on the horizontal line. Note: 1. If make a straight vertical (up-and-down) mark on the line, at the left-hand end of the line, i.e. NO PAIN EXTREME PAIN Then you are indicating that you have no pain. Note: 2. If make a straight vertical (up-and-down) mark on the line, at the Right-hand end of the line, i.e. NO PAIN EXTREME PAIN Then you are indicating that you have extreme pain. 3. Please Note: a) that the further to the right-hand end you place your straight vertical (up-and-down) mark on the line, the more pain you are experiencing b) that the further to the left-hand end you place your straight vertical (up-and-down) mark on the line, the less pain you are experiencing c) Please do not place your straight vertical (up-and-down) mark on the line outside the markers. You will be asked to indicate on this type of scale the amount of pain, s

Ednas Awakening Essay -- essays papers

Edna's Awakening Kate Chopin's "The Awakening" is a work of litature like none other I have read. It is not hard to imagine why this major work of Chopin's was banished for decades not long after its initial publication in 1899. Most of society did not like the fact that "The Awakenings" main character, Edna Pontellier, went against the socially acceptable role of women at that time. At that time in history, women did just what they were expected to do. They were expected to be good daughters, good wives, and good mothers. Edna seemed to fit this mold at first, but eventually as the story develops Edna breaks free from that mold. Edna chose to do what society expected of her, she marries, and leaves her fantasies and dreams in the depths of the shadows. "The acme of bliss, which would have been a marriage with the tragedian, was not for her in this world. As the devoted wife of a man who worshiped her, she felt she would take her place with a certain dignity in the world of reality, closing the portals forever behind her upon the realm of romance and dreams." After marriage, Edna faced the expectations of motherhood and being a devoted mother, after all "if it was not a mother's place to look after children, whose on earth was it?" The outward appearance of Edna's life looked perfect, she was the envy of many women. "And the ladies, selecting with dainty and discriminating fingers and a little greedily, all declared that Mr. Pontellier was the best husband in the world. Mrs. Pontellier was forced to admit she knew of none better." The cover of her life was a picture of a fairy tale, but inside, the pages were filled with the emptiness and the loneliness she was feeling. During that ... ...obert, but he will not because it will disgrace her to leave her husband. Now, the wings that once held such possibilities for her new life were shattered and "a bird with a broken wing was beating the air above, reeling, fluttering, circling, disabled down, down to the water." In the end Edna takes a death walk down to the beach. When she arrives at the shore, she "casts the unpleasant pricking garments from her." This symbolizing the shedding of her "unpleasant" and "pricking" life. She could hear the waves inviting her, and "She felt like a new-born creature, opening its eyes in a familiar world that it had never known." As Edna swims towards eternity she thinks of many things. Now the shore was far behind and her strength was gone, not only to swim, but live. Edna underwent an "awakening" and as a result chose the endless sleep of death.

Brain and Behavior of Men and Women Essay -- Females Males Paperes Com

If we were to examine a high school calculus classroom or the staff at an engineering program of a college or university, chances are that the male to female ratio would be significantly skewed. Why are women and men so different in their choices and behavior? The brunt of popular opinion focuses on the environmental cues that lead to our distinct behaviors. But is there also an innate biological basis to the choices and differing abilities between men and women? Cognitive functioning or brain processing differences in the two genders has been a point of interest and contention for many years. The purpose of this essay is to explore if neuroanatomical and genetic differences between males and females play a role in the development of "gender-specific" behaviors, perceived intellectual strengths and professional choices. Equality regardless of gender or creed is an axiom that is crucial to our modern day society. And yet even in this 21st century, the number of women in certain "male dominated" professions, has remained fairly unchanged. Many social theorists believe that women are discouraged from such professions and that if they were given an unbiased, level playing field, that demand for these professions would be identical for both males and females. Mary Pipher, a psychotherapist for adolescent females writes, "With girls... their success is attributed to good luck or hard work and failure to lack of ability, with every failure, girls' confidence is eroded. All this works in subtle ways to stop girls from wanting to be astronauts and brain surgeons. Girls can't say why they ditch their dreams, they just 'mysteriously' lose interest" (10). Experiments have shown that women perform better when given tests that they... ...nd environment play on sexual identity is uncertain. References 1) Gender Identity Disorder by Anne Vitale 2) The Role of Estrogen in Sexual Differentiation by Elaine Bonleon de Castro 3) Gender Differences in Cognitive Functioning by Heidi Weiman 4) Sex on the Brain - Biological Differences between Genders by Deborah Blum 5) Cognitive Development 6) Gender-Related Heart Differences in Human Neonates by Emese Nagy 7) Boys will be Boys: Challenging theories on Gender Permanence by Josh Greenberg 8) Neural Masculization and Feminization by Mary Bartek 9) Thinking about Brain Size 10) Gender Issues - Excerpt from "Reviving Ophelia" by Mary Pipher 11) Women's Brains - More Effective? 12) Speech Processing in the Brain 13) The Nature Versus Nurture Debate 14) The Genetic-Gender Gap 15) Explanations of Criminal Behavior Brain and Behavior of Men and Women Essay -- Females Males Paperes Com If we were to examine a high school calculus classroom or the staff at an engineering program of a college or university, chances are that the male to female ratio would be significantly skewed. Why are women and men so different in their choices and behavior? The brunt of popular opinion focuses on the environmental cues that lead to our distinct behaviors. But is there also an innate biological basis to the choices and differing abilities between men and women? Cognitive functioning or brain processing differences in the two genders has been a point of interest and contention for many years. The purpose of this essay is to explore if neuroanatomical and genetic differences between males and females play a role in the development of "gender-specific" behaviors, perceived intellectual strengths and professional choices. Equality regardless of gender or creed is an axiom that is crucial to our modern day society. And yet even in this 21st century, the number of women in certain "male dominated" professions, has remained fairly unchanged. Many social theorists believe that women are discouraged from such professions and that if they were given an unbiased, level playing field, that demand for these professions would be identical for both males and females. Mary Pipher, a psychotherapist for adolescent females writes, "With girls... their success is attributed to good luck or hard work and failure to lack of ability, with every failure, girls' confidence is eroded. All this works in subtle ways to stop girls from wanting to be astronauts and brain surgeons. Girls can't say why they ditch their dreams, they just 'mysteriously' lose interest" (10). Experiments have shown that women perform better when given tests that they... ...nd environment play on sexual identity is uncertain. References 1) Gender Identity Disorder by Anne Vitale 2) The Role of Estrogen in Sexual Differentiation by Elaine Bonleon de Castro 3) Gender Differences in Cognitive Functioning by Heidi Weiman 4) Sex on the Brain - Biological Differences between Genders by Deborah Blum 5) Cognitive Development 6) Gender-Related Heart Differences in Human Neonates by Emese Nagy 7) Boys will be Boys: Challenging theories on Gender Permanence by Josh Greenberg 8) Neural Masculization and Feminization by Mary Bartek 9) Thinking about Brain Size 10) Gender Issues - Excerpt from "Reviving Ophelia" by Mary Pipher 11) Women's Brains - More Effective? 12) Speech Processing in the Brain 13) The Nature Versus Nurture Debate 14) The Genetic-Gender Gap 15) Explanations of Criminal Behavior

Laws That Contradict

| State Laws That Contradicts Federal Laws| Which One Must We Fallow? | | | State Laws That Contradict Federal Laws Abstract: This Paper explains using proof and some facts from researched sites and articles on the internet using sites like Google as a research source. This also going to show some views that the people have on this subject. We will see information and ideas on this topic (How state Laws Contradict Federal Laws) there all going to be different opinions because we all have different views on this question (Which One Should Fallow.? . I’m here to open your mind and interest you in this subject to see what your opinion is on this. This article will explain you this. You will see 1 article on a situation of wen a state law contradicts a federal law and 2 view of what people think we should do each one of course different. This paper will answer some questions we might ask of or think of. Hope you catch some interest and hope it opens a new perspective to you and yo u get interested in this topic. State Laws That Contradict Federal LawsQuestions we might have and ask in our minds here are some than again this is on some web pages online you can think otherwise you will see examples throughout this report and see why people might say this. Every question will be answered and you will see examples What happens if a state law contradicts the US Constitution or a federal law? What  happens  when a  state  law  conflicts with a  federal  law? If a  state  law  conflicts with a  federal  law  which  law  will prevail? Which should we fallow? In case a person violets one of this laws by doing another what happens?These and more questions can be in our mind and yeah we want an answer to this so I’ll try to a answer these and more. Get ready to learn some stuff we didn’t know. State Laws That Contradict Federal Laws A very important state law that contradicts federal law is the prescribed marijuana. In some st ates they have legalized it for people that have health problems than again what's the point of having a state law that allows you to prescribe marijuana when FBl can arrest you for violating the Federal law.How can they allow it in some states when it’s supposed to be a drug and is prohibited and against all law to have it or consume it? We have seen many issues that have happened when it comes to this like people making fake prescriptions to obtain it and the sale of it. It has been something we have tried to battle against and the police and states try to end but how can they end something when is the own state that’s the approving the legalization. Many people are confused about the legality of medical access to marijuana.First text from online site (First and foremost:  Marijuana, for  any  use,  is illegal under federal law. Even if you live in a state that has enacted legislation or passed a ballot initiative that recognizes marijuana's medical utility y ou are subject to arrest by federal officials for possession or cultivation of marijuana. (Based on this we see that the text is saying that it is illegal under federal law even if u lived in a state where it is legal you would need a ballot or an ID of authorization.I think this is a good way of keeping it from going into the wrong hands but yet there are always ways people forfeit documents and make fake prescriptions to get that Id there should be more ways of verification. ) Federal Laws: The Controlled Substances Act classifies cannabis as a Schedule I drug and defines it as a drug â€Å"with no accepted medical value in treatment. † Despite its long history of use as a medication, cannabis is classified as a â€Å"new drug† and legal access is only possible through an Investigational New Drug Application (IND) issued by the Food and Drug Administration (FDA). This helps to see the medical past of the person asking for the drug even though people use it as a pain reliever they should do this drug for people that have very severe drug issues. What do you think should they give it to any sick person or to the ones that have really severe illnesses? ) State Laws: Beginning in 1978, the states began responding to pleas from the seriously ill for legal access to marijuana for medical purposes. Thirty-four states  have enacted laws which recognize marijuana's medical value.Many of these laws authorized state research programs which would allow citizens to gain legal access to marijuana. Several states developed complicated research programs which gave their citizens limited access to legal supplies of medical marijuana. These programs were short-lived, however. Complex federal regulations and the continuous intervention of federal officials made such programs too difficult for most states to administer. This state law has many different views and sides you can take. Like you can be in favor of allowing it yet you can also be against.So here is t he question which one should we fallow? Based on the supremacy claw if the state law contradicts the federal law you have to fallow the federal law so if we fallow the federal law that means that any patient with severe illness and who passes approbation of his/her application should get the illegal drug than again only if passed investigation (IND: Investigational New Drug Application) What happens if someone violates the law? If state has there different laws and penalties and regulations that occur when violating their terms or abusing there.Reference page Question 1 Pg. 3 http://wiki. answers. com/Q/What_happens_if_a_state_law_contradicts_the_US_Constitution_or_a_federal_law#ixzz26xSIZOoV Question 2 Pg. 3 http://wiki. answers. com/Q/What_happens_if_a_state_law_contradicts_the_US_Constitution_or_a_federal_law#ixzz26xUDqStq Question 4 Pg. 3 http://wiki. answers. com/Q/What_happens_if_a_state_law_contradicts_the_US_Constitution_or_a_federal_law#ixzz26xUDqStq First text in parenthes is http://www. marijuana-as-medicine. org/Federal%20;%20State%20Law. htm

Resto bar feadibility study Essay

Pinoy Restaurant Bar, the reason why we choose this name because Pinoy Resto Bar are few place you can reliably turn to for a meal serves Filipino Cuisine that is excellent and innovative. However, is almost never a problem at citizen easily of the reloved and be respected restaurants in the province both among foodists and chefs combining impiceable service and a modern atmosphere. We also considered some services like for the celebration of the program like graduation, wedding reception, christening, birthdays and etc Ilonggo Native Resto Bar (A Project Mini-Feasibility Study Proposal). Executive Summary Ilonggo Native Resto Bar is one of the leading food establishments here in Panay Island. The main branch of this restobar is located along the highway of the city of Iloilo, Diversion Road, Mandurriao. It opens from 10 am until 10 pm during weekdays and during weekends it opens from 10 pm until midnight. The whole structure of this restobar is made up of native bamboo, woven grass mat, four inch light weight natural fiber reinforced lime-pozzolanic concrete deck, lime plaster finish coat with broadcasted mica flakes and cobwall with carved out niches, daylighting screen, and rainwater harvesting from roof. It is like a tree house type of restobar and good place to dine. During night it offers a free live band, singers, and a pianist as an entertainer while dining. You will really enjoy the good taste of foods as well as the entertainment. It offers different specialties of native foods that are originated by pure iIonggos, seldom to the eye of some customers. It also offers drinks that are fresh, just like tuba, lambanog and rice wine. The target market of this restobar is the Ilonggo itself, foreigner and the Filipino â€Å"Balik-Bayan†. The competitors of this are those who are already offer native foods like Ponsyon by Breakthrough at Plazuela, Ted’s, Uncle Tom’s, Mang Inasal and Buto’t Balat. But the foods we offer has a great difference because of its signature dishes like sisig na kambing, linabugang manok, pinangat na gabi, ginataang talbos ng kamoteng kahoy,etc. Not only are the foods native and original but also the ambiance as well. You can really experience the nativeness of this certain restobar as you dine.