Disease Control And Prevention Starting Reporting Lyme...

Introduction Since the Centers for Disease Control and Prevention starting reporting Lyme disease as a reportable disease in 1991 it has been the most commonly reported vector-borne illness is the United States1. It should be noted that Lyme disease does not occur everywhere in the US, and is heavily concentrated in upper Midwest and northeast United States1. This report has been compiled to provide recommendations for prophylactic treatment of Lyme disease once a patient encounters a tick bite. Lyme disease is caused by the spirochete Borrelia burgdorferi, which is transmitted by Ixodes dammini, otherwise known as the deer tick3. B. burgdorferi lives in the midgut of the deer tick, and becomes active after a tick’s gut is filled with†¦show more content†¦Serologic testing has not been proven to be effective in identifying B. burgdorferi. Antimicrobial therapy has been at the forefront of research in trying to identify if prophylactic treatment is necessary and what drug and dosing is most appropriate. Antimicrobial Prophylaxis In 1992 Shapiro et al. published their research informing providers prophylactic antimicrobial treatment is not routinely indicated.2 There were a total of 387 patients in the controlled trial, 203 patients assigned to receive amoxicillin and 182 were given a placebo. Either 250mg of amoxicillin or a placebo was given to subjects three times a day for ten days. 15 subjects dropped out and 7 subjects had already shown positive serologic testing to B. burgdorferi and were therefore dismissed from the study. Out of 173 subjects who received the placebo only two developed symptomatic infection with B. burgdorferi; whereas, none of the 192 subjects who were given amoxicillin showed any infection. They concluded the risk of actually becoming infected with B. burgdorferi is so small that the prophylactic use of antibiotics does not make a clinical significance and should not be used. The authors also indicated that most deer ticks are actually not infected with B. burgdorferi, which may he lp explain why so little placebo subjects showed a positive infection after their encounter. While Shapiro et al. was not able to recommend antimicrobial prophylaxis with amoxicillin Nadelman et al. devised

Enron s Of Houston Natural Gas And Omaha Based Inter North

Enron s origins date back to 1985 when it began life as an interstate pipeline company through the merger of Houston Natural Gas and Omaha-based Inter North. Kenneth Lay, the former chief executive officer of Houston Natural Gas, became CEO, and the next year won the post of chairman. From the pipeline sector, Enron began moving into new fields. In 1999, the company launched its broadband services unit and Enron Online, the company s website for trading commodities, which soon became the largest business site in the world. About 90 per cent of its income eventually came from trades over Enron Online. Growth for Enron was rapid. In 2000, the company s annual revenue reached$100 billion US. It ranked as the seventh-largest company on the Fortune 500 and the sixth-largest energy company in the world. The company s stock price peaked at $90 US. However, cracks began to appear in 2001. In August of that year, Jeffrey Skilling, a driving force in Enron s revamp and the company s CEO of six months, announced his departure, and Lay resumed the post of CEO. In October 2001, Enron reported a loss of $618 million its first quarterly loss in four years. Chief financial officer Andrew Fastow was replaced, and the U.S. Securities and Exchange commission launched an investigation into investment partnerships led by Fastow. That investigation would later show that a complex web of partnerships was designed to hide Enron s debt. By late November, the company s stock was down to lessShow MoreRelatedJaclyn Givens. Kathy Osburn. Management 101. 5/8/17. The1400 Words   |  6 PagesJaclyn Givens Kathy Osburn Management 101 5/8/17 The Enron Era â€Å"Just as character matters in people, it matters in organizations,† says Justin Schultz, a corporate psychologist in Denver. The Enron scandal had a big exposure in 2001 confirming the big secret to the increase in billions. 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Judge (2011) Organizational Behaviour 15th Edition New Jersey: Prentice Hall393164 Words   |  1573 Pagesand permission should be obtained from the publisher prior to any prohibited reproduction, storage in a retrieval system, or transmission in any form or by any means, electronic, mechanical, photocopying, recording, or likewise. To obtain permission(s) to u se material from this work, please submit a written request to Pearson Education, Inc., Permissions Department, One Lake Street, Upper Saddle River, New Jersey 07458, or you may fax your request to 201-236-3290. Many of the designations by manufacturersRead MoreStrategic Human Resource Management View.Pdf Uploaded Successfully133347 Words   |  534 PagesPrentice-Hall, Inc. A Pearson Education Company Upper Saddle River, New Jersey 07458 Compilation Copyright  © 2003 by Pearson Custom Publishing All rights reserved. This copyright covers material written expressly for this volume by the editor/s as well as the compilation itself. It does not cover the individual selections herein that first appeared elsewhere. ii Permission to reprint these has been obtained by Pearson Custom Publishing for this edition only. Further reproduction by any

Hitchcocks Stylistic innovations Essay Example For Students

Hitchcocks Stylistic innovations Essay The camera spirals out from Marions eye and a tracking shot moves out of the bathroom over to the money. The camera then reframes again to look out of the window to the Bates house. Off screen Norman is heard shouting to mother. Then you see him running towards the motel room. The camera now follows Norman and we watch him wash away all traces of murder. The dual narrative of Psycho was also incredibly shocking as the comtenpary audience, used to a Classic Hollywood Narrative, would have expected to follow the protagonist, Marion until the end of the film. At this point the audiences sympathies lie with Norman. He is a dutiful son trying to help his psychotic mother. When the beams of a cars head light passes over his face it makes us feel concerned. Also when he drives Marions car into the tar pit and it stops sinking, he looks around nervously. When it finally does disappear we feel relieved for him. Psycho amounted to three blood-chilling moments, the shower scene (which I have concentrated on), the attack on the landing and the mummified corpses in the basement all of which was held together by not very much. This allowed Hitchcock to underline the astonishing impact these scenes would have on the cinema audience. Psycho, which Hitchcock once described as my first horror film is in fact a supinely structured thriller, and its a pretty heartless one at that, for it was made when the directors appeared to have abandoned a warmth for a macabre fascination with the darker aspects of evil. This had never been attempted on screen, which was why Hitchcock sent out directions to the cinema manager allowing for a new cinematic experience to be had by the audience. From its quiet opening (Janet Leigh embezzling her employers money and leaving town) to its shocking climax, it is most artfully put together. Hitchcock cheats outrageously allowing to lead the audience towards sinister expectations that are not fulfilled, nor was theyre any intentions that there should be. False trails abound; car number plates are given a significance that they never deserve. All this was simply the master toying with his audience, playing them along, deluding them, misdirecting them, confident in the knowledge that when the big moments came they would frighten the life out of everyone in the cinema. Due to Psycho, audiences no longer wanted or expected to go to the cinema to watch story, plot, dialogue they went for a cinematic experience Psycho is regarded as a masterpiece in the history of cinema and there is no shock horror movie which is more compulsively watch able. It is outrageously manipulative, its subject matter is essentially banal and yet it is not too much to describe it as the work of a genius. The doors Psycho opened for directors have moved the film industry on more than any other film in history especially in the realms of horror movies.