Hillcrest Case 7 Essays

Hillcrest Case 7 Essays Hillcrest Case 7 Paper Hillcrest Case 7 Paper This is a 44 year old Hispanic male who I was kindly asked to admit by Dr. Max Hirsch. The patient is status post arthrodesis of the left ankle and has newly diagnosed diabetes and hypertension. PAST MEDICAL HISTORY: Pre-op blood glucose was noted to be greater than 200. The patent asked for a medicine consult/admission for further evaluation. Currently he denies chest pain and shortness of breath. No dysuria, or increased urinary frequency. Past history is significant for hearing loss in the right ear subsequent to an assault several years ago. PAST SURGICAL HISTORY: Lower back surgery and a left ankle surgery. SOCIAL HISTORY: Patient admits to drinking beer on the weekends, some tobacco use, but no illicit drug use, is divorced with four children, is a long haul truck driver, lives with his fiancee. MEDICATIONS: Patient is to provide a list, admits to taking no diabetes meds. PHSYICAL EXAMINATION: VITAL SIGNS: afebrile BLOOD PRESSURE: 155/98. HEART RATE: 69. In general he is in no acute distress, alert and oriented X4. HEENT: Mucus membranes moist. No facial asymmetry. Left ear : WNL, Right ear: with profound hearing loss. LUNGS: clear to auscultation and percussion bilaterally. CV: Normal. S1, S2 without murmurs or rubs. GI: soft, non-tender, non-distended. No HSM. Positive Bowel sounds. GENITALIA: deferred. EXTREMEITIES: No edema. He has been admitted for left ankle surgery. NEUROLOGIC: intact with the exception on cranial nerve on the right. LABS: CBC within normal range. Pre-op glucose 239. BUN and creatinine of 8 and 0. 5. Pre-op UA with 3+ glucose. HISTORY AND PHYSICAL EXAM Patient: T. J. Moreno. Patient ID: 110497 DOB: 02/15 Age: 44 Sex: M Room No. : 502 Page: 2 ASSESSMENT AND PLAN: Â  Status post ankle arthrodesis: tolerated procedure well, will continue to monitor. Diabetes: patient with elevated glucose and blood in urine. We will start sliding scale for now. Likely needs Lantus. Possible candidate for Metformin. Hypertension: We will start lisinopril. Pain: we will continue to monitor pain post-op and provide adequate pain control.

Writing Business Email Conclusions

Writing Business Email Conclusions "I am the world's worst salesman. Therefore, I must make it easy for people to buy." - F.W. Woolworth In continuation of last month's issue addressing current economic challenges, let's look business writing techniques which promote business. One of the most overlooked opportunities is the conclusion. We want to leverage them - always.Too often, business writers use a boiler-plate phrase to conclude a letter, memo or email. For example, "Should you have any questions, please feel free to contact me." Blah, blah, blah. Of course, every business reader knows they can contact you with a question! There is no value added by this statement, it adds meaningless length, and worse, it does not drive the reader to action.To increase business, put meaning into a conclusion. Write directlyto your reader, and guide them specifically to the action you want.Let's examine conclusions that would drive business for an insurance company, a CPA firm, a package shipping company and a property management firm, as examples: If you work in sales for a freight transfer company, and are responding to a fare inquiry: The fare to ship a 3 pound box from Atlanta to Duluth, with guaranteed overnight delivery, is $23. You can schedule pick up at your office on this website (provide link) or drop your package off at (provide address). If you are a claims manager for an insurance company, and are responding to a coverage addition inquiry: The premium to add flood insurance to your homeowner's policy is $100. To enact this very important insurance, sign the enclosed policy amendment where I have highlighted in yellow, and date the document. Mail this form to our office at (state address). If you are a CPA firm, arranging a client meeting in preparation for an IRS audit: We will meet three weeks ahead of your scheduled audit date, on November 19, 2008 at 2:00 pm in our conference room. Please be certain to bring your tax returns, with all schedules, for tax years 2005, 2006 and 2007 to this meeting. If you are a Property Management Company, confirming contractor work: Please see Susan Archady in the main office at 246 Downington Lane when you arrive. She is expecting you and has a key to all units. Susan will arrive at work by 8:00am. Conclusions are a powerful opportunity to drive business, and so often are overlooked as a business opportunity. Your readers are buried in information, so make certain you have included in your conclusion all of the action-eliciting information your reader needs to act. This is typically just an extra sentence or phrase, but it should enable your reader to move decisively to your business objective. Master All Business Writing Skills in This Course: Effective Business Writing Techniques

Landlord and Tenant law Essay Example | Topics and Well Written Essays - 1500 words

Landlord and Tenant law - Essay Example The law protects and acts on behalf of both the landlord and the tenant. Ms. Richard the tenant has occupied the dwelling unit for a number of months. Since she moved in, the flat has been constantly damp due to roof leakage every time it rains. This has brought severe cold on her. She has frequently complained to the landlord who has not taken any action. Consequently, she has terminated paying the rent to accumulate enough money to engage a builder do the repairs. It is worth to note that Mr. Samson gave her a tenancy agreement, which is for a fixed term of two years. In the agreement tenancy, there is no reference to any repairing obligation of the landlord. It also prohibits keeping of pets but Ms. Richards keeps an Alsatian dog in the flat. She has also been convicted of possessing cannabis on the premises. Mr. Samson intends to evict Ms. Richards from his premises soon. According to section 109 (b) of the Landlord and Tenant Act, rent should be paid at the time and place agreed by the parties. The entire rent should be paid at the beginning of any term. One month’s rent should be paid at the beginning of each month of a longer term. Unless otherwise agreed, Mr Samson is justified to claim the rent arrears in a court of law and obtain possession of his house. He can evict Ms. Richard who has bleached the agreement under the Serious Rent Arrears ground and pursuant to section 21 of the Housing Act, 1998. We can compare the above justification to a case in London where one Mr. O had extensive rent arrears in Mr. S’s dwelling unit. Though Mr. S had not given a written tenancy agreement to the tenant, he was finally able to obtain possession of his property under the ground of Serious Rent Arrears. Compared to Mr. S, Mr. Samson is in a better position to acquire possession of his premises as he had issued a tenancy agreement to Ms. Richard at the commencement of her tenancy. (See, Landlord law 2009-Examples of successful

Definition of the Word Courage Essay Example | Topics and Well Written Essays - 500 words

Definition of the Word Courage - Essay Example The average person derives an image of a superhero when thinking about courage. However, that a limited view of what courage means. This is because it can be applied to so many other aspects of life. The second half of the definition in regards to negative forces is what allows for individual perspective on the word. For example, courage can pertain to a person stopping a gunman from shooting another victim despite the immense danger he or she faces in possibly getting maimed or dying in the process. On the other hand, courage can be reflected in the depths of an individual who recently became crippled and has to face the pain, difficulty, and fear of starting life in a new way with new challenges. Both situations involve a form of evil to some extent and to be courageous is appropriately applied to the people involved.   As the discussion highlights  the situation also does not have to be a severe one that radically changes peoples’ lives. There is no indication in the definition of courage that there has to be a big or massive negative situation that happens to someone for it to maintain its context. Courage can be applied to as little a situation as giving a successful speech in front of a classroom of students or having the courage to try something new whether it is a type of food or physical activity.

Comparing coverage in two different Newspapers Essay Example for Free

Comparing coverage in two different Newspapers Essay The incident covered in the two articles I have studied was a train fire in the Austrian ski resort of Kaprun on Saturday 11th November 2000. The first article I looked at was in the tabloid paper the Sunday Express. The second article I looked at was in the broadsheet paper the Observer. The two articles were very similar but had some differences. Both the articles emphasised that British people were among those that had died. The Sunday Express said Britons among 170 victims and The Observer said Britons among 170 dead The Observer also stated that children died Children among victims. Although both articles covered the same subject and seemed to emphasise the greatness of the tragedy, they had different approaches, The Sunday Express article was sensationalist and over emotive inferno as it tore through carriages The Observers article was a calmer and more concise report and, within a few minutes, almost everyone on board was dead. The articles both contained similar factual information. In the Article in the Sunday Express, facts were intertwined with opinions and emotive language. engulfing tourists in temperatures of up to 1,000 degrees Centigrade. The Observer had some emotive language but seemed to keep the facts separate which reached temperatures of more than 1,000 C The only discrepancy between the two articles was over the initial cause of the fire. The Sunday Express interviewed a cable car technical expert Klaus Einsenkolb. He said that either a short circuit in the batteries or the possibility that someone had started it with a naked flame was more likely, This was their only reference to the cause of the fire. The Observer had many different statements about the cause of the fire. Yesterdays fire is believed to have startedafter one of the cables that pull the train up the mountain snapped, apparently starting the blaze They also had a statement from the local company Gletscherbahn Kaprun who owned the train. Due to a fire in the tunnel there was a shorting in the electrical circuit, consequently causing the train to catch fire. They also interviewed Klaus Einsenkolb, but stated nothing about his opinions of what caused the fire as in The Sunday Express. Both articles used similar language, but The Sunday Express used more emotive variations of language to put across the same point. The Sunday Express said the harrowing task today of identifying 170 young skiers burned alive The Observer stuck to the facts, however, some sensationalist language was used. 170 people were killed yesterday when a fire engulfed an Austrian funicular train The Sunday Express sensationalised the incident by using words like inferno and disaster repeatedly throughout their report. This created a mood in the article, expressing how terrible this tragedy was. Despite The Observer being a broadsheet paper, their article also used this type of language, such as inferno and tragedy. I think this also was used to create the mood. The underlying feeling in The Observers report was that this incident could have been prevented or its consequences reduced, had their been adequate safety measures and better maintenance. Manfred Muller, security director for the railway, admitted that there had been no emergency fire fighting equipment in the tunnel, or on the train The journalists use of admitted in this sentence supports his views that safety precautions were inadequate. After reading this article the reader was left with the impression it was just a terrible accident. Yesterdays disaster was the second tragedy to hit Kitzsteinhorn this year. announced a criminal investigation into the tragedy. No blame seemed to be pointed at anyone in this article. The Sunday Express article contained many interviews and comments from people involved with the incident. Most of the people interviewed were officials linked with the accident, like Norbert Karlsboeck, the town mayor of Kaprun, and Franz Schausberger the Salzburg governor. Mr Karlsboeck said: I did not realise the full extent of the catastrophe Salzburg governor Franz Schausberger said: I have declared a day of mourning. We can presume that everyone still on board the train is dead. They were commenting on their feelings about the incident. Klaus Eisenkolb, a cable car technician who worked on the planning of the line was also interviewed and spoke of what he thought about the occurrence of this incident and what could have possibly caused it. One witness and one survivor were also quoted. The Observer had fewer people interviewed, but had interviews with relatives and witnesses. They also had a statement from the company who owned the train, Gletscherbahn Kaprun, who commented on their feelings about this incident. In a statement, the company said: We and the whole town of Kaprun are in mourning. An unidentified man whose son had gone skiing that day, and a deacon were also interviewed. This gave the article a more personal feel, as the reader felt that they could relate to the people whos lives had been affected by this and so understand the tragedy better. The layout of these reports was very different. Article I had a large bold headline on the front cover saying INFERNO in capital letters, to draw peoples attention. There was also a large illustration of one of the survivors with a caption. There was then a double page spread. On the first side of the double spread was a pull quote in large bold letters Theres no hope left, the fumes were just terrible next to another illustration of a survivor with a caption. This would also get peoples attention; the reader may look at the pictures and then want to read on. Under the title was a diagram of the mountainside with text pointing out where the events took place. This was quite easy to understand and gave the basic information. Inside that diagram was another diagram showing where Kaprun was in context to Austria and then to the rest of Europe. The text was in columns around these illustrations. The double page was split into three blocks of text, an individual report started on the second page written by Greg Swift, a continuance of the first article by David Dillon, and then an additional report: Rising tide of Alpine tragedies. The Observer had a medium sized headline Inferno in the Alps in bold letters. Underneath was a large illustration of a survivor (the same as in article 1) with a caption. The article was started with two large bullet points, which would grab the readers attention. There was then a tiny diagram of where in Austria the incident took place, and where it was in relation to Europe. The article was again written in columns. It then too went to a double page. The headline on this double page A couple of breaths and they were lost was also a pull quote, keeping the readers attention. There was a block of pictures with quotes in the top centre of the pages showing the rescue team, survivors and their families, and the train. This was really effective. The block of pictures would really attract the readers attention, urging them to read the article. There was a large diagram showing a picture of the mountainside and where the tunnel was, and then a diagram of the actual train, showing in steps what happened and when. This diagram was very clear, showing exactly what happened in an easily understandable way. The double page was again split into sections of text. There was the main report by Denis Staunton, and then two smaller reports. One was by Jason Burke telling how former British Olympic skier Martin Bell feared that some of his friends could have been on the train. This linked the incident back to this country and how it affected people here. The other was by Anthony Browne, talking of worries over how many recent tragic accidents have occurred in the Alps. I think that the article that explained what happened and suggested the full horror of this incident more effectively was the article from The Observer. I felt that the way in which it was written managed to create a balance between putting across the facts but still expressing the horror of the tragedy. I think because the facts were not clouded with opinions, they were easier to understand. I thought that the double page spread was particularly effective. The pictures were clearer and attracted the readers attention. The diagram on the double page was very clear and easy to understand. It showed exactly what happened in stages, with information about the mountain and the tunnel. I also thought that the headline Inferno in the Alps on the front page was really effective. It gave enough information for you to know what had happened but was short enough for the reader to read at a glance. I felt that The Sunday Express article was more difficult to understand as there were fewer facts and the writing was very opinionated. Also because there were fewer interviews with people who were directly affected by the incident, such as survivors, and relatives of victims, it wasnt as easy to relate to that article. There was less text in general, as much of the space was taken up by large illustrations and headlines. Although the articles seemed to be similar they had differences which although may not be drastically apparent I felt they made a big difference to the effectiveness and success of the articles.

Virtue Ethics: Deontological and Eudaimonist :: Ethics Judgements Papers

There are two basic types of ethical judgments: deontological judgements that focus on duty and obligation and eudaimonist judgements that focus on human excellence and the nature of the good life. I contend that we must carefully distinguish these two types of judgement and not try to understand one as a special case of the other. Ethical theories may be usefully divided into two main kinds, deontological or eudaimonist, on the basis of whether they take one of the other of these types of judgement as primary. A second important contention, which this paper supports but does not attempt to justify fully, is that neither type of theory trumps the other, nor should we subsume them under some more encompassing ethical synthesis. There are two basic kinds of ethical judgments. The first have to do with duty and obligation. For example: "Thou shalt not kill, lie, or steal." "You just keep your promises." These judgments often uphold minimal standards of onduct and (partly for that reason) assert or imply a moral ‘ought.’ The second kind of judgment focuses on human excellence and the nature of the good life. These judgments employ as their most general terms "happiness," "excellence," and perhaps "flourishing" (in addition to "the good life"). For example: "Happiness requires activity and not mere passive consumption." "The good life includes pleasure, friendship, intellectual development and physical health." I take these to be the two general types of ethical judgment, and all particular ethical judgments to be examples of these. The main contention of this paper is that we must carefully distinguish these two types of judgments, and not try to understand the one as a special case of the other. Ethical theories may be usefully divided into two main types, deontological or eudaimonist, on the basis of whether they take one or the other of these kinds of judgments as primary. (1) In the main, ancient ethical theories were eudaimonist in both form and content (in the kinds of judgments and terms they took as primary, and in the questions they spent the most time investigating). Most modern ethical theories have been deontological, again in both form and content. (2) Aristotle’s central question is: What is the good life for a human being? Kant and Mill’s central question is: What are our duties to our fellow human beings? My second main contention, which I cannot fully argue for here, is that neither type of theory trumps the other, nor should we attempt to subsume both types under some higher ethical synthesis.

Urban Farming in New York

Ilona Mukhisnova ENG 1101 10/22/2012 Prof. Alatriste Home Paper #2 – Argumentative Essay Urban Farming for Providing NYC with a Sustainable Food System ?Nowadays, a life in a huge megalopolis like New York can be very advantageous for a person in things like an easy access to business, culture, politics, and entertainment. However, live in the big city can has its own negative sides. Scott Stringer, in the report â€Å"Food NYC: A Blueprint for Sustainable Food System† points out serious nutrition and pollution issues in the city.Indeed, there are a lot of problems that New Yorkers have to face with, but a lack of â€Å"affordable and healthy† food is one of things that the City’s residents suffer most from. The report contains ideas and recommendations that New York can adopt to â€Å"balance health, economic, and environmental needs. † According to the report, it could be reached by changing processes of producing and consumption of food such as t he use of efficient and energy-saving technologies which may lead to reducing NYC’s GHG emissions.I think that sustainable food system could be developed by means of promotion of local agriculture and encouraging residents and businesses to consume locally produced food. ?There are a lot of problems that make the developing of local agriculture in the city difficult. One of such problems is the high CO2 production. In his report, Stringer says that â€Å"the city has committed to reducing its GHG emissions by 30 percent by the year 2030,† if it sticks to Mayor Bloomberg’s PlaNYC initiative.However, a lot of people think that it’s really a low percentage of improvements for almost twenty-year period, but I believe that it’s way better than no improving at all, and that there’s some other ways to improve the environmental situation the city. One of the ways to reduce such problems as CO2 emission is to increase the number of parks and gardens in the city. According to Stringer’s report, some people consider gardens as â€Å"a transitional use of land, available until the land is ready for urban development. I find this point of view wrong, as these green oases in the middle of the concrete jungles help to keep our city healthier by both â€Å"absorb[ing] carbon through photosynthesis† and, thus, preserving the environment and being a place for community activities. Lubie Grujicic-Alatriste, the author of the article â€Å"New York City Community Gardens Are in Full Bloom,† says community gardens â€Å"bring so much needed relief from urban pollution. I agree with the author’s view that local residents’ help in maintaining community gardens are one of the best examples of people’s efforts to save the green â€Å"plots of land,† and this, most importantly, can help decrease the negative impacts of food sector. ?One of the biggest stoppers of developing urban agriculture in New York City is a lack of available for gardening and farming lands. In a built-up city like New York, the demand on land is great.There are some groups of people such as construction companies who are against securing the City’s land for agriculture purposes. They all need land for developing new projects and getting large profit. I think the City Government should create proper legislation to regulate the City’s land use and protect existing parks and gardens from being replaced with buildings. Also, the land demand keeps the prices on land extremely high, what makes it difficult to do business by growing fruits and vegetables; farms’ profits not always can cover the costs of production.Danielle Sonnenberg writes in her article â€Å"Interest Grows in Urban Farms: City’s Green Movement Has Ear of Wall Street† that â€Å"real estate costs are high†, and that the City and community organizations should increase the interest of Wall Street to invest in urban farming. The author points out that agriculture companies like NewSeed Advisors and Gotham Greens find urban farming profitable. Examples of these companies show that projects like hydroponic greenhouse are actually â€Å"commercially viable. That makes Wall Street consider urban farming as a good source of investment. All of the above reasons bring us to the point that we should consider new ways of city farming. According to the â€Å"Food NYC†, urban agricultural growth may be achieved by considering opportunities of using of â€Å"underutilized spaces, such as rooftops, basements, or warehouses. † In the article â€Å"Huge Rooftop Farm is Set for Brooklyn†, which appeared in the New York Times on April 5th, 2012, the author (Lisa W.Foderato) tells about a new project of â€Å"Bright Farms, a private company that develop greenhouses,† the world’s largest rooftop farm in Sunset Park, Brooklyn. The farm is going to work on the hydroponic technology, – â€Å"vegetables are [going to be] grown in water rather than soil. † Rooftop farms are not a novelty for New York: there are already farms in Long Island City, the Greenpoint, etc. Thus, the development of alternative urban farms may encourage city residents to consume locally produced food.The supporting and developing untraditional type of urban farming will bring affordable fresh produce to the City’s counters. Locally produced food with the use of modern technology can improve the overall health of the City’s population, lower the food’s costs, and reduce negative environmental impact. Securing the land for parks and gardens use can also improve NYC environment. Promoting urban agriculture and encouraging residents to consume locally produced food can help the City Government to provide New Yorkers with sustainable food system.