Asd Asdf Oeer - 2098 Words

Study Guides and Literature Essays Editing Services College Application Essays Writing Help Q A Lesson Plans Home : The Handmaids Tale : Study Guide : Summary and Analysis of V: Nap - VI: Household The Handmaids Tale Summary and Analysis by Margaret Atwood Buy PDFBuy Paperback V: Nap - VI: Household Summary This section begins with Offred simply sitting alone, waiting. She had not been prepared for all this stillness, all of this boredom. She thinks about experiments they used to do on animals, how they would give them something to distract them. She wishes she had something to distract her. She lies down on the floor and begins to do her exercises, tilting her pelvis back. She remembers how at the training†¦show more content†¦Offred knew that they had changed the facts in the stories, but she could not prove it. She remembers meeting Moira in the washroom. Moira told her that she was going to try to escape by faking illness. She said that she knew how to give herself scurvy by not eating vitamin C. Offred told Moira not to do such a thing, but Moira ignored her. She snaps out of her reverie to listen to the Commander, who is continuing with the story. Serena Joy is crying as always. During the silent prayer, she whispers the Latin words written in her closet by the woman she believes was like Moira, though she does not know what they mean. It was at dinner that she had learned that Moira had gone away. Then she saw the ambulance come back. They took Moira into the Science Lab and beat her feet with steel cables until she could not fit them into her shoes. Feet and hands, she understood, were not important parts of a womans body. Offred remembers what Moiras feet looked like. The Commander finishes the prayer, and everyone stands up. The Commander, Serena Joy, and Offred go upstairs into the marital bedroom. Offred lies fully clothed on the bed, looking up at the canopy. Serena Joy takes her head in her lap and holds her hands. Her rings cut into Offreds hands - perhaps on purpose. The Commander moves below her skirt. What is happening doesnt fit any definition of sex that Offred can think

Schizophrenia Is More Than Just Hearing Voices - 1030 Words

Understanding Schizophrenia During your lifetime, chances are you’ve probably met someone who has been affected by schizophrenia in some way and you might not have even known. So what is Schizophrenia? Schizophrenia is a group of severe disorders involving major disturbances in perception, language, thought, emotion, and behavior. People with schizophrenia are able to control the disorder with medications and therapy and can even lead normal lives. Schizophrenia is not something everyone understands. This disorder is more than just hearing voices. To be able to fully understand schizophrenia you must know the symptoms, how it affects you biologically, psychologically, socially, and how to treat it. People who have this disorder can multiple symptoms leading to the diagnosis. Some symptoms are known as â€Å"psychotic symptoms† which includes a break with reality, hallucinations, delusions, or evidence of thought disorder. These symptoms are referred to as positive symp toms because they are so readily available. Negative symptoms, which are less readily observed, include withdrawal from society, the inability to show emotion or to feel pleasure or pain, total apathy, and lack of facial expression (Piotrowski, 2015). People schizophrenia also have senses that typically become enhanced or weakened. It can also be hard to concentrate or difficult to focus on things because their selection and filtering process may become impaired. One of the â€Å"psychotic symptom† of SchizophreniaShow MoreRelatedSchizophrenia Sufferers Hear Voices763 Words   |  4 PagesMakes Schizophrenia Sufferers Hear voices†. The sources of the article are from The Telegraph and it was published on September 5, 2017.The article is about how to decrease or fix voices that is a symptom of Schizophrenia. More than half of people with schizophrenia have voices in their head. Your mine can your friend or enemy. The was many research try to see if a certain type of th erapy of work of losing the voices. Scientists have found where part of our brain cause and produces the voices in ourRead MoreDissociative Identity Disorder And Schizophrenia893 Words   |  4 PagesBlunt, American politician, once said, â€Å"People with mental health problems are almost never dangerous. In fact, they are more likely to be the victims than the perpetrators. At the same time, mental illness has been the common denominator in one act of mass violence after another.† There is a misconception that mental disorders such as dissociative identity disorder and schizophrenia are the same. Today’s society often see all mental disorders as one, however, they are very much different. If one wasRead MoreSchizophrenia, Perception, And Behavior1712 Words   |  7 Pagesdeeper than paranoia. It is all much deeper that just a feeling, the feeling you feel is very real in your mind and eyes but it is all only something you can see. 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With the different studiesRead MoreMental Illness And Its Effects On Society Essay1475 Words   |  6 Pagesfound not criminally respon sible (NCR) last Thursday after he attacked a stranger with a hammer. At the time of the attack, Weber was on his way back to a transitional group home. He d been released from the Royal Ottawa Mental Health Centre less than two months earlier and was under a care plan prepared by his psychiatrist. He got off the bus, went into a grocery store and purchased a hammer and a knife. When Weber emerged from the store, he attacked an unsuspecting 55-year-old Ghebrehiwet suddenlyRead MoreSchizophreni A Mental Disorder Essay1278 Words   |  6 PagesSchizophrenia is a mental disorder that takes over a patient’s body and mind. Schizophrenia’s causes and mechanisms remain poorly understood, and the most common treatments do little to restore patients health (Kurtz 7). Schizophrenia affects the person’s brain and ability on to think and function. People with Schizophrenia have voices inside their heads telling them to do things they don t want to. People with schizophrenia are not eligible to control the things they do or say. Schizophrenia isRead MoreThe Frightening Trauma Of Schizophrenia1288 Words   |  6 PagesThe Terrifying Trauma of Schizophrenia Elyn Saks, expert in mental illness, once said, â€Å"The schizophrenic mind is not much split as shattered. I like to say schizophrenia is like a walking nightmare† (Saks). Being affected by schizophrenia is not just a walk in the park; it damages and then destroys the victim’s ability to think. One can define schizophrenia as an illness that affects and damages a human’s brain. Schizophrenia affects victims in many different ways: mentally, physically, and sociallyRead MoreSchizophrenia Is More Common Than The Average Person852 Words   |  4 PagesSchizophrenia is more common than the average person believes it to be. According to SARDAA (Schizophrenia and Related Disorders Alliance of America), approximately3.5 billion people in the United States have schizophrenia. Additionally, a great portion of this population is homeless, and about half of everyone diagnosed have never received treatment for it (SARDAA, 2014) . For something that is so popular in our society today, it is important to understand what schizophrenia is and how it is diagnosedRead MoreSchizophreni A Psychological Condition That Causes Delusions Or Hallucinations?887 Words   |  4 PagesSchizophrenia is a psychological condition that causes delusions or hallucinations making it extremely difficult for those who have the disorder to discern between reality and the imaginations (American Psychiatric Association, 2013). These fictitious experiences are often frightening situations where the victim cannot properly respond if the danger were reality because he/she believes everything is reality, even events that are produced by the imagination. â€Å"Emil Kraepelin, who coined the termRead MoreAre You Really Insane? Essay1544 Words   |  7 Pagespsychiatric hospitals (Thirunavukarasu). These psychotic episodes consisted of hearing voices and noises. The eight patients fabricated the lie making these auditory hallucinations, considered signs of schizophrenia, more authentic by connecting the lie to personal memories and situations in their life (Rosenhan). Each pseudopatient gained admittance into a psychiatric hospital; seven receiving a diagnosis of schizophrenia while the other one received a diagnosis of manic depression, also known as bipolar

The Secret of Ella and Micha Chapter 12 Free Essays

string(47) " my eyes off her, I nod my head at the garage\." Micha â€Å"Dude, where the fuck is your head today?† Ethan asks and seconds later a grease rag hits me in the face. I throw it back at him, hard. â€Å"You’re starting to piss me off with this crap. We will write a custom essay sample on The Secret of Ella and Micha Chapter 12 or any similar topic only for you Order Now † Ethan widens his eyes exaggeratedly. â€Å"Whatever man. You’ve been so distracted for the last two days.† He sticks his head back under the hood. â€Å"And I’m not going to say why.† â€Å"Good, because I don’t want to hear it.† I round the back of my car and eye over the tools on the wall of the garage. I grab a rusty toolbox, one of the few things my dad left behind, and toss it into the garbage can. He called again this morning, begging on the answering machine for either my mom or I to pick up. Ethan raises his head up and eyes the garbage can. â€Å"Wanna explain what that was for?† â€Å"Nope.† I pick up a wrench and start working on the car. We work on it for a while, but it’s hot and I’m getting more pissed off at my dad by the second. Finally, I move back and throw the wrench down onto the concrete. Ethan doesn’t ask questions this time. â€Å"We should have a party tonight,† I announce, unable to hold still. â€Å"A big one, like the one we had on graduation night.† â€Å"You really want to relive that night?† Ethan backs out from under the hood. â€Å"Because I’m not sure I do.† I step outside into the sunlight, determined to get my mind off stuff. â€Å"What you can’t remember doesn’t hurt, right?† â€Å"I don’t think you want to go there.† Ethan walks next to me and we stare down the driveway at an old guy pushing a shopping cart. â€Å"There are plenty of times in my life I wish I could remember – that I’d give anything to remember – but I can’t. I lost like a year of my life. It’s better to stay within the boundaries of a semi-clear head. Besides, this doesn’t sound like you at all. What’s up?† â€Å"Nothing’s up.† I sigh, raking my fingers through my hair. â€Å"I’m just thinking out loud.† Ethan returns to the garage and starts working on the engine again. Around sophomore year, he started hanging out with these kids at school, who had really heavy views on the world and liked to sit around and get high while they talked about it. Ethan somehow ended up being friends with them, and within a month, he had dropped out of school and got into some pretty heavy shit. A year later he made the decision to get some help. He cleaned up his life, cut the habits, and worked the hell out of himself to catch up in school. He was a grade behind, but managed to graduate with our year. Looking at him, you wouldn’t guess. The side door of Ella’s house swings open and Lila steps out. She looks upset, although not as bad as she did last night. She glances up the driveway at the house across the street, where there’s a very loud game of tackle football going on in the front yard. Her eyes roam to my house and then widen when she sees that I’m watching her. She gives a tentative wave from the top step. â€Å"Hey, Micha.† â€Å"What’s up?† I say with a nod of my chin. â€Å"Is Ella up yet?† Shielding her blue eyes from the sun, she looks up at Ella’s window. â€Å"Yeah, she said she’d be out in a second. She’s just talking to her brother.† â€Å"He’s not being a dick, is he?† â€Å"I’m not sure what constitutes as a brother being a dick, since I don’t have one.† A smile cracks at her lips. I walk toward the fence, pulling up my jeans that are riding low on my hips. â€Å"There’s no yelling going on?† Lila shakes her head and meets me at the fence, plucking some of her blonde hair away from her mouth. â€Å"But Ella’s not much of a yeller, is she?† I rest my arms on the top of the fence. â€Å"It depends on which one we’re talking about.† Her face falls. â€Å"How could I know her for eight freaking months and not know anything about her. It must say something about me, right?† I feel bad for her. â€Å"I think Ella kind of made it her mission to keep who she was hidden from you. It’s not your fault.† She eyes me over with this suspicious look. â€Å"Honestly, it seems like she’s that way with everyone, except for you.† â€Å"We’ve known each other forever,† I say. â€Å"We have a comfortable relationship.† Her blue eyes twinkle with mischievousness. â€Å"One where you feel her up in the car?† â€Å"It feels like you’re trying to start some trouble,† I say, liking the girl even more. â€Å"Maybe I am.† She leans over the fence to the side of me so she can get a better view of the inside of the garage. â€Å"Is that Ethan in there?† I step back so she can get a better look. â€Å"Yep, he’s working on the car.† â€Å"I think I’ll go give him some help.† A grin spans across her face and she hops over the fence, squealing as her shoe gets caught in the wire. Trying not to laugh at her, I unhook her shoe and she walks into the garage, surprising Ethan. The door to Ella’s house opens and my attention centers on her as she steps out into the sunlight. She’s wearing a tight, black and purple plaid dress, and knee high lace-up boots, but her hair is curled up neatly. It’s like a mix of her old look and her new one. Her face is guarded as she ambles across the driveway, with this strange look in her eyes, like she’s terrified yet excited at the same time. â€Å"Did Lila come out here?† She bites her lip and I want to lean over and bite it for her; taste her and feel her like I did last night. Without taking my eyes off her, I nod my head at the garage. You read "The Secret of Ella and Micha Chapter 12" in category "Essay examples" â€Å"She’s in there with Ethan. I think she might have a thing for him.† â€Å"I think you’re right.† She pauses. â€Å"I think I might have freaked her out a little, just barely.† â€Å"You mean you and Dean might have freaked her out a little?† â€Å"She told you I was talking to Dean?† â€Å"She mentioned it.† I extend my hand to her. â€Å"Why don’t you come over and join the party on this side of the fence?† â€Å"A party of four?† she asks, trying not to grin and looking as cute as hell. I snag her by the hip, jerk her toward me playfully, and dip my lips to her ear. â€Å"It can be a party of two. Just say the word.† She shivers from the feel of my breath on her neck. â€Å"I think we better keep it a foursome.† I press my fingers into the curve of her hips. â€Å"I didn’t know you liked it kinky.† She swats my shoulder and I laugh, my dad problems feeling less heavy. â€Å"Relax, I was just kidding, even though you’re the one who brought it up first.† â€Å"I was joking.† â€Å"I know†¦ I think I am going to have a party tonight.† â€Å"Don’t you have one of those every night?† I cock my eyebrow. â€Å"Besides the night you showed up, have you seen one going on?† She wrinkles her forehead. â€Å"No.† She sits down on the fence, swinging her legs over to my side. â€Å"Micha, what have you been doing for the last eight months?† â€Å"Pinning for you.† I avoid the truth. That I haven’t been doing much of anything besides looking for her and helping my mom take care of things. She tucks her dress underneath her legs and I get a small glimpse of the black lacy panties she has on. â€Å"Where do you work?† Against her protest, I spread her legs apart and put myself between them. â€Å"I work at the shop with Ethan a lot, but it’s not going to be forever. I have plans. I’m still working on getting everything lined up.† She places her hands on my chest, holding me back. â€Å"I think the lines between our friendship are getting a little blurred.† â€Å"That happened a long time ago,† I tell her, gliding my palms up the sides of her bare legs. â€Å"At least for me it did.† Her jaw tightens. â€Å"It’s things like that which make them blurry and things last night†¦ and things like in the car.† â€Å"There seems to be a lot of things, which I think might be a hint that you and I belong together.† Her eyes snap wide and I back off to try another tactic. She needs to smile and let those stressed lips free. I pinch her side and she squeals. â€Å"Don’t do that,† she says, holding back a laugh. â€Å"You know I hate being tickled.† I graze my fingers across her other side and she squirms, before falling over the fence and landing on her back in the grass. I leap over the fence easily as she scrambles to her feet. She narrows her eyes, backing toward her back door. I run up to the side of her and she skitters out of my reach. She glances at the door and then at the front yard, which is closer to her. â€Å"Micha, seriously,† she warns. â€Å"We’re too old for this.† I spread my arms out to the side innocently. â€Å"I’m not doing anything.† Her eyes flick to her house one last time and then shaking her head, she spins around and runs for the front yard. I give her a head start before I sprint off after her. When I round the house, she’s up on the front porch, jiggling the door knob. I laugh at her. â€Å"Is it locked?† She heaves a frustrated sigh and hops over the railing, slipping on the grass. â€Å"Dammit Micha! I’m so going to kick your ass for this.† â€Å"I’m planning on holding you to that threat.† I jog after her across the neighbor’s yard. She races across the grass, her hair falling out of a clip. She leaps over the brick fence into the next yard and smashes a row of flowers. Without using my hands, I hop onto the fence, but trip during my dismount and fall on my knees. She freezes in the middle of the lawn and starts to laugh at me. â€Å"You so deserved that.† I get to my feet, dusting the dirt off my knees, and a dark smile rises on my face. â€Å"You think that’s funny?† Her eyes sparkle and it’s worth the fall. â€Å"You look ridiculous.† â€Å"Do I?† I take a step toward her. She takes a step back. â€Å"You do.† Abruptly the sprinklers turn on, drenching the grass and her. She screams and covers her head with her arms. â€Å"Serves you right for laughing at me,† I say with a grin. She lets her arms fall to the side and smirks. â€Å"Well, at least it keeps you away from me.† Her dress is clinging to her body in all the right places and pieces of her wet hair stick to the sides of her face. She begins to twirl in circles with her hands up above her head. â€Å"You’re beautiful,† I say, unable to help myself. Ella Micha looks ridiculous and I can’t help but laugh. I haven’t laughed in so long that it feels unnatural leaving my mouth. It’s like we’re kids again, as if this moment belongs in another time where things are weightless and full of sunshine. As I’m laughing at him, the sprinklers turn on and my clothes instantly get soaked. At first I squeal, but then I let go, lifting my hands above my head and twirling in the water, figuring he won’t come in after me. He calls out something about me being beautiful and then he charges into the sprinklers, completely blind-siding me. His arms snake around my waist and we collapse to the ground but Micha holds my weight up, so I land on the wet grass gently. â€Å"Micha,† I say, trying to be serious. â€Å"Don’t do it. You know how much I hate being tickled.† â€Å"Which makes it even more appealing.† Water beads in his hair, his long eyelashes, his lips. With one hand, he pins my arms above my head and presses his body against mine. My wet clothes cling to my skin and I can feel every part of him. â€Å"I take that back. This is more appealing.† He lets his hand move up my ribs, his thumb sketching along the ridges, sending my body into a frenzy. I stop fighting him and lay perfectly still. Water sprinkles our faces as he lowers his lips to mine. Our wet tongues twine together, full of desire as they collide. A strange, unfamiliar feeling opens inside of me again and my legs fall apart and hook around his waist, requesting more of him, like they did last night. Micha draws back, looking surprised as he glances at the house to the side of us and then at the street. Then he lets out an untamed growl and deepens the kiss, thrusting his tongue deep into my mouth. I suck on his bottom lip and trace my tongue along his lip ring. It sends a quiver through his body and I’m secretly pleased, but my pleasure confuses me. â€Å"Ella,† he groans and then kisses me fiercely. His hand travels upward and cups my breasts. His thumb circles around my nipple and through the wet fabric of my clothes, the feeling is mind blowing. It’s driving me wild and my knees vice-grip against his hips. A moan laced with ecstasy crumbles from my lips. I’m starting to lose control again and it’s alarming. I try to get past it this time, but it consumes me and I have to stop. After a lot of effort, I get my arms between our bodies and I push him away. â€Å"We should get back.† I look at the brick home of the yard we’re laying in. â€Å"Besides if Miss Fenerly comes out, she’ll have a heart attack.† Micha’s aqua eyes penetrate me. There’s mud on his forehead and grass in the locks of his blonde hair. â€Å"If that’s what you want.† Maneuvering to his feet, he takes my hand and lifts me to mine. He plucks pieces of grass out of my hair and lets his hand linger on my cheek. Holding hands, we walk across the grass and down the sidewalk, leaving a trail of water behind us and something else. Something invisible to the outside eye, but to me it’s more noticeable than the sun in the sky. How to cite The Secret of Ella and Micha Chapter 12, Essay examples

Global Destination and Competitiveness

Question: Discuss about the Global Destination and Competitiveness. Answer: Introduction In the sector of tourism and hospitality, the chief aim of is to increase the number of the visitors and to hold a potential brand image. In order to accomplish this core aim of business, an organization belonging to the tourism sector prioritizes destination marketing. In the words of (), the phrase destination marketing is a distinct form of marketing whose sole concern is to promote an individual destination. Unlike the form of product marketing, in which products are provided to the clients with the help of distribution channel, in the destination marketing it is the interested individuals who come to the destinations to become the customers. Therefore, it is to say that in terms of destination marketing, an organization also advances its competitive edge. The present purpose of the considered assignment is to accomplish a policy review for the organization Tourism Australia. Most important to denote in this respect, that the considered destination for this organization is the S unshine coast of the Queensland Australia. For accomplishing this very purpose, the assignment has intended to establish an in-depth literature review initially about the core aspects of the policy of destination marketing, which are destination branding, positioning, visioning and targeting. Thereafter, reviewing the policy, the paper has preferred to make fruitful recommendations for the considered organization. Literature review Getz and Page, (2016) has stated that destination marketing organizations being public or private organizations must have an in-depth understanding of the tourism policy of the operating countries. The understanding of the tourism policy is categorized into three aspects such as process, content and structure. Structure and content of tourism policy illustrates a framework of relationships with the government and organization. Process includes the involvement of stakeholders towards the tourism policy (Pike, 2015). Branding in Destination Marketing Destination branding identifies the strongest point and mostly competitively appealing aspect of a particular destination. Destination marketing aims at making the strong point of a destination appealing to the potential visitors. It builds a story about the destination, which make it stand out above its competitors (Gummesson, 2014). Destination marketing organization use destination branding for promoting a specific place to the specific audience like leisure travellers. Moreover, it communicates the special offerings of a specific destination to the potential visitors. On the other hand, it can be stated that accomplishment of destination branding depends on the brand images used for establishing the destination choice. According to Pike and Page (2014), in destination marketing, the images of the travelers regarding a destination contributes significantly in destination choice. In this context, it can be stated that the problem in destination branding is the intangibility of the destinations that cannot be tested prior to the final purchase. Furthermore, in terms of destination branding, the definition of destination images is a sum of impression and ideas those people possess regarding a destination. On the other hand, as per Smith and Font (2014), destination image in terms of destination branding is a set comprised of cognitions and affections to represent a particular entity to the general audience. The concept of branding is important in marketing of a product, place or a service. The role of branding is vital that can be categorized into two aspects such as pre-experiences and post-experiences. Pre-experiences in terms of branding include differentiation, identification, expectation, reassurance, and anticipation (Ritchie Crouch, 2003). On the other hand, recollection or post experiences in the perspective of branding include consolidation and reinforcement (Line Runyan, 2014). Visioning in Destination Marketing Visioning is a useful technique for supporting group of stakeholders towards developing shared vision for the future. It is extremely important in destination marketing, which plans the strategies for making a particular destination attractive to the tourists. The vision statement is essential to engage the stakeholders with common direction for destination management. Proper visioning is also important for setting the future strategies towards promoting the specific destination (Smith Font, 2014). Nevertheless, as per Lugosi and Walls (2013), a vision statement for destination marketing is essential for providing an exact overview of the marketing mix to the employees. Therefore, it can be said that a vision statement in tourism strategic marketing is necessary for providing inspiration to the employees, which implicates that visioning in marketing is useful for advancing the internal strength by educating them about the marketing plan. Tourism visioning allows an agreed focus rega rding the way the tourism organization should develop their plan manage and market their destination over the times. It also leads to shared statement of intent, which is manageable and promote unite tourism organization in a specific destination. Positioning in Destination Marketing Position is an effective form of marketing communication, which plays a vital role towards enhancing the attractiveness of tourism destination. The objective behind the position of a specific destination is to create a distinctive place in the minds of potential visitors. Positioning differentiates a destination from its other competitive destination. It conveys the diverse mix of features regarding a destination, which makes it different from others destination. It identifies the competitive advantage of a particular destination and effectively communicates it with the visitors. Positioning also identifies the potential visitors, who can be interested on the specific destination place. In this context, it is to state that in destination or tourism marketing, positioning imprints destination images in the minds of the customers. On the other hand, positioning in destination marketing is considered as a communication strategy that is thoroughly followed through segmentation and target marketing. More precisely, according to Heeley (2015), the concept of positioning is not related to the particular premises needed to be covered for the product. Therefore, it is to say that the intension of positioning is to influence the minds of the prospects. Specifically, in destination and tourism marketing, based on Line and Runyan (2014), positioning in terms of marketing is indicative of an individual statement that will inspire as well as guide the entire marketing plan. In this respect, it is to keep in mind that in tourism marketing, positioning statement is required to encompass the particular destination and should give a hint of the marketing tools. As per Gummesson (2014), three key elements of the tourism positioning are an emotive expression, brand personality and particular attributes of the destination. It has been understood that accomplishment of a tourism-marketing plan is possible only when the positioning statement of an organization is honest. In this case, a positioning statement should be prioritize when an organization is designing its advertisement choices, change management and making progressive plans for the future ventures (Ghosh Sarkar, 2016). Henceforth, it can be concluded that positioning in specifically tourism destination is essential for the acquisition of competitive edge. Policy Review Prior to review the tourism policy, it is required to have a profound knowledge about the considered destination for the DMO. Sunshine Coast of Queensland territory is identified as a per-urban area of Queensland, which is also known as the third most populated area of Queensland. The significance of this place is probably a handful of stretches of stitched beaches that has covered the area from the Sunshine Beach to the Coolum Beach and from Point Arkwright to Mudjimba and Buddina past the Caloundra CBD. The place is located between the south peninsula and the mountains of Inskips Glasshouse. It is probably the natural amenities of the mountains and of south peninsula, which works in favor for marketing for the travel organizations of the place (Barnes Ballou, 2014). Most significantly, the place is also enriched with excellent restaurants and five-star resorts, which attract an impressive amount of both domestic and international customers from all over the world. However, the considered DMO Tourism Australias destination marketing relies upon the organizations honest approach towards destination marketing, which is its positioning strategy. Keeping in mind about the poor infrastructure quality, the organization has taken the initiative to improvise the infrastructure facility of the place. In terms of destination policy, the organizations main vision is to attract the visitors through honest offering and their initiative to modify the infrastructure of the place proves that they prioritize their vision sincerely. Moreover, it has been understood that the outline of the destination policy indicates that familiarization tours, cooperative programs, trade shows and public events are their prime promotion strategies. On the other hand, in terms of positioning, it has been identified that the considered DMO utilizes the natural amenities of the Sunshine coast. The unbroken beaches along with the Australian zoo are key aspects of positioning for t he DMO (Ghosh Sarkar, 2016). On the other hand, in terms of branding, the Tourism Australia has seven international hubs and industry developments in near about 16 core markets accompany the organizations policy for destination branding. On the other hand, in terms of target policy, it has been identified that the DMOs two prime target markets are the connectors in regional Queensland and the unwinders in Sydney. However, in this respect it is significant to denote that the concerned DMO prioritize Tourism 2020 in terms of destination policy and it has been identified that the organization has designed most of its strategic methods in accordance with this national strategy of Tourism 2020. Branding of Tourism Australia Tourism Australia has seven international hubs and through these hubs, the organization pursues consumer marketing and industry development in 16 core markets. The organization has targeted the visitors of Europe, America, New Zealand, Greater China, Japan and South Korea and South East Asia. While branding Sunshine Coast, Tourism Australia conveys the unique attraction of the destination to the visitors. The Aquatic Costal Campaign highlights the varied and unique fishing experience in Sunshine Coast (Lugosi and Walls, 2013). Moreover, the destination management organization also promotes the wild life attraction to the adventurous visitors of the world. One of the most attractive features promoted by the DMO is the Australia Zoo of Sunshine Zoo. The visitors can also enjoy bushwalking and cruises, which are great medium for spending leisure time. Tourism Australia is focused on international recognition in the perspective of the destination marketing and branding approach of the particular destination. In this particular case, the destination selected for the marketing and branding is Sunshine Coast, Australia. The market segmentation is a method that is important for formulation of marketing and branding strategies. Sunshine Coast is an area that can attract almost all tourists of age groups. However, in form of destination branding, it has been found that there are some negative aspects related with the brand destination policy of the organization. It has been indicated that the DMO organizes various public events and campaigns to increase its brand image. It is unfortunate to notice that due to large number of destination branding, the organization is representing the nation to be a leisure-oriented one that is strongly making constraints for the territorys reputation in technological, political and product exporting field . Target Market It has been reviewed that considering the natural quality of the Sunshine coast, the organization has a targeting policy that involves three tiers. According to the DMOs policy and the first tier, the DMO targets the connectors belonging to the regional Queensland and Brisbane, whereas according to tier two, the DMO targets the unwinders in Sydney, Melbourne, Germany, Scandinavia and North America. On the other hand, according to the tier three of their policy, Tourism Australia targets the population of Hong Kong, India and Korea. Most significantly, it has been identified that the DMO is presently developing a new target market from the territory of Taiwan. Visioning of Tourism Australia The vision of Tourism Australia is to encourage high quality tourism experience and develop tourism infrastructure for driving demand of tourism industry. The organization is visioning for better investment facilitation for improving the tourism infrastructure of Sunshine Coast. Better infrastructure would help the tourism organizations in this destination to attract the potential national and international visitors. Moreover, the organization has concentrated on more aviation capacities towards transportation facilities for the visitors. Accessible tourism is the ongoing endeavour of the organization, which ensures that tourism destination is accessible to all people regardless of their age, disabilities and physical limitation (Heeley, 2015). The organization also has better access to labour and skills towards effective promotion for Sunshine Coast to the potential visitors. However, the organization stills lack in entering in some developed countries, which is limiting the number visitors in Sunshine Destination. Positioning of Tourism Australia Sunshine Coast is regularly rated as the most desired tourism destination in Australia. Moreover, it stands at number one position in terms of its attractive features. Tourism Australia strives to convert this support to travel in Sunshine Coast. Visitors can enjoy the opportunity to explore an incredibly diver array of sea life. They also can interact with wonderful Marine Park in the underwater world. Visitors can also invent 100 different species in the Australian Zoo and have exciting experience of wild life (Pike Page, 2014). However, with the increasing number of visitors, there is a problem in accommodating visitors in the national park. Tourism Australia also promotes Sunshine Coast as a greater place to have excellent flying experience. The visitors can have exceptional flying experience with excellent scenery of sea beaches, forest park and multi city attraction. The community in this destination is still unable to learn towards providing warm welcome to the visitors. More over, the visitors also face road congestion at the peak time of tourism, which bothers the visitors. Recommendation Tourism Australia should improve the tourism infrastructure of the Sunshine Coast. The organization should highly concentrate on enhancing the space at National Park and other forest parks. Moreover, the organization should also improve the transportation facility of the destination for both national and international visitors. The organization should train the employees of tourism sectors towards providing excellent tourism experience to the visitors. On the other hand, the DMO should promote the importance of tourism in Sunshine Coast within the community people. It would help the community people to provide warm welcome to the visitors. Furthermore, the organization should also improve the road transportation condition of Sunshine Coast. However, considering the possible constraints related with the destination branding of Tourism Australia, it can be recommended that to maintain the political, technical as well as the exporting nature of the Queensland regime, the campaigns shoul d act as the organizations corporate social responsibility. Considering this, it can also be recommended that in their public events and campaigns, the organization could also promote the areas any contemporary political interest or technological investment (Dwyer et al. 2014). Conclusion From the entire assignment, it can be deduced that the considered DMO has adopted some of the most relevant positioning, branding and visioning strategy. In forms of branding, the organization mainly depends on public events and campaigns. However, unfortunately the paper indicates that in terms of branding, the DMO has some constraints such as the trend of organizing public events is creating problem for the territorys voices for technical, political and other business approaches. Therefore, at the final stage, the paper has given the recommendation, which says that the DMO can combat this problem by promoting contemporary technical, political and business approaches through their own public events and campaigns. On the other hand, it is fortunate to denote that the DMO has adopted the Tourism 2020 for developing the entire dimension of the tourism sector of Queensland. In accordance with this mission, the DMO prioritize in advancing the infrastructure of the entire place. References Barnes, J. C., Ballou, D. (2014). Case Study: Using a Sport Event within Coordinated Destination Marketing: A Case History of the New Mexico Bowl.The Journal of SPORT,3(1), 5. Dwyer, L., Pham, T., Forsyth, P., Spurr, R. (2014). Destination Marketing of Australia Return on Investment.Journal of Travel Research,53(3), 281-295. Ellram, L. M., Cooper, M. C. (2014). Supply chain management: It's all about the journey, not the destination.Journal of Supply Chain Management,50(1), 8-20. Getz, D., Page, S. J. (2016).Event studies: Theory, research and policy for planned events. Routledge. Ghosh, T., Sarkar, A. (2016). To feel a place of heaven: examining the role of sensory reference cues and capacity for imagination in destination marketing.Journal of Travel Tourism Marketing,33(sup1), 25-37. Gummesson, E. (2014). Productivity, quality and relationship marketing in service operations: A revisit in a new service paradigm.International Journal of Contemporary Hospitality Management,26(5), 656-662. Heeley, J. (2015).Urban Destination Marketing in Contemporary Europe: Uniting Theory and Practice(Vol. 66). Channel View Publications. Line, N. D., Runyan, R. C. (2014). Destination marketing and the service-dominant logic: A resource-based operationalization of strategic marketing assets.Tourism Management,43, 91-102. Lugosi, P., Walls, A. R. (2013). Researching destination experiences: Themes, perspectives and challenges.Journal of Destination Marketing and Management,2(2), 51-58. Pike, S. (2015).Destination marketing. Routledge. Pike, S., Page, S. J. (2014). Destination Marketing Organizations and destination marketing: A narrative analysis of the literature.Tourism Management,41, 202-227. Smith, V. L., Font, X. (2014). Volunteer tourism, greenwashing and understanding responsible marketing using market signalling theory.Journal of Sustainable Tourism,22(6), 942-963.

Task Analysis Essay Example

Task Analysis Essay Law and Management in Occupational Health and Safety Patients in the Perioperative environment are often required to be repositioned on the operating table and most of these patients have had a regional or general anaesthetic, making it impossible for them (the patient) to assist staff in that repositioning. The added risk in any repositioning is loss or damage to the patients’ airway, and maintaining the patients’ musculoskeletal alignment, so as to not cause any damage to nerves, muscles, limbs, spine and or neck etc. The repositioning should be assessed to determine if it can be done manually or by some assistive devices. During the surgery it may be necessary to lift the patients’ legs, arms or head to prepare the area for sterile field draping, which may result in nursing or theatre support staff at risk of musculoskeletal injuries, and in situations where bariatric patients (over 100kgs) the manual handling staff may need limb holding devices. Prior to surgery, the anaesthetic nurse, anaesthetist, surgeon, theatre support technician or orderly should plan and collaborate regarding positioning, support and moving devices as well as the technique which will be utilised in the moving and repositioning of the patient – during and after the procedure when the patient will be transferred on to another bed for the post-operative recovery period. When transferring a patient from patient bed to operating table, it is important to have enough staff to assist with the transfer and to use the correctly placed support devices as well as using good body mechanics (ergonomic techniques). We will write a custom essay sample on Task Analysis specifically for you for only $16.38 $13.9/page Order now We will write a custom essay sample on Task Analysis specifically for you FOR ONLY $16.38 $13.9/page Hire Writer We will write a custom essay sample on Task Analysis specifically for you FOR ONLY $16.38 $13.9/page Hire Writer When patients are obese it may be necessary to use soft gel straps to support the patients legs so that they do not move off the operating table and cause debilitating and painful nerve damage. This project is to develop a Safety Management Plan to implement a safe practical way to identify, assess and control risks in the Perioperative environment (Operating Theatre) specifically relating to the lateral transfer and or movement of patients requiring surgery at this hospital facility. Perioperative Manual Handling Safety Management Plan Perioperative Manual Handling Safety Management Plan Using the 5 step process in the Queensland Government risk assessment plan the following matrix is how the Perioperative unit could benefit from experienced, safety motivated and interested staff could act as agents for change and safety in a more deliberate and focussed way to reduce the hazard of musculoskeletal injuries to staff especially in the task of laterally transferring patients from the operating table to the postoperative bed. These patients are usually unconscious and unable to assist or communicate their needs and concerns at this time. Perioperative Safety Management – Risk Identification and Controls| Step 1| Look at the Hazard * Musculoskeletal disorders in nursing staff and orderlies when undertaking a lateral or horizontal transfer of unconscious patient from operating table to post-operative bed| How to look for HazardsKnowledge and Understanding Manual Handling Policies * Manual Tasks Involving the Handling of People Code of Practice 2001 * Workplace Health and Safety Act 1995 * Workplace Health and Safety Regulation 2008 * Manual Handling Training especially regarding unconscious patients| What to look for * Practices that are causing discomfort either for the member of staff or patient * Practices that are likely to cause nerve or musculoskeletal injuries – shoulder, fingers, wrist, forearm, back, neck, sciatic nerve, knees, ankles| Step 2| Decide who might be harmed and how * Nursing Staff * Orderlies * Anaesthetists * Surgeons/Assistants * Recovery Staff | Assess the riskHow might someone b e harmed * Injury to patient when moving the unconscious patient from operating bed to recovery bed with a supported airway * Lateral or sideways movement requiring pushing, pulling and lifting of limbs by team members * The staff member who controls move not always in ‘sync’ with rest of team – uncoordinated transfer * Existing musculoskeletal disorders experienced by staff and patients| What is this harm? * Airway becoming dislodged * Back, Neck, arm, shoulder injury to staff using Manual Handling techniques and devices * Uncoordinated transfer * Sideways twisting for person holding feet during transferHow likely is this harm? According to the consequences/ likelihood matrix below * Injury to patient – likely/major consequences * Unplanned airway removal – likely/major to catastrophic * Musculoskeletal injury – likely/moderate to major * Exacerbating and worsening musculoskeletal disorders– likely/major to catastrophic (permanent loss of employment) * Team unpreparedness – likely/minor major| Step 3| Decide the control measures| Regulations ? * Workplace Health and Safety Act 1995 * Workplace Health and Safety Regulation 2008Codes of Practice? * Manual Tasks Involving the Handling of People Code of Practice 2001What are existing controls? * Mater Operating Theatres Manual Handling Policies and Clinical Practices Manual * Manual Handling Training – Generic – needs to be targeted especially movement and care regarding unconscious patientsAre controls as high as possible? Current Manual Handling training stands at a compulsory slide sheet in-service lasting approximately 5 minutes every six months * In-service is generic and not specifically targeted to moving unconscious patients who are not able to follow instructions or cooperate with staff requests in this lateral move post operatively * Training needs to be comprehensive and developed with ergonomic and physical therapist input so that staff movement and body positioning minimises potential and foreseeable damage to limbs, nerves, shoulders and lower backs * Equipment needs be demonstrated in a non-clinical simulation before using on any patients to maximise the potential for team confidence and competence in the use of equipment – minimising harm in actual situations| Do controls protect everyone? * Controls at present minimise the importance of Manual handling techniques * Manual handling needs to have a higher profile in the unit so that it is possible to protect patients, staff and visiting surgeons and anaesthetists * Controls in place are in policy manuals, and highlighted at orientation (can be months after starting employment). * New staff are on the job immediately and therefore don’t have ‘training’ at the best and high est level of competency and developmentWhat additional controls are required? Higher profile on training by manual handling experts * Regular manual handling workshops and training groups in simulated situations = staff practice on other staff. * In-service and practical demonstrations to highlight the importance of correct posture for staff, correct lateral moving techniques and equipment for staff * Correct and helpful exercises that staff can do ‘on the run’ so that the manual handling tasks are done after staff are ‘warmed up’ * Weekly highlights on noticeboard on an important point regarding safe lifting, moving and back care for staff = many hospitals and aged care centres have excellent back injury prevention programs and are readily available at websites and search engine destinations. Step 4| Put Control measures in placeOHamp;S representative to Train and utilise staff who are Interested and experienced in Manual Handling of people| Developing a p lan for improving controlsTrain the Trainer programs for interested personnel not necessarily Registered Nurses (Enrolled Nurses with experience and interest)Train staff in the Incident Reporting Program and to build Staff confidence in using the software – when a hazard is reported or an injury – Staff need to be confident that it will be followed up and that negative consequences of hazard identification and reporting are not safe practices in the workplace | Improving controls * Making the Incident reporting program more user friendly and encourage staff to use the program and give timely feedback on statistics * Encourage staff to report all injuries and near misses so that the unit builds a culture of ‘safety is every ones business and responsibility’ * Make safety a priority and that means staff safety as well as patient safety – reward safety issues and hazard reporting * Encourage staff to come up with solutions to risks and hazard identifi cation – involve everyone| Step 5| Review the Controls * 3 monthly reviews of competencies and updating of training for any new staff * Staff surveys to indicate self- satisfaction of training and competencies| Are the controls working? * Feedback from Staff self-satisfaction surveys * Anecdotal feedback from workshops and training sessions * Improvement or decline – what would staff change or improve? | Are there any new Problems? * New staff training before actually moving a patient * Generic manual handling policies * Minimum lateral transfer equipment – slide sheet and patslide? Hovermat beds possible? * People not lifting feet when patslide positioned – heel damage or pain if patslide strikes patients heel or ankle? * Apathy, lack of interest and poor technique? | PURPOSE AND SCOPE of Safety Management Plan Mercy Health and Aged Care Central Queensland Limited (MHAACCQ, 2010) is committed to the provision of a place of work that is safe and without r isk to the health, safety and welfare of its employees, or any other person of our workplace We believe that * All injuries can be prevented * Working safely is a condition of employment * Employee involvement is essential * Management are ultimately accountable for safety Munn (2011) suggests that tasks performed in the perioperative environment may present a high risk to staff for musculoskeletal injuries relating to patient handling include * Transferring patients on and off operating tables ( in this case Lateral pushing and pulling of up to 180 kgs) * Repositioning patients on operating table ( this unit has weight limits on operating table 300 kgs) * Lifting and holding patients extremities – orthopaedic, cosmetic and general surgery * Standing for prolonged periods of time – scrub nurse has limited movement whilst scrubbed * Holding retractors for long periods of time – self retaining retractors not always suitable * Lifting and carrying equipment and supplies Pushing, pulling and moving equipment on wheels – endoscopic and microscopes Manual Handling is a major cause of injury in health care facilities. Manual handling regulations require a hazard identification, risk assessment and control approach. Obligations and the Workplace Health and Safety Act 1995 The Workplace Health and Safety Act 1995 imposes obligations on people at workplaces to ensure workplace health and safety. This is done when persons are free from the risk of death, injury or illness created by workplaces, relevant workplace areas, work activities or plant and substances for use at a workplace. Ensuring workplace health and safety involves identifying and managing exposure to the risks at your workplace. RESPONSIBILITIES Part 3, Division 2, Section 28 Obligations of persons conducting business or undertaking (1) A person (the relevant person) who conducts a business or undertaking has an obligation to ensure the workplace health and safety of the person, each of the person’s workers and any other persons is not affected by the conduct of the relevant person’s business or undertaking. (2) The obligation is discharged if the person, each of the person’s workers and any other persons are not exposed to ri sks to their health and safety arising out of the conduct of the relevant person’s business or undertaking. (3) The obligation applies— (a) whether or not the relevant person conducts the business or undertaking as an employer, self-employed person or otherwise; and (b) whether or not the business or undertaking is conducted for gain or reward†¦Ã¢â‚¬  Work Health and Safety Act 1995 (Qld) Part 3, Div 1, Section 26 (3) If a code of practice states a way of managing exposure to a risk, a person discharges the person’s workplace health and safety obligation for exposure to the risk only by— (a) adopting and following a stated way that manages exposure to the risk; or (b) doing all of the following— (i) adopting and following another way that gives the same level of protection against the risk; (ii) taking reasonable precautions; (iii) exercising proper diligence. † People handling activities and injury The most frequently injured body part s from people handling activities undertaken without assistance are the back, shoulders and wrist. People handling activities can contribute to a number of Work-Related Musculoskeletal Disorders (WRMDs) including: a) Low Back Disorders (injuries to muscles, ligaments, inter-vertebral discs and other structures in the back). b) Tendon Disorders (injuries affecting the tendons in the wrist, and elbows particularly). c) Nerve Disorders (injuries affecting the wrist, neck and shoulder). d) Upper limb muscle strains (injuries affecting the rotator cuff* and forearm particularly). â€Å"WRMDs occur in two ways: gradual wear and tear (cumulative trauma) caused by frequent periods of muscular effort involving the same body parts, and sudden damage caused by nexpected movements, intense or strenuous activity, for example, when people being handled move suddenly or when the worker is handling a load beyond their capacity. Gradual wear and tear is the most common way WRMDs occur. Even when an injury seems to be caused by overload, the triggering event might just be the final trauma to tissu es already damaged by previous exposures to people handling and other manual activities. It is recommended that when a healthcare worker needs to lift more than 15. 3 kilos of patient weight, lifting aids should be used. The lateral transfer of a patient from one surface to another, such as from operating table to patients bed, poses a risk to staff for developing musculoskeletal disorders. Some general guiding principles pertaining to the transfer of a patient to an operating table are: * The number of staff involved in a transfer is needed to be sufficient based on the patients weight, and to ensure that ALL extremities are supported and the patients alignment and airway are maintained * The lateral transfer device needs to support the whole length of the patients body * The are where the patient is being transferred to needs to be slightly lower * When a patient is being transferred from supine (on back) to prone (on front) the support equipment (such as pillows or spine table need to be utilised in the transfer * Mechanical devices such as Hover Mat air assisted mattress transfer devices have been devised to assist in the safe transfer of Perioperative patients† Manual Tasks Involving the Handling of People Code of Practice 2001, Qld. â€Å" Section 27A Managing exposure to risks (1) To properly manage exposure to risks, a person must— (a) identify ha zards; and (b) assess risks that may result because of the hazards; and (c) decide on appropriate control measures to prevent, or minimise the level of, the risks; and (d) implement control measures; and e) monitor and review the effectiveness of the measures. (2) To properly manage exposure to risks, a person should consider the appropriateness of control measures in the following order— (a) eliminating the hazard or preventing the risk; (b) if eliminating the hazard or preventing the risk is not possible, minimising the risk by measures that must be considered in the following order— (i) substituting the hazard giving rise to the risk with a hazard giving rise to a lesser risk; (ii) isolating the hazard giving rise to the risk from anyone who may be at risk; (iii) minimising the risk by engineering means; (iv) applying administrative measures; (v) using personal protective equipment. 9 Without limiting section 28, discharging an obligation under the section includes, having regard to the circumstances of any particular case, doing all of the following— (a) providing and maintaining a safe and healthy work environment; (b) providing and maintaining safe plant; (c) ensuring the safe use, handling, storage and transport of substances; (d) ensuring safe systems of work; (e) providing information, instruction, training and supervision to ensure health and safety. † Workplace Health and Safety Act 1995, Qld Manual Tasks Involving the Handling of People Code of Practice 2001 The People Handling Code of Practice states ways to prevent or minimise exposure to risk due to the handling of people that can cause or aggravate work related musculoskeletal disorders. It applies to any workplace activity requiring the use of force by a person to hold, support, transfer (lift, lower, carry, push, pull, slide), or restrain another person at a workplace. This code outlines practical ways in which a person to whom this code applies can meet the requirements of the Workplace Health and Safety Act 1995. Guidance on the broad area of manual tasks in all its forms, including the moving of equipment used for handling people, is provided in the Manual Tasks Code of Practice. What is â€Å"people handling†? People handling refers to any workplace activity where a person is physically moved, supported or restrained at a workplace. Specifically, people handling refers to workplace activities requiring the use of force exerted by a worker* to hold, support, transfer* (lift, lower, carry, push, pull, slide), or restrain* a person* at a workplace. * Exacerbating and worsening musculoskeletal disorders– likely/major to catastrophic (permanent loss of employment) * Team unpreparedness – likely/minor major * http://www. noweco. com/risk/risk04e. gif All people handling activities are a potential source of injury and therefore, a hazard. If you undertake people handling at your workplace, you should use a process to manage the risks associated with this hazard People handling is often only one part of a theatre nurses job. If other parts of the nurses job also involve manual handling of other loads, it is necessary to assess the whole job and manage the risks associated with undertaking those activities which add to the accumulative stress on the worker’s body. 1. People handling activities is a collective term for a group of related people handling tasks. 2. People handling tasks are the specific ‘pieces’ of work undertaken at the workplace, which involve the physical movement of a person. 3. People handling actions are the individual elements of the task and refer to movements which are undertaken. † Manual Tasks Involving the Handling of People Code of Practice 2001, Qld. Common work-related actions within people handling tasks which contribute to WRMDs include: * frequent and repetitive lifting with a bent and/or twisted back regardless of weight * static working positions with the back bent, for example, holding a limb during a surgical procedure or providing stability while a person stands â€Å" Manual Tasks Involving the Handling of People Code of Practice 2001, Qld. Risk factors To gain a greater understanding of the relationship between people handling activities and injury, it is useful to consider the ‘risk factors’ which influence the level of risk associated with undertaking people handling tasks. These risk factors can be grouped into two distinct categories: * direct risk factors – which directly stress/injure the worker’s body * contributing risk factors and modifying risk factors which affect how the task or action is done. There are three direct risk factors: * forceful exertion * working postures (awkward, static) * repetition and duration. The risk management process Under the Workplace Health and Safety Act 1995 (the Act), exposure to health and safety risks that arise from workplace hazards (such as people handling) must be managed. The Act places this responsibility for workplace health and safety upon certain people (such as relevant persons and persons in control of workplaces) Risk management is an ongoing process. It should be undertaken: * now, if it has not been undertaken before * when changes occur at, or are planned for, the workplace * when there are indications for potential injury * after an incident (or ‘near miss’) occurs * at regularly scheduled times appropriate to the workplace. The steps below illustrate the application of the risk management process to managing exposure to the risks associated with people handling. Identification The first step in the process of managing exposure to people handling risks is identification. This step involves identifying people handling tasks, actions within each task, direct risk factors, and, contributing and modifying risk factors The first part of identification is to make a list of those tasks undertaken at the workplace that involve handling people. 1. Consult with workers and observe the tasks. 2. Make a list of all the people handling tasks. 3. Make a list of the actions within each of these tasks 4. For each action, determine which of the direct risk factors are present. 5. For each action, identify the contributing and modifying factors Assessment Assessment involves determining the level of risk associated with each of the people handling actions identified. The desired outcome of the assessment step is a prioritised list of people handling actions requiring control. Further, when more than one people handling task is assessed, then the overall risk estimate for the task can be used to develop a prioritised list of tasks requiring control. Consult with workers throughout this process to assist with determining the level of risk associated with each of the people handling actions and the priority of each task. 1. Consult with the workers. 2. Determine the level of risk associated with each action 3. Prioritise actions for control. In order to prioritise the people handling actions, the risk associated with performing each action should be assessed. It is up to the assessor how this assessment is done. The assessor can choose any method of risk assessment as long as a prioritised list of actions is achieved. A way of assessing risk is to consider the likelihood and consequences of an incident occurring at the workplace. Likelihood – of an incident occurring at the workplace * To estimate the likelihood of an incident occurring at the workplace, the following aspects can be considered: * how often the action is undertaken the number of workers performing the same or a similar action * the duration of time that the action is performed * distractions * the effectiveness of existing control measures * capacity and characteristics of the workers * environment * availability and use of equipment * condition of equipment * injury data/history6. Consequences – of an incident occurring at the workplace To estimate consequences, the severity of a potential injury or illness that could result from performing a people handling action can be considered. Reference can also be made to injury records and statistics, and information on injuries from people handling in related industries for an indication of the potential severity of injury. Use this likelihood and consequence estimate to rank and then, list the people handling actions requiring control. The decision is then made that for some actions, for example, those for which it is very unlikely that an incident would occur and for which the consequences are minor, may not require control. A summary of the assessment process Consult with workers: * Estimate the likelihood of an incident occurring at the workplace. * Estimate the consequences of an incident occurring at the workplace * List the people handling actions in the order of they require control. Questions to ask: * What do the workers think? * What is the likelihood and potential severity of injury associated with each action? * What should be fixed? What should be fixed first? Control Risk control strategies involve: * making decisions about the best measure(s) to control exposure to the contributing and modifying risks identified * implementing the chosen controls. Consultation with workers is an importan t part of this process. Design controls involve the arrangement, or alteration of: * physical aspects of the work area such as equipment or furniture/fittings, or * the work procedure. * Design controls are preferred because they * can eliminate or at least minimise exposure to risk factors * have the advantage of being relatively permanent (compared with administrative controls). For these reasons, implement design controls wherever possible. Administrative controls are achieved primarily by modifying existing personnel arrangements. Administrative controls do not remove the root cause of potential problems. These controls can only reduce exposure to the risk of injury. They might also be forgotten or not followed under stressful or other conditions as they are behaviour based, for example coping with staff reduction It includes consideration of factors such as – * the work postures required to carry out the action, how often it is repeated and for how long. Provide mechani cal aids where appropriate given the sterile environment in the perioperative unit – Hovermats are elpful in reducing the load of manual handling – but these are prohibitively expensive and require as many people to move patient safely as any other method Task-specific training Training in work methods for specific tasks or actions helps workers to carry out these tasks/actions in a safe and effective way. * Controls should not create other risks – the solutions should not result in a transfer of risk, for example, incorrect use of a handling aid, such as a transfer sheet can create forceful exertions on the workers forearm Although all the manual handling issues in the Perioperative are beyond this papers’ parameters, at least this area of patient care should be lifted to a much higher profile from a management, safety and a professional longevity perspective. Low back pain has been described as one of the main occupational problems among healthcare workers and nurses frequently have the highest incidence (Karahan, Kav, Abbasoglu amp; Dogan,2008) What is needed is a consistent, determined and educated effort on the part of the unit manager, nurse educator and occupational health and safety team to implement a program that will drive the manual handling of people to the forefront of safety practices in the unit – where bariatric patients (more than 100kgs) are becoming the norm rather than the exception, across all age groups and gender. Hospital and other care facilities have not generally been designed with the movement of bariatric patients in mind. ( Safework Australia, 2009). It is assumed largely by practicing nurses in the perioperative unit that new staff that join the team have some background in manual handling. Many students report that they have little to no manual handling training, other than hands on with another marginally more experienced nurse directing their work task, this is not a satisfactory or safe method of training – either for the nurse or the patient. Much more emphasis must be directed at the pre-employment and career development process in the safe development and competent use of manual handling techniques of vulnerable, often otherwise well patients who have mostly elective surgery for non- life threatening procedures. As the patient advocate, it is the nurses responsibility to ensure a safe passage through the perioperative journey.

What Does It Mean To Be a Muslim Essays

What Does It Mean To Be a Muslim Essays What Does It Mean To Be a Muslim Essay What Does It Mean To Be a Muslim Essay Recent events have put the Muslim population of the world in the middle of public attention. Unfortunate events like the 9/11 terrorist’s bombings have place Muslims in a bad light because of some people’s accusations that the Islamic religion is somehow related to terrorism. Nevertheless, even though the suicide bombers who are responsible in these terrorists’ acts are indeed Muslims, it does not necessarily mean that all those people should be characterized as such. However, those people who lack the necessary knowledge about Islam as well as those people who adhere to these beliefs become susceptible in giving judgments toward the Muslims in the forms of stereotypes and prejudices. Being the case, a persisting question arises, what does it really mean to be a Muslim? To be a Muslim means to have a deep commitment towards your religion that is observable in words and in actions that is mindful of the well-being of oneself and most especi ally of other people.In order to understand what it is to be a Muslim, the meaning of the Islamic religion must first be understood. The word â€Å"Islam† means â€Å"to submit† or â€Å"submission† (Chittick, 1992, 2). Thus, Islam is defined as â€Å"voluntary submission to God’s will by following His revealed messages† (Chittick, 1992, 2). The Koran states that â€Å"Muslims† are those who freely submit to God. As such, religion is a very important aspect of being a Muslim wherein they adhere and practice the different teachings and beliefs of their religion. The principles that guide the Islamic religion are found in the Koran. The Koran or Qu’ran is a book of Holy Scriptures of the Islamic religion that contains a record of the Prophet Muhammad’s teachings, which he delivered during the seventh century (Dawood, 1990). Since, Muhammad is considered as the messenger of Allah or God; his teachings are also recognized as coming from the divine. Among the most notable principles that guide the Muslim in the practice of their faith are the Five Pillars of Islam.The five pillars of Islam are: Shahadah, Salat, Zakat, Sawm, Hajj. First, the Shahadaha also known as the testimony is the basic foundation of remaining four pillars as it is considered as the gist of Islam’s central points. It is a profession of faith wherein an individual bear witness that there is no other god but Allah and Muhammad is His prophet (Schimmel, 1992). Second, the Salat or the ritual prayer, which is performed properly five times a day. Third, the Zakat or giving alms or tax is considered as a form of charity, which is given to the poor and the needy. Fourth, Sawm is the practice of fasting during the month of Ramadan. Lastly, the Hajj is the pilgrimage to Mecca, the center of Islamic teaching, at least once in a Muslim’s lifetime (BBC, 2008). These Five Pillars served as the framework in the life of every Muslims. These also proves that Muslims give due importance to their religion by actually practicing it in their daily lives and not just merely something that believe or preach.The important element in a Muslim’s worldview is rooted in their Islamic belief. The Islamic perception of the world is concerned not only in the present situation or reality of events but it also includes the life after death or the Day of Judgment. It can be said that Muslims believe in â€Å"dual worldviews†, which makes it different from the Westerners’ view. Dissimilar to Western perspective that is dependent on logical reasoning and rationality, Muslims still based their views mainly from the Koran (Asri and Fahmi, 2004). This only shows the great influence that their religion has with the other aspect of their lives.The attitudes or characteristics of a Muslim are also influenced by his or her religion. According to the Prophet Muhammad, a believer of Islam also known as the Muslims are describ ed as morally upright, giving, and compassionate. This is clearly seen in his sermon, which states that a believer has a life that is mindful of the law and exemplified righteous deeds. He or she has good morals and treats other with respect. A Muslim also has a purified heart and soul because he or she does not hate others or being hypocritical about them. A believer of the Islamic religion spends his or her wealth for the cause of Allah, which could be exemplified through acts of charity. Most importantly, Muslims are compassionate. They are not offensive towards other people and their actions are guided accordingly in order not to harm their fellow human beings (Al Balagh Foundation, n.d.).Since Muslims are characterized as morally upright individuals, they tend to adhere to strict codes of conduct. The moral teachings of the Islamic religion is grounded from the belief that Allah gave every individual the necessary intellect in order for him or her to differentiate what is right from what is wrong. Temptation is something that is present and observable in the world. It exists among the midst of every individual but a human being’s capability to discern and make morally judgments should enable him or her to fight these temptations.  Ã‚   In this sense, an individuals’ morality is what makes him or her different from other living creatures that Allah created. Animals do not have the capability to distinguish good from evil, which made humans distinct from them. Being the case, an individual who practiced lying, cheating, deceitfulness, and other unjust deeds are worse than an animal. The Islamic teachings mandate that humans should have a life that is guided by principles and moral virtues. Muslims should follow good, praiseworthy as well as moral behavior and forego of immoral and bad conduct. This is related from the belief that an individual who possesses a bad character causes harm to oneself as well as to the society as a whole because h is or her actions affect other people (Al Balagh, n.d.).Contrary to some people’s belief that resurrection and the judgment day are only observable in religions like Christianity, Islam also has their own teachings when it comes to these matters. The central doctrine of the Qu’ran also give due importance to the Last Day or the Day of Judgment. Based upon the Islamic belief, the souls of the death remain in their graves while waiting for resurrection to take place. Nevertheless, during this period of waiting they already can already foresee what will happen to them during the Day of Judgment. Those people who follow the teachings of Islam and live a life that is in accordance with the principles that Allah gave them will always be at peace. On the other hand, those people who lived an immoral life and completely disregard the teachings of their religion will suffer in their graves, which only indicate that they are bound for hell (Religion Facts, 2008).During the Judgm ent Day, those humans that are resurrected will face Allah. Allah will judge them according to their actions while they are still on earth. Their eternal destination is dependent upon the balance of their good and evil deeds. There are only two destinations that these people will go to. They can either be admitted to Paradise wherein they will experience spiritual and physical well-being forever or they will be condemned to Hell in which they will suffer spiritually and be physically tormented for eternity. This kind of judgment is also described as passing over Hell through a narrow bridge in order to get to Heaven. Those who are sinful will be weighted by their bad deeds and fall in Hell forever (Religion Facts, 2008).People who do not completely understand the Islamic teaching thought that Muslims practiced intolerance especially with regards to non-believers or those who adhere to a different religion. This kind of adage is proven to be wrong. According to the basic principle of Islam, faith should be observed towards all prophets of the world. This clearly debunks this aforementioned allegation. The Islamic religion preached the love and respect for other religions in the world but more than that it gives emphasis in having â€Å"faith† for these other beliefs. This only proves that Muslims are tolerant of people who do not adhere to their religion. Moreover, it does not only preach faith for other religions, Islam also gives equal for all (Ali, n.d.).Being a tolerant and inclusive systematic religion, Islam is characterized with an interrelated set of ideals and realities that influence individuals. As such, many concepts in this religion are also connected with each other. This is exemplified by martyrdom and Jihad. Jihad is often described as the mere idea of holy war; however, its literal meaning is the â€Å"struggle† or â€Å"effort† (BBC, 2008). Muslims pertain to Jihad in three various kind of struggle. First, a believer of th e religion’s internal struggles to live a life that is guided by the Muslim faith. Second, is the struggle to establish a sound society of Muslims. Lastly and the most controversial is the struggle to defend the Islamic religion even with the use of force. There are references in the Islamic writings that describe this third form of struggle as military in nature wherein this means is utilized in order to counter anything that threatens Islam (BBC, 2008). The concept of martyrdom is usually related with the idea of holy war because it is being prepared to die in the process of submission to the Islamic religion. However, martyrdom is not only realized by dying in the course of battle because the other kinds of struggle in the light of living the Islamic faith are also associated with it (Ezzati, 1986).During this modern age, Islam is also faced with numerous challenges with regards to criticisms about the practice of this religion. One of the most notable issues being raise i s the inequality between men and women in Islamic religion. However, the scriptures of Islam disprove such claim. It gives men authority over women but it gives emphasis that men should treat them properly. Divorce is also seen as a prerogative of the man but women also have to divorce their husband if it is stated in the contract. Moreover, the way women conservatively dress and act in the Muslim society is also scrutinized by Westerners as a form of subordination. Nevertheless, Muslim women defend these practices as a part of their religion and culture, which they willingly and voluntarily follow. In relation to these, other modern phenomena like globalization and internationalism are not something the Islamic society completely disagrees from, the only thing they want to ensure is that modernity will not disrupt the Islamic religion that they uphold.Being a Muslim entails being committed to the religion that you adhere to. This is clearly established by the great influence that I slam has in the different aspects in the life of a Muslim. Muslims does not merely believe or preach about their religion but rather they make sure that they practiced its very values and ideals in their everyday lives. This is observable in their decisions, actions, and even when it comes to their perspective about the world. It only shows that to be a Muslim is indeed to be a firm believer of Islam.ReferencesAl Balagh. (n.d.). The Characteristics of a Muslim. Retrieved October 6, 2008, fromal-islam.org/gallery/kids/Books/bca3/.Ali, M.M. (n.d.). Liberal view of other religions by Islam. Retrieved October 6, 2008, frommuslim.org/islam/tolerance.htm.Asri, M., Fahmi, M. (2004). Contribution of the Islamic Worldview Towards CorporateGovernance. Retrieved October 6, 2008, fromiiu.edu.my/iaw/Students%20Term%20Papers_files/Asri%20and%20Fahmi%20IslWWandCG.htm.BBC. (2008). Five Pillars of Islam. Retrieved October 6, 2008, frombbc.co.uk/religion/religions/islam/practices/fivepillars.shtml.B BC. (2008). Jihad. Retrieved October 6, 2008, frombbc.co.uk/religion/religions/islam/beliefs/jihad_1.shtml.Chittick, W. (1992). Faith and Practice of Islam: Three Thirteenth Century Sufi Texts. NewYork: SUNY Press.Dawood, N.J. (1990). The Koran: Revised Edition. New York: Penguin Classics.Religion Facts. (2008). Islamic Beliefs about the Afterlife. Retrieved October 6, 2008, fromreligionfacts.com/islam/beliefs/afterlife.htm.Schimmel, A. (1992). Islam: An Introduction. New York: SUNY Press.

Data analysis Essay Example | Topics and Well Written Essays - 1250 words

Data analysis - Essay Example The data gathering process is conducted through online questionnaires or surveys in order to determine the information, which is gathered and then analyzed. The Strategic Communication is first important in communicating to authors what was uncovered in the research. Secondly, when the book is ready to be sold, the Strategic Communication, through advertising and public relations (PR), reflects the changes made in this new edition to all those who potentially will adopt or purchase this book for their courses (Churchill and Iacobucci 566). As another example of Strategic Communications, a Vice-President in a business may need to inform the board of directors about a new process that can be implemented, but with some additional costs. The research done as to the plan’s effectiveness and what it will cost, is essential to selling this new process to the board of directors. Therefore, the statistics which shows this information, is an essential part to successfully selling the ne w plan or operation. 2. Differentiate between a population and sample. The difference is that a population consists, for example, of all people who drink coffee at Starbucks (Zikmund 296). The sample of the population must be taken from within that population of all people who drink coffee from Starbucks (Week 4, p.2). ... This is part of variables when we determine these parameters of the data while canvasing those people who have applied to take the survey Week 4, p.4). If any of the required parameters (variables) are not present, such as a certain age group, buying Starbucks coffee more than once a month, who are currently working, and own a home, for example, then those returns are not vetted or accepted. In general, use 10% of the overall group to get a representation, such as 100/1000 (Muijs 35). In describing a sample of School of Communication students, they would need to be taking classes in public relations, journalism, marketing, and radio/television courses (Zikmund 296). Age is not considered a factor but it can be a descriptive of the sampling, as older students also take these courses, not just those who are 18 to 22 years of age. In defining parameters for attaining the sample, the objective for this might be that only those who are majoring in any of these courses, and within a certai n age group, can apply to the research study. Other parameters that could be applied in some cases, is to only have honor students apply, rather than the whole population of students in the School of Communications. Creating such parameters in the invitation communication means that only those who closely fit the parameters, will apply, rather than the whole school or college, thus saving on wasted time weeding out those who do not fit in to the objective (Muijs 35; week 4, p.6). 3. Explain what statistical significance is. Statistical significance is the process of testing data through various operations. One example might be in creating two different messages, with a call to action, which will be sent to a sample group. This would be called A/B testing to see which

Write an analysis of an authors works, first discussing the authors Research Paper

Write an analysis of an authors works, first discussing the authors life to put the author in an accurate time and place relevant to your analysis of his or her work - Research Paper Example The works of Faulkner, Hughes and Poe represents a typical middle class American family in the early 19th century struggling to handle financial challenges. The compositions reflect a time when the society was reeling from the effects of wars (Miller 3). Despite the difference in the backgrounds of the three composers, they were investigative in their compositions. Henceforth, people refer to them as gothic composers. Indeed, they pondered at miseries in the societies as presented in their compositions. The authors utilized imagery and symbolism in their creations. This piece analyses the works of Faulkner, Hughes and Poe in relation to their lifestyles. William Faulkner grew up from a humble background in Mississippi where he joined the military and later rose to the rank of a sergeant. The military provided Faulkner an exposure like no other. While working in the forces, he interacted with people from various backgrounds (Aiken 7). At first, it was hard for William to acknowledge the challenges that people were facing in the society. The author got the idea of writing creative compositions from his environment. This was his mission to salvage the society from the problems people were facing. His first work was a novel he wrote in 1925 (Aiken 2). The compositions that followed were influenced by the stories he heard from his elders about the Americas history. He used imagery in his works. He devoted to inform the audience the decadence that was going on in the southern states. Hughes focused on enlightening the American society from undertaking several odd jobs. At the time, he had intended to reflect on the challenges that affected blacks in America. According to Miller (8), literature gave Hughes an opportunity of reflect on the challenges that affected blacks in America. The previous scholars who had written works on

Contextual Analysis of Rodney Graham's Halcion Sleep Term Paper

Contextual Analysis of Rodney Graham's Halcion Sleep - Term Paper Example The pill has been presented as the leap from the societal pressures that an individual takes to escape the pressures of society, which is certainly inappropriate for him. In the film Halcion Sleep, Rodney Graham has been filmed on the backseat of a car in the state of unconscious due to the dose of drug. The whole film is a sequence of Graham’s journey in an unconscious or sub-conscious state from the room of the motel, where he has consumed the drug, to his apartment in the center of Vancouver city. In the film, the city lights and life of Vancouver is being focused through the rear windshield of the car. The total length of the film is twenty six minutes in which the journey of sleeping Graham has been presented; however, the production of the film is contained with deeper interpretations which will be explicated in the following paper (Graham 0:01-26:21). Halcion Sleep is metaphoric representation of the average human individuals who bears significant and severe societal pr essures to survive in the society. ... Although these problems are diverse and multilateral in nature, but it can be categorized in multiple dimensions from which the pressure on individuals builds up. The most significant and grave problems, which develop pressure in individuals are social problems which are further correlated with political problems (Sterba 103-114). The political structure of a society determines the quality of life, economic conditions and stability and individual’s status and roles in a society. These determinations are necessarily coupled with several responsibilities for each individual to survive in the society. In the traditional or modern, that is capitalist system, systems, every individual cannot be pertained to be considered on similar grounds. These grounds are being measured in terms of social economic status of individuals. As this dissimilarity among the individuals of society is developed, the society becomes divided into classes in which individuals belonging to lower or middle c lasses are pertained to struggle more than the higher economic class. These struggles are largely focused on the acquisition of better economic status by which there social status can be raised (Sterba 120-126). These striving life of individuals make them mentally fatigued and pressurized due to the political and social structure of the society. It is the class difference, which inevitably creates the divide in individuals of the society. It is because of the class difference, there is status divide and with this discrimination, individuals are brought to mental and physical pressures. Life’s struggle which is actually futile in a sense has to be made by each member of the society, because the society sets a tradition that every man is part of this competition. Consequentially the

Posterior Reversible Encephalopathy (PRES)

Posterior Reversible Encephalopathy (PRES) Posterior Reversible Encephalopathy (PRES): A Rare Presenting Feature of Pheochromocytoma Abstract Hypertension in young is mostly due to secondary causes and one of them is pheochromocytoma. These are catecholamine secreting enterochromaffin tumors causing paroxysmal hypertension. Adrenal pheochromocytoma presenting as posterior reversible encephalopathy syndrome (PRES) is very rare and has not been described in literature so far. Here, we report a case of previously healthy adolescent boy, who presented with acute onset severe headache, blurring of vision, generalized tonic clonic motor seizure and altered sensorium. His blood pressure was 234/126 mm Hg. The magnetic resonance imaging (MRI) of brain showed hyperintense signal on T2-weighted and fluid attenuated inversion recovery (FLAIR) images in bilateral parietal and occipital regions. High blood pressure and classical MRI findings were consistent with the diagnosis of PRES. Abdominal ultrasonography (USG) revealed a right adrenal mass. A diagnosis of pheochromocytoma was confirmed by abdominal triple phase contrast- computed tomography (CT) and 24-hour urinary metanephrine assay. After the blood pressure was stabilized with alpha and beta blockade, adrenal tumor was surgically excised. Histopathologic examination of tissue confirmed the diagnosis of pheochromocytoma. The MRI brain showed complete resolution of hyperintense signals (T2-weighted and FLAIR images) on two-months follow-up. He was symptom free at six months and one year follow-up. Key words: Posterior reversible encephalopathy syndrome (PRES); Reversible posterior leukoencephalopathy (RPLE); Pheochromocytoma; Hypertensive Encephalopathy; Hypertension Abbreviations: ADC: apparent diffusion coefficient; CT: computed tomography; MRI: magnetic resonance imaging; DWI: diffusion-weighted imaging; PRES: posterior reversible encephalopathy syndrome Introduction Hypertension in young is mostly due to secondary causes which include renal diseases (chronic renal failure, renal artery stenosis, polycystic kidney disease), coarctation of the aorta, systemic lupus erythematosus (SLE) and endocrinopathies. Pheochromocytomas are rare catecholamine secreting enterochromaffin tumors. The patients of pheochromocytoma usually present with spells of headache, sweating and palpitations due to excessive catecholamines. The cerebral manifestation of pheochromocytoma are uncommon. Posterior reversible encephalopathy syndrome (PRES) as a presenting feature of pheochromocytoma is rare. Case Report A 14-year-old previously healthy boy presented in emergency department with acute onset severe holocranial headache, blurring of vision, generalized tonic clonic motor seizure followed by altered sensorium. There was no previous history of nausea, vomiting, diarrhea, flushing, excessive sweating, migraine, autoimmune and connective tissue disorders, drug abuse, toxin exposure, hypertension or diabetes mellitus. He had no similar illness in past and family history was negative. His pulse rate and blood pressure were 130 beats per minute and 234/126 mm Hg, respectively. He was confused but followed simple commands. The pupillary size and light reaction were normal on both sides. Fundus examination showed bilateral papilledema. He was moving all the four limbs equally without asymmetry on painful stimulus. Plantars were bilaterally extensor. Signs of meningeal irritation (neck rigidity and Kernigs signs) were negative. Complete hemogram, serum electrolyte, renal function tests and other biochemistry including thyroid function tests were normal. Serum anti-nuclear antibodies (ANA), anti-double-stranded DNA antibody (anti-dsDNA) and ELISA test for human immunodeficiency virus (HIV) were negative. X-ray chest was normal. Electrocardiography (ECG) showed tachycardia. Magnetic resonance imaging (MRI) of brain showed hyperintense signal changes on T2-weighted and fluid attenuated inversion recovery (FLAIR) images in bilateral occipito-parietal regions. No restriction was seen on diffusion-weighted images (DWI) [Figure 1]. CT angiography of brain vessels was normal. High blood pressure and classical MRI findings were consistent with the diagnosis of PRES. On further evaluation, abdominal ultrasonography (USG) showed right adrenal mass. An abdominal triple phase contrast-enhanced CT scan revealed heterogeneous, contrast enhancing adrenal gland mass lesion measuring 32 x 26 mm suggestive of pheochromocytoma [Figure 2]. The diagnosis was confirmed by 24-hour urinary metanephrine assay. The plasma aldosterone concentration (PAC) and plasma renin activity (PRA) ratio (PAC/PRA) was 10.4. The 24- hour urinary normetanephrine was 31,572 Â µg/24 hour (normal: 63-402 Â µg/24 hour), urinary metanephrine was 1,524 Â µg/24 hour (normal: 32-167 Â µg/24 hour) and plasma noradrenaline level was 18,635 pg/mL (normal: 0-400 pg/mL). Patient was managed intensively with nitroprusside infusion to reduce blood pressure. Injectable phenytoin was administered according to body weight to control seizures. Once patient was stabilized, he was started on oral alpha-blocker prazosin (20 mg/day) followed by beta-blocker propranolol (40 mg/day). After adequate alpha and beta blockade, patient was planned for surgery and resection of adrenal mass was done. Histopathologic examination confirmed the diagnosis of pheochromocytoma without invasion of the adrenal capsule [Figure-3]. The MRI brain showed complete resolution of hyperintense signals (T2-weighted and FLAIR images) and 24-hour urine metanephrines were normal on two-months follow-up. He was asymptomatic at six months and one year follow-up. Discussion Pheochromocytomas are neuroendocrine tumors arising from chromaffin cells of the adrenal medulla or extra-adrenal paraganglia. The classical features like holocranial headache, palpitations, hypertension, hyperhidrosis, hyperglycemia and hypermetabolism are due to excessive catecholamines production in these tumors. The cardiac complications such as arrhythmias, myocardial infarction and sudden deaths are associated with cardiotoxic effects of high blood catecholamines levels. Pheochromocytoma is a rare cause of secondary hypertension and accounts for 0.5% to 2.0% of all causes of hypertension in children. The neurological complications (ischemic or hemorrhagic stroke) are related to increased platelet aggregation, hypertension and vasospasm due to high catecholamines levels. The various potential triggers of pheochromocytoma crisis leading to hemodynamic instability are stress, blood loss, surgery and anesthesia. The diagnosis of pheochromocytoma is confirmed by 24-hour urinary meta nephrine and normetanephrine levels. Clinical features of reversible posterior leukoencephalopathy syndrome (PRES) are acute onset headaches, vision loss, seizures and altered sensorium. It is mostly due to hypertension, however other common causes are chronic renal disease, uremic encephalopathy, ergot alkaloids, steroids, chemotherapy, vasculitis and tumors. Pheochromocytoma is one of the rare cause of PRES due to secondary hypertension. However, to the best of our knowledge, acute, life-threatening initial presentation of pheochromocytoma as PRES has not been described in literature. Magnetic resonance images (MRI) of brain typically shows hyperintense signal changes on T2-weighted and fluid attenuated inversion recovery (FLAIR) images due to vasogenic edema. It mostly involves the cortical and subcortical white matter of the parietooccipital, frontal and temporal regions. Cerebral hemorrhage, cytotoxic edema and contrast enhancement are atypical imaging findings of PRES. The parietooccipital cortex and subcortical w hite matter were affected in our case. Classically, these signal abnormalities are reversible on antihypertensive therapy. The pathophysiology of PRES is still poorly understood, however, various hypothesis have been proposed. Severe hypertension causes deranged autoregulation of sympathetically mediated cerebral arterioles. It leads to increased permeability in the blood-brain barrier and causes vasogenic edema. Sympathetic innervation of the vertebrobasilar system is not as extensive or as complete as that of the anterior circulation. Therefore, PRES predominantly affects parietooccipital cortex and subcortical white matter. Other possible mechanism may be endothelial dysfunction due to circulating toxins or chemotherapy agents. There may be cerebral infarction or hemorrhage due to compromise of the microcirculation by pressure from surrounding vasogenic edema. The exact etiology of the seizure remains unknown, but may result from effects of the pheochromocytoma on reducing seizure threshold via its actions on metabolic or hypertensive parameters. Our patient had high levels of circulating catecholamin es, produced autonomously by tumor. Once vasogenic edema subsided with antihypertensive therapy, all the abnormal MRI findings vanished. Clinical topography (acute onset headache, visual blurring, seizure and altered sensorium), high blood pressure and typical MRI findings suggested diagnosis of PRES. In our patient, other differential diagnosis such as thrombocytopenic thrombotic purpura (TTP), hemolytic uremic syndrome (HUS), encephalitis, systemic lupus erythematosus (SLE), brain mass lesions and drug toxicity were ruled out by appropriate clinical and laboratory investigations. In our patient, hypertension was detected for the first time on hospital admission and before that he never had any symptoms like headache, palpitations, perspiration or diarrhea. Our patient is of clinical interest as pheochromocytoma presented with life-threatening hypertensive encephalopathy. Management of pheochromocytoma requires aggressive approach including fluid resuscitation and antihypertensive therapy (both alpha and beta blockade) followed by surgical resection of tumor. Conclusion Pheochromocytomas are catecholamine secreting enterochromaffin tumors causing paroxysmal hypertension. Our patient is of clinical interest as an acute, life-threatening hypertensive encephalopathy (PRES) as a presenting feature of adrenal pheochromocytoma has not been described in literature so far. Pheochromocytoma should be ruled out in every young patient with acute hypertensive encephalopathy. Figure Legends Figure 1. Magnetic resonance imaging (MRI) of brain showing hyperintense signals on T2-weighted and fluid-attenuated inversion recovery (FLAIR) images in parieto-occipital region. No diffusion restriction is seen. [ T1-weighted axial (A), T2-weighted axial and sagittal (B,C), FLAIR (D), diffusion weighted (DWI) (E) and corresponding apparent diffusion coefficient (ADC) (F) images]. These abnormal signals completely vanished on follow-up MRI after six weeks. Figure 2. Triple phase contrast-enhanced computed tomography (CT) of abdomen showing heterogenous enhancing mass lesion measuring 32 x 26 mm in right adrenal gland. [Axial CT: Arterial phase (A,B), Venous phase (C) and Delayed phase (D)]. Figure 3. Hematoxylin and eosin (HE) stained microphotographs showing large pleomorphic nuclei, abundant basophilic cytoplasm and cell-nesting pattern (zellballen pattern). [HE stain 40x view (A), 100x view (B,C)]. 1