The car crash Essay Example for Free

The car crash Essay Joni woke remembering that she still needed to get out of the car her last thought before shed fell unconscious, even though the bright lights stung her eyes her headache worse than before. She pushed her self up onto her elbows, groaning quietly at the pain that suddenly shot down her arm in response to this movement, though she couldnt tell whether they were cut or bruised. Trying to open her eyes Joni squinted at the bright strip lights directly above her. A strong antiseptic smell filled her nostrils causing a nauseous feeling to wash over her. A noise that sounded as though it was coming from far in the distance was beeping in a steady rhythm, sounded amplified against the otherwise still silence. Trying to look round the room Jonis eyesight, which was not yet adjusted to the bright light, saw that her surroundings consisted of mainly white. The dark shape of a man sitting by Jonis bed stood out against the whiteness of the room. The man wore casual clothes so he couldnt have been a doctor or nurse, and yet Joni didnt know who this man was or why he was visiting her. Ssshh, lie back down you need your rest now an unfamiliar voice told her, standing up from where he was sitting he looked tall leaning over Jonis bed. But she tried to answer being interrupted not only by the constant throbbing of her head but also the man continuing to speak. Deciding that lying down was a good suggestion Joni did as the man had told her, but was still fighting to keep her usually clear blue eyes open which felt red and sore. Im really sorry there was nothing that I could do, you drove straight into me before swerving off the edge of the road. I just wanted to stay with you at least until your family or someone came, so that you wouldnt be alone when you woke. The man told Joni in a low but concerned tone of voice. Joni relaxed realising that she was now safe in one of the hospital beds not too far from home. She recalled what had happened that had made her end up here. Jonis vision had blurred at the bright headlights approaching from the car  heading towards her. Outside the increasing rain splattered heavily on the roof of Jonis car to the same rhythm of her thumping head. It was only 11.30 when Joni had decided to leave the party early, feeling yet another headache coming on, the one that she was now suffering from. Joni hadnt had anything to drink, partly as she had wanted to drive home but also as she had been topped up with paracetamol for the past few weeks miserably trying to fight of the constant headaches though theyd had little affect. It was mid November; the wipers on Jonis old car, which her Dad had bought her only the year before to make do with until she could afford her own was having difficulty keeping the windscreen, clear of the heavy rain. The car ahead was getting closer and the lights getting brighter, it must now have been about 12.00, as Joni was driving down the sandy cliff edge road about 10 minuets from home. The road had been cut out of the dusty hillside in which Joni lived. The road itself was little more than a dusty track, turning quickly into mud as the rain beat down. One side of the road exceptionally dark with trees thickening into woodland the other a steep drop eventually ending in the distance with another small village embedded amongst the hills which could only be seen due to its thousands of glittering lights. The road didnt have any lights of its own Jonis own car lights and the lights from the car ahead were the only thing illuminating the dark road. Jonis eyes stung transfixed on the road ahead, her head still pounding somewhat worse than they were earlier and then Joni could remember nothing for what could have barely been a minuet. I must have blacked out she told the man in some sort of an explanation. The next thing that she could remember was colliding with the car that had been approaching, in her dazed state of mind Joni then tried to control the car from falling off the edge of the cliff. She felt the tumbling weight of the car, with her in it feeling like a metal ball inside a pinball machine,  only she was being thrown around inside the car. Then silence as the car suddenly sat still knowing that this could only mean that she had finally reached the bottom of the cliff she tried to host herself from the wreckage feeling a warm liquid trickling down her face which could only be blood she fell unconscious. I pulled you from the car as soon as I got down to the bottom of the cliff, it was a pretty steep climb, then called for an ambulance, I didnt think that you was still alive The man explained. Thank you Joni replied, looking at him for the first time noticing that he could be no more than 18. He had dark eyes brown or grey with longish dark which was ruffled and matted with mud and dry blood probably mine Joni thought, his face full of small cuts and bruises defined his boyish features. He shrugged shyly smiling It was nothing

Essay --

The function of proto-oncogenes in cells is to dictate the specific cell type and how often it divides. So, a proto-oncogene that undergoes a mutation â€Å"may† become an oncogene. Just because a gene undergoes a mutation does not make it a malignancy. Normally, cells that undergo mutations are detected and destroyed. However, the undetected/discovered oncogene are believed to contribute to the possibility and probability of developing cancer. â€Å"Normal genes, or proto-oncogenes, are transformed into activated oncogenes in certain malignancies through the actions of viruses, irradiation, or excessive amounts of new genetic material through amplification or over expression of the involved gene† (Neville, 2009). Furthermore, there are several well identified behavioral factors that increase the rate of development of oncogenes. â€Å"It’s major risk factors in the western world include smoking and drinking alcohol, whereas in Asia, it is primarily caused by tobacco/arecanut/betel leaf chewing and/or human papilloma virus (HPV) infections† (Mishra, 2012). Proto-oncogenes can be induced to undergo a mutation and form an oncogene in a variety of ways. â€Å"Before oral cancer appears, it undergoes several stages of oral premalignant lesions (OPLs) with varying types of dysplasia. Though these OPLs are very common precursors of OSCC, some oral cancers appear de novo from histologically normal oral epithelium. Oral cancer is very aggressive and commonly migrates invading distant organs.† (Mishra, 2012). Currently, the primary method of detecting oral cancers is via visual inspection/exam. However, it is essentially impossible to visually detect cellular changes that progress to the development of a malignancy. â€Å"Pain is a common symptom in oral cancer... ...iagnostic techniques than visual inspection, so that we can treat oral cancers sooner. Even with the current treatment option(s) biopsy/radiation/chemotherapy, earlier and better detection will surely improve the prognosis for oral cancers. â€Å"The overall 5-year survival rate in OSCC has not significantly increased in the last few years. The overall and disease-free survival rates are 56% and 58%, respectively. The most important task is to establish an early diagnosis at the first stages of the disease,† (Jose Bagan, 2010). â€Å"Although the epidemiology of oral cancer is well-established, the prognosis and survival rates for oral cancer patients have not improved significantly over the past three decades, (S.C. Cheong, 2009). Lastly, a better understanding of oncogenes for oral cancer will have additional benefits for diagnosing/managing/treating other forms of cancer.

Surgical Technology

In order to apply these concepts you first need to understand ways to evaluate the Issues. How is ethics defined? According to the Ethics Center for Engineering and Research, ethics means being concerned with what Is right or wrong, good or bad, fair or unfair, responsible or irresponsible, obligatory or permissible, praiseworthy or blameworthy. (Online Ethics Center for Engineering, 2006) It Is associated with guilt, shame, indignation, resentment, empathy, compassion, and care. It Is being Interested In character as well as conduct.This article presents two ways to evaluate potential ethical questions: First is the utilitarianism system. This system concerns itself with determining the greater good and what decision will be beneficial to the most people. The second system presented Is the deontological system. Under this system, a worker would look at the needs of the individual and determine the best course of action for the patient themselves. There is no suggestion that these tw o methods should conflict. In fact, quite often, what is best for a patient is often what is best for society as a whole.The robber arises In the Instances where these two methods conflict. In these cases, a worker must apply the concept of prudence. This Is the Idea that a salary person would make the same decision under the same circumstances. After presenting the general concepts of ethics, the author lists several examples of situations where questions of this nature may arise. Personal decisions such as abortion, Den's, drug use, and sterilization are explored. Society decisions to allow animal and human experimentation and organ transplantation are also reviewed.Situations that could tangentially cause a worker to be uncomfortable are examined. The author points out how difficult it is watching a DEN patient pass without acting can be. The issue of a patient's right to privacy Is also delved Into. A patient Is not required to reveal their HIVE status even though this could pos e a danger to any worker in the operating room. Quality versus quantity of life is explained, however, the ethical problem is not a decision that needs to be made. In this case, the law has already determined assisted suicide Is not an option.The problem lies in the workers desire to help a wing individual die, even though they are unable to do so. This instance shows that ethical problems do not necessarily Involve decision making on the surgical technician's, but rather a state of mind in many circumstances. Despite the medical reason one might have for being hospitalized or cared for by a health care professional In an operating room setting and, regardless of how â€Å"ethically or unethically† the medical situation may be perceived through the eyes of the medical 1 OFF professional, It Is ten Neal care proportional's duty to De Touches on ten patient.The patient has a right to quality health care regardless of the circumstances or situations surrounding the procedure. Th is includes, but is not limited to, any situation that evokes an inevitable emotional human response. The underlying theme in patient care and ethics is that the health care worker's feelings do not play into the decisions that need to be made for the patient nor do they have any bearing on what is best for society as a whole. Our responsibilities, as Purpose Surgical Technologists, go beyond the mere ability to perform our daily Job functions.Our position is all encompassing in that, not only does it include the use of surgical instruments and equipment towards promoting health and well being, but it also extends to the rights of the patients under our care to receive the best quality, appropriate care within the patient's wishes and desires. We, as health care professionals, owe it to our patients to give them the highest possible quality of care of which we are capable. Uses in Career In order to be able to provide care without Judgment you need to do some deep soul searching and have a complete understanding of your ethical beliefs and biases.Once you have that understanding, if you find your ethical beliefs could interfere with your work performance, you need to share these feelings with your employer. Each patient is entitled to the same level of understanding regardless of your personal Judgment. What you feel or believe to be wrong does not necessarily have a bearing on what is best for the patient. Summary The intent of this article is to point out the various ways a health care professional can evaluate circumstances they may encounter in the work place.They can determine what is the best ethical course of action for society as a whole, they can determine what is best for the patient and his or her personal situation, or they can combine the two methods and approach the situation prudently. No matter which approach is taken, it is always best to take your personal feelings and emotions out of the equation. The bottom line is to combine doing what is right in general with what is right for the patient. Even in a surgical situation, customer service is paramount. Putting yourself in another person's shoes may be a simple click, but it goes a long way in this occupation.

Analysis of ICICI bank and Bank of Rajasthan merger - Free Essay Example

Sample details Pages: 4 Words: 1122 Downloads: 3 Date added: 2017/06/26 Category Finance Essay Type Compare and contrast essay Did you like this example? Analysis of ICICI bank and Bank of Rajasthan merger– Reasons for the deal The promoter group of the Bank of Rajasthan (BoR) had been under immense pressure from regulatory authorities to restructure the Bank due to a variety of problems from 2009 onwards. RBI levied a penalty of INR25 lakhs in February, 2010 for a series of violations including extension of repayment period over permissible limits on intra-day overdraft, irregularities in the accounts of corporate groups, deletion of corporate records from the information systems , irregular property deals, actions against money laundering norms, and poor corporate governance. Further, the RBI nominated 5 directors for the Bank and appointed a new CEO. Don’t waste time! Our writers will create an original "Analysis of ICICI bank and Bank of Rajasthan merger" essay for you Create order Tayal family decided to merge BoR with ICICI Bank due to these regulatory actions. ICICI Bank was also looking for a target to increase their customer base and geographical reach in northern India. Important dates in ICICI Bank- Bank of Rajasthan Merger – Corporate Profile of ICICI Bank ICICI Limited was incorporated in the year 1955 by joint efforts of the Government of India, World Bank and representatives of the Indian Banking Industry’s. However, ICICI Bank was established in 1994. ICICI Bank had around 2000 branches in May 2010. An extensive range of Product and services offered by ICICI though diverse delivery channels are personal banking, corporate banking, retail banking, commercial banking, NRI banking, asset management, investment banking, finance and insurance, mortgages, credit cards. Merger experience: Since 2000, ICICI bank has been using mergers as a strategy to expand its geographical coverage, customer base and to meet regulatory req uirements. Merger with BoR is the 4th acquisition by ICICI Bank. Corporate Profile of Bank of Rajasthan The bank of Rajasthan was established in 1943. In the year ended March 31st, 2010, it had asset base of INR17,300.06 crores and it incurred net loss of Rs. 102.13 crores. The bank had around 463 branches spread across India. It also had 67 onsite and 29 offsite ATMs. The bank provides range of products and services in 3 segments including treasury operations, Banking operations and residuals. Glimpse of the Banks Merger Details Branches of Bank of Rajasthan will function as branches of ICICI Bank. A holder of 118 shares of BOR will be given 25 shares of the combined entity. Existing products of BoR will continue with same charges and features. Customers will get services as per existing procedures of Bank of Rajasthan. 58 branches of a regional rural bank sponsored by BOR will also be transferred to ICICI in addition to the other 468 branches. Negatives – BoR’s non-performing loans are a source of significant risk for the combined entity. As in FY-10 the net worth of BoR was approximately Rs. 760 crore and that of ICICI Bank Rs. 51,700 crore. For December 2009 quarter, BoR reported loss of Rs. 44 crore on an income of Rs.373 crore. Table 1 ICICI Bank offered to pay 188.42 rupees per share, in an all-share deal, for Bank of Rajasthan, a premium of 89 percent to the small lender, valuing the business at $668 million. The BoR approved the deal, which was subject to regulatory agreement. Strategic fit A merger will substantially increase the value of the firm only when there is a proper integration of strategic, financial, economic and organizational aspects. These factors are directly correlated to the performance of the firm after the merger. However, there should be proper strategic fit for a successful integration. Strategic similarity index gives the distance between banks by difference in the k ey strategic variables Table 2 Strategic Variables ICICI Bank (in %) Bank of Rajasthan (in %) Return on loan 12.71 16.30 Liquidity ratio 49.85 48.15 Financial leverage 14.21 5.40 Cost to income ratio (CIR) 87.86 106.86 Efficiency ratio 34.85 38.09 Loan to deposit ratio 89.71 55.31 CRAR 19.41 7.75 NPA 1.88 1.60 Source: Annual reports of the banks, Note: Calculations are based on secondary data Relative size of the target bank is a significant determinant of post-merger performance. A smaller size of BoR compared with ICICI implies easier integration, limited or no overlapping of branches, sharing of technology, etc. BoR’s CIR stands at 106% (including fee expenses) which show that their expenses exceed income. While ICICI Bank’s CIR stood at 87.87 % (including fee expenses). Financial leverage of ICICI Bank is higher than BoR which implies ICICI Bank has higher fixed expence obligations in terms of interest. The net NPA of the target bank is 1.6% against ICICI’s 1.87% but, in Capital Adequacy Ratio, the situation is worse for BoR. ICICI Bank has a strong CRAR of 19.4% against 9% prescribed by RBI and Basel II norms, whereas BoR’s CRAR is 7.74% which may harm the post-merger performance. BoR’s non-interest expenses (efficiency ratio) are more but, their earnings diversity (non- interest income) is better than ICICI Bank which may offs et in effect. The earnings diversification strategy indicates the bank’s exposure to the components of revenue other than interest income. Merger Announcement, Share Price Movements and Shareholding Pattern Changes The deal appears more favourable to BoR since their shareholders gained almost 90% between 07.05.2010 (the start of merger negotiations) and 23.05.2010 (Board Meeting approval). Swap ratio and relevant closing prices of banks Particulars ICICI Bank Bank of Rajasthan Swap ratio 1:4.72 ( 25:118) Price before a day of merger announcement 901.10 82.85 Price on the day of merger announcement 809.20 99.45 Price after a day of merger announcement 824.45 99.45 Source: Economic Times and website of NSE On February 26th, the closing price of BoR’s scrip was 61.8 and on 6th May, it was 84.7. This is the period where the bank faced serious actions from the regulators. During this period, the bank’s scrip value appreciated by 20.9% against the Bank Nifty return of 9.9%. Share price movement of Bank of Rajasthan February 26 to May 6 On May 6th, BoR’s scrip was at 84.7 and ICICI Bank was traded at 902.85. On May 17th, ICICI Bank and BoR recorded a price of 901.1 and 82.25 respectively. It indicates that merger negotiation has a zero effect on the price of merging entities. The Bank Nifty return for the period was 2.7%. Share price movement of BoR and ICICI Bank after the merger announcement (May 17 to June 28) On June 24th, BoR filed the information about the merger to the Bombay Stock Exchange. On May 16th, BoR’s price was 82.85. After the announcement of the merger, it shot up drastically to 99.45, 119.35, 131.30, 144.45, 158.9, and 162.3 on May 17th, 18th, 19th, 20th, 21th and 24th respectively. On the contrary, ICICI’s price reduced from 901.10 to 809.35. During the period, BoR gained about 77%, whereas ICICI lost 1.7% of its value. It is interesting to note that Bank Nifty showed a decline of 4.6 % during this period. Short term wealth creation of BoR can be read in line with the valuation and fixation of swap ratio. The indicative price agreed by both the banks was 188 per share. In the light of the present analysis, it can be concluded that there was not much vulnerability in the prices during the negotiation period. But, after the announcement, BoR’s share price adjusted almost to the price offered by ICICI.