Study and learning skills Essay Example | Topics and Well Written Essays - 1000 words

Study and learning skills - Essay Example The learning process requires person’s activity - it is not limited to the university or school. You keep yourself acquainted with new literature, make your own little discoveries, determine your own position on one or another issue and apply your knowledge to solve specific problems. You should not regard yourself as a passive object of the learning process; object, which is able to receive information only in the classroom and is not going to analyze it. Prepare to the fact that your self-study time will exceed time, spent in the classroom. The sooner you get the necessary skills to be successful in studying, the more efficiently your time will be used, and the greater your success will be. Nobody can deny the fact that acquiring knowledge is not easy task to do. Sometimes studying is quite a painful process and lots of factors can influence it. First of all, a student needs to develop some skills that will be necessary for further efficient and successful studying. Studying skills or strategies are characterized â€Å"as the approaches applied to learning, which are generally critical to success in school, are considered essential for acquiring good grades, and are useful for learning throughout one's life† (Preston, 1989). Everybody is aware or such simple truth that time is money, nonetheless, so many people neglect it and go on wasting time. Students are not exception. It is impossible to grasp the immensity and learn all the material just before taking test or writing an important essay. If you want to be a successful student, you should never try to do too much studying at once. Such experiments with yourself may result in your being too tired, exhausted and thus, unable to write your test well. So, when you have some free time, it should be planned accordingly. Space the work you have to cope with over short time periods and never forget about having brakes between studying periods. Your schedule should be evaluated, so take care of it and do not let your friends or family member to draw your attention off the studying process. Planning time properly is a very important skill not only for studying but also for your future profession. First, all your zeal got to be directed to coping with the most difficult tasks, requiring much time and efforts. And what about the students’ working place? Should we actually pay so much attention to the working place arranging? Of course, we do. Very few students think about the studying places, though when chosen incorrectly, such place can do more harm than good. Studying place should be quiet; its being free from any interruption is of paramount importance to you. Your studying place also should be available to you when you need it; it should be spacious and comfortable, for you not to

Patient Safety in Rural Nursing Because of Nursing Shortage Essay Example for Free

Patient Safety in Rural Nursing Because of Nursing Shortage Essay The United States is in the midst of a nursing shortage that is being increasingly discussed in the context of declining healthcare facilities in the nation. Over 1 in 7 hospitals (15%) report a severe RN nursing shortage with more than 20% of their nursing positions vacant and 80%-85% of hospitals report that they have a nurse shortage This shortage is predicted to intensify over the next decade or two as nurses belonging to the generation of baby boomers retire. The Nursing Management Aging Workforce Survey released in July 2006 by the Bernard Hodes Group reveals that 55% of surveyed nurses and nurse managers reported their intention to retire between 2011 and 2020 (AACN, 2006). In April 2006, officials with the Health Resources and Services Administration (HRSA) released projections that the nations nursing shortage would grow to more than one million nurses by the year 2020 (HRSA, 2003). Nursing colleges and universities are struggling to expand enrollment levels. In the report titled â€Å"What is Behind HRSAs Projected Supply, Demand, and Shortage of Registered Nurses? † analysts show that all 50 states will experience a shortage of nurses to varying degrees by the year 2015 (AACN, 2006). Factors driving the growth in demand for nurses include: an 18 % increase in the population; a larger proportion of elderly persons requiring proportionally higher levels of medical care; advances in medical technology that heighten the need for nurses; an increase in the number of work settings for nurses and demographic changes in an increasing U.  S. population (HRSA, 2003). Factors that are causing a decrease in the supply of nurses are: the declining number of nursing school enrollees, graduates and faculty; the aging of the registered nurse workforce; work environment issues leading to job burnout and dissatisfaction; high nurse turnover and vacancy rates; and declines in relative earnings (HRSA, 2003). Due to this critical imbalance between the supply and demand of nurses, the United States is today facing a nursing shortage crisis. Nursing shortage in rural settings: Research shows that nursing shortage as defined by the federal government exists mainly in rural areas of the country that are far away from metropolitan areas. These areas suffer more from nursing shortage than urban areas due to lack of economic resources to compete with urban based employers, inadequate training for nurses to practice in rural settings and dependence on non-hospital care settings in the rural areas. According to a paper published by the National Clearinghouse for Frontier Communities, â€Å"Impacts and Innovations in Frontier America† (December 2004), nurse shortages in frontier and rural communities derive not only from the current national shortage of nurses but also a long-standing trend favoring rural-to-urban migration of the educated, skilled workforce. There is also the issue of money. When examined by rurality, LPNs in rural settings ($21,941) report an income 23% lower than that reported by LPNs in urban settings ($28,408) (NCSBN, 2006). A large number of rural communities are losing existing employment and education opportunities and the paper suggests that the community context of a nurse shortage can be addressed only through community-based development approaches as well as the crafting of healthy rural policies. The Robert Wood Johnson Foundation published a report titled The American Nursing Shortage with the help of its researchers Bobbi Kimball and Edward ONeil. According to this report, even when some people feel a calling for the professions such as nursing, they are deterred by certain dimensions of the lifestyle, such as low pay, compulsory mobility and the need for service in rural areas. Available data and literature suggest that the impact of the nursing shortage on rural and frontier communities varies greatly from community to community. IN some rural places, there is no difficulty in filling vacancies but there may be just a few good paying jobs. However, in most rural areas, recruiting for openings is estimated to take about 60 percent longer to fill than in urban areas (Long 2000). Nurse employers receive many applications but often find applicants do not meet desired qualifications and then, they often have to accept lower qualifications to fill positions. Differences in education between frontier and non-frontier nurses exist both in their basic nursing education and the highest degree earned (FEC, 2003). Fully half of frontier nurses had qualified as RNs through associate degree (ADN) programs, in comparison with 40% of the non-frontier nurses; in contrast, non-frontier nurses were more likely to have attended diploma or BSN programs. Differences remain when looking at highest degree received; 44% of frontier nurses’ highest degree is the ADN, in contrast with 34% of the non-frontier nurses. And, while the percentage of nurses who have earned a bachelors degree is slightly lower among frontier nurses (30% frontier, 33% non-frontier), the percentage who has earned masters degrees is also lower among frontier (7% frontier compared with 10% non-frontier) (FEC, 2003). At Prairie Vista Nursing Home in Holyoke, Colorado, a town of about 1,900 people about 130 miles northeast of Denver, administrators reportedly had to work double shifts to cover shifts after a nurse retired. Recruiting nurses to work in rural areas is difficult to begin with; and, when urban-trained nurses enter rural practice, they often find they are ill-prepared for the demands of the job, contributing to job dissatisfaction and turnover. Once there, they typically find it difficult to access continuing education opportunities that fit their needs. â€Å"When educators bring their knowledge to us, they often do not realize that we practice differently than urban centers do† (rural nurse, quoted in Molinari 2001). In the rural setting, nurses typically fill multiple roles. There is a need for a broad range of skills and cross training in multiple jobs. â€Å"Rural nursing requires a high level of generalist skills and critical thinking† (Fahs, Findholt et al. 2003). Another issue is that the ethnic composition of the rural nurse workforce does not correspond with the population it serves. The ANA Rural Nursing module identifies five factors that affect rural nursing practice: threats to anonymity and confidentiality; traditional gender roles; geographic isolation; professional isolation; and scarce resources (Bushy 2004). Patient safety for nursing shortage in rural settings: Surveys and studies published recently confirm that the shortage of registered nurses is impacting the delivery of health care in the U. S. and negatively affecting patient outcomes. Research now shows that how well patients are cared for by nurses affects their health, and sometimes can be a matter of life or death. These studies have found that (HRSA, 2003): †¢ A total of 53% of physicians and 65% of the public cited the shortage of nurses as a leading cause of medical errors (Harvard School of Public Health, 2002,); A higher proportion of nursing care and a greater number of hours of care by nurses per day are associated with better outcomes for hospitalized patients (Needleman et al. , 2002); †¢ Nursing actions, such as ongoing monitoring of patient’s health status, are directly related to better health outcomes (Kahn et al. , 1990) ; †¢ 126,000 nurses are needed immediately to fill vacancies at our Nations hospitals. Today, 75% of all hospital vacancies are for nurses (American Organization of Nurse Executives, 2002); Low nurse staffing levels have contributed to 24% of unanticipated events in hospitals that resulted in death, injury or permanent loss of function (Joint Commission of Accreditation of Healthcare Organizations, 2002); †¢ Patients who have common surgeries in hospitals with low nurse-to-patient ratios have an up to 31% increased chance of dying. Every additional patient in an average hospital nurses workload increased the risk of death in surgical patients by 7% (Aiken et. al. , 2002); Low nursing staff levels were a contributing factor in 24% of hospitals’ reports of patient deaths and injuries since 1996 (Joint Commission of Accreditation of Healthcare Organizations, 2002); †¢ Less nursing time provided to patients is associated with higher rates of infection, gastrointestinal bleeding, pneumonia, cardiac arrest, and death from these and other causes (Needleman et al. , 2002); and †¢ Nurse executives surveyed indicated that staffing shortages are contributing to emergency department overcrowding and the need to close beds (American Organization of Nurse Executives, 2002). The Joint Commission on Accreditation of Healthcare Organizations, 2002 has issued a warning that failure to address the problem of nursing shortage in rural areas will result in increased deaths, complications, lengths-of-stay and other undesirable patient outcomes. JCAHO examined 1,609 hospital reports of patient deaths and injuries since 1996 and found that low nursing staff levels were a contributing factor in 24% of the cases (Joint Commission on Accreditation of Healthcare Organizations, 2002). New research indicates that a shortage of registered nurses prepared at the baccalaureate and higher degree level is endangering patients. In an article in the September 24, 2003 issue of the Journal of the American Medical Association, Dr. Linda Aiken and her colleagues at the University of Pennsylvania found that patients experience significantly lower mortality and failure to rescue rates in hospitals where more baccalaureate-prepared nurses provide direct patient care. At least 1,700 preventable deaths could have been realized in Pennsylvania hospitals alone if baccalaureate-prepared nurses had comprised 60% of the nursing staff and the nurse-to-patient ratios had been set at 1 to 4. Unfortunately, only 11% of PA hospitals have more than 50% of the nursing staff prepared at the baccalaureate level ( Institute of Medicine, 2003). A survey titled â€Å"Views of Practicing Physicians and the Public on Medical Errors†, conducted by the Harvard School of Public Health and the Henry J. Kaiser Family Foundation reported in the December 12, 2002 issue of the New England Journal of Medicine found that 53% of physicians and 65% of the public cited the shortage of nurses as a leading cause of medical errors. Overall, 42% of the public and more than a third of U. S. octors reported that they or their family members have experienced medical errors in the course of receiving medical care (AACN, 2006). Nurse researchers at the University of Pennsylvania determined that patients who have common surgeries in hospitals with high nurse-to-patient ratios have an up to 31% increased chance of dying. Funded by the National Institute for Nursing Research, the study found that every additional patient in an average hospital nurses workload increased the risk of death in surgical patients by 7% (AACN, 2006). According to an extensive study by Dr.  Jack Needleman and Peter Buerhas, published in the New England Journal of Medicine in May 2002, a higher proportion of nursing care provided by RNs and a greater number of hours of care by RNs per day are associated with better outcomes for hospitalized patients (AACN, 2006). Conclusion: Available data and literature suggest that the issue of nurse shortage is a national one. Yet, the impact of nurse shortage is better seen in the rural areas where nurses are not well paid, existing nurses are not well qualified and patients are dependent on local medical facilities. Because most frontier and rural communities are distant from hospitals, residents may rely on non-hospital based care settings for a greater proportion of their care than their urban counterparts. Due to these reasons, nurse shortage in rural areas has endangered patient safety. Nurses are the primary source of care and support in the health care sector and hence, a sufficient supply of nurses is critical in providing the national and especially the rural population with quality health care. Nurses are expected to play an even larger role in the future.

Name: Abraham Yeh :: English Literature

Title of Presentation: How Marvell has used language to show his concerns in the poem, â€Å"To His Coy Mistress† and how it makes it a makes it a memorable one. â€Å"To His Coy Mistress† is a love poem written by Andrew Marvell to his mistress to accept his love proposal. Throughout the poem, he shows his concern about how time is running out between the two of them by the use of convincing and persuasive words. I the first two line of the poem, â€Å"Had we but world enough and time, This coyness, Lady were no crime† ,He says this to explain to the mistress that if they did have time, he wouldn’t care about her shyness and by the use of words like â€Å"had† and â€Å"enough† show clearly that they do not have time. In the next two lines, â€Å"We should sit down and think which way to walk, and pass our long love’s day† which is related to the first two sentences explains that they would sit down and think where to walk to and have a nice day if they had time. â€Å"Thou by the Indians Ganges’ side Shouldst rubies find: I by the tide of Humber would complain†. He tells her this to show his love to her to mean that if they were far apart, he would complain. â€Å"I would love you ten years before the flood: And you should, if you please, refuse till the conversion of the Jews† is said by the persona probably to show her how long he has loved her and that they will have a never ending love. Also in this statement, â€Å"till the conversion of the Jews† which might never happen, is said to show that he will love her forever. He goes on to exaggerate that the love he has for her will slowly but surely grow larger then an empire by saying, â€Å"My vegetable love should grow vaster than empires, and more slowly. By the tone of the persona in this statement, it shows a bit of confidence and boldness. In the next line, â€Å"An hundred years should go to praise thine eyes, and on thy forehead gaze. Two hundred to adore each breast: But thirty thousand to the rest. An age at least to every part." Over here, he uses erotic and passionate words to show to the mistress how much he adores her body. There is a bit of lust and obsession. He also uses the word â€Å"gaze† to show her that he would never be tired of looking at her body and he also relates it to time.

Spirit Bound Chapter Eight

AFTER THE BITCHING I'D DONE to Abe about always going to remote, crappy places, I should have been excited about the prospect of going to Sin City. Alas, I had a few reservations about my next epic trip. First of all, somewhere like Las Vegas was the last place I would expect a semi-crazy recluse to be. From the bits and pieces I'd heard, Robert had dropped off the radar and wanted to be alone. A busy, tourist-filled city didn't really fit that description. Second, cities like that were perfect feeding grounds for Strigoi. Crowded. Reckless. Low inhibitions. Very easy for people to disappear–especially when most of them were out at night. Part of me was certain it had to be a trick on Victor's part, but he swore up and down that it was true. So, with no other leads, Las Vegas became our next destination. We didn't have much time to debate the matter anyway, knowing the guardians would be searching Fairbanks for us. Admittedly, Lissa's charms had altered our appearances enough that they wouldn't be looking for people with our descriptions. They knew what Victor looked like, though, so the sooner we were out of Alaska, the better. Unfortunately, we had a slight problem. â€Å"Victor has no ID,† said Eddie. â€Å"We can't take him on a plane.† It was true. All of Victor's possessions had been seized by prison authorities, and in the midst of disabling surveillance and taking out half a dozen guardians, we'd hardly had time to go searching for his personal stuff. Lissa's compulsion was phenomenal, but she was exhausted after wielding so much at the prison. Besides, guardians would likely be watching the airport. Our â€Å"friend† Bud the car rental guy provided the solution. He hadn't been thrilled to see his car returned with all the scratches from Eddie's daredevil driving, but enough cash had finally stopped the human's muttering about â€Å"renting to a bunch of kids.† It was Victor who thought of an alternative plan and suggested it to Bud. â€Å"Is there a private airport nearby? With flights we might charter?† â€Å"Sure,† said Bud. â€Å"But it won't be cheap.† â€Å"It's not an issue,† I said. Bud eyed us askance. â€Å"Did you guys rob a bank or something?† No, but we were packing a lot of currency. Lissa had a trust fund that doled her out monthly money until she was eighteen, as well as a high-limit credit card. I had a credit card of my own, leftover from when I'd sweet-talked Adrian into funding my Russian trip. I'd let go of the rest of my assets, like the huge bank account he'd set up. But, wrong or not, I'd decided to keep one card on hand, just in case of emergency. This was certainly an emergency, so we used the card to pay for part of the private plane's cost. The pilot couldn't take us as far as Las Vegas, but he could take us to Seattle, where he was able to connect us with another pilot he knew who could go the rest of the way. More money. â€Å"And Seattle again,† I mused, just before the plane took off. The little jet's interior had a set of four seats, two on each side facing each other. I sat next to Victor, and Eddie sat across from him. We figured that was the best protective configuration. â€Å"What about Seattle?† asked Eddie, puzzled. â€Å"Never mind.† Little private jets aren't nearly as fast as big commercial ones, and our trip took a large part of the day. During it, I continued asking Victor about his brother's role in Las Vegas and finally got the answer I wanted. Victor would have had to tell us eventually, but I think he'd gotten a sadistic thrill out of prolonging the answer. â€Å"Robert doesn't live in Las Vegas proper,† he explained. â€Å"He has a small house–a cabin, I suppose–out by Red Rock Canyon, miles outside the city.† Ah. Now that was more what I'd expected. Lissa stiffened at the mention of a cabin, and I felt unease through the bond. When Victor had kidnapped her, he'd taken her to a cabin in the woods and tortured her there. I gave her as reassuring a look as I could. It was times like these I wished the bond worked both ways so that I could truly send her comfort. â€Å"So we'll go out there?† Victor snorted. â€Å"Certainly not. Robert values his privacy too much. He wouldn't let strangers come to his home. But he'll come to the city if I ask.† Lissa eyed me. Victor could be setting us up. He had lots of supporters. Now that he's out, he could call them instead of Robert to meet us. I gave her a tiny nod, again wishing I could respond back through the bond. I'd thought of this as well. It was imperative we never leave Victor alone to make unsupervised calls. And actually, this plan to meet in Las Vegas itself made me feel better. For our own safety from Victor's henchmen, it was better to be in the city than out in the middle of nowhere. â€Å"Seeing as I've been so helpful,† said Victor, â€Å"I have the right to know what you want with my brother.† He glanced at Lissa. â€Å"Looking for spirit lessons? You had to have done some excellent investigative work to find out about him.† â€Å"You have no right to know about our plans,† I retorted sharply. â€Å"And seriously? If you're keeping track of who's been the most helpful here, we are totally beating you on the score-card. You've got a ways to go to catch up after what we did at Tarasov.† Victor's only response was a small smile. Some of our flight time took place at night, which meant it was early morning when we landed in Las Vegas. The safety of sunlight. I was surprised to see how crowded the airport was. The private one in Seattle had had a fair amount of planes, but the Fairbanks airport had nearly been deserted. This strip was chock-full of little jets, many of them screaming â€Å"luxury.† I shouldn't have been surprised. Las Vegas was the playground of celebrities and other wealthy people, many of whom probably couldn't lower themselves to fly commercial with ordinary passengers. There were taxis there, sparing us the ordeal of another rental car. But when the driver asked us where we were going, we all stayed silent. I turned to Victor. â€Å"The middle of the city, right? The Strip?† â€Å"Yes,† he agreed. He'd been certain Robert would want to meet strangers somewhere very public. Somewhere he could easily flee. â€Å"The Strip's a big place,† said the driver. â€Å"You got any place in particular or should I just drop you off in the middle of the street?† Silence fell over us. Lissa shot me a meaningful look. â€Å"The Witching Hour?† I considered it. Las Vegas was a favorite place for some Moroi. The bright sun made it less appealing for Strigoi, and the windowless casinos created comfortable, dark atmospheres. The Witching Hour was a hotel and casino we'd all heard of. While it had plenty of human customers, it was actually owned by Moroi, so it had lots of clandestine features to make it a great getaway for vampires. Feeders in back rooms. Special Moroi-only lounges. A fair number of guardians on patrol. Guardians†¦ I shook my head and glanced sideways at Victor. â€Å"We can't take him there.† Of all the hotels in Las Vegas, the Witching Hour was the last we'd want to go to. Victor's escape had to be breaking news all over the Moroi world. Taking him into Vegas's largest concentration of Moroi and guardians was probably the worst thing we could do at this point. In the rearview mirror, the driver's face looked impatient. It was Eddie who finally piped up. â€Å"The Luxor.† He and I were in the backseat, with Victor between us, and I peered over. â€Å"Where did that come from?† â€Å"It puts distance between us and the Witching Hour.† Eddie suddenly looked a little sheepish. â€Å"And I've always wanted to stay there. I mean, if you're coming to Vegas, why not stay in a pyramid?† â€Å"You can't fault that logic,† said Lissa. â€Å"The Luxor it is,† I said to the driver. We rode in silence, all of us–well, except for Victor–staring at the sights in awe. Even in the daytime, the streets of Las Vegas were teeming with people. The young and glamorous walked side by side with older couples from Middle America, who'd probably saved and saved to make this trip. The hotels and casinos we passed were huge, flashy, and inviting. And when we reached the Luxor†¦ yup. It was just like Eddie had said. A hotel shaped like a pyramid. I stared up at it when we got out of the car, trying hard not to let my jaw drop like the starry-eyed tourist I was. I paid the driver and we headed inside. I didn't know how long we'd be staying, but we definitely needed a room as our base of operation. Stepping into the hotel was like being back in the night-clubs in Saint Petersburg and Novosibirsk. Flashing lights and the overwhelming scent of smoke. And noise. Noise, noise, noise. The slot machines beeped and rang, chips fell, people yelled in dismay or delight, and the low thrum of conversation filled the room like humming bees. I grimaced. The stimuli grated on my senses. We passed through the casino's edge to get to the front desk, where the attendant didn't even blink at three teenagers and an old man getting a room together. I had to imagine that around here, they saw it all. Our room was average-size, with two double beds, and somehow we'd lucked out with an amazing view. Lissa stood at the window, entranced by the sights of people and cars on the Strip below, but I jumped straight to business. â€Å"Okay, call him,† I ordered Victor. He'd settled down on one of the beds, hands crossed and expression serene, as though he truly were on vacation. Despite that smug smile, I could see the fatigue etched on his face. Even with his blood refill, the escape and long trip had been exhausting, and the effects of his slowly returning disease were naturally taking a toll on his physical strength. Victor immediately reached for the hotel's phone, but I shook my head. â€Å"Liss, let him use your cell. I want a record of this number.† She gingerly handed the phone over, as though he might contaminate it. He took it and gave me a nigh-angelic look. â€Å"I don't suppose I could have some privacy? It's been so long since Robert and I have talked.† â€Å"No,† I snapped. The harshness in my voice startled even me, and it occurred to me Lissa wasn't the only one suffering from all the spirit used today. Victor gave a small shrug and began dialing. He'd told us on one of the flights that he had Robert's number memorized, and I had to take it on faith that that was who he was calling. I also had to hope Robert's number hadn't changed. Of course, even if Victor hadn't seen his brother in years, Victor had only been imprisoned a short while and had probably kept tabs on Robert beforehand. Tension filled the room as we waited while the phone rang. A moment later, I heard a voice answer through the phone's speaker–though I couldn't make out the exact words. â€Å"Robert,† said Victor pleasantly, â€Å"it's Victor.† This received a frantic response on the other end. I only could hear half of the conversation, but it was intriguing. Victor first had to spend a lot of time convincing Robert that he was out of prison. Apparently, Robert wasn't so removed from Moroi society that he was out of touch with current news. Victor told him that the details would be revealed later and then began making his pitch for Robert to come meet us. It took a long time. I got the feeling that Robert lived in fear and paranoia, which reminded me of Ms. Karp when she'd been in the advanced stages of spirit's insanity. Lissa's gaze stayed fixed on the scene outside the window during the entire call, but her feelings mirrored mine: fear that this could someday be her fate. Or mine as well, if I siphoned away spirit's effects. The image of the Tarasov sign flashed briefly through her mind: WARNING–NOW ENTERING PRISONER AREA (PSYCHIATRIC). Victor's voice turned surprisingly cajoling as he spoke to his brother, gentle even. I was reminded uneasily of the old days, before we'd known about Victor's demented plans for Moroi domination. Back then, he'd treated us kindly too and had practically been a member of Lissa's family. I wondered if at some point he'd been sincere or if it had all been an act. Finally, after almost twenty minutes, Victor convinced Robert to come see us. The unintelligible words on the other end of the phone were filled with anxiety, and at this point, I felt convinced that Victor truly was talking to his crazy brother and not one of his accomplices. Victor set up a dinner meeting at one of the hotel's restaurants and at last disconnected. â€Å"Dinner?† I asked when Victor set the phone down. â€Å"Isn't he worried about being out after dark?† â€Å"It's an early dinner,† Victor replied. â€Å"Four thirty. And the sun won't go down until almost eight.† â€Å"Four thirty?† I asked. â€Å"Good God. Are we getting the senior citizen special?† But he made a good point about the time and sun. Without the safety of Alaska's nearly nonstop summer light, I was starting to feel suffocated by the pressure of sunrise and sunset boundaries, even though it was summer here. Unfortunately, a safe early dinner still meant we had hours to pass. Victor leaned back on the bed, arms behind his head. I think he was attempting an unconcerned air, but my guess was that it was actually exhaustion driving him to seek the bed's comfort. â€Å"Care to try your luck downstairs?† He glanced over at Lissa. â€Å"Spirit users make remarkably good card players. I don't have to tell you how good you are at reading people.† She made no response. â€Å"Nobody's leaving this room,† I said. I didn't like the idea of us all being cooped up here, but I couldn't risk an escape attempt or Strigoi lurking in the casino's dark corners. After showering the dye from her hair, Lissa pulled up a chair by the window. She refused to get any closer to Victor. I sat cross-legged on the second bed, where there was plenty of room for Eddie to sit too, but he remained upright against a wall, in perfect guardian posture as he watched Victor. I had no doubt Eddie could maintain that position for hours, no matter how uncomfortable it got. We'd all been trained to endure harsh conditions. He did a good job at looking stern, but every once in a while, I'd catch him studying Victor curiously. Eddie had stood by me in this act of treason but still didn't know why I'd done it. We'd been there a few hours when someone knocked at the door. I leapt up. Eddie and I mirrored each other, both of us straightening to rigid attention, hands going for our stakes. We'd ordered lunch an hour ago, but room service had long since come and gone. It was too early for Robert, and besides, he didn't know the name our room was under. There was no nausea, though. No Strigoi at our door. I met Eddie's gaze, silent messages passing between us on what to do. But it was Lissa who acted first, rising from her chair and taking a few steps across the room. â€Å"It's Adrian.† â€Å"What?† I exclaimed. â€Å"Are you sure?† She nodded. Spirit users usually only saw auras, but they could sense each other if they were close enough–just as she had at the prison. Still, none of us moved. She gave me a dry look. â€Å"He knows I'm here,† she pointed out. â€Å"He can feel me too.† I sighed, still keeping my hand on my stake, and strode to the door. I squinted through the peephole. Standing there, his expression amused and restless, was Adrian. I could see no one else, and with no indication of Strigoi to be found, I finally opened the door. His face lit with joy when he saw me. Leaning in, he gave me a quick kiss on the cheek before stepping into the room. â€Å"You guys didn't really think you could go off on a party weekend without me, did you? Especially here of all places–â€Å" He froze, and it was one of those rare moments when Adrian Ivashkov was caught totally and completely off guard. â€Å"Did you know,† he said slowly, â€Å"that Victor Dashkov is sitting on your bed?† â€Å"Yeah,† I said. â€Å"It was kind of a shock to us too.† Adrian dragged his gaze from Victor and glanced around the room, noticing Eddie for the first time. Eddie had been standing so still that he practically seemed like part of the furniture. Adrian turned to me. â€Å"What the hell is going on? Everyone is out looking for him!† Lissa's words spoke to me through my bond. You might as well tell him. You know he won't leave now. She was right. I didn't know how Adrian had found us, but now that he had, there was no way he'd go. I glanced hesitantly at Eddie, who guessed my thoughts. â€Å"We'll be fine,† he said. â€Å"Go talk. I won't let anything happen.† And I'm strong enough again that I can compel him if he tries anything, Lissa added. I sighed. â€Å"Okay. We'll be right back.† I took Adrian's arm and led him outside. As soon as we were in the hallway, he started in again. â€Å"Rose, what's–â€Å" I shook my head. In our time here, I'd heard enough noise from other hotel guests in the hall to know that my friends would hear our conversation if we talked out there. Instead, Adrian and I took the elevator and headed downstairs, where the noise of the casino would mask our words. We found a slightly out-of-the-way corner, and Adrian practically pushed me against the wall, his expression dark. His light attitude annoyed me sometimes, but I preferred it to when he was upset, largely because I feared spirit would add an unstable edge. â€Å"You leave me a note saying you're sneaking off for one last party weekend, and instead I find you holed up with one of the most notorious criminals ever? When I left Court, that's all everyone was talking about! Didn't that guy try to kill you?† I answered his question with a question. â€Å"How did you even find us?† â€Å"The credit card,† he said. â€Å"I was waiting for you to use it.† My eyes widened. â€Å"You promised me when I got all those that you wouldn't go snooping!† Since my accounts and cards had come with his help, I'd known he had access to the records but had believed him when he'd said he'd respect my privacy. â€Å"When you were in Russia, I kept that promise. This is different. I kept checking and checking with the company, and as soon as the activity with the charter plane showed up, I called and found out where you were going.† Adrian's arrival here so soon after ours wasn't that unbelievable if he had been monitoring the card. Once he'd had the information he needed, he could have easily booked a flight. A nonstop commercial jet would have made up the time on our slower, multistop trip. â€Å"There was no way I could resist Vegas,† he continued. â€Å"So I thought I'd surprise you and show up to join in the fun.† I'd used my card for the room, I realized, again tipping off our location. No one else was linked to my or Lissa's cards, but the ease with which he'd tracked us made me nervous. â€Å"You shouldn't have done that,† I growled. â€Å"We might be together, but there are boundaries you've got to respect. This is none of your business.† â€Å"It's not like I was reading your diary! I just wanted to find my girlfriend and–† It was a sign of Adrian's distress that his mind was only now beginning to backtrack and put pieces together. â€Å"Oh lord. Rose, please tell me you guys aren't the ones who busted him out? They're all looking for two human girls and a dhampir guy. The descriptions don't match at all†¦Ã¢â‚¬  He groaned. â€Å"But it was you, wasn't it? Somehow, you broke into a maximum-security prison. With Eddie.† â€Å"Must not have been all that secure,† I remarked lightly. â€Å"Rose! This guy has fucked with both of your lives. Why would you free him?† â€Å"Because†¦Ã¢â‚¬  I hesitated. How could I explain this to Adrian? How could I explain that which, by all evidence in our world, was impossible? And how could I explain what goal in particular was driving this? â€Å"Victor has information we need. Or, well, he has access to someone we need. This was the only way we could get it.† â€Å"What on earth could he possibly know to make you do all this?† I swallowed. I walked into prisons and nests of Strigoi, but saying what I did next to Adrian filled me with apprehension. â€Å"Because there might be a way to save Strigoi. To turn them back to the way they were. And Victor†¦ Victor knows someone who might have done this.† Adrian stared at me for several long seconds, and even in the midst of the casino's movement and noise, it was like the world grew still and silent. â€Å"Rose, that's impossible.† â€Å"It might not be.† â€Å"If there was a way to do that, we would know.† â€Å"It involves spirit users. And we only just found out about them.† â€Å"That doesn't mean it's–oh. I see.† His deep green eyes flashed, and this time, they were angry. â€Å"It's him, isn't it? This is your last crazy attempt to get to him. To Dimitri.† â€Å"Not just him,† I said vaguely. â€Å"It could save all Strigoi.† â€Å"I thought this was over!† Adrian exclaimed. His voice was loud enough that a few people at nearby slot machines glanced over. â€Å"You told me it was over. You told me you could move on and be with me.† â€Å"I meant it,† I said, surprised at the desperate note in my voice. â€Å"It's something we only just found out about. We had to try.† â€Å"And what then? What if this stupid fantasy works? You free Dimitri in some miraculous act, and you drop me like that.† He snapped his fingers. â€Å"I don't know,† I said wearily. â€Å"We're just taking this one step at a time. I love being with you. Really. But I can't ignore this.† â€Å"Of course you can't.† He turned his eyes heavenward. â€Å"Dreams, dreams. I walk them; I live them. I delude myself with them. It's a wonder I can spot reality anymore.† The weird sound of his voice made me nervous. I could recognize one of his slightly crazy, spirit-induced lapses. Then, he turned from me with a sigh. â€Å"I need a drink.† Whatever pity I'd felt for him turned to anger. â€Å"Oh, good. That'll fix everything. I'm glad in a world gone mad, you've still got your old standbys.† I flinched at his glare. He didn't do it very often, and when he did, it was a powerful thing. â€Å"What do you expect me to do?† he asked. â€Å"You could†¦ you could†¦Ã¢â‚¬  Oh God. â€Å"Well, now that you're here, you could help us. Plus, this guy we're meeting. He's another spirit user.† Adrian didn't betray his thoughts, but I had a feeling that I had piqued his interest. â€Å"Yeah, that's exactly what I want. To help my girlfriend get her old boyfriend back.† He turned away again, and I heard him mutter, â€Å"I need two drinks.† â€Å"Four thirty,† I called after him. â€Å"We're meeting at four thirty.† There was no response, and Adrian melted into the crowd. I returned to the room in a dark cloud that had to be obvious to everyone. Lissa and Eddie were smart enough not to ask questions, but Victor, of course, had no such reserves. â€Å"What? Mr. Ivashkov isn't joining us? I'd so been looking forward to his company.† â€Å"Shut up,† I said, crossing my arms and leaning against the wall near Eddie. â€Å"Don't speak unless you're spoken to.† The next couple hours dragged by. I was convinced that any minute, Adrian would come back and reluctantly agree to help us. We could use his compulsion if things went bad, even though he couldn't match Lissa. Surely†¦ surely he loved me enough to come to my aid? He wouldn't abandon me? You're an idiot, Rose. It was my own voice that chastised me in my head, not Lissa's. You've given him no reason to help. You just hurt him again and again. Just like you did Mason. When four fifteen came around, Eddie looked over at me. â€Å"Should we stake out a table?† â€Å"Yeah.† I was restless and upset. I didn't want to stay in this room any longer, trapped with dark feelings that wouldn't go away. Victor rose from the bed, stretching as though getting up from a relaxing nap. Still, I could have sworn there was an eager glint hidden in the depths of his eyes. By all accounts, he and his half-brother were close, though I'd seen no indication that Victor displayed love or loyalty to anyone. Who knew? Maybe somewhere there was true affection for Robert. We formed a sort of protective configuration with me in the front, Eddie in the back, and the two Moroi between us. I opened the room's door and came face-to-face with Adrian. His hand was raised as though he'd been about to knock. He arched an eyebrow. â€Å"Oh, hey,† he said. He had the standard laid-back Adrian expression on his face, though his voice was a bit strained. I knew he wasn't happy about any of this. I could see it in the tight set of his jaw and agitation in his eyes. Nonetheless, he was putting on a good front for the others, for which I was grateful. Most importantly, he'd come back. That was what mattered, and I could ignore the scent of alcohol and smoke wreathing him. â€Å"So†¦ I hear there's some party going on. Mind if I join you?† I gave him a weak, grateful smile. â€Å"Come on.† Our group now up to five, we headed down the hall toward the elevator. â€Å"I was cleaning up at poker, you know,† Adrian added. â€Å"So this better be good.† â€Å"I don't know if it'll be good,† I mused. The elevator doors opened. â€Å"But I think it'll be memorable.† We stepped inside, off to see Robert Doru. And what might be Dimitri's only salvation.

Factors Affecting Fermentation of Glucose by Yeast

Fermentation is anaerobic respiration whereby food is altered into more simple compounds and energy in the form of chemicals is produced, an example being adenosine triphosphate (biology-online. org/dictionary/Fermentation). All this occurs with the lack of atmospheric oxygen. At the end of the day alcohol and carbon dioxide are the end products when yeast is used in the fermentation procedure. But end products like acetic acid or lactic acid can also be gained depending on the circumstances. The salinity, air conditions, temperature, pH of the system, the enzyme systems of microorganisms, and the type of sugars being fermented can show a variety in the type of end products produced. In this study the tube with the highest amount of chlorine is added, an increase in the rate of fermentation should be observed. Methods and Materials: 100ml of the stock solution of 10% glucose was placed into four separate beakers. Each beaker was labeled â€Å"1 (control),† â€Å"2 (5 drops),† â€Å"3 (10 drops),† and â€Å"4 (15 drops)†. Five drops of 6% sodium hypochlorite was added to beaker #2, 10 drops to beaker #3, and 15 drops to beaker #4. The contents of the yeast suspension were then stirred thoroughly to be sure the yeast cells were suspended and not settled at the bottom and to each solution 50ml of the yeast suspension was added. The contents of each beaker were stirred with a glass stirring rod to mix the solutions thoroughly. Each of the four fermentation tube bowls were filled with one of the solutions and the tubes were tilted so that the vertical arm was full, but the bowl was nearly empty. Each fermentation tube was labeled in order to indicate its contents. The tubes were placed in a warm place (in an incubator or near a heat lamp). Every 10 minutes for 90 minutes a measurement was made and the amount of gas produced in each of the four fermentation tubes was recorded and graphed. Results: Figure 1 As shown in figure 1, this study revealed that when chlorine was added there was a decline in the fermentation tubes excluding group â€Å"two,† the five drop tube. Therefore this observation concluded that when there’s a large amount of chlorine the fermentation rate slowed down. But when there was a little amount of chlorine there was increase in the rate of fermentation. An average of about 15 additional minutes were spared in order to equal the amount of fermentation in the control tube and five drop tube when large amounts of chlorine were evident. Discussion: All four beakers were evaporated by the 60 minute mark. The solution with five drops was the first to completely evaporate, following with the control group, the 10 drops and finally the 15 drops. No real conclusions could be drawn from this study because of the order in which the evaporation was completed. This lab also generates questions that could not have been asked before the lab. Why do some fermentation tubes have all their solution evaporate and not others? What would have happened if more yeast solution were added to the fermentation tubes? With the information discovered, experimenters know some of the different factors affecting fermentation of glucose by yeast. This information will help alcoholic fermentation in the wine and beer industries.

Writing Resources for Teenagers

Writing Resources for Teenagers Writing Resources for Teenagers Writing Resources for Teenagers By Ali Hale I know from the comments that lots of teens read Daily Writing Tips, and as a former teenage writer myself, I wanted to offer some of my tips and favourite resources. I’ve been telling stories for as long as I can remember – even before I could write, I made up stories to tell to my mum and baby brother. As a teen, I wrote a science-fiction novella (about 40,000 words) aged 14/15. I still have it tucked away in a wardrobe in my parent’s house. Here’s some of the advice I could have done with back then (I’m going to be focusing on teen fiction writers here, but you’ll find some useful links if you’re a blogger or non-fiction writer too. A lot of the sites referenced are great for under-13s too, and plenty of the good writing advice applies to adults, not just teens!) Ali’s tips Before I get to the list of resources, I’ll give you three quick tips that helped me as a teen writer. 1. Join a writers’ circle or evening class – I started going to one when I was 14 and stayed until I left for university aged 18. I was the youngest member by a long way, but I was made very welcome and I learnt a huge amount. 2. Write every day – I used to scribble away in the school library in my lunch-hour, and my parents gave me a word processor (more like a glorified typewriter than a computer) when I was 15. (Aged 16, I discovered an online writing game, and the rest of my writing all but stopped for two years†¦) 3. â€Å"Borrow† plots from classics – The first stories I wrote that I was happy with, aged 12, were based on Beowulf (see a study guide for this book here) and the Ballad of Semmerwater (both of which we were studying in English class). Young Writer Magazine I used to read this when I was about 12, and then it stopped being published for years. It’s being published regularly again (hurrah!) though a bit late for me. It caters for writers under 18, and publishes children’s and teens’ fiction and poetry. You might have trouble finding it on the magazine racks if you’re outside the UK, but you can subscribe on the Young Writer website, wherever you live in the world. (I also recommend reading general writing magazines aimed at adults – these will have plenty of articles aimed at beginners, and give you a real sense of the publishing industry.) Competitions Open to Teens One of my real frustrations as a teen writer was that Writing Magazine’s competitions were only open if you were 16+ (due to awarding cash prizes). Happily, there are lots of teen-specific writing competitions. Here’s just a couple of them: TooWrite (run by Young Writer) which is open to writers aged 16 and under, of any nationality. The prizes on offer are great, too; your height in books if you’re under 10, the length of your foot in CDs if you’re 11-13, and your age in number of DVDs if you’re 14-16. The Green Story Teen Version (Link no longer active) – This is a competition where you can submit a chapter of a collaborative novel. The chapters get voted on and the best one becomes part of the novel. If you google writing competitions, youll find plenty of links and keep an eye out on noticeboards at school, in bookstores or at public libraries for local competitions. Online Articles Over the past few years, I’ve come across some excellent online articles aimed at teen writers. Here’s a few that I recommend reading: From Vision: A Resource for Writers: Being a Teenage Writer – by Lorianne Watts (aged 17 at the time she wrote the article). Five Practical Tips for Young Writers – by Beth Adele Long, the associate editor of Young Writer’s Scene. (NB: something is wrong with the formatting of this one; if you copy-and-paste the whole thing into Word, it’s readable!) Helping Younger Writers by Lazette Gifford, the editor of Vision. Aimed at adults who want to help younger writers, but give it a read if you’re a teen too. Starting Out: A Guide for Young Writers by Victoria Hastings (who had her first newspaper publication when she was in the fifth grade). Articles from elsewhere: Guidelines for Teen ProBloggers – from ProBlogger. Great advice if you want to get into professional (i.e. money-making!) blogging. Tips for Young Writers – from Zoe Marriott (who writes for a young adult audience). She answers several reader questions here. 10 Things Teenage Writesr Should Know About Writing – very honest advice, humorously offered. I wish I’d read this when I was fourteen†¦! Recommended books Try borrowing, begging or buying copies of a few good books on writing. These tend to be aimed at adult (or college student) writers, but the advice is usually straightforward and perfectly suitable for beginners. Two of the books I’ve found very useful are: Nigel Watts’ Teach Yourself: Writing A Novel And Getting Published – I’ve had my copy since I was 14 (I still remember buying it with my birthday money in 1999) The cover’s almost fallen off now, which shows how useful it’s been over the years! Palgrave’s How to Write Fiction (And Think About it). This is aimed at students, and goes into a lot of depth and theory about fiction writing – but I’d suggest giving it a go anyway. If you’re an intelligent teen, you can handle it. Your school librarian may be able to recommend some good books, and if you know any adult writers, try asking them. NaNoWriMo I’ll end this article by pointing you towards NaNoWriMo (National Novel Writing Month), which starts on November 1st. Challenge yourself to write a 50,000 word novel in just one month – hundreds of thousands of people get involved every November, and there’s a dedicated Young Writers’ program for kids and teens (where you set your own target number of words). If you’re aged 13 – 17, you can sign up for the Young Writers’ program or the main site. It would be fantastic to hear from some of Daily Writing Tips’s teen writers – we know you’re out there! What are you working on at the moment? Do you write fiction, a blog, or something else entirely? What do you find best and worst about being a teen writer? Want to improve your English in five minutes a day? Get a subscription and start receiving our writing tips and exercises daily! Keep learning! Browse the Fiction Writing category, check our popular posts, or choose a related post below:Direct and Indirect ObjectsLoan, Lend, Loaned, LentKn- Words in English

Free Essays on “Rape Fantasies” vs. “Looking at Woman”

â€Å"Rape Fantasies† vs. â€Å"Looking at Woman† The following essay goes in depth about the concern for female power and if females even have any power over males. â€Å"Rape Fantasies† is written in a woman’s perspective and â€Å"Looking at Woman† is written in a male’s perspective. As you continue to read this essay you will see the differences that men and woman share, and how the authors differ when talking about the roles of woman today. â€Å"Rape Fantasies† is an essay where a woman named Estelle is the narrator and she speaks to the reader about her life and her own rape fantasies. The fantasies are not so much rape fantasies, but fantasies of meeting different people in the wrong way. Estelle befriends the rapists and has conversations with them and this is her way of meeting different people. Estelle narrates this essay. She is at work with her co-workers and is listening to each one of them tell their rape fantasy stories and then goes on to tell hers too. At this point when she is telling hers, it is Friday night and she is at a bar with a complete stranger. Estelle is in her mid-thirties, roughly, and seems to have a dull, boring job. Due to the lack of excitement at her job, she creates these fantasies about men entering her life and wanting to have sex with her, but she always end up feeling sorry for that person in each fantasy. One has an acne problem and she wants to give him the name of her dermatologist and the other has a cold and she offers him some Kleenex and he ends up staying the night with her. These fantasies are created by her need to be with someone and not to be lonely. When Estelle enters the bar on a Friday night she sits at a table and begins talking about her rape fantasies with a random stranger that she meets. She reveals a lot about her self to this complete stranger and I believe that she is trying to fulfill one of her fantasies with this man. Estelle wants to have someone in... Free Essays on â€Å"Rape Fantasies† vs. â€Å"Looking at Woman† Free Essays on â€Å"Rape Fantasies† vs. â€Å"Looking at Woman† â€Å"Rape Fantasies† vs. â€Å"Looking at Woman† The following essay goes in depth about the concern for female power and if females even have any power over males. â€Å"Rape Fantasies† is written in a woman’s perspective and â€Å"Looking at Woman† is written in a male’s perspective. As you continue to read this essay you will see the differences that men and woman share, and how the authors differ when talking about the roles of woman today. â€Å"Rape Fantasies† is an essay where a woman named Estelle is the narrator and she speaks to the reader about her life and her own rape fantasies. The fantasies are not so much rape fantasies, but fantasies of meeting different people in the wrong way. Estelle befriends the rapists and has conversations with them and this is her way of meeting different people. Estelle narrates this essay. She is at work with her co-workers and is listening to each one of them tell their rape fantasy stories and then goes on to tell hers too. At this point when she is telling hers, it is Friday night and she is at a bar with a complete stranger. Estelle is in her mid-thirties, roughly, and seems to have a dull, boring job. Due to the lack of excitement at her job, she creates these fantasies about men entering her life and wanting to have sex with her, but she always end up feeling sorry for that person in each fantasy. One has an acne problem and she wants to give him the name of her dermatologist and the other has a cold and she offers him some Kleenex and he ends up staying the night with her. These fantasies are created by her need to be with someone and not to be lonely. When Estelle enters the bar on a Friday night she sits at a table and begins talking about her rape fantasies with a random stranger that she meets. She reveals a lot about he rself to this complete stranger and I believe that she is trying to fulfill one of her fantasies with this man. Estelle wants to have someone in...

What Should You Do If You Have a C Average GPA

What Should You Do If You Have a C Average GPA SAT / ACT Prep Online Guides and Tips If your grades have been on the lower side in high school, you might be wondering what steps you can take to improve your situation before you appy to college. With a C average, you may run into some trouble in the application process, so you should start taking measures to mitigate these problems now. In this article, I'll go over what a C average means for you and how you can make smart changes to your academic strategies to end up with better prospects for college. What’s a C Average GPA, and How Will It Affect Your Chances for College? If you have a C average, your GPA is a 2.0.This is significantly below the average for high school students, which is a 3.0 or a B average.A GPA that's this low will put you in jeopardy when it comes to college admissions.There are only a couple of schools where your current GPA would make you a competitive applicant. If you’re still an underclassman, you may be able to improve your grades enough to have a better chance at college by the time you apply to college your senior year.If you’re an upperclassman, you're in a more difficult position, but don’t freak out yet!There are a couple of measures you can take to mitigate the impact of a low GPA on your admissions prospects.In the next section, I’ll go over different ways you can improve your chances of college admission based on where you are in your high school career. How Can You Improve Your Chances for College Admission With a C Average GPA? As a freshman or sophomore, there are steps you can take to end up with a better GPA by the time you apply to college.Here are some tips that may get you on the right track: Ask for Extra Help and Extra Credit You need to be proactive about getting help if you’re stuck at a C average. If you’re struggling in any of your classes, let your teacher know as soon as possible.Most teachers will be happy to answer any questions you have about the subject and explain things in a way that’s easier for you to understand. It can be helpful to prepare a list of questions that you have or problems you'd like to go over before you meet with your teacher. This way, you'll be getting the most out of the session. Sometimes all it takes is a slightly different explanation to give you that flash of total understanding.If you clear up these comprehension issues as soon as they emerge, you will do better on tests later. Extra credit is another avenue to consider if you're hoping to improve your grades dramatically. Of course, not all teachers offer extra credit, but if you have the opportunity to earn it, don't hesitate! Even if you don't think you can get extra credit on an assignment, you should ask your teacher about it. I know this feels like you're sucking up, but it will end up being worth it if you can improve your grade by a significant number of points. Learn More Effective Study Habits With a C average, you almost certainly have some fundamental problems in your study methods. It’s important that you’re getting the most out of the time you spend studying.If you’re just reading over the material you need to know, you might not be retaining it in your mind.When you read something over, look away and repeat it to yourself in your head before moving on to make sure you really know it.You should also ask a friend, parent, or sibling to test you after every study session to verify that you’ve learned the information. You may need to extend your study time significantly in order to ensure that you have solid knowledge of the material. In your position, you should also avoid cramming for tests. For a big test, plan out your studying a week in advance so that you can study for an hour a night rather than five hours the night before. You’re more likely to retain information if you learn it gradually over time rather than trying to stuff it in your brain all at once.This will lead to much less stress on test days. Don't try to fit too many knowledge apples in your short term memory basket at once. Some of them are going to fall out! If you fill up the basket gradually, you will digest some of the apples and store them in your deeper long term memory. You'll end up with a manageable basket by the time the test comes around. Avoid Procrastination and Stay Organized As a student with a low GPA, procrastination is your worst enemy.If you have a long-term assignment that’s due in a month or two, you should make a timeline for when you need to finish different components of the project.Aim to complete the most time-consuming parts of the project a week in advance of the due date.This way, you’ll have time to polish your work before you turn it in. You'll also have time to read and reread the directions to ensure that you've included all the right components and have finished them to the best of your ability. An â€Å"editing phase† like this can be the difference between a C quality project and a B or even A quality project. It's also important that you develop strong overall organizational skills so you can stay on top of both short and long term assignments. Make sure that you always mark the start of a new unit in your notebooks so you can easily refer back to the material when you study for tests. You should also have a folder for each class where you can store important papers. Don't just throw them into your backpack and expect to find them later (trust me, I've been there). Get into the habit of writing down your assignments every night in an agenda book so you don't forget about anything. Even if you don't have homework for a certain class, write down anything that you could do to prepare for future assessments. For example, you might decide to review what you've learned over the past week in your math class if you haven't been assigned any problem sets for one night. Extra math!!!!! Woohooooooo!!! Pay Close Attention in Class Being mentally present in your classes is critical if you want to improve your grades. If you listen to your teacher’s lectures and ask questions when you don’t understand something, you will have a much easier time studying for tests later.You’ll find that you already know some of the material just by following along diligently in class. To facilitate this behavior, you should avoid looking at your phone or getting sidetracked by other distractions. The best way to force yourself to commit to this is to sit near the front of the class so you're always held accountable by the teacher. You should shut off your phone in class (or better yet, don't bring it with you at all) so that you're not tempted to check it. For more advice, read my article on how to raise your GPA in high school.Even if you only manage to raise your GPA slightly (say, up to a 2.5 instead of a 2.0), you’ll be a competitive applicant at many more colleges.Don’t let your GPA slip any further! A 2.0 is essentially the lowest high school GPA you can have if you hope to attend a four year college.If you drop down to a 1.8, you won’t be up to the minimum GPA standards at any schools.I only say this to motivate you; as an underclassman you still have time to do much better in your classes if you put in some serious effort! Time to get as serious as this serious(ly cute) cat. If you’re a junior or senior, you unfortunately don’t have much time left to improve your grades.In this case, you should focus on other aspects of your application that can have a positive impact on your chances of admission. Here are some measures you can take to give yourself the best shot at attending college: Work on Improving Your Standardized Test Scores Your SAT and ACT scores will play a significant part in most admissions decisions. At many schools, test scores are given relatively equal weight to GPA in the admissions process.This means that you can greatly improve your chances of attending a four year college if you raise your scores.We have written a ton of articles on our blog about strategies for improving your scores on both the SAT and the ACT.Please use them as a resource! Write a GreatCollege Essay Your college essay is a chance for you to showcase what makes you unique as a student and as a person.Colleges are looking for high achieving students, but they’re also looking for students who will bring enthusiasm and passion for both academic subjects and extracurricular activities to their campuses.Think about the ways in which you will make a positive contribution to the community in college.What makes you special? What are you enthusiastic about?This is information that can help you to stand out in the pool of applicants despite a low GPA. What makes you unique? Try to write an essay that will help you to stand out from the crowd. What Are Your Options for College If Your Grades Don’t Change? With a GPA that’s this low, you will have trouble getting into most colleges.Like I said in the previous section, raising your test scores and writing a great essay can help your chances.However, you’ll still only be looking at the least selective schools. If you still have a shot at raising your GPA, you should start working towards that goal sooner rather than later! You also have the option of going to a community college for your first year of undergrad and then transferring out to a more selective four year college.This can be a really great option if you have a low GPA in high school, but you have to be willing to work hard during your first year of college.If you can commit to that and to going through the transfer application process, this approach will save you tuition money, AND you will end up with a degree from a more competitive college that might not have accepted you right out of high school. Conclusion If you have a C average in high school, you may have a tough time getting into college.A C average translates into a 2.0 GPA, which is far below the national average of a 3.0 for high school students.If you’re a freshman or sophomore, you still have time left to raise your GPA before you apply to college.It’s important that you start adopting better study habits as soon as possible. If you take initiative, you may be able to improve your grades significantly and have a much better chance at attending a four year college. If you’re a junior or senior, it might be too late to raise your GPA. In this case, you should work on improving your standardized test scores and writing the best application essays possible.In the end, if you’re stuck with a C average, you can try applying to some of the least selective four-year colleges or go to community college for your first year of undergrad and then transfer to a more competitive school. Even though your grades are lower than average, you still have a shot at obtaining a good college education.You may be able to make changes before you apply that will dramatically improve your chances of admission.Don’t get discouraged! What's Next? If you're working on improving your standardized test scores, read these articles to learn some great study strategies for SAT Reading, Math, and Writing. Wondering how much a significant improvement in your grades next year impact your chances for college? Find out which year of high school is most important to colleges in assessing your academic performance. If you're still working on planning out your schedule for the rest of high school, this guide will help you figure out the best way to navigate those decisions. Want to improve your SAT score by 160 points or your ACT score by 4 points? We've written a guide for each test about the top 5 strategies you must be using to have a shot at improving your score. Download it for free now:

Author decide Essay Example | Topics and Well Written Essays - 2750 words

Author decide - Essay Example They include (taken randomly) the agenda setting theory, classic rhetoric, hypodermic needle theory, face negotiation theory, cognitive dissonance theory, and uncertainty reduction theory. This random list was provided to illustrate the seriousness and earnestness by which communication is seen by scholars and scientists. Another line of thought that emerged with regard to communication and culture was the Frankfurt School during the 1930s primarily through scholars associated with the Institute for Social Research in Frankfurt, Germany. This paper is a study on communication theories with special relevance of the Frankfurt School of thought in modern day capitalistic structure. The one term that comes to mind regarding language is glottogony. Campbell and Mixco, in their book A glossary of historical linguistics define the term as â€Å"the emergence (origin) of human language, the study of the origin and earliest development of human language, the name for a kind of linguistics concerned with the origin and evolution of language† (Campbell & Mixco 72). There is no clear evidence as to when language evolved. It is believed that communication started with guttural sounds and actions or pantomimes which later led to the development of a pidgin language. According to Ellis, â€Å"when a pidgin language becomes more accepted and standardized, when it becomes the native language of a generation of children, then it is called a Creole† (Ellis 149). Language further developed with structure and grammar and came to be referred to as prestigious forms of speaking, for example the English language. As mentioned earlier, both humans and species in the a nimal kingdom communicate. In the latter case, communication is primarily through sounds (including variations in pitch) and actions. The monkey watchman on the tree top will cry in alarm at the approach of the predator.

Personality Disorders Essay Example | Topics and Well Written Essays - 750 words

Personality Disorders - Essay Example The paper reviews how chaotic lifestyles coupled with chronic life interruptions, frayed identities, and fractured support systems influence characteristics of individuals suffering from personality disorders. Not everyone finds it easy to relate with others according to the society’s expectations. In a manual by the American Psychiatric Association (2000), such manifested deviance is referred to as a personality disorder. An individual may find him or herself incapable of relating with others in conformity with accepted societal modes. Mental health disorders are categorized using a multidimensional approach envisaged in the diagnostic and statistical manual of mental health disorders by assessing clinical syndromes, developmental and personality disorders, physical conditions, psychosocial sensors, and highest level of functioning. Psychology professionals often encounter various challenges in assigning accurate diagnoses of personality disorders due to the complexity of diagnosis. In the said case study, the patient does not recognize that he has a personality disorder. Judging from the age of his mother, he is a middle aged man who feels no need to associate with other human be ings and spends his time playing video games. As described by American Psychiatric Association (2000), the first axis offers descriptions of clinical symptoms that cause considerable consequences in the client’s behavior and personality. The disorders are categorized into disorders of adjustment, anxiety and pervasive development. The case study patient seems to be suffering from adjustment disorders with depressed moods. The patient, who is in his middle age, seems to suffer from the effects of his father refusing him playtime with his age mates when he was a boy. He recalls instances of his father chasing away his playmates and cites this as reason why he stays indoors playing

U02d2 The Uninsured Problem Essay Example | Topics and Well Written Essays - 500 words

U02d2 The Uninsured Problem - Essay Example It was noted that this number increased to 255.1 million in 2008, when compared to 253.4 million in 2007 (U.S. Census Bureau, 2010). c) The year has also shown the decline in use of private health insurances. It was noted that the health insurance from private providers has reduced from 202.0 million in 2007 to 201.0 million in 2008 (U.S. Census Bureau, 2010). d) The government health insurance saw a higher level of applicants and people have turned more towards the government insurance than the private. The year 2007 saw a total of 83.0 million while this increased to 87.4 million in 2008 (U.S. Census Bureau, 2010). e) As mentioned earlier the private insurances reduced a great extent. In 2007 the total percentage of people covered by the private insurances was around 67.5% which reduced to 66.7% in 2008 (U.S. Census Bureau, 2010). f) The employment based health insurances also saw a decline and it fell from 59.3% in 2007 to 58.5% in 2008. The number of people covered by health insurance for employment bases also decreased from 177.4 million in 2007 to 176.3 million in 2008 (U.S. Census Bureau, 2010). CNN has also presented a report which talks of the issue of uninsured. Here in an interview with Ron Pollack, the Executive Director of Families USA, stated, ‘The huge number of people without health coverage is worse than an epidemic’. He also went on to explain, ‘Inaction on health care reform in 2009 cannot be an option for the tens of millions of people who lack or lose health coverage each year ... the cost of doing nothing is too high’ (Pifer-Bixler, 2009). The report has also brought out more details of the issue of being uninsured. The report also states that, ‘Critics say the number of uninsured Americans cited in the Families USA report is misleading. "No one disagrees we have a problem with the uninsured," says Douglas Holtz-Eakin, who advised Sen. John McCain on domestic and economic policy during the 2008 election’

Bioenergy Term Paper Example | Topics and Well Written Essays - 750 words

Bioenergy - Term Paper Example When forests are managed sustainably, their biodiversity, vitality, productivity, and capacity to regenerate both at present and in the future is conserved. As a result, the forests maintain their capacity to perform social, economic, ecologic functions without interfering with other ecosystems negatively at the local, national and global levels. There are several challenges to sustainable use of forest-derived bioenergy sources including the land-use conflict and land availability in many areas (Oko Institut 10). When selective logging is done at a rate that is sustainable, the forest is bound to be conserved. By adopting Reduced Impact Logging (RIL) practices such as establishing buffer zones along watersheds and streams, applying modern technologies to mitigate effects of log extraction and careful planning of the forest to prevent forest encroachment by humans, the productivity of the forest will be sustained according to CBD (Oko Institut, 8). Even as forest resources are harves ted, the way they are used determines the how much sustainable the resources will last. Wood products can be recycled to reduce the rate at which forests are harvested. Furthermore, when agro-forest bi-products and residues such as leaves, husks, shells, and straw are used in producing energy, the rate at which felling of trees is done can be greatly reduced. Developing countries have a lot of forest resources compared to developed countries according to Tomaselli (V). In this respect, the capacity of developing nations to produce high amounts of bioenergy compared to developed countries. However, with respect to sustainability, the developing countries have a long way to go. This is so considering that the policies instituted by their governments with an aim of making sustainable development are never well implemented. Furthermore, the technologies that they commonly use in the production and application of the energies are less efficient. In overall, both developed and underdevelo ped countries have a huge capacity to increase their share of forest bioenergy production, the former having the need to capitalize on the technological advantage that they have. 2. Realizing the potential a. Compare and contrast developed and less developed countries with respect to the potential for increasing the share of energy supplied by forest resources. Both developed and developing countries to some extent depend on forest resources to provide energy used in industries and for domestic purposes. However, forest resources can easily get depleted when used in a manner that is unsustainable whether in developed or underdeveloped countries. Forest derived bio-energy in most places is used in the form of fuel wood or charcoal. In developed countries, using biofuels including those from forests has often been considered old fashioned, its share in the national economy grossly declining until the period succeeding the oil crisis that hit the world in the 1970s. However, production of this kind of energy has been on the steady rise following growing concerns related to climate change, and the development of new biomass technologies among other factors. Following several studies conducted on the potential of bioenergy on a global scale taking into consideration population, yield and agricultural factors, it has been realized Africa and

Summary Essay Example | Topics and Well Written Essays - 500 words - 124

Summary - Essay Example The banker contradicts the peasant’s judgment on the state, he or she judges the government based on a future goal that it works towards realizing. Economics manipulates and dictate the political behavior. Administrations lose supporters in seasons of hard times while a massive gain of the supporters seen in good times. The two models involving both retrospective and prospective of the index of consumer sentiment as contradicting variables between economic conditions and approval, it is found out that the probable component adequately accounts for the presidential approval time series. The next article voting successfully addresses an average voter as one who falls far short of the prescriptions of classic autonomous hypothesis in terms of interest, facts, and participation in politics. The authors suggest a more realistic standard involving the citizens fulfilling their democratic duties by voting correctly. Five decades of behavioral research in political science reveals that only a tiny marginal of the citizens in any democracy live up to the lines and goals of democracy. Interests in politics become generally weak, political discussions limited and political knowledge is diminishing. The result leads to the majority of American citizens not participating actively in politics beyond voting. The determination of voters on their correct vote choices can be predicted reasonably well using the widely available survey data. The authors illustrate how the prediction can help in determining the proportion of the voters voting correctly, which they calculate at about 7 5 percent for the five US presidential elections between 1972 and 1988. The third article is a decisive study of voting in America and talks about the American voter. Michigan model is a theory formulated on voter choice. Based on all-inclusive studies of election study data in America, most voters cast their ballots

Bioenergy Term Paper Example | Topics and Well Written Essays - 750 words

Bioenergy - Term Paper Example When forests are managed sustainably, their biodiversity, vitality, productivity, and capacity to regenerate both at present and in the future is conserved. As a result, the forests maintain their capacity to perform social, economic, ecologic functions without interfering with other ecosystems negatively at the local, national and global levels. There are several challenges to sustainable use of forest-derived bioenergy sources including the land-use conflict and land availability in many areas (Oko Institut 10). When selective logging is done at a rate that is sustainable, the forest is bound to be conserved. By adopting Reduced Impact Logging (RIL) practices such as establishing buffer zones along watersheds and streams, applying modern technologies to mitigate effects of log extraction and careful planning of the forest to prevent forest encroachment by humans, the productivity of the forest will be sustained according to CBD (Oko Institut, 8). Even as forest resources are harves ted, the way they are used determines the how much sustainable the resources will last. Wood products can be recycled to reduce the rate at which forests are harvested. Furthermore, when agro-forest bi-products and residues such as leaves, husks, shells, and straw are used in producing energy, the rate at which felling of trees is done can be greatly reduced. Developing countries have a lot of forest resources compared to developed countries according to Tomaselli (V). In this respect, the capacity of developing nations to produce high amounts of bioenergy compared to developed countries. However, with respect to sustainability, the developing countries have a long way to go. This is so considering that the policies instituted by their governments with an aim of making sustainable development are never well implemented. Furthermore, the technologies that they commonly use in the production and application of the energies are less efficient. In overall, both developed and underdevelo ped countries have a huge capacity to increase their share of forest bioenergy production, the former having the need to capitalize on the technological advantage that they have. 2. Realizing the potential a. Compare and contrast developed and less developed countries with respect to the potential for increasing the share of energy supplied by forest resources. Both developed and developing countries to some extent depend on forest resources to provide energy used in industries and for domestic purposes. However, forest resources can easily get depleted when used in a manner that is unsustainable whether in developed or underdeveloped countries. Forest derived bio-energy in most places is used in the form of fuel wood or charcoal. In developed countries, using biofuels including those from forests has often been considered old fashioned, its share in the national economy grossly declining until the period succeeding the oil crisis that hit the world in the 1970s. However, production of this kind of energy has been on the steady rise following growing concerns related to climate change, and the development of new biomass technologies among other factors. Following several studies conducted on the potential of bioenergy on a global scale taking into consideration population, yield and agricultural factors, it has been realized Africa and

Internet in Organizations Essay Example | Topics and Well Written Essays - 1000 words

Internet in Organizations - Essay Example Providing quality is arguably the most important quality of the internet. There is cut throat competition all across the globe and companies can access pivotal information of other rival companies and they can benefit from the same. All the required information is available on the internet, for instance the internet offers access to various libraries and other good resources, the financial information can easily be retrieved of any company by making use of this wonderful technology. Websites like Google, Yahoo have become global leaders in helping shape up business ideas. There are several professional software like Tally etc that specialize in easy business transactions. Tally has become very popular and it is capable of doing multi tasking. It is the best software to record business transactions. Internet is without a doubt a very big boon to the society, it is extremely efficient in getting information about the demographics of various potential customers. This data is very handy and it further helps in the growth of the business. The internet is capable of displaying precise results for queries within a few seconds and its speed is probably the most outstanding factor. Dial up is preferred in a company that has several employees working in different geographical locations. There are several benefits that can be derived when an organization tends to choose the internet for the growth of the business that they are engaging in. The information transmitted when a business activity takes place, takes a lot of time to reach the concerned people, when the use of internet takes place in the same process, the process gets completed much faster. For instance, transferring the invoices, shipping notifications takes a lot of time but the same can be done with the help of the internet within seconds. Internet has rejuvenated information management, the important e-mails and other files can be transferred at a lightning speed and the same saves a lot of time of the organization, providing them with an opportunity to utili ze the same time elsewhere creatively. Dependability The internet is an extremely dependable technology; it enables organizations to avoid various errors which would have been inevitably made had this technology not had a major influence. The internet is made use of to develop better user interface that help the organizations in expanding. It is capable of coping with unexpected uncertainties like data loss etc. It is extremely beneficial in minimizing the uncertainties so that future of the organizations using this technology becomes bright. The various data protection software offered by the internet ensures the safety of the organization and enables the growth in the organization. From the points mentioned it is well understood that internet is extremely dependa

The Hobby of Running Essay Example for Free

The Hobby of Running Essay Running as a hobby is recommended because it is beneficial in helping to improve health, helps you to meet new people and is versatile and relatively inexpensive. Running is also a useful tool in reducing stress and provides other psychological benefits. Running is a relatively easy hobby to take up. Running requires no new skills. You can begin running at any age with many people over 40 taking their first running steps as they embark on the path to health and a new and exciting hobby. The cost to start running is low requiring only a good pair of running shoes and a supportive sports bra for women. No expensive equipment or gym membership is required to be a runner. You can run anywhere virtually year round. You can run almost any time of day or night that suits your preference. There are many social benefits from running. You can join a running club to meet new people, find a training partner, or simply to pick up running tips from others. Running with a buddy can help strengthen the bond of friendship as well as provide the safety aspect of running in pairs. If one runner gets sick or injured the second runner can assist. An attacker will be less likely to attack a pair of runners or a group of runners than a person running solo. Running clubs often host social runs and also serve as a team cheering squad during long runs. There are fundraising training groups such as the Arthritis Foundations Joints in Motion Training Team or the Leukemia and Lymphoma Societys Team In Training, which will train you to run a half or full marathon in exchange for fundraising efforts. Many organized races are fundraising events for local organizations such as schools and churches and national organizations such as Ronald McDonald House Charities, Scottish Rite Hospital for Children and Team RWB supporting America’s veterans. Not only will you be helping yourself with the gift of health but you will be supporting a great cause and helping others along the way with a portion of your entry fees being used for these charitable causes. Running for leisure can help you to improve your health in many ways. It reduces the risk of heart attack by lowering your blood pressure and raising good cholesterol. Running helps reduce the risk for osteoarthritis because it is considered to be a weight bearing exercise which helps to increase bone density. Recent studies also show that it also helps in the fight against osteoarthritis because it helps increase oxygen flow and flushes toxins out of the body. It is believed that the impact of running generates eight times your body weight as an impact on your joints and this is thought to increase the production of proteins in cartilage that makes your bones and joints stronger (Thomas, 2013). Running is a great method for helping you to lose weight or maintain a healthy weight. Running helps burn calories in two ways; calorie expenditure during and immediately following the run and by building muscle. The calorie burn from running is approximately 600 calories per hour based on a six mile run at 10 minutes per mile. To calculate the total calorie burn for running use a calculation method of . 75 x your weight in pounds (lbs. ) (Burfoot, 2005) . Muscle built and maintained by running also helps in all day calorie burn. Muscle burns calories and fat does not therefore the more muscle mass you build the higher your metabolism will be and the more calories you will burn even at rest. Running is a great way to relieve stress and has been used by mental health experts to treat depression and addiction. Running for 20 to 30 minutes releases endorphins leading to a relaxed and peaceful feeling. Longer distance running increases the release of endorphins and can lead to what is known as the â€Å"runner’s high†, a feeling of euphoria which is also often associated with completing an endurance event such as a half or full marathon. Running allows you to use the time on the trail to clear your head and think about issues that you are struggling with. Often times the problems that seemed daunting before a run can seem smaller or non-existent afterwards. Speed running or completing a few sprints are healthy ways to release the emotional negativity that comes with anger and frustration as long as it is done safely. The positive energy from overcoming obstacles of completing a run in a certain amount of time or meeting the goal of completing a distance run can provide mental benefits of helping you to learn about your personal strength and mental focus. This new found self-confidence and knowledge about yourself can also be transferred to other areas of your life and help you cope with issues in a healthy way. Whether you are running to lose weight, running alone or with a group, running away from stress, no matter the reason, the road to better health begins when you decide to lace up a pair of shoes and put on foot in front of the other.

Potentially Inappropriate Medication at a Private Hospital

Potentially Inappropriate Medication at a Private Hospital Abstract The use of certain medications in geriatrics when potential risks outweigh the potential benefit and an effective alternative is available is called as Potentially Inappropriate medication. Because geriatrics are more sensitive towards adverse effects of medications. Beers criteria which is updated and reviewed by American Geriatric society list out 53 medications/therapeutic classes of drugs to be avoided in geriatrics. Methodology: A prospective observational study was conducted for 9 months in a 650 bed private corporate hospital, South India. All geriatric patients admitted in the hospital during the study period was included. Beers Criteria 2013 were used to identify potentially inappropriate medications. Result: The prevalence of PIM use (52%) was significantly higher in study population. An avg of 10 drugs were taken by the study population. A total of 215 medications were identified as PIMs. Among them 195(90%) medications should be avoided by the geriatrics independent of th eir condition (category I). 66(60%) of the study population had used more than one PIMs. 91(83%) of the PIM users had atleast one DRPs and the mean DRPs value of the PIM users were 1.59à ¯Ã¢â‚¬Å¡Ã‚ ±1.3. Conclusion: High prevalence of PIMs in the study population signifies the need of monitoring geriatric prescriptions. Key words: PIMs, Beers Criteria, Geriatrics Introduction In recent years proportion of geriatric hospital admission with comorbidity and polypharmacy has been increasing continuously (1, 2). Adverse drug events (ADRs) are the most common reason for hospital admission, but sometimes it’s not identified. Medication errors (MEs) or conventional adverse drug reactions (ADRs) are the common reason for adverse drug events which ends in clinical symptoms. Overall, elderly patients need greater attention to drug therapy and safety parameters (1, 3-5). Greater attention is needed for geriatric population due to age related pharmacodynamics and pharmacokinetic changes. But appropriate pharmaceutical care for elderly are determined on the basis of clinical trial conducted with adult population.(6) The burden of harm resulting due to the use of multiple drugs in geriatric populations is a major health related problem in developed countries. A research study reveals that around one in four geriatrics admitted to hospitals are prescribed with at least one inappropriate medication and potentially preventable adverse drug reactions accounts for nearly 20% of all inpatient deaths (7). The assessment of potentially inappropriate medication (PIM) in geriatric is a challenging work and there is a need for considering many factors which influences the prescribing as well as outcome. Eight well known tools are available to identify the PIMs and studies reports that Beers criteria is the best and easy one to assess the PIMs. Beers criteria also has the advantage over others because it is periodically updated (8).This study therefore aimed to investigate the prevalence of PIM use on geriatric population using Beers criteria 2012 and its association with Drug Related Problems (DRPs) . Methodology Study Site: The work entitled â€Å"A study on prevalence and impact of Potentially Inappropriate Medication use in geriatrics at a private corporate hospital† was carried out in a 640 bedded private corporate hospital, South India. Study Design: Prospective –Observational study. Study Period: Nine months. Inclusion criteria: Patients above age of 65 yrs. Exclusion criteria: The patients who are unwilling to participate in the study and out patients METHOD: A regular ward rounds was carried out in all the wards of General medicine. Each patient’s medication profile was reviewed. Patients who met the inclusion criteria were briefed on the project with the help of patient information form and if they are willing to participate in the study their consent was obtained. The data from medical chart were recorded in customized data entry form. The prescribed drugs were evaluated and PIMs use were identified with the help of Beer’s criteria. The drugs which are identified as PIM are categorized into following: Potentially inappropriate medications /classes to avoid in geriatrics, Potentially inappropriate medications /classes to avoid in geriatrics with certain pathological condition that the listed PIM use can exacerbate Medications to be used with caution in geriatrics. ADRs associated with PIMs use were assessed. Drug interaction and ADR was monitored and reported. DRPs and Drug Risk Ratio (DRR) were calculated for PIMs. DRPs were the sum of ADR, drug interaction and drug allergy.DRR was calculated as the number of DRPs in relation to how often the drug was used (DRPS/number of times used). Results and Discussion In the study period, 212 patients were included in the study as per inclusion criteria and exclusion criteria. 110 (52%) patients were found to be prescribed with PIMs listed in Beers criteria (fig no: 01). A similar study conducted by Birader K et al (2013) (9) reported that PIM prevalence were 38% in their study population. Increased anxiolytics use as a prophylaxis for hospital related anxiety might be the reason for high prevalence of PIM than the later study. The total number of patients in study population were 110. Among them 62(56%) were males and 48(44%) were females.The study result reveals that PIMs user are mostly males. A similar study conducted by Birader K et al (2012) (9) reported that prevalence of PIM use is more among males than females. The age categorization of PIM users was done. The maximum age of PIM users was 93 years and mean age of PIM users was found to be 70.2 ±5.77. The median age for PIM users was 68.5 years. The result indicated that age group of (65-69) were commonly prescribed by PIMs. This results compared with a previous study carried out by Birader K et al (2012) (9) which also reports that PIMs were frequently prescribed in the age group of 65-69 years. The social habit of the PIM users shows that 8(7%) patients were smokers and alcoholics, 14(13%) patients were alcoholics, 21(19%) patients were smokers and 67(61%) patients were teetotalers in PIM users. The comorbidities of the PIM users was analyzed. There were 52 (47%) suffering from hypertension and 32(29%) were suffering from DM. The results shows that most of the study group had comorbidities of hypertension followed by DM and CVDs. A similar study conducted by Fouquet A (11) also reported that most common diagnosis among their study population was hypertension and diabetes. The number of drugs prescribed for the PIM users were calculated (fig no: 2). The mean number of drugs per prescription was 9.9 ±2 with the maximum of 16 drugs and minimum of 5 drugs prescribed. The above results signifies that all prescriptions were in polypharmacy category. A similar study conducted by Blozik E (12) concluded that one of the main factor for PIM use is â€Å"polypharmacy†. The number of PIM drugs per prescription in the study population was calculated (Fig no: 3). The result reveals that 44(40%) were using one PIM drug, 50(45%) were using two PIMs, 14(13) were using three PIMs, 1(1%) were using 4 PIMs and the maximum of 5 PIMs use were found in 1(1%) of the study population. 66(60%) of the study population consumed more than one PIM. The mean was found to be 1.8 ±0.78 and an avg of 2 PIM was used by the study population. A similar study conducted by Dormann H (2013) (13) were reported that 87% of the study population consumed at least one PIM. Among the PIM users the total number of PIM drugs was calculated and it was found to be 215 drugs. PIM users were categorized into three groups according to Beers criteria. (Table no: 2) There were 195(90%) belongs to category I, 12(6%) were in category II and 8(4%) were in category III. The individual categories of PIM was analyzed. It was found that alprazolam 57(52%), clonazepam 17(15%), hyocyamine 10(9%), Lorazepam 10(9%), hydroxyzine 10(9%), zolpidem 10(9%), ketorolac 10(8%) were prescribed in category I (table no: 3). A similar study conducted by Birader K et al (2013) (16) reported that alprazolam and cimetidine were frequently used PIM among their study population. Use of hyocyamine in constipation 3(25%) accounts for the most frequent inappropriate drug use in category II (table no: 4). Hydroxyzine in constipation 2(17%), cyproheptidine in constipation 2(17%), ketorolac in PUD 2(17%), clonazepam in frequent fall 1(8%), ketorolac in CHF 1(8%) and theophylline in insomnia 1(8%) were other category II inappropriate medication use. Use of escitalapram 3(40%), mirtazapine 2(30%), fluoxetine 1(10%), sertraline 1(10%) and Duloxetine 1(10%) were the category III PIMs (table no:5). The DRP among the PIM users were analyzed (fig no: . It was found that 19(17%) of the PIM users were free from DRPs. Majority of the study population had at least one drug related problems. The mean value of DRP in the study population was found to be 1.59 ±1.3. The minimum observed number of DRP per patient was one and maximum observed number of DRP per patient was six. The ADR use was monitored in the study population. A total number of 40 ADR associated with PIM use (Fig no:5) and 14 ADR associated with nonPIM use were identified. The study result reveals that one among three PIM users were found to have at least one ADR. A similar study conducted by N. Nixdorff et al (2008) were also reported that PIM users were found to experience ADR most frequently than nonPIM users. As a part of our study, screening of drug interactions were done. A total number of 131 major drug interactions were identified, in that 111 were unique. Among the drug interactions found 16(12%) were PIM-PIM drug interactions, 39(30%) were PIM-other drugs drug interactions and 76(58%) were caused by non PIM drugs (table no: 6). Drug risk ratio were calculated for the study population (table no:7). It was observed that prochlorperazine had the highest DRR (4) followed by phenobarbitone (2), digoxine (2), pentazocine (2) and duloxetine (2). The statistical analysis of obtained results has been done using statistical tools. The association of different variables are analyzed using à ¯Ã‚ Ã‚ £2 test. On assessment of association between â€Å"number of comorbidities† with â€Å"number of drugs† and â€Å"number of PIMs† (table no:8), the result proved that â€Å"number of comorbidies† are statistically associated with â€Å"the number of drugs† at 0.001 level of significance and â€Å"number of PIMs† at 0.05 level of significance. It means that as number of comorbidity increases polypharmac and PIM use also increases. On assessment of association between â€Å"number of drugs† and â€Å"number of PIMs† (table no: 9), the result proved that â€Å"number of drugs† are statistically associated with â€Å"number of PIMs† at 0.05 level of significance. This result proves that polypharmacy is one of the reason for PIMs. On assessment of association between â€Å"number of DRPs† with â€Å"number of drugs† and â€Å"number of PIMs† (table no:10), the result proved that â€Å"DRPs† are statistically associated with â€Å"number of PIMs† at 0.01 level of significance but not associated with â€Å"number of drugs† at 0.05 level of significance. This result proves that DRPs is more associated with PIMs than polypharmacy which means it not the number of drugs contributing to DRPs but the use of PIMs. Conclusion Our study identified a high prevalence of PIMs use and associated DRPs in the study population. DRPs due to PIMs is preventable. Development and implementation of new criteria or modification of already existing criteria such as Beers criteria, START STOPP criteria which will helps in safe prescribing practice can reduce the PIMs use. References Budnitz DS, Lovegrove MC, Shehab N, Richards CL. Emergency hospitalizations for adverse drug events in older Americans. N Engl J Med 2011; 365: 2002–12. Budnitz DS, Shehab N, Kegler SR, Richards CL: Medication use leading to emergency department visits for adverse drug events in older adults. Ann Intern Med 2007; 147: 755–65. Lau DT, Kasper JD, Potter DE, Lyles A, Bennett RG: Hospitalization and death associated with potentially inappropriate medication prescriptions among elderly nursing home residents. Arch Intern Med 2005; 165: 68–74. Pirmohamed M, James S, Meakin S. Adverse drug reactions as cause of admission to hospital: prospective analysis of 18 820 patients. BMJ 2004; 329: 15–9. Chrischilles EA, VanGilder R, Wright K, Kelly M, Wallace RB. Inappropriate medication use as a risk factor for self-reported adverse drug effects in older adults. J Am Geriatr Soc 2009; 57: 000–6 Avorn J, Shrank WH. Adverse drug reactions in elderly people: A substantial cause of preventable illness. BMJ. 2008;336:956–7 Minimizing Inappropriate Medications in Older Populations: A 10-step Conceptual Framework. Ian A. Scott, MBBS, MHA, MEd,a Leonard C. Gray, MBBS, MMed, PhD,b Jennifer H. Martin, MBChB, MA (Oxon), PhD,c Charles A. Mitchell, MBBSd Opondo D. 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AJEM 2008 26: 697–700 Tables and figures NO. of PIM/prescription Number of patients N=110 Percentage 1 44 40 2 50 45 3 14 13 4 1 1 5 1 1 Table no:1 Number of PIM per Prescription sl no category no. of PIMs percentage 1 PIM drugs/classes to be avoid in geriatrics (category I) 195 90 2 PIM to be avoided in certain pathological condition (category II) 12 6 3 PIMs to be used with caution (category III) 8 4 Table no:2 Categories of PIM sl no Drugs No. of Patients sl no Drug No. of Patients 1 Alprazolam 57 (29%) 16 Nitrofurentoin 3(1.5%) 2 Clonazepam 17(9%) 17 Mirtazapine 2(1%) 3 Hyocyamine 10(5%) 18 Cyproheptidine 2(1%) 4 Lorazepam 10(5%) 19 Diazepam 2(1%) 5 Hydroxyzine 10(5%) 20 Piroxicam 2(1%) 6 Zolpidem 10(5%) 21 Prochloperazine 2(1%) 7 Ketorolac 10(5%) 22 Chlorphemiramine 2(1%) 8 Aceclofenac 9(4.5%) 23 Trihexylphenedine 2(1%) 9 Propoxyphene 8(4%) 24 Digoxin 2(1%) 10 Diclofenac 7(3.5%) 25 Phenobarbitone 1(0.5%) 11 Spironolactone 6(3%) 26 Naproxen 1(0.5%) 12 Prazosin 5(3%) 27 Clinidium-chlordiazepoxide 1(0.5%) 13 Clonidine 5(3%) 28 Indomethacin 1(0.5%) 14 Chlordiazepoxide 3(1.5%) 29 Metachlopramide 1(0.5%) 15 Amitriptyline 3(1.5%) 30 Pheniramine 1(0.5%) 31 Pentazocine 1(0.5%) Table no: 3 Category 1(PIM drugs/classes to be avoid in geriatrics) Sl no Drug Disease No. Patients Percentage 1 Ketorolac CHF 1 8 2 Hydroxyzine Constipation 2 17 3 Hyocyamine Constipation 3 25 4 Ketorolac PUD 2 17 5 Cyproheptidine Constipation 2 17 6 Clonazepam Frequent Fall 1 8 7 Insomnia Theophyllin 1 8 Table no: 4 Category II (PIM to be avoided in certain pathological condition) sl no Drug No of Patients percentage 1 Mirtazapine 2 30 2 Fluoxetine 1 10 3 Sertraline 1 10 4 Duloxetine 1 10 5 Escitalapram 3 40 Table no: 5 Cateegory III (PIMs to be used with caution) NO OF INTERACTION PERCENTAGE PIM-PIM 16 12 PIM- OTHER DRUGS 39 30 OTHER DRUGS 76 58 Table no:6 Categories of Drug Interactions Sl No Drug DRPs Total Drug Risk Ratio 1 PROCLORPERAZINE 8 2 4.00 2 PHENOBARBITONE 2 1 2.00 3 DIGOXIN 4 2 2.00 4 PENTAZOCINE 2 1 2.00 5 DULOXETINE 2 1 2.00 6 NAPROXEN 2 1 2.00 Table no.7 Drug Risk Ratio Sl no Varience No. of comorbidities Chi squire value P value 1 2 ≠¥ 3 1 No. of PIMs 1 5 21 13 12.76* 0.05 2 10 12 15 ≠¥ 3 7 15 12 2 No. of drugs 6-8 13 16 4 26.77* 0.001 9-11 8 25 17 ≠¥ 12 1 7 19 Table no:8 Association of no. of comorbidities with no. of drugs and PIMs . varience No. of Drugs Chi squire value P value 6-8 9-11 12-14 ≠¥15 No. of PIMs 1 16 21 4 3 21.76* 0.001 2 14 24 8 4 ≠¥ 3 2 5 5 4 Table no: 9 Association of no. drugs and no. PIMs Sl no Varience No. of DRPs Chi squire value P value 0 1 2 ≠¥3 1 No. of PIMs 1 11 21 10 2 21.76* 0.001 2 7 23 8 12 ≠¥ 3 1 4 2 9 2 No. of drugs 6-8 9 15 11 1 11.77 0.05 9-11 4 25 6 12 ≠¥ 12 6 8 3 10 Table no:10 Association of DRPs with no. of drugs and PIMs Fig no:1 Prevalence of PIMs Fig no:2 Number of Drugs Prescribed per Patient Fig no:3 Number of PIM per Prescription Fig no: 4 Adverse Drug Events and Its frequency Fig no:5 Adverse Drug Events and Its Frequency