Construction dissertation ideas

Argumentative essay dedicated to the parking situation at a growing university. Essay by construction picklepie , College, Undergraduate , A+ , January 2006. On Management! Parking - Another Stress for University Students. They paved paradise. And put up a parking lot - JONI MITCHELL, Big Yellow Taxi (1969) Although my drive to school takes only 10 minutes, I leave my house at construction dissertation, 10:30 to be at my 11:30 class. Essay Questions Grapes Of Wrath! At 10:40 I pull into the parking lot with what looks like one hundred other students. As I am wedged behind other anxious commuters I can only envision the convenience of another parking lot. Once in my classroom, I am late, thus frustrated - concentration in a three-hour class is going to be non-existent. Students at **** stress over finding a parking spot, although we should be more concerned with English papers, lab reports and math midterms.

Discussions of the Greater Vancouver transit system, the stress, the cost, and inconvenience of parking, and fit solutions to the parking problem will explain how parking could be convenient, thus less stressful, for construction dissertation **** commuters if a multi-level parking garage were added. Of my new responsibilities as a college student, I expected parking to be the least time consuming and stressful. Stress became a product of the interaction between myself and my environment - the parking lot (Whitman and Spendlove and Clark 21). Expository Research Paper! Parking so far away my first day of classes made me late, thus blistering with annoyance, but I knew I was not alone; almost the whole of my psychology class was red with exercise and construction ideas, aggravation. Justin Hull, a first year college student, complains that parking is a general annoyance, which subsequently leaves him less than focused for the majority of his first class. Also a commuter from Langley, Hull says that if he didn't have to allow himself another 25 minutes to find a parking spot, sleep could be pro-longed, or more importantly essential. Argumentative essay dedicated to essay questions on the the parking situation at a growing university. (2006, January 23). In WriteWork.com. Retrieved 08:23, October 06, 2017, from http://www.writework.com/essay/argumentative-essay-dedicated-parking-situation-growing-un.

WriteWork contributors. Argumentative essay dedicated to the parking situation at a growing university WriteWork.com. WriteWork.com, 23 January, 2006. Web. 06 Oct. 2017. WriteWork contributors, Argumentative essay dedicated to the parking situation at a growing university, WriteWork.com, http://www.writework.com/essay/argumentative-essay-dedicated-parking-situation-growing-un (accessed October 06, 2017) Reviews of: Argumentative essay dedicated to the parking situation at a growing university : I hate over populated Universities. I totally agree with what your saying!! I hate it when I'm waiting half an hour for a parking spot, and I'm always late for dissertation classes!! This essay is really good, keep up the good work!! 1 out of 1 people found this comment useful. . Paper South! do not achieve a college diploma you might not appear in society as well put together as you would like.

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Generalising about the Arab Spring is playing with fire. Ahistorical portrayals of the Arab uprisings fail to capture the political transformations afoot – and worse, perpetuate a false need for security and stability when institutional reform is the solution. The euphoria and promise of the “Arab uprising” or “Arab Spring” have given way to what many refer to as a “winter” rather than a “spring”. Headlines such as “Military coup in Egypt”, “Civil war in construction ideas Syria”, “Armed militias in assagioli psychosynthesis a collection of Libya”, and “Sectarianism in Iraq” have come to dominate media outlets and policy discussions. The problem with selecting the most ill-fated of the construction dissertation “uprising” cases and paper example painting them as illustrative of the Arab world as a whole is that they are unrepresentative of the diverse political transformations throughout the region.

Such essentialist narratives present events outside of their context and history. They distort the image of the “uprisings”, and of the Arab world generally as a perpetually violent and chaotic region incapable of strong institutional and democratic reform. This narrative conveniently propagates a policy, advocated by construction ideas, actors both within and psychosynthesis of outside the region, which prioritises stability and security while diverting attention away from needed political and construction ideas institutional reforms. The key challenge for democratic transitions is the construction of a system characterised by elections, equality of a4 typek paper africa, citizenship and opportunity, the rule of dissertation, law and inclusiveness. The success of transitions should be measured against these criteria. This essay will focus on Egypt and Tunisia: two countries that have become the phillis thesis statement symbols of the Arab uprising and reflect wide-scale implications for dissertation the region. The comparison of these two countries – particularly the creation of expository paper example, their constitutions and their electoral laws - reveals differences in their transitional political paths and highlights the power and importance of the agency of political elites. Dissertation! The variation between the two cases serves as a useful indicator of the a4 typek for sale south africa extent of success or failure in the political struggles towards democratic transition.

Since the ousting of Zine El Abidine Ben Ali in 2011, Tunisia has, on the whole, made significant strides towards democratisation. Despite strong disagreements and politically motivated roadblocks, Tunisia’s political elites have demonstrated a strong commitment to national unity, the institutional formation of a robust democracy, characterised by an inclusive constitution, a progressive electoral law, and an institutional setting that has prioritised dialogue and compromise over exclusion and partisanship. This process was aided by a favourable context. In the construction ideas wake of the uprisings, Tunisia’s brutal security apparatus collapsed and its small yet professionalised military, which historically had no interest in politics, remained silent in the wings. In civilian politics, Islamists and secular factions were evenly matched; Ennahda won a plurality in Tunisia’s first free democratic elections and had reached out to include secular opposition parties in the government. In addition, the essays on management sequence of democratic transition in Tunisia is worth mentioning as a favourable factor. Rather than beginning with electing a parliament charged with the selection of a constitutional committee, as seen in Egypt, Tunisia began with an interim government and construction ideas developed a consensual constitution, which preceded parliamentary elections. In contrast, since the 2011 overthrow of Hosni Mubarak, Egypt has undergone a more turbulent political transition process. A parliament was elected, and dissolved; a democratically elected president faced a wave of popular opposition and was ultimately overthrown by a military-led coalition. July 3, 2013 marked a new phase in Egypt’s political trajectory. The political process has been heavily tainted by a rivalry between a security state and its opponents.

The development of institutions and documents of the state and their interpretation have been shaped by circumstance, i.e. by the military-Muslim Brotherhood rivalry. Political elites in Egypt, in an effort to ensure the exclusion and limitations of the rights of oppositional forces and especially the Muslim Brotherhood (by outlawing and declaring it a terrorist organisation) have significantly backtracked from their promised neutrality and inclusiveness. New constitutions, different means. In theory, Tunisia’s new constitution is by many democratic measures a guarantor of equal opportunity and equal distribution of power. The constitution contains inclusive content that guards against the exclusion often observed in other Arab constitutions, and prevents the return of dictatorship. In a speech to the National Constituent Assembly last January, President Marzouki said: “With the birth of this text, we confirm our victory over dictatorship.” The document’s careful wording has secured agreement from both sides of the assagioli psychosynthesis political spectrum by presenting a model of reconciliation, while simultaneously addressing the perplexing question of Islam’s role in public life. The Constitution declares: “Tunisia is construction, a free, independent and sovereign state, Islam is her religion, Arabic her language and republic her regime” and “Tunisia is a state of civil character, based on citizenship, the thesis statement will of the people and the primacy of law. Ideas! In exchange for explicit mention of Islam as the religion of the state, Ennahda compromised on the inclusion of Islamic law.

Secular parties, aided by a strong civil society, secured guarantees that Tunisia would remain a civil state with separation of state and wheatley thesis religion (something that Rachid Ghannouchi, Ennahda’s leader, had also advocated) and placed preeminence on the freedoms of its people. Construction Dissertation! It is also important to system note that future governments cannot amend the two clauses. Tunisia established a semi-presidential system of government: both the president and the parliament have the ability to form and dissolve a government; however, neither the parliament nor the president can fully dominate the other. Construction Dissertation! Moreover, Article 49 incorporates what is probably the region’s most detailed limitations clause, designed to prevent parliaments from arbitrarily, unfairly or inequitably curbing citizens’ rights. The Tunisian constitution is phillis wheatley thesis, also the first to introduce gender-sensitive language in relation to key issues. For instance, Article 40 stipulates that the right to work is construction dissertation, now “a right for every citizen, male and female”. This theme of gender equality runs throughout and encompasses the right to a fair wage, to decent working conditions, and to stand for election. Article 73 provides that every male and female has the a4 typek for sale south right to run for president of Tunisia, a feature absent in all other Arab constitutions. While Tunisia’s constitution has been hailed as the region’s most progressive constitution, it falls short in some areas. The constitution requires that the state treat men and women equally in the application of the law, however this does not mean that men and women have the same rights in all circumstances (such as, for example, inheritance and child custody).

However, despite its imperfections, many Tunisians believe the constitution to be a welcome departure from what was once there. They also reason that the constitution represents the theoretical formulation of the state. Dissertation Ideas! What really matters is of, how it is practiced and implemented. Thus far, the behaviour of the political elite has been mostly positive, which has eased social discontent. Tunisians have condemned abuses of power and have outlined the path they wish Tunisia would take. While there are some inherent contradictions in the constitution, the dissertation ideas reality is that it is unlikely that the parties could have negotiated a better outcome given the circumstances and paper for sale south africa the existing ideological differences.

Like many skilled constitutional legislators, the Tunisian political elite seems to have honed their ability to use constructive ambiguity to generate balanced and inclusive outcomes. Egypt’s 2014 constitution - the drafting process (headed by a government-appointed Committee of 50), the construction dissertation ideas referendum that passed it with a near unanimous 98.1 percent (with a relatively substantial 38.6 percent voter turnout), and the content of the document itself - has fallen under criticism for the deeply politicised context in which it emerged, and assagioli within which it is currently implemented. In contrast to Tunisia, Egypt’s constitution does little to increase accountability among the country’s political institutions, particularly the military, police and judiciary, or to guarantee citizen rights and the rule of law. Despite the representation of a vast cross-section of society in the Committee of 50, with the conspicuous absence of ideas, Muslim Brotherhood affiliates, and public debates during the drafting period, the rushed, two-month process took place amidst heavy restrictions on the media and in the aftermath of the closure of many Islamist-affiliated organisations, and a security crackdown that involved the arrests of several activists who had publicly opposed the charter. The vote on the constitution was thus carried out under suppression of the opposition. However, some viewed these measures as a necessary part of the security hype against the recently ousted MB.

Furthermore, some advocated acceptance of the charter as a symbolic means of closing a chapter of africa, increasingly unpopular Brotherhood rule and legitimising the interim government. Under such conditions, the vast affirmation for the document was unsurprising. In terms of content, while the constitution does make important improvements upon past documents in guaranteeing rights and freedoms (women, children and the disabled are more clearly protected by the constitution), ambiguous clauses leave sufficient space for the circumvention of such rights. For example, the document allows for the military trial of civilians under numerous, vague circumstances. The wide room for interpretation has already been exploited; applied not only to Brotherhood members, but also to many prominent revolutionary activists, journalists and dissertation others who are currently imprisoned under the pretext of allowances made by the new constitution. The document further augments the power of the president, military, police and judiciary—institutions that would be difficult for opponents, particularly Brotherhood members, to infiltrate. The rivalries that marred the constitution’s writing process have led to continued concentration of power, lack of accountability and oversight. Egypt’s military had been involved in the transition process since the toppling of Hosni Mubarak; its second round of intervention, in the name of establishing security and placing Egypt on a proper path to democratic transition, has continued to make it a key player in wheatley statement the political process. Beyond the accusations that the interim government was a facade for military rule, and that former Defense Minister Abdel Fattah al-Sisi’s presidency bolsters that rule despite his resignation from the military upon his candidacy, the constitution and laws that have since been enacted work to effectively protect the construction military from civilian oversight or accountability. Therefore, overall, the rivalry between a security state and its opponents has resulted in the production of a highly politicised document that further concentrates power and leaves ample room for politically motivated infringement upon citizen rights. Political elites and their electoral laws.

Tunisia’s new electoral law is another example of the role of political elites in the democratic transition. The introductory articles commit to free and fair elections, and maintain democratic principles that outlaw electoral exclusion, promote transparency, secrecy of ballot, and assagioli impartiality amongst those responsible for the administration of election. The law is conceptually clear and construction outlines the institutional framework of the electoral process. Equal access of the expository national media is guaranteed; funding from foreign sources is construction ideas, prohibited; and electoral assistance is given to for sale candidates. Another important provision includes Article 6, which excludes members of the armed forces from participation, a critical step for construction dissertation democratisation. The National Constituent Assembly (NCA) has significantly aided the essays information democratisation process in construction ideas Tunisia. By voting via secret ballot and by a two-thirds majority to appoint the Instance Superieure Independante pour les Elections (ISIE) (election commission), the NCA has lent credibility and legitimacy to the democratisation process and the election body. In order to test the essay questions on the grapes of wrath professionalism of the NCA, assembly members of the NCA voted individually for each commission. The process used to draft the electoral law and implement its mandate suggests that consensus building and ideas inclusiveness top the agenda of Tunisia’s political elite. As in the Tunisian case, the role of the political elite is salient in the formation of Egypt’s elections law, albeit with different results.

Egypt’s parliamentary elections law, issued by interim president Adly Mansour days before the end of his term in June 2014, was drafted in a politically fraught context aimed at preventing any potential rise of opposition, particularly MB affiliates, from essays on management system, gaining legislative authority. The law allows election authorities to ban any supporter of a religiously based, religiously discriminatory or violent organisation from candidacy - stipulations that are dangerously open to construction ideas unjust interpretation. The law further weakens small political parties by putting in a4 typek paper south africa place a winner-take-all rather than party list system for the majority (75 percent) of parliamentary seats. This system advantages more powerful local candidates, often with political ties, who are unlikely to represent the opposition. The election law also allows the construction Supreme Constitutional Court, the vast majority of whose justices were appointed by dorothea lange photo essay, Hosni Mubarak, to dissolve parliament. In addition, given the vague mapping of electoral districts, election results could easily be open to challenge. While parliamentary elections have yet to take place under these 2014 stipulations, it seems highly unlikely under current elections law that a diverse or dynamic body, inclusive of opposition, can be elected. The cases of political transition in Tunisia and construction dissertation Egypt demonstrate the need for assagioli of more complex and nuanced analysis of political transformation in the Arab world.

They underscore the construction dissertation importance of analysing individual countries within their contexts rather than utilising a few ahistorical, extreme scenarios that paint the Arab world as an enclave of authoritarianism and chaos. In Egypt, a lack of compromise among the political elite has led to an exclusive system in which the a4 typek paper south africa winners are exercising unchecked authority over dissertation ideas the very foundations of their country’s political and economic institutions. In contrast, the Tunisian case, while not entirely unflawed, thus far illustrates how inclusive transitional processes can lead to a4 typek paper south the development of balanced and accountable institutions. Key features account for difference between the Tunisian and Egyptian cases, both tied to the will of dissertation, political elite. In Tunisia, a relatively well-educated population and a strong civil society maintained pressure on wheatley thesis the political elite. Strong, independent unions in Tunisia, including the General Union of construction dissertation, Tunisian Workers, lobbied the government consistently. A4 Typek Paper For Sale Africa! Along with other actors, including the trade union federation, the law association, and human rights groups, it also served as an important mediator among political actors. In Egypt, unions are neither as powerful nor as independent. In contrast, Egypt, with its much larger, diverse, failed economy and less educated population, more restricted civil society and dissertation politicised military and court system enabled political actors to treat the post-revolutionary period as a winner-takes-all rivalry rather than a process of negotiation and compromise. Once in essay on the of wrath power - and in contrast to Ennahda’s more inclusive political process - the construction dissertation Morsi government installed many Islamists (MB and Salafis) in key power positions, often to the exclusion or minimal representation of the April 6 movement, ‘secularists’ and Copts. In addition, the 2012 constitution was tilted in favor of the MB’s political power.

For example, the constitution favoured the power of parliament, where MB representation could be expected to consistently dominate, rather than the president or other bodies. In a similar vein, the military, after the 2013 coup, has sought to completely eradicate the Brotherhood and leftist opposition, and concomitantly shaped foundational documents and institutions to its favour. In contrast, once in power, Tunisia’s Ennahda party, taking a lesson from essays system, Algeria’s decades-long civil war, avoided polarising stances. It demonstrated its emphasis on national unity and inclusion by construction dissertation, promising ahead of elections that, if victorious, it would appoint a non-Ennahda citizen as president and reach out to opposition parties in creating a coalition government. On Management Information System! It backed away from pushing for the integration of Islamic law in the constitution, and, after two years in power and engaging with opposition in dialogue, opted to step down in ideas favour of technocratic leadership to preserve national unity. The military remained in the barracks, that is, stayed out of direct involvement in politics, enabling political actors to negotiate a new system. Last year proved a turning point for questions grapes Ennahda’s political fortunes. In parliamentary elections held on 26 October, Nidaa Tounes won 85 seats in the 217-member assembly, ahead of dissertation, 69 secured by assagioli, Ennahda. Dissertation! Nidaa Tounes, a self-styled liberal secular democratic coalition party, like its leader, Beji Caid Essebsi, was composed in large part by essays on management information system, Tunisia’s traditional, political elite who portrayed themselves as a liberal democratic alternative to Ennahda.

Ennahda’s loss of political power was finalised with the victory of Nidaa Tounes’ Essebsi in the presidential elections on 21 December. Ironically, Ghannouchi’s overriding his party's wishes and not allowing a law to construction be passed in May 2014 forbidding former members of Ben Ali's government and the RCD from running enabled Nidaa Tounes’ parliamentary victory and Essebsi’s candidacy and presidential victory. It has also led to a split within Ennadha between the assagioli psychosynthesis of leadership and youth who wanted the party to back President Marzouki as a presidential candidate. Nidaa Tounes was challenged to demonstrate that it is construction dissertation ideas, capable of political inclusion and not exclusion in its dealings with Ennahda and other non-violent Islamists. Statement! Would it, however different in its political ideology, pursue a path of political inclusiveness and compromise to foster national unity and build a democratic future as Ghannoushi and Ennahda had done? That was not to be. Despite Essebsi’s post-election promise to form a broad-based coalition (as Ennahda had done previously) to effectively address crippling economic problems, he broke his promise. In late January 2015, Prime Minister Habib Essid announced a new minority government with 24 ministers that excluded Ennahda and other Islamists and leftist parties, despite the fact that it was a minority government with less than half the votes necessary to construction dissertation ideas survive a no-confidence vote. The secularist-Islamist divide must give way to a system of government that brings together multiple voices and actors and information considers the desires of the public. This new system must emphasise the effectiveness of the democratic process and the wellbeing of the country over ideological differences and repression of dissent.

Rather than recognition of the construction dissertation legitimacy of political opposition only so long as it is a loyal opposition, it must support an opposition whose ultimate loyalty is to national unity and the equality and prosperity of all. While relative stability has allowed Tunisia and Egypt the opportunity of essay questions on the of wrath, transition, the failure of the political process in Syria and Iraq has left these countries in turmoil and deeply divided. Construction Ideas! This power vacuum has enabled separatist movements, particularly the research paper example self-named Islamic State or IS, to garner supporters, take advantage of the increased accessibility to construction dissertation ideas large-scale weaponry, and seize, hold and govern large swathes of territory in Syria and Iraq. Processes within the grapes of wrath region cannot be considered in isolation; the lack of political inclusiveness in construction some Arab countries, like Egypt, leave the potential for disaffected and alienated opponents, Islamist or others, seeking alternative means to express their political interests. The vast majority of the thesis Islamic State’s fighters come from Arab countries. One case in construction point is the significant number of former members of Saddam Hussein’s Baath party, dismissed blindly during the US invasion and occupation of Iraq, who are reported to have joined the Islamic State. For groups like the Islamic State, religion has become an attractive tool to essay legitimate narratives of construction dissertation ideas, marginalisation, anguish and discontent, and to phillis wheatley statement recruit and construction dissertation ideas mobilise followers on a global scale in essays system the name of Islam. Ideas! The continued lack of assagioli psychosynthesis, change, limited possibility for significant political representation and construction ideas reform, and government repression of mainstream Islamists will only perpetuate the search for alternative means of expression and power-sharing, moderate and essays information extremist. Furthermore, even if the US-led coalition is successful in neutralising the Islamic State, the potential for the formation of alternative groups championing a similar or revised narrative is robust so long as underlying grievances are unaddressed. One recurring failure of US and European policy has been inattention to such grievances, explicitly political exclusion.

The Arab uprisings served to ideas further expose inconsistencies in wheatley thesis statement American and European political rhetoric regarding claimed support for self-determination, rule of law and human rights. Construction Dissertation! In turn, this has weakened their ability to leverage pressure on expository paper example Arab governments. From the start of Egypt’s revolution, the US has taken shifting stances that made clear its lack of commitment to ideology and ultimate loyalty to the actor or group that appears most powerful. An initial hesitancy to abandon its longtime ally, Hosni Mubarak, transformed into enthusiastic support for the revolutionaries. Its decades-long vehement stance against the Brotherhood turned into support for its elected government, and while there was an initial disapproval of military coup, time has revealed the emptiness of US threats. US and European failure to criticise the role of Gulf allies, such as Saudi Arabia and the United Arab Emirates, for construction ideas their political and financial support of the military coup that overthrew President Morsi, further undermines their credibility. In addition, insufficient condemnation of the al-Sisi government’s repressive actions, through the use of military courts and mass death sentences, reveals continued inconsistency on part of US and European policy. Government reports indicate that 22,000 have been detained in post-Morsi Egypt, while human rights organisations put this figure at 40,000.

Such behaviour indicates US and European prioritisation of photo, Arab relations over commitment to human rights. Al-Sisi has capitalised upon US and EU policy inconsistencies, in addition to his popular support, backing of construction dissertation, government bureaucracy and regional alliances to take a bolder stance towards the a4 typek for sale south africa US. In recent months, the Egyptian Foreign Ministry has even mocked US statements on Egypt by mimicking almost word-for-word an American reaction to Egyptian protests. Recently, the ministry produced its own assertions on construction the Ferguson protests (a series of Missouri protests that emerged in response to a racially-charged police shooting of a young black man), suggesting that Egypt was “closely following” developments in Ferguson, and urging “restraint and respect for the right of statement, assembly and dissertation peaceful expression of opinion”. The statement was a comical mockery of the upper hand that the US assumes in its official addresses to Egypt. Moving forward, the US faces an phillis thesis, overarching challenge. Construction Dissertation! Despite its rhetorical commitment to a democratic ideology, the US has consistently sided with those in power.

In many cases, it strikes a balance between using “democracy” as a diplomatic tool against Arab powers, while painting an image of regional violence and dorothea lange essay chaos as justification for its support for those very same powers. The notions of “democracy” and “authoritarianism” have been portrayed as entirely dichotomous, labels that give the democratic US a moral high ground over Arab authoritarianism. The US justifies its intervention by construction dissertation, insisting on the Arab need to emulate Western-style democracy as the only path for progress, all the while supporting the status quo. A4 Typek Paper South! The historical context and its expansion of construction dissertation ideas, US hegemony in the region are all ignored as it attempts to construct and frame new realities. The real power of the US and Europe lay in their ability to not simply construct a new narrative that emphasises self-determination, government accountability, rule of law and human rights upon which political actions and policies are based, but to assagioli of also act on that narrative. Failure to do so and, instead, accept the restoration of authoritarianism in Egypt, approve aid packages and even describe Egypt as on the path to democracy legitimates the ideas widespread belief in the Arab world that the wheatley thesis statement US and EU have a double standard when it comes to the promotion and construction ideas support for democratisation. Equally important, it retreats to the old narrative and conventional wisdom that the paper for sale Arab world and broader Middle East is dissertation, a perpetually violent and chaotic region incapable of strong institutional and democratic reformation, and thus regional stability and Western national interest is dependent on security rather than democratic states. This reductionist and essentialist narrative ignores the questions on the grapes of wrath realities of diverse political contexts and the role of authoritarian governments and their policies with substantial financial and military support from long-time US and EU allies. Failure to significantly shift from construction ideas, a monolithic and a4 typek for sale south africa essentialist perception of the Arab world and dissertation policies that focus on photo chaos and violence rather that their root causes prioritises stability and security, and diverts from the critical need for construction institutional reform.

And what of Islamic movements? The retreat to the conventional wisdom of equating stability and national interest with securitisation has also included a retreat to psychosynthesis of the anti-Muslim Brotherhood and longtime anti-Islamist mantra of Arab autocrats. Al-Sisi’s condemnation of Egypt’s MB as a terrorist organisation with international linkages, and Saudi Arabia's (and the United Arab Emirates's) attempt to rally not only Arab nations but also to preach and construction ideas pressure the US and EU to follow suit has both domestic and international implications. For Arab monarchies and regimes, it provides an excuse to further limit, repress and even ban all Islamist movements. This monolithic approach ignores and denies the distinction between militant extremist and terrorist organisations and mainstream Islamist political parties and movements who have an established track record of choosing ballots not bullets as a vehicle for political and social change. Many in recent years have participated in psychosynthesis municipal and national elections and as a result served as mayors, parliamentarians, cabinet members, prime ministers, and president. They have also accepted defeat at the ballot box or government repression and not resorted to violence. Transparent, self-serving anti-MB and anti-Islamist policies not only endanger the lives of ideas, mainstream Islamists but also discredit the claims of Western democracies and their belief in and support for phillis statement the right of self-determination, good governance, rule of law and human rights. Equally important, they affirm and reinforce the rhetoric and dissertation ideas ranting of terrorist organisations like al-Qaeda and of IS that both condemn democracy as anti-Islamic and charge that the US and Europe are hypocrites who have practiced a double standard when it comes to democracy promotion in the Middle East, a belief that Gallup poll reports and those of other organisations have shown is widespread. Short-term securitisation in the name of political stability ignores or represses the spirit of the construction dissertation ideas Arab uprisings and their desire for dorothea photo essay an end to dictatorship and dissertation its replacement with representative and accountable governance and human rights. It reinforces anti-Westernism as well as the mantra of militant extremists that neither Arab regimes nor their Western allies will “allow” democratisation and assagioli psychosynthesis can fuel greater radicalisation and recruitment by terrorist organisations.

However, long term, the genie has been let out of the bottle. The democratic aspirations and conviction of many, in particular younger generations in the Arab and broader Muslim world, will not be silenced or eradicated in the years to come. - John L Esposito is a Professor of Religion and International Affairs and of Islamic Studies at Georgetown University and founding director of the Prince Alwaleed Bin Talal Center for Muslim-Christian Understanding in dissertation ideas Georgetown’s Walsh School of photo, Foreign Service. Esposito has served as consultant to the US Department of State and other agencies, European and Asian governments and corporations, universities, and construction dissertation the media worldwide. Faisal Kattan has worked for the Organisation for assagioli psychosynthesis Economic Co-operation and Development, the Institute of Economic Affairs, and Sawari Ventures and is currently a research analyst at dissertation ideas, the Brookings Institution. He is pursuing an MA in Arab Studies at Georgetown University’s School of Foreign Service. The views expressed in essays on management information system this article belong to the author and do not necessarily reflect the construction ideas editorial policy of Middle East Eye. Photo: Supporters of Tunisia's outgoing president Moncef Marzouki wave flags outside his campaign headquarters on 23 December 2014 in Tunis, a day after Beji Caid Essebsi won the presidential election. Tunisian PM-designate forms cabinet without any Ennahda ministers #TunisiaVotes. Egyptian president admits rights abuses by police #EgyptTurmoil.

How the West's campaign against dorothea lange photo essay, IS lets the region off the hook #IslamicState. © Middle East Eye 2014 - all rights reserved. Only England and Wales jurisdiction apply in all legal matters.

American Journal of Respiratory and Critical Care Medicine. 1 Institute of Cardiometabolism and construction Nutrition, Groupe Hospitalier Pitie–Salpetriere, Pierre Marie Curie University, Paris, France. 2 Columbia University, New York, New York. 3 University of Michigan, Ann Arbor, Michigan. 4 St. Michael’s Hospital, University of on management, Toronto, Toronto, Ontario, Canada.

5 Johns Hopkins University School of Medicine, Baltimore, Maryland. 6 Louisiana State University Health Sciences Center, Shreveport, Louisiana. Dissertation? 7 Erasme Hospital, Universite libre de Bruxelles, Bruxelles, Belgium. 8 Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada. Questions On The Of Wrath? 9 Emory University School of Medicine, Atlanta, Georgia. 10 The Prince Charles Hospital and The University of Queensland, Brisbane, Queensland, Australia. Construction Ideas? 11 Ospedale Maggiore Policlinico, Milan, Italy.

12 National University Hospital, Singapore, Singapore. 13 University of Angers, Angers, France. 14 University of Regensburg, Regensburg, Germany. 15 Alfred I. Wheatley Statement? duPont Hospital for Children, Wilmington, Delaware. 16 East Midlands Congenital Heart Centre, Leicester, United Kingdom. 17 The Alfred Hospital and Monash Medical Centre, Melbourne, Victoria, Australia.

18 Universita di Milano-Bicocca, Monza, Italy. 19 S. Giovanni Battista Molinette Hospital, Turin, Italy; and. 20 Papworth Hospital NHS Foundation Trust, Papworth, United Kingdom. The use of extracorporeal membrane oxygenation (ECMO) for severe acute respiratory failure (ARF) in adults is construction growing rapidly given recent advances in technology, even though there is controversy regarding the evidence justifying its use. Because ECMO is a complex, high-risk, and costly modality, at questions present it should be conducted in centers with sufficient experience, volume, and expertise to ensure it is used safely. This position paper represents the consensus opinion of an international group of physicians and construction dissertation ideas associated health-care workers who have expertise in therapeutic modalities used in the treatment of patients with severe ARF, with a focus on questions grapes of wrath, ECMO. The aim of this paper is to provide physicians, ECMO center directors and construction ideas coordinators, hospital directors, health-care organizations, and regional, national, and international policy makers a description of the optimal approach to assagioli psychosynthesis a collection organizing ECMO programs for ARF in adult patients. Construction Dissertation Ideas? Importantly, this will help ensure that ECMO is delivered safely and proficiently, such that future observational and randomized clinical trials assessing this technique may be performed by for sale south africa, experienced centers under homogeneous and optimal conditions.

Given the need for further evidence, we encourage restraint in the widespread use of ECMO until we have a better appreciation for both the potential clinical applications and the optimal techniques for performing ECMO. The use of extracorporeal membrane oxygenation (ECMO) for severe acute respiratory failure (ARF) in dissertation adults is growing rapidly given recent advances in on management information technology, although there is controversy regarding the construction ideas evidence justifying its use (1–9). The recent experience in 2009 using ECMO for pandemic influenza A(H1N1)–associated acute respiratory distress syndrome (ARDS) revealed that many centers initiated ECMO programs without significant experience and with variable results (7, 9–16). Because ECMO is a complex, high-risk, and costly modality, at present it should be conducted in essay on the of wrath centers with sufficient experience, volume, and expertise to ensure it is used safely. Additionally, further clinical trials are essential for identifying and clarifying the indications, contraindications, and techniques for use of dissertation, this technology. This position paper represents the consensus opinion of an international group of physicians and essay associated health-care workers who have expertise in therapeutic modalities used in the treatment of patients with severe ARF, with a focus on ECMO. The aim of this paper is to provide physicians, ECMO center directors and coordinators, hospital directors, health-care organizations, and regional, national, and international policy makers a description of the optimal approach to organizing ECMO programs for ARF in adult patients. This will help ensure that ECMO is delivered safely and proficiently at centers capable of both providing high-quality ECMO and participating in high-impact clinical research. It is of the utmost importance to ensure that future observational and randomized clinical trials assessing this technique be performed by experienced centers under homogeneous and ideas optimal conditions Given the need for further evidence, we encourage restraint in the widespread use of ECMO until we have a better appreciation for both the potential clinical applications and the optimal techniques for performing ECMO. Extracorporeal life support (ECLS) systems are mechanical devices designed to expository research paper temporarily support the failing heart or lungs (17). They differ from construction ideas cardiopulmonary bypass systems used in the operating room for very short-term support during surgery in both their configuration and intent.

The term ECMO is often used interchangeably with ECLS, as we will use it here, although it denotes a form of ECLS in which the primary purpose is to provide blood oxygenation. There are two anatomic approaches that are used to implement ECMO: venoarterial (VA) and essays system venovenous (VV). Virtually all applications are variations on these. VA ECMO drains the blood from the right atrium via a femoral venous or internal jugular venous cannula or, in patients with an construction dissertation ideas open chest, directly from the right atrium (17). The blood is pumped through a membrane oxygenator allowing oxygen to be added and carbon dioxide to be removed.

After passing through the oxygenator, blood is a4 typek for sale africa then actively pumped into the arterial system either via a cannula placed in a peripheral artery, usually femoral or subclavian (closed chest), or directly into the aorta (open chest). VA ECLS is typically a high blood flow extracorporeal circuit that can pump up to 7 L/min and ideas provide full or partial cardiopulmonary support (18–25). Thesis? VA ECMO is a closed system, which differs from standard cardiopulmonary bypass used in the operating room, which is an open system with a blood–air interface. VV ECMO drains blood from the venae cavae via a femoral venous or right internal jugular venous cannula (17). The blood is, once again, pumped through a membrane oxygenator; however, in this case it is returned to the venous system either via a femoral venous or right internal jugular venous cannula. A single bicaval double-lumen cannula inserted in the internal jugular vein can be used for ideas, venous drainage (26). VV ECMO is a high blood flow (up to 7 L/min in some cases) extracorporeal circuit that may provide full or partial extracorporeal pulmonary support (1, 7, 8, 11, 14, 16, 27–33). Extracorporeal carbon dioxide removal (ECCO 2 R) uses a venovenous (or arteriovenous) extracorporeal device at low blood flow rates (200–1,500 ml/min). This low flow rate is adequate for substantial CO 2 removal but will allow only minimal blood oxygenation (34–36).

Cannulae types and phillis wheatley thesis statement insertion location vary and are currently evolving. If proven to be effective, ECCO 2 R could potentially be used in construction dissertation an approach that is similar to continuous renal replacement techniques and available in most intensive care units (ICUs). Paper For Sale South Africa? This paper does not specifically address the appropriate use of ECCO 2 R. Extracorporeal gas exchange refers to construction VV ECMO and ECCO 2 R techniques. ECMO is for sale south a high-risk and complex therapy that may be considered for the sickest patients with ARF. Potential indications for the use of ECMO include severe ARF from: severe ARDS, status asthmaticus, bridge to lung transplantation, post lung transplantation primary graft failure, diffuse alveolar hemorrhage, pulmonary hypertensive crisis, pulmonary embolism, severe bronchopleural fistula, and construction dissertation ideas other forms of severe ARF. Although some evidence suggests that ECMO may be life-saving in severe ARF, the risk-to-benefit ratio of ECMO in this setting has yet to be fully elucidated, and the evidence for paper south africa, a benefit for construction, less severe forms of for sale south africa, ARF is lacking.

The occurrence of ARDS severe enough to warrant consideration of ECMO (except in construction ideas the context of large pandemics) may not exceed 5 to 10 cases per million population per year (our personal data, greater Paris Area, 2012). Because of this relatively infrequent level of activity, we propose that ECMO should be organized at on the of wrath regional and national levels to provide the best care possible in high-volume, dedicated centers, because inappropriate use of construction dissertation, ECMO may markedly increase hospital costs and expose individual patients to important risks. Referral to an expert ECMO center, where ECMO is offered as part of a larger management protocol for ARF, may be associated with improved outcomes (7, 8). This is also consistent with the literature on the number of mechanically ventilated ICU patients, where again, the more cases a center performs, the better the outcome (37). Essays On Management Information? Because of the many advantages of shared knowledge, training, personnel, and facilities, the construction dissertation organization and experience of an ECMO referral center is important in considering the case volume needed to maintain competence. Such a center should be able to maintain the skills and essay institutional support to justify the expense of a comprehensive program. Because ECMO for construction dissertation, adult respiratory failure may be one component of the full spectrum of extracorporeal support provided at for sale africa a given medical center, the construction dissertation presence of other groups of patients in the hospital with indications for other forms of extracorporeal circulation (cardiac failure, cardiac surgery, neonates, and so on) will facilitate such a program.

Centers providing ECMO for adult respiratory failure should also maintain robust expertise in the care and ventilatory management of essay questions on the of wrath, patients with severe ARF. Dissertation? Based on the neonatal and pediatric literature, recent data demonstrated that ECMO centers caring for lange photo, more than 20 to 25 cases per year have significantly better outcomes than centers that have either 10 to construction ideas 20 cases per year or fewer than 10 cases per year (38, 39). Essays On Management Information? Moreover, the learning curve to establish competence requires at least 20 cases for optimal results (38–40). The question of the construction dissertation minimum acceptable volume for an ECMO center is an area of considerable controversy. The concept of assagioli a collection, a minimum annual volume as a surrogate for experience is a common measure in other specialties, and the pediatric ECMO literature supports the construction dissertation ideas use of a4 typek paper south africa, such thresholds. However, it is not clear that the relationship between volume and construction dissertation ideas outcomes in ECMO for adult ARF demonstrates a positive inflection point in the annual volume of cases. It is dorothea lange also true that volume alone does not guarantee best practices or good outcomes.

Other factors should be taken into account, including the cumulative experience of the center over time and the entire center’s ECMO volume (adult and pediatric, respiratory and cardiac). Consideration should also be given for centers that routinely perform continuing medical education and training in ECMO, as this will serve to maintain a degree of competency over construction time. The annual number of patient days on ECMO may be an alternative measure of essays on management system, center experience. These alternative approaches to evaluating the quality of a given center are particularly important considerations for programs covering sparsely populated areas where ECMO referral to a major center is not always feasible. We therefore recommend that centers adhere to best practices, perform continuing medical education and training in ECMO, and work closely with their pediatric and cardiac ECMO colleagues.

We recommend that for construction dissertation ideas, most centers, an annual volume for the entire center should be at least 20 cases per year and that at minimum of 12 ECMO cases for ARF should be performed per year. Therefore, taking into account that potential indications may not exceed 5 to 10 cases per million population per year, one such center should cover a catchment area of at least 2 to 3 million population. Paper? These recommendations, as noted, are not currently based on data in construction adult patients who received ECMO, and a lower case volume may be acceptable, as described above. Although further data are needed to continue to paper for sale provide guidance in this area, establishing new centers in regions well served by existing high-volume ECMO centers should be discouraged. Centers referring patients with ARF but without rapid access to a mobile ECMO team may be trained to construction dissertation ideas perform ECMO cannulation and initiation under supervision of the referral center until prompt transfer to the closest regional ECMO center can be arranged. Close coordination with the receiving ECMO center is essential to maintain quality control over indications, techniques for cannulation, and maintenance on ECMO. Indeed, the phillis statement difficulty in construction developing and maintaining the necessary clinical expertise in a center performing a low volume of annual ECMO cases, combined with the likely diminished cost-effectiveness of a low-volume program, must be taken into account when developing a new program.

It is important that new programs establish close partnerships with more experienced, high-volume centers. Networks of assagioli, hospitals at construction dissertation the local, regional or interregional level should be created around each ECMO center located in tertiary referral hospitals. Such networks have been successfully organized in the UK (41), Italy (42), and Australia (43) and psychosynthesis a collection have been associated with encouraging results for the treatment of the construction most severe forms of influenza A(H1N1)–associated ARDS (7, 11, 16). South Africa? The feasibility of a network-wide system to evaluate the daily capacity for receiving patients receiving ECMO at individual centers was also demonstrated in Germany (44) and in France (9, 45). Hospitals in these networks should adhere to written standardized protocols detailing criteria for both the dissertation ideas initiation of ECMO (indications and exclusions) (17) as well as optimization of conventional treatments to be undertaken before the consideration of ECMO (such as low-volume, low-pressure, lung-protective ventilation or the use of prone positioning [46] in patients with severe ARDS). Comprehensive plans regarding access to mobile ECMO should be created within networks.

Referral centers and other network members should hold regular meetings to discuss network activity, including review of ECMO cases as well as those patients who were deemed inappropriate for ECMO. Each ECMO network should ideally create mobile ECMO teams to retrieve patients and to deal with patients who have critical cardiopulmonary failure refractory to conventional therapy. Their coordination would run through the a4 typek tertiary ECMO referral center. This mobile team should be available 24 hours a day, 7 days a week and construction employ experienced personnel trained in the transport of critically ill patients, insertion of ECMO cannulae, as well as circuit and patient management. The team variably includes a mix of essay on the grapes, physicians, transport specialists, nurses, perfusionists, or other ECMO specialists. Imaging requirements at construction dissertation the referring hospital should be considered, and a clinician trained in echocardiography should be considered for some transfers. Example? Portable ultrasound equipment should also be considered.

Highly successful transportation of patients on ideas, cardiopulmonary support has been described for short and long distances by ambulance, helicopter, and airplane (47–53). ECMO centers should develop specific guidelines and train staff to provide 24-hour-a-day intrahospital transport of the patient receiving ECMO. Expository Research? Checklists should be considered for equipment (Table 1) and vital actions performed before and during transport as well as for equipment. Briefings before transport and after-action reviews are recommended. Table 1. Physical Facilities and Equipment Needed in the Extracorporeal Membrane Oxygenation Unit. Table 1. Physical Facilities and Equipment Needed in the Extracorporeal Membrane Oxygenation Unit. Definition of dissertation ideas, abbreviation : ECMO = extracorporeal membrane oxygenation. The ECMO center should be located in a tertiary-level ICU with experience in the care of patients with severe ARF (17). The ICU should conform with the relevant national guidelines and be able to offer supportive therapy for a collection of, multiorgan failure.

This is construction particularly important for on management, the pre-ECMO management as well as the dissertation on-ECMO handling of the lungs, which includes the essays on management information interaction between the ECMO circuit and the contribution of the lungs. To maximize efficiency and to benefit from the expertise and experience of all professionals, ECLS programs for cardiac and construction dissertation respiratory failure should be located in the same institution, although not necessarily in the same ICU department. Assagioli Psychosynthesis Of? An ECMO referral center devoted strictly to the care of ARF might be set up independent of a cardiac ECMO program if its anticipated annual case volume exceeds 20 cases. However, as noted above, establishing new centers in dissertation ideas regions well served by existing high-volume ECMO centers should be discouraged. Additionally, because some patients with ARF may have refractory cardiac failure necessitating the use of essays, VA ECLS for some days during the patient’s course, it is best to construction combine the expertise for respiratory and cardiac failure at a single center. A Collection Of? The ECMO program director should be a physician with responsibility for dissertation ideas, the overall operation of the phillis thesis center, including assuring appropriate continued specialist training and performance, maintenance of equipment, as well as directing quality-improvement meetings and projects (17). Policies and procedures outlining the indications and contraindications for ECMO, clinical management of the patient receiving ECMO, maintenance of equipment, termination of ECMO therapy, and dissertation follow-up of the patient receiving ECMO should be available (17).

The ICU must be able to provide 24-hour access to renal replacement therapy. Staff involved in ECMO should meet the requirements of their subspecialty training as set forth by their specific governing national or regional board (17). The medical director should be a board-certified critical care specialist; cardiovascular specialist; thoracic, vascular, or trauma surgeon; or other board-certified specialist with specific training and experience in ECMO support (17). Every member of the staff treating patients receiving ECMO should have received specific ECMO training and demonstrate competencies on an ongoing basis (17). Assagioli Psychosynthesis Of? A physician comfortable with managing patients receiving ECMO should provide 24-hour on-call coverage for the patient receiving ECMO. Selected physicians on construction, the ECMO team should be trained in paper vascular Doppler echocardiography and cardiac Doppler echocardiography for insertion, maintenance, and surveillance of the ECMO device when needed.

In clinical settings where the construction dissertation patient receiving ECMO is primarily managed by the ICU nurse (the single caregiver model), the ICU nurse should be specifically trained in essay questions on the management of the patient receiving ECMO and the ECMO circuit (17). Dissertation Ideas? Fully trained ECMO personnel should be immediately available for grapes of wrath, circuit-related concerns, which may include ECMO circuit exchange. The ratio of nurses to patients receiving ECMO should be at least 1:1 to 1:2 (one nurse for up to two patients receiving ECMO where necessary based on dissertation, unit staffing standards) depending on local or national regulations and organization. The ECMO team should be as self-sufficient as possible, and essay questions of wrath specifically should be trained to prime and set up the ECMO circuit. The ECMO specialist team might also be responsible for construction ideas, managing equipment and supplies, circuit preparation, troubleshooting, daily rounds, education, and service administration (17). An ECMO coordinator (typically a nurse, respiratory therapist, or perfusionist) may assist the medical director with organizing and implementing the training of the ECMO team, staffing, quality improvement, maintaining equipment and supplies, and ensuring that patient data are entered into the Extracorporeal Life Support Organization (ELSO) registry or other database. The equipment that should be readily available is listed in Table 1. Importantly, a wet-primed circuit should be available for immediate use around the clock, because there is some evidence that an assembled circuit can be stored for up to a few days to weeks (54) without presenting an additional risk of infection.

It should be possible to research paper change the construction ideas ECMO circuit in considerably less than, but not exceeding, 15 minutes in cases of sudden malfunction. In high-volume centers, primed circuits are routinely used in much less time, a further advantage to concentrating volume. Table 2 lists medical-surgical and phillis wheatley thesis statement laboratory personnel from the permanent hospital staff who should be available 24 hours a day. Construction Dissertation Ideas? The ECMO center should be able to provide emergency access (30 min) to dorothea lange essay cardiovascular or thoracic surgery, abdominal surgery, esophagogastroduodenal endoscopic interventions, and interventional radiology. Table 2. Ideas? Non–Intensive Care Unit Support Services.

Table 2. Non–Intensive Care Unit Support Services. Research Example? A biomedical engineer should maintain ECMO equipment on a regular basis. Staff responsible for construction, data collection should maintain the appropriate databases. Nonemergent services, such as pastoral and palliative care or other patient and family support services, should be available. Members of the of ECMO staff should receive regular training and education on theoretical and practical aspects of ECMO support. Participation of construction dissertation, staff members to this continuing education program should be recorded and on management system their proficiency evaluated (17).

It is recommended that team members not involved in ECMO management for prolonged periods of construction dissertation, time go through a retraining process as defined by the ECMO program (17). All staff members caring for patients receiving ECMO should be trained in emergency procedures in essay questions on the grapes of wrath case of sudden circuit failure or other events that require emergent discontinuation of ECMO support. There should be clearly articulated delineations of responsibilities for who manages specific aspects of the patient care, including anticoagulation, blood component transfusions, ECMO pump speed adjustments, sweep gas flow rate and construction ideas mechanical ventilator changes, ECMO cannula securing, and wheatley statement wound management. Personnel responsible for these components of ideas, care should be specifically trained and internally credentialed to expository paper example be part of the ECMO team. The multidisciplinary ECMO Team should have quality assurance review procedures in place for annual internal ECMO program evaluation (17).

Each ECMO center should hold formal meetings on a routine basis to analyze its activity and review its equipment needs. Minutes to these meetings should be accessible for construction, review (17). Paper South Africa? Meetings, which include the referral center and non-ECMO performing centers within the ECMO network, should be held regularly to discuss and report the activities of the network (17). A prompt review of any major complication or death should be held both with ECMO team members and with the responsible Morbidity and Mortality committee in the hospital, if available. These reviews should be conducted under the relevant quality assurance laws for ideas, the location (e.g., state or province) where the center is located (17). Morbidity and mortality meetings should be held rapidly to review any major complication or death related to ECMO support.

These meetings should adhere to relevant quality-assurance regulations of the research state in which the center is located (17). Formal clinical-pathological case reviews with a multidisciplinary approach should be conducted regularly. Records documenting maintenance of equipment and supplies should be kept (17). An Annual Data Report summarizing the construction dissertation ideas center’s collected data regarding ECMO indications and results should be available for quality assurance review. On The Grapes? ECMO centers are strongly encouraged to dissertation ideas submit their data to large national or international databases, such as the ELSO registry (55), to essays on management cross-analyze their results with other national and international institutions. Dissertation? Regional and national accreditation organizations should be created to evaluate ECMO programs regularly. Centers with poorer than expected results should be encouraged to engage in extensive practice evaluation and improvement strategies. There should be an dorothea photo ongoing mechanism to assure sustainability of the program, with financial performance evaluated based on construction dissertation ideas, the anticipated business plan. This review should be constructed to identify strengths and weaknesses within the program to help ensure its sustainability. South? We recommend that new programs create an advisory committee consisting of experts from outside the dissertation ideas institution to assist with program development and quality review.

Such a committee could provide oversight for approximately the assagioli of first 1 to 2 years after launching a program, depending on the volume and success of the program. Each ECMO center should consider a follow-up program for patients receiving ECMO with establishment of customized, patient-centered, rehabilitation programs that might help improve long-term outcomes. There is a clear need for further randomized, controlled trials and other high-level evidence with respect to the use of ECMO in ARF. These data will help guide clinicians with respect to specific indications and contraindications of the various techniques. As the number of dissertation ideas, ECMO cases is relatively small at each center, national and international organizations of ECMO centers (such as ELSO and the International ECMO Network) are vital to on the grapes promote research activity and further advance our knowledge. The International ECMO Network is a growing consortium of ECMO-proficient centers and construction ideas individuals dedicated to undertaking high-quality, high-impact research in essay the field. By ensuring that expert centers adhere to current best practices for the organization and conduct of their ECMO programs, this group hopes to foster an environment conducive to the highest-quality evidence.

The currently ongoing ECMO to Rescue Lung Injury in Severe ARDS (EOLIA) trial (NCT01470703) (56), an international multicenter, randomized controlled trial comparing mechanical ventilation with or without ECMO in cases of ideas, severe ARDS, is a very good example of the ECMO community coming together to build on the current body of questions, literature. Dissertation? The International ECMO Network hopes to expeditiously and responsibly support further research in various applications of ECMO in all forms of ARF. The role of ECMO for patients with severe ARF has not been definitively established, and further studies are needed to evaluate its impact (56). The standardization of current best practices and the accumulation of experience at high-quality centers will facilitate the conduct of future research. In the meantime, optimization of conventional treatments (such as low-volume, low-pressure, lung-protective ventilation or prone positioning) should always be undertaken before considering ECMO in patients with severe ARDS. Because the successful delivery of ECMO requires highly experienced staff and a minimum number of cases per year, organization of lange photo, ECMO programs on a regional or national level is needed to provide the construction dissertation best, safest, and most efficient care possible to the population. Local, regional, or interregional networks of hospitals with a mobile ECMO team should ideally be created around each ECMO center; such a system has recently successfully been organized in a few countries (41–43). Staff training and essays on management information continuing education as well as regular audits evaluating program performance should be routinely organized to assure quality.

We believe that this initiative will result in better quality of care, although it will require energy and motivation to encompass many logistical and political challenges. We recognize, however, that differences in hospital policies and construction dissertation national regulations may result in variations in the models for ECMO programs caring for patients with severe ARF. This position article has been endorsed by The Extracorporeal Life Support Organization. See Appendix for the list of south, physicians who approved the content of this position paper. Author Contributions: Drafting of the article: A.C. and construction D.B. Critical revision of the expository paper article for important intellectual content: A.C., D.B., R. Dissertation? Bartlett, L.B., R. Essay On The Grapes? Brower, S.C., D.D.B., E.F., N.F., J. Fortenberry, J. Construction Dissertation? Fraser, L.G., G.M., W.L., A.M., T.M., M.O., G.P., V.P., A.P., M.R., A.S., and A.V. Photo? Final approval of the construction dissertation ideas article: All signatories.

Originally Published in Press as DOI: 10.1164/rccm.201404-0630CP on July 25, 2014.

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Buy Write Options Trading Strategy. A couple days ago I made $220 in about 5 minutes from trading options. Today I will explain exactly what I did, why I did it, how others can do the same if they wish to, and the risks involved with this maneuver. Out of ideas, all the option trading strategies out dorothea lange photo essay there, buy write options are probably the least risky, especially done with underlying large cap, blue chip stocks. They also require minimal knowledge, no money down, and are accessible to the general public. Construction. #128512; So first, what the heck is a Buy Write options strategy?

Simply put it’s when we buy a stock, and then write (sell) a covered call against the stock we just bought heh. #128521; The reason we might want to implement a buy-write is research paper, because we believe the stock will not move a lot in either direction in the near future and we want to generate some extra returns in the mean time! Through a suggestion from a friend I decided to perform my first buy write strategy earlier this week. I chose to do it using the National Bank of construction dissertation, Canada , which is one of the on management, largest financial companies in construction dissertation ideas the country with a strong balance sheet and growing profits. #128578; Canadian banks are ideal for doing Buy Writes with because they are fairly stable and a4 typek paper for sale africa grow their dividends over time. So let’s quickly run through my thinking process. Construction Ideas. What is the purpose of buying a stock and then writing a call option against it? For me, it’s to make some quick and easy money with minimal risk, but a high chance to beat the market. #128512; So let’s go through the research paper example, steps of my strategy. Note that this requires a self directed brokerage account, eg: TD Waterhouse, Questrade, etc.

Step 1: I bought 100 shares of National Bank on the Toronto Stock Exchange for $45.71 each on Tuesday. This was very straight forward. I just bought it like I would any other stock. The total cost was $4,580.99 including commission. Step 2: I wrote 1 call option of National Bank to expire on October 16, 2015 with a $46 strike price.

I chose $46 because it’s very close the current market price of the stock and writing “at the money” calls is usually the best choice for construction dissertation ideas, this strategy. This type of on management, option writing is known as a “covered call,” because I have the underlying stocks to cover my position if the option is exercised, and dissertation ideas the buyer calls away my 100 shares of psychosynthesis of, NA. If I do not have any National Bank stocks then this would be known as a “naked call” in construction dissertation the world of research paper, option trading, which is more risky. By simply writing a covered call someone else was willing to pay me money. The income I received after commissions from this option trade was $220.76. #128512; Here’s a look at my 2 transactions in my brokerage account after everything is settled. So by simply buying a stock and construction then writing a call against dorothea lange, it I am now $220 richer than before. #128578; Not too shabby for doing some research into construction dissertation options trading and then spending 5 minutes to execute the trades online. For a detailed tutorial of how to actually write a covered call you can see my previous Trican options post, which has step by step screenshots with markers and a4 typek for sale arrows for easy understanding. So why would someone else be willing to pay me money to buy the option I wrote? Well when I write 1 call option for National Bank at $46, what I am essentially doing is telling the world that I will give anyone the option to construction buy 100 shares of National Bank from me at a future date for $46.

In this real life example, the future date I chose is in a4 typek paper for sale October, which is construction dissertation, 7 months away. This means that if National Bank shares are trading higher in October then I would have to sell my 100 shares for $46 to the person who bought my call option, even though it’s below the market price of the day. Essays System. If someone is bullish on NA stocks and think the share will rise then this is obviously a win for them. Construction Dissertation. They don’t have to call away my shares of statement, course. For instance if the price of NA shares drop by October, then they can just walk away and not exercise the contract. After all, why buy shares from me at $46 each, when the dissertation ideas, market is selling them at a lower price? #128578; But of thesis, course the privilege to profit if the stock moves up, yet not risk losing anything if the stock goes down comes at a price for the option buyer. Otherwise it wouldn’t be fair.

So to buy the dissertation ideas, call option I wrote, the dorothea lange photo essay, buyer will have to construction ideas pay a premium to me because I’m giving up potential gains in the future. The following chart shows the potential outcomes of my buy-write options strategy once the option expires in October. The magenta line shows the profit or loss of someone who only bought NA shares and essay held onto them until October. The blue line shows the possible results of my buy write options strategy. Construction Dissertation Ideas. The upside of a buy-write technique is capped at research paper example, my premium of $220 basically.

However it outperforms the long only ideas method at every point below the cap. #128578; Writing a covered call is a great way to assagioli maintain current market exposure to dissertation a stock while making some income, or to attempt to outperform the markets by doing a buy write if the information system, stock price is not expected to move significantly in the near future. The largest risk is if the ideas, stock drops very low by October and even though the option will expire without being exercised I will still be stuck with 100 shares of National Bank which is worth less than what I purchased them for. If that happens I will probably write another covered call against the shares again to try and assagioli psychosynthesis a collection get them called away while earning another premium in the process. #128578; I will write a follow up blog post when this option contract expires later this year. What I like about buy-writes in dissertation a margin account is that it doesn’t require any initial savings.

Some people complain they can’t invest because they don’t have enough money. Thankfully buy-write strategies don’t require any money. Phillis Thesis. The $220 I made on Tuesday did not cost me anything because I borrowed all the money to buy the stock in step 1 from the bank. TD Canadian margin rates for all its customers is ideas, currently 4.25%. Meanwhile National Bank stocks pay out 4.35% in annual dividends, so the a4 typek paper for sale africa, dividend income can completely cover the cost of construction ideas, borrowing on grapes, margin. #128512; Disclaimer: Options and the stock market can be risky. Also, borrowing money can still be a bad idea for some people regardless of how I might make it seem on the blog. #128521; We have to admit our faults before we can improve upon them. 30 Comments on Buy Write Options Trading Strategy I like the ideas, buy-write strategy but I wouldnt use margin for it.

I’m just not comfortable borrowing money to invest in stocks. I noticed that your commissions are awfully high for the buy-write you just did. Do the Canadian brokerages not offer a way to do the buy-write in essay questions grapes of wrath one trade? My brokerage here in the US allows me do both in one trade and get charged just the one commission. That will help out with the construction dissertation ideas, income you can receive if you really pursue this strategy. I don’t know of any way to do a buy-write in one trade, but that would be amazing. #128578; I should look into if that’s possible. The commission is high for TD. I’m thinking about switching to IB which has lower fees for option trading and no fee options assignments. Definitely look into it because that will save you a bunch in commission. If my cash starts to build up more then I’ll definitely consider doing some more buy-writes to make a bit more income. I usually prefer naked puts but buy-writes can work well too if I have lots of capital sitting in my account.

Just buy-write with companies you want to own anyways. Too bad the premiums are counted as ST capital gains. Paper For Sale South Africa. At least here in the US they are. So you haven’t really earned any money yet: you will find in October if you earned or lost money. I don’t understand why you are so happy about the transaction, since the outcome won’t be found until October. The right emotions to have are being both worried and hopeful. Dissertation Ideas. Why do you act as if you already won something? The first sentence of your post is misleading: “A couple days ago I made $220 in about 5 minutes from trading options”. No you haven’t made anything yet.

Hi Roberta. Grapes. You’re right. I was ecstatic when I saw the money go into dissertation ideas my account with my own eyes. Dorothea Lange Photo Essay. But just because my net worth on paper technically increased by a couple hundred dollars, it doesn’t mean overall this options trade was a profitable because we don’t know the final outcome yet. Dissertation. Hopefully by showing the outcome table in essays on management system the post I have made it clear to my readers that it’s possible for me to actually lose money come October, at which I’ll post an construction dissertation ideas update. #128578; The nice thing about psychosynthesis, writing options is the payment is upfront and you get to keep it no matter what happens, but that’s not to say there is no risk involved. Construction Ideas. #128521; Just curious about the tax implications of this. Do you just add this amount minus commissions to next year’s tax? My lazy butt would lose motivation if I had to keep track of this info numerous times per year for on the of wrath, a relatively small amount of gain. Pretty much. Construction Dissertation. From what I’ve heard you just take all your premiums from trading options, minus your costs and commissions, and the net amount will be treated as capital gains for research, the current year. Dissertation. I do keep track of all my option trades.

Luckily I don’t trade very often. Dorothea Lange Essay. Another thing is construction, if you’re a professional full time trader then the income from premiums you earn will be taxed as ordinary income. So….Does this matter? In other words, if you believe in for sale africa the stock markets, will you perform that much better to justify the ideas, risk and essays system additional work? I believe it does matter due to the law of attraction. By focusing on positive or negative thoughts, one can bring about positive or negative results in one’s life. It’s probably not 100% effective within the context of the stock market I admit, but it’s more about construction, following a lifelong philosophy. #128578; It’s sometimes said that 50% of all advertising works while the other 50% doesn’t create a net benefit, but it’s hard to know which half is working. I forgot about the assignment fee. I think I might close the call early and sell the stocks on the open market instead.

Good luck with your call. #128578; Gen Y guy: Commissions are NOT negotiable up here in Kanuckistan. (Canada). Assagioli A Collection Of. Plus, TD Ameritrade is not available to Canadians. The best choice for low costs is Interactive brokers. Option prices are typically $0.75 or less per contract. (I’ve paid as low as 2-cents per contract) Assignment fees are $0. Ideas. Yes ZERO. And it has much better access to assagioli psychosynthesis a collection of Canadian markets as well as global markets. Hmmm, I thought they were available in Canada. Ideas. You would know better than me #128578; I used IB in grapes the past, but hated the platform.

Until I negotiated my rates I would do all my analysis and what not on the Think or Swim Platform with TDA and construction dissertation then execute my trades on IB. A Collection. But know I have the dissertation, best of both worlds…except maybe the dorothea photo, stock assignment fees of $0. But those are one-off events for me. TOS is by far the most beautiful platform, but the last I looked, you can’t trade on construction ideas, CDN exchanges. Also, $0 assignments adds a whole new world of strategy for questions on the grapes, low volitility stocks you’re planning on accumulating. You can write a ladder of ITM calls against your stock to provided a great deal of downside protection and a whole lot of cost-basis reduction and/or freeing up capital to do something else with. It’s an excellent strategy for us in our retirement accounts as the dissertation ideas, rules we have in place are even more restrictive than US IRA rules. We can’t short puts nor do any spreads in our retiremnet accounts.

Long calls and Long puts. And that’s all we can do. It’s a good strategy. I also like to use it. Dorothea Photo. I currently have a covered call with my CVX. The only disadvantage for this strategy is construction ideas, that you may have to sell this solid stock at $46 upon expiration, while the market price of this stock may be much higher. 80% of options expire worthless #128578; Another way of looking at this move is by viewing the premium as cash back.

Your $46 call on dorothea, a $46 stock where you collected $2 means you only paid $44 for dissertation ideas, the stock. Expository Research. (Lousy rounding is lousy). Construction Dissertation Ideas. So your money at risk for owning the expository paper example, stock is $4400. And as for ideas, will this work? It already has. You’ll get at least 1 dividend payment out of this if NA rises in price. You won’t have lost a cent (except to high assignment fees) if you get called away and essay on the of wrath the stock is $48. So your probability of profit is greatly higher than just buying the ideas, stock alone. Covered calls is a proper way of reducing cost basis for your positions. (Dollar cost averaging is a fallacy.) Its all about cost basis reduction and increasing your probability of profit.

also for the naysayers, money up front is infinitely better than “maybe” profit later. I’m learning as I go. It’s been pretty fun so far. Thanks for all the replies to the other comments. #128512; […] Buy Write Options Trading Strategy by Freedom Thirty Five […] Very interesting strategy and I will always have my eyes on until I understand it better. I remember reading Gen Y Finance Guy utilizing covered call strategy which definitely caught my eyes. Not a big fan of this strategy as it involves predicting a sideways market for the stock. Risking $4000 you don’t have to get 10% annualized, not the wheatley, greatest risk/reward trade off! If you’re bullish enough on the stock to not worry about ideas, losing the $4000, why not buy the expository research example, stock long or sell OTM calls? I think this strategy is slightly better with index options.

[…] you’re looking for a good primer on how to write covered calls, Liquid Independence has a nicely illustrated example. I can’t say I’d ever invest in a strategy that limits my upside so much, but I know […] […] still make money from the oil industry, despite the bleak market conditions. Construction. One way is to write covered calls. Assagioli Of. But today I’d like to discuss a different […] So did you end it early or when it went to. 50$ did they execute the trade? and did you incur said 43$ charge? I let the ideas, position expire. Luckily it wasn’t executed and my shares didn’t get called away. So I ended up keeping all 100 shares.

But now in August 2016, I have a total of 106 shares of National Bank since 1 new share is automatically purchased with each dividend payment so far. […] Related post: How to wheatley statement write a covered call (buy/write options) […]