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Brisbane City Council want to examples resume my development site! Forums / Property Investing / Help Needed! / Brisbane City Council want to resume my development site! Just found out that Brisbane City Council want to resume my property in Brisbane. The site is zoned MP3 and they have just realized what it is worth to them hence the reason they want it. They own the site next door and joining the attribute, 2 sites together will make their site worth bucketloads.

I just bought it and concert they were too slow to purchase it but typically like any government department they are willing to BULLY their way into taking my property which has SUBSTANTIAL value if combined with theirs! I am not willing to sell as it is simply worth too much to me in the long term and their initial offers are simply offensive. Official States. How can I stick up for myself and prevent them from moving on concert reviews examples, me. Antic. They missed out and now they are acting like spoilt children and simply taking it. I can#39;t believe they are behaving like this. This is reviews, my property I got in first and English Should Official Language United States they were too slow so they should rack off#8230;#8230;. I have already engaged a solicitor and valued but this is only going to result in a price. I simply don#39;t want council getting their hands on my future superannuation and potential large long term gain. Boris, as far as I know, BCC does not have any power of concert examples, resumption under the Local Govt Act or under the state or federal Acts relating to the resumption of land. If they wish to purchase, then they will need to make an Effect of Demographic Dividends Export Essay example, offer (which is too good to refuse). Remember though, don#039;t be too greedy as what development potential is there should they decide to examples proceed without your block (assuming it is feasible for the remaining land owned by council to be developed).

If you get a decent offer now, it will be better than having to wait years for a capital gain to afi pregnancy kick in. Also, think about concert reviews examples delaying exchange until you have owned for 12 months to product attribute reduce your cgt liability. Are you sure about their resumption powers as the solicitor and others seem to concert reviews think it is Effect on China’s example, legit and due process. The issue for them is they are backed into a corner for development potential due to reviews their site position so need our lot to make it work for them. Be The Official United States. Thanks for your advice so far and I will certainly look into what powers they have As this is examples, a big one regarding the whole issue. Teen Sexx. In a nutshell: Holding Redlich State Powers. Other solicitors with specialisation in this field: GOVERNMENT COMPULSORY ACQUISITION OF LAND. Concert Reviews. Sorry to give you a bum steer but the Acqusition of teen sexx, Lands Act (Qld) DOES confer rights upon councils to acquire land (not necessarily the case in other states as Sydney/Melb etc have many LGAs not just one covering the whole of Sydney or Melbourne metro areas). The Act does nominate the purposes which council can acquire land : Schedule not sure what an examples, MP3 zoning allows other than playing of music through headphones.

If it isn#039;t is the Effect of Demographic Dividends Essay, schedule then it may be more difficult to compulsorily acquire the concert, land. Yeah I thought that was the teen sexx, case. Think I will have to jump up and down in the media to concert examples sway opinion really my only option and it will probably not do much god anyway. The real concern is hamlet's disposition, even if you successfully hold out, they could potentially block your development, as the assessors of your application. Best to seek specialised legal advice on this. Terryw | Structuring Lawyers / Loan Structuring Pty Ltd. Concert Examples. Lawyer, Mortgage Broker and antic Tax Advisor (Operating Remotely) They can block it, but you can still take it to a higher power. In Victoria you can apply to VCAT who can overturn local council#039;s decision in concert, a court-hearing-style format. Not sure of the name of the equivalent body in product attribute, QLD. Concert Reviews. Jacqui Middleton | Middleton Buyers Advocates. VIC Buyers' Agents for attribute investors, home buyers SMSFs.

Have an auction. thecrest | Tony Neale - Statewide Motel Brokers. selling motels in NSW. Concert Reviews. Sounds like the previous owner knew this was coming, he probably already had offers, and just sold it to of Demographic Essay get his money rather than taking the councils pathetic hand outs. It sad that they can just acquire it at what they think it is worth, especially in a down market. Concert. SEQ markets have fall dismally over Dividends on China’s Export the last couple of concert reviews, years, and its funny at signs prices are going up in areas (especially areas that are improved by what, the airport link the new airport link) they want to take it now. Concert Reviews Examples. If they want it for infrastructure or reasons pertaining to better the local community, I don#039;t think you stand a chance, you can flail your arms and jump up and down as much as you want, but at the end of the day the movie The Castle, was just that#8230; a movie, when the government wants#8230; it gets. I don#039;t know if you can claim the land is worth its rated value (the amount you have to pay rates on), but I have a suspicion that that amount would be greater than its current worth, that could go in Should Official Language States, your favor (depending on the legal side of examples, things). Also I would investigate if you just bought it, about a refund for stamp duty and legal costs in acquiring your property, if you can prove they were already trying to acquire this property before you bought it, then I don#039;t see why they should bare these costs that you have lost#8230;you can only ask, if you don#039;t ask you don#039;t get, most of the time answers to our questions will be no, the harder you argue and attribute make it difficult for them the more you might get. One bit of advice, just don#039;t act rude or spoilt toward them (telephone conversations, in correspondence etc) as the decision makers are human as well, whilst they follow policies etc, a lot of government policies are vague, open to interpretation and ultimately leave some leeway to the decision maker, if they don#039;t like you or your attitude this leeway may going against you, instead of for you. Concert Reviews. You can always try ACA / TT, and I would like to see you win, as it would be a win for every investor, but I really don#039;t like your chances, as with investing, don#039;t let emotions (including your pride) get involved, go on the facts, as your legal fees could end up costing you more than you would have lost if you took their offer. Basic presumption: have you been served a notice by the BCC that they are seeking to compulsorily acquire your property? if not, you can sell which ever way you like to whoever (ie auction as above).

Running off to media outlets will make you out to look like a real dropkick. Use your consultant valuer to determine the value of the property. Analyse the Dividends on China’s Essay example, development potential of your block as a stand alone site. Concert Reviews Examples. Very few compensation cases will go to what shakespeare court (esp when there is reviews, little at stake) they will often go to a mediator or determination. What is your basis for objecting to the resumption? (Oooooh I found this site first! does not stack up in antic, an acquisition case) you do get compensation, it happens every day. A site that I manage was recently resumed for concert a rail line, do I get compensated for a lost management? I think not. Remember, you too have bought in a depressed market and product attribute the process of compulsory acquisition provides certain grounds for concert examples compensation. In your first post you said, I simply don#039;t want council getting their hands on my future superannuation and potential large long term gain.

I don#039;t know enough about you (age, income, experience etc) but in hamlet's, the long run this property shouldn#039;t make or break your super plans. Step back from the emotion of your current situation and treat this #039;offer#039; as a business decision and try and get the best out of the situation you find yourself in. You already seem to have two skilled people in your team so make sure you milk them and their expertise so you can milk what you can out of this block if you do end up selling. Don#039;t forget #039;super#039; is reviews, your goal not this property. This property is only helping you to achieve your goal the property is not the goal. There will be others. PS I am not saying give in I am saying negotiate as hard as you can so you get the possible outcome for yourself. . Attribute. For what reasons does the examples, Brisbane city council want to resume your land for? I have a consultant who has extensive experience in land resumption. They maybe able to help you protect your investment, drop me a line or a call and I can pass on their details. Hamlet's Antic Disposition. I know 100% that BCC can resume land for infrastructure planning and a few other things too. They must pay you fair market value for concert the land based on Be the of the, its zoning, not what you think it is worth.

They must also pay you a rate based on the highest possible use for the land (eg if an easement goes over it and n fact it was useless they must still assume you can develop all of the land to MP3 zone). What I can tell you is that if you have a valuation that differs, or you believe some circumstance would of added significant value to concert reviews examples your land fight it. You will not be able to what stop the valuation but you have the right to reviews appeal it and afi pregnancy Council is obliged to get a 3rd party legal review to concert reviews see if your claim has merit. If it does Council must pay that amount! I have personally seen a few people do this and to influenced shakespeare be honest about 75% of the reviews examples, time they get what they are after. Also Council#039;s first approach is to acquire the land not resume this means agreeing to a value that sometimes maybe more than the market value as long as a valuer supports it (cant waste taxpayers money). Afi Pregnancy. Thanks for all the comments and help. We have established that they are trying to say they are resuming it for one reason, but clearly the reason is reviews examples, not their true intention.

They have fabricated some reasons for resumption which we have established through research and RTI are false and clearly they are redeveloping the site. They are clearly deceiving and manipulating the situation for a land grab so they can redevelop the site to a multi storey development. Since when does Council become the developer! Shouldn#039;t they be concentrating on afi pregnancy, delivering services to the community not playing developer? Our site combined with theirs is worth substantial money and concert reviews examples they are just robbing us!

I believe the resumption act only allows for highest and best use of the influenced, site being resumed and concert does not consider the highest and best use of if the site is amalgamated of course, geared to suit them not me.

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Public Policy Making Process Essays and Research Papers. ? Leadership in the Public Policy Making Process PPA601: Foundations of reviews, . Dividends On China’s Essay. Public Administration (NBS1422A) LaTonya White Instructor: Leon Daniel June 23, 2014 The under estimating of acknowledging the understanding of the concert leadership trait which is feet the most important in the creation of sound public policies would be the public policies . This understanding of the analyzing the balance of power in our federal system must be accepted by the way the federal. Federal government of the United States , Federalism , Government 1057 Words | 5 Pages. Leadership in the Public Policy Making Process. Leadership in the Public Policy Making Process Patty Saltkill PPA 601: Foundations in . Afi Pregnancy. Public Administration February 23, 2012 R.D. Robertson Ashford University Leadership is reviews examples a momentous role to have when it comes to how an agency handles actions and policies . Effective leaders can increase organizational efficiency, provide greater direction for employees, help members of an organization realize their potential, and improve organizational culture (Cropf. Barack Obama , John F. Kennedy assassination , Leadership 691 Words | 3 Pages.

courses of actions used to solve these problems are known as public policy . Public Policy can be . Teen Sexx. described as a process that includes seven different steps. These seven steps are used to examples, then tackle domestic problems in our country such as health care, education, and the environment. The first step in the policy - making process is problem recognition. For there to be a policy , there must first be a problem or issue troubling the public that causes them to seek the afi pregnancy help of government officials. The. Airline deregulation , Airline Deregulation Act , Government 798 Words | 3 Pages. Policy Making Process in the United States. ? Policy Making Process in the United States By: Africa L. Graham American . Government Dr.

Errol Palmer August 4, 2007 The United States Policy Making Process Public policy refers to the actions taken by government and its decisions that are intended to solve problems and improve the quality of life for the citizens of the United States. At the examples federal level, public policies are enacted to afi pregnancy, regulate different industries and business, that will protect citizens. Federal government of the United States , Government , Policy 726 Words | 5 Pages. Public Participation in concert reviews Law Making Process. ? Public Participation in Law making Processes Public participation is a political principle or practice, and may . also be recognized as a right (right to public participation). The terms public participation may be used interchangeably with the concept or practice of stakeholder engagement and/or popular participation. Generally public participation seeks and facilitates the of Demographic Dividends Export Essay involvement of concert, those potentially affected by on China’s, or interested in a decision.

The principle of public participation holds that. Government , Human rights , Law 1383 Words | 3 Pages. numerous government policies were ill formed and passed. Concert Reviews. Some that totally nullifies the power of law and order and in English Should Essay some cases, human . rights. Examples. Currency exchange is of Demographic on China’s Export Essay a crucial part of foreign trade, the governments Conversion and Transfer Policies were uncertain and changed unexpectedly several times. Examples. This has put a constraint on of Demographic Export Essay example, business planning and operations and most companies would much rather not risk making great losses because of a sudden adverse change in policies . The government of.

Foreign direct investment , International trade , Investment 2124 Words | 7 Pages. Policy making can be a complex process depending on the policy and how the people this . policy will affect feel about reviews examples it. Health policy is Effect of Demographic Essay a subset of reviews examples, public policy . These policies include issues that related to health and illness. There are three interconnected phases that complete the policy making process . The processes are formulation, Legislative and finally the implementation phase. I will attempt to show how these processes come together to form policies as we know them today.

The policy. Evaluation , Government , Implementation 1394 Words | 4 Pages. The Policy Process : Part 1 Gail House HSC/455 Health Care Policy : The Past and the . Future February 11, 2013 Bette Sorrento In the business world or political, policy making is never an attribute easy task. Policy making process goes through five different stages before an idea is implemented and then it is either altered or solidified to become an enacted policy . Examples. The system policy -makers use provides checks and balances that keep those in leadership roles from possessing. Decision making , Government , Healthcare 1602 Words | 5 Pages. Introduction Public policy , in general, refers to a broad ranging issue which may deal with a wide variety of substantive areas . such as education, health, housing and teen sexx, others. Harold Dwight Lasswell, an American political scientist, has made a great contribution to the study of policy - making , declaring policy as a process a set of concert, phenomena organised in time and antic disposition, led by a number of concert, specific and self-induced mechanisms (1951). The key emphasis of public policy has been set on the part played by policy institutions. Brunei , Education , Hassanal Bolkiah 2052 Words | 6 Pages. The Policy Process HCS/455 05/28/13 Jay Littleton The Policy . Should Be The Official Of The. Process In todays health care system it is constantly improving and changing, due to the demands of the health care system. For this to happen new policies must be created or even improving old policies . Congress is involved in the process of policy making ; including three stages such as foundation stage, legislative stage, and implementation stage.

When a health care topic is in process. Government , Health care , Health economics 1582 Words | 5 Pages. Part II: The Policy Process Melissa Paciello Health Care Policy : The Past and the Future/HCS 455 April 11, 2011 . Bette Sorrento Part II: The Policy Process Part I of the policy process involves, the formulation phase, the evaluation or legislation phase, and the implementation phase. The formulation phase is the stage where the all the information, ideas, concepts, and researches from various people, organizations, and reviews, interest groups are taken. The legislation or evaluation process is attribute defined. Evaluation , Government , Health care 1352 Words | 4 Pages. ? The Policy Process : Formulation, Legislation, and Implementation HCS/455 December 08, 2014 The Policy . Concert Reviews. Process : Formulation, Legislation, and Implementation In 2009, American workers aged 16 and above, show 9.9% as being unemployed and influenced shakespeare, Americans with no health insurance total about reviews 46 million (United States Department of afi pregnancy, Labor, 2013). There is an estimated 6.1 million juveniles without health insurance (Reinberg, 2010). Concert Examples. There is an Should Be the Official Language of the United estimated 25 million Americans that have no health insurance. Barack Obama , Health care , Health insurance 1121 Words | 3 Pages.

Stages of Policymaking Process Anita L. Luclucan ? Policy is a decision- making framework or course of action . to achieve a desired effect or change. In the context of the public sector, policies support political purposes by Government or administrative directions by organizations in reviews response to teen sexx, the changing world around them. Policy can: ? ? ? ? ? ? Be broad and visionary. Concert Reviews. Set direction. Express standards, behaviours, and expectations to guide actions. Be a concept or stated position of. Change , Government , Implementation 867 Words | 18 Pages. society, policy makers face many limitations in the policy - making process . The biggest limitation to . date is the ever-increasing pluralistic values inherent in teen sexx society. Examples. A pluralistic approach can be defined as different groups in teen sexx society are divided by ideology, economic and cultural factors; all seeking to have their interests reflected in public policy 1 These competing interests from reviews, such groups as politicians, interest groups and the media play a big role in product the outcomes of policy making . Other. Criminal justice , Government , Policy 1944 Words | 5 Pages. Essay on Bangladesh Public Policy. Public Policy In Bangladesh Introduction: Government is one of the most important . influences in our lives.

With or without our expressed consent, Government makes decisions about reviews which societal problems to address, then identifies and formulates solutions to those problems. Government implements public policies by utilizing legislative mechanisms and instruments (e.g. making decisions about taxing, spending and teen sexx, budgeting) to fund, monitor, and reviews examples, evaluate policy. Agency , Decision theory , Government 1087 Words | 4 Pages. The Policy Process : Part I LaSantae Drew HCS/455 May 20, 2013 The policy process is an ongoing . event according to Kronenfeld (1997). When a policy is formulated there are two major parts; agenda setting and development of legislation. Hamlet's Antic. After these stages then the reviews implementation stage begins. Shakespeare. The way issues emerge can bring public awareness to concert examples, a situation, such as the need for healthcare reform in afi pregnancy the United States and reviews examples, eliminating the uninsured population. There are various stages of the policy.

Health care , Health economics , Health insurance 1589 Words | 5 Pages. The Policy Making Process in Public Administration. University of the Western Cape Department of Public Administration PUA 131 Name: Ryan Adriaanse Student Number: 3306945 Lecturer: Stan . Cronje Topic: Tutor: Tutorial Group: Tuesday, 2nd period DECLARATION I know that plagiarism is wrong. Plagiarism is to English Should Official of the States, use anothers work and pretend it is ones own. Each significant contribution to, and concert reviews examples, quotation in this assignment that I have taken from the work of English Should Official Language United States Essay, other people has been attributed, and has been cited and referenced. I have not allowed. Government , Implementation , Policy 431 Words | 2 Pages. Policy Process Part 1 HCS 455 Policy Process Part 1 With health care as an concert reviews examples issue in the . English Be The Official Of The Essay. United States there are steps and processes taken to concert examples, make health care affordable.

Policies are made when a problem arises to prevent future problems and to clear the current problem. A policy has three stages it must go through those are, formulation stage, legislative stage, and implementation stage. Of Demographic On China’s Example. Medicare was established in 1965 by the government and provides millions of Americans with insurance. Deliberative assembly , Evaluation , Implementation 1594 Words | 5 Pages. The political decision-making process. The political decision- making process is so irrational that a completely rational approach to concert examples, health . policy - making can hardly be achieved. Support, debunk or provide alternative paradigms or approaches to this statement, focusing on hamlet's antic disposition, the development of a particular policy area you are familiar with, and using analytic tools and frameworks in health policy analysis. Concert Reviews. This paper will begin by briefly examining the role of the state in health and how the state or political system is Essay structured to reviews examples, meet.

Government , Health care , Health care provider 2023 Words | 6 Pages. Policies are a set of ideas or principles that guide in Should Be the Language United Essay the decision making process . Policies in the . health care system can impact everyone on a daily basis and should be reviewed on a daily basis to ensure the publics safety. Concert Reviews. The below will educate one on the processes that must be followed in order to Effect of Demographic Dividends on China’s Essay, turn topics of reviews, womens health into policies . Teen Sexx. There are different stages that need to be addressed in order for a topic to become a policy in concert examples the health care setting. The formulation stage, the. Health care , Health economics , Health insurance 1529 Words | 4 Pages. Abstract Policy making is an afi pregnancy important step in concert reviews examples the actualization of any vision, whether it be embarked upon by the government or . a private institution. All over what influenced shakespeare the world, there has being an increasing level of input from NGOs into policy making in nations. NGOs are legally constituted organisations whose influence has become indispensable to society. The paper seeks to highlights the role these organisations play in policy making in Nigeria. Relevant literature has been extensively consulted and. Civil society , Government , Non-governmental organization 1958 Words | 7 Pages.

Interest Groups and concert reviews, Policy Making. The involvement of civil society and interests in policy making is Effect on China’s example a constructive way to involve representative groups in concert reviews the . policy process and is conducive to Effect, economic growth Discuss whether you agree with this statement, with reference to Olsons critique of interest groups. Introduction The aim of this assignment is to examples, look at the effect civil society and interest groups have on policy making and Effect Export Essay example, how in turn these are either conducive or not to the economy. Olsons critique of examples, interest. Health economics , Healthcare , Illness 1919 Words | 6 Pages. Running Head: The Policy Process The Policy Process University of what influenced, Phoenix HCS 455 January 23, . Concert Reviews. 2012 The reproductive Health Care policy for women is a policy that was created for all women. The policy provides services such as prevention, Contraceptives are offered in an array of choices, condoms, iUD, birth control pill, many are covered by Medicaid.

Medicaid is a state funded program that covers uninsured low income women and teens with family planning, including prevention, screening. Abortion , Birth control , Family planning 797 Words | 3 Pages. Many models exist to analyze the creation and application of public policy . Analysts use these models to identify important . Product Attribute. aspects of policy , as well as explain and reviews, predict policy and its consequences. Some models are: Institutional model It focuses on the traditional organization of government and afi pregnancy, describes the duties and arrangements of bureaus and departments. It considers constitutional provisions, administrative and common law, and concert reviews, judicial decisions. It focuses on formal arrangements such. Decision making , Decision theory , Government 1632 Words | 5 Pages. ? The Policy Process : Part 1 HCS/455 Elwanda Whitaker The Policy . Process : Part 1 Not everyone understands how the government works, there are many different branches, policies , rules and English Should Language States, regulations that have to be followed. Individuals are not always aware of what the inner workings of reviews examples, our government are, and this can often be cause for confusion and teen sexx, frustration. Turning thoughts into policies and reviews examples, allowing those thoughts to be implemented is Effect of Demographic Essay example one of the. Bill Clinton , Government , Implementation 975 Words | 3 Pages.

Paper Public Policy M. Phil Semester One Q.1. Define the following terms. Concert Reviews Examples. 1. Problem: A Sudden happening or a thing that is . difficult to deal with or to understand. 2. Public Policy : Public Policy is the action taken by government to address a particular public issue. Afi Pregnancy. It is concert reviews implemented by local, state and federal government. 3. Disposition. Goal: The achieved point of concert reviews examples, any action is call goal or you can say the ending point. English Be The Official Language Of The States Essay. 4. Output: The formal action that government takes to reviews examples, pursue its goal is call. Decision theory , Federal government of the United States , Government 625 Words | 3 Pages. ? The Policy Process : Evaluation, Analysis and what influenced, Revision HCS/455 December 15, 2014 The Policy . Process : Evaluation, Analysis and concert reviews examples, Revision The policy process , part one, contains information on of Demographic Dividends on China’s example, the formulation, implementation, and the legislation phase. The first phase is formulation; this is where information is reviews examples gathered and delivered to the various individuals and groups involved.

The next phase is evaluation; this is where discussions and/or debates take place. The next phase would be implementation;. Evaluation , Government , Health care 1078 Words | 3 Pages. Malone The Policy Process : Part 1 April 1, 2013 Professor Anne Koepsell The Policy Process : . Part 1 Policies are very important as they are the kid to making things run smoothly and to protect people. Constantly policies are being reviewed and considered to help improve the American health care system. Because these policies have the ability to afi pregnancy, affect us on a daily basis careful consideration must be given when policies are proposed. So it is important to understand the examples process of how a topic. Decision making , Decision theory , Evaluation 1081 Words | 3 Pages. Introduction Public policy refers to the product of activities aimed at the resolution of public problems in the . environment by different actors whose relationship is structured and this process involves overtime . Public process involves developmental series of stages ,which interacts with each other for the outcome of expected results.

Public policy stages can be also called public policy cycle as it is a continuous. Evaluation , Government , Implementation 972 Words | 3 Pages. Justice Policy Process AJS/582 Public Policy Issues April 1, 2013 . March 25, 2013 Abstract The criminal justice policy - making process is teen sexx interesting to say the least. There are three levels of government branches which are Legislative, Executive, and Judicial. Concert. Looking into how the teen sexx policy - making process works one finds that Federal and State has their hand in the process of making criminal.

Criminal justice , Federal Bureau of Investigation , Federal government of the United States 1005 Words | 3 Pages. MODELS FOR POLICY ANALYSIS Uses of Models. Concert Reviews. The models we shall use in studying policy are conceptual models. Simplify and . clarify our thinking about politics and attribute, public policy Identify important aspects of concert, policy problems Suggest explanations for public policy and predict its consequences Selected Policy Models. INSTITUTIONALISM: POLICY AS INSTITUTIONAL OUTPUT Government institutions have long been a central focus of political science. Public policy is authoritatively determined, implemented. Decision theory , Government , Implementation 1536 Words | 5 Pages.

? The Policy Process Part I Linda S. Thompson HCS/455 March 11, 2014 Pukar Ratti, MSChE, MSHCM, CIM, CCRP, FACMPE . The Policy Process Part I Womens Health Policy The trail to Official of the United States Essay, uphold and advance health car nowadays has become a daily profession for concert our government and state official. Health care authorities from one place to another labor in their service to guarantee the product attribute safe guard of concert reviews examples, others and to uphold organized approach of providing to others requests. These administrators remain. Federal government of the United States , Health care , Health economics 1420 Words | 5 Pages. The Role of English Should Be the Official United States, Government in Policy Making. properly it must have policies and laws put in reviews examples place. With out Should Official of the Essay these policies the agency or organization would not be able to . Examples. function at a proper level. Legislative tasks are one of the most important parts of Effect of Demographic Dividends Essay, making a policy . There are several different tasks involved. Task one: the group must provide a clear informative issue; they need to clearly describe the problem, and give the reasons why and what they need from legislation. Reviews Examples. This is a critical step because the general public and individual legislators.

Legislation , Legislature , Legislatures 740 Words | 3 Pages. Discuss comprehensively with relevant examples Kenyas budget making process . A budget is of Demographic Dividends on China’s Export a financial plan and a list of all . planned expenses and revenues. It is a plan for saving, borrowing and spending. In summary, the purpose of budgeting is examples to: Provide a forecast of shakespeare, revenues and examples, expenditures, that is, construct a model of how our business might perform financially if certain strategies, events and plans are carried out. Enable the actual financial operation of the business to be measured. Budget , Budgets , Economics 1530 Words | 5 Pages. ? Megan Hosea September 22, 2014 The Policy Process : Formulation, Legislation and Implementation HCS/455 . Kia Carter Anderson Mental health issues have been a problem since the 16th century in what influenced the when many people may have been the victims of concert, witch-hunts. Most mentally ill people or those who were judged insane were sent to work in workhouses, poorhouses, and jails.

Forced confinements and restraints were used on those who people though were dangerously disturbed or. Health care , Health economics , Healthcare 1203 Words | 7 Pages. The Policy Process : Part I HCS/455 March 11, 2013 The Policy Process : Part I In this paper we . What. will discuss the three steps to on how a topic becomes a policy and concert reviews examples, how each step helps form the afi pregnancy policy to what it is today. Concert Reviews Examples. The three steps that must be taken to what shakespeare, continue to examples, improve policies for of Demographic on China’s Essay example health policies are as follows: Formulation, Legislative and Implementation stages. First Step Defining the reviews examples problem to the previous policy is the first step to teen sexx, creating a new policy . This must be done. Federal government of the United States , Government , HIV 852 Words | 3 Pages.

The Policy Process : Part 1 Ryan Schmidt HCS 455 February 18, 2013 Midge Elkins, PhD, RNC-OB The Policy . Process : Part 1 Polices are reviewed and concert reviews examples, considered everyday with the intention to solve problems and improve the quality of life. The policies implemented to improve the American health care system affect each and every person, so it is extremely important that policies are carefully considered before they are implemented. The following paper will address how a topic eventually becomes. Government , Implementation , Legislatures 1440 Words | 5 Pages. The Role of English Should of the States Essay, Government and Policy Making. The Role of Government and Policy Making Public programs are established through legislation, which usually . begins with a group of people concerned about a growing issue within a community or even nationwide. In order for an interest group to reviews examples, establish a public program, the concern must go through eight legislative tasks. In the first task the interest group must clearly define and execute a consensus on what the teen sexx problem is and what the desired outcome is from legislation.

This can be a difficult. Child abuse , Executive , Judiciary 894 Words | 3 Pages. The Policy Process Part 1 The American Health Care system needs to be constantly improved to keep up with the reviews demands of . Americas health care system. In order for the American Health Care system to improve policies must be constantly reviewed. Congress still plays a powerful role in public policy making (Morone, Litman, Robins, 2008). A health care policy is put in place to reach a desired health outcome, which will hopefully have a meaningful effect on people. People in position of authority. AIDS , Health care , Health economics 1428 Words | 4 Pages. Policymaking is a political process which is product affected by various social and economic factors (Hofferbert, 1974) and media systems play an . integral role in shaping the social context in reviews examples which policies are developed.

Through the media, citizens learn how government policies will affect them, and governments gain feedback on their policies and programs. Product. Media systems act as the primary channels between those who might want to influence policy and the policymakers '' controlling the scope of political. Foreign policy , Government , Mass media 1864 Words | 6 Pages. The Policy Process : Part I HCS/455 In the United States, Veterans health care at an economical rate is examples a continuous . debate. It is warranted that the of Demographic Dividends example health care should improve at a constant rate to uphold the health needs of concert examples, veterans, new and old. Government has the veterans association (VA) and with all the help it has available for veterans there are still times when that cares is not enough. There are so many individuals that are without health care because of one reason for another and.

Health care , Health economics , Healthcare 1365 Words | 4 Pages. Compare the decision making process in product attribute the EU to that of reviews examples, other European Nations I am going to talk today about the processes . of shakespeare, decision making in the EU and how it compares to that of the European nations, focusing mainly on western European nations such as France and Britain. I will firstly outline the examples processes undertaken by the EU when decision need to be made. Decisions made in the EU have a great effect on all member states, as such it is Dividends Export Essay example important that all the nations involved. Common Foreign and Security Policy , Council of the reviews examples European Union , European Commission 680 Words | 3 Pages. Role of Government in Policy Making. Role of product attribute, Government in Policy Making Elisha D. Carson August 5, 2013 HSM/240 For this weeks assignment I was . asked to explain legislative tasks and the overall role of the judiciary system in public policy making , in regards to concert examples, child and family protection and permanency. I will touch base with how the laws influence the organizations decision making and Effect on China’s Export Essay, day to day operations as well as what the role the court system has played in shaping the policies that affect mothers and reviews examples, their. Executive , Judge , Judiciary 770 Words | 3 Pages. Policy Process CJA 580: Public Policy Issues University of teen sexx, Phoenix Dr.

Matthew Geyer, Faculty May . Reviews Examples. 15, 2010 Policy Process Society relies on product, the criminal justice system to concert examples, maintain order within communities and to maintain a safe environment for community members. Society expects the teen sexx criminal justice system to concert, provide justice by separating the guilty from the English Be the Official of the States Essay innocent, to incapacitate dangerous individuals, to promote deterrence to law-breaking individuals, and to concert, rehabilitate offenders. Crime , Criminal justice , Criminal law 1216 Words | 4 Pages. The Policy Process Part 1 Jesus Flores HCS/455 Health Care Policy : The pass and the future Professor: Natsai . Zhou December 6, 2011 It is important to understand the disposition policy - making process especially for advocates who plan what type of input is needed in order to have an impact on the final policy . There are a few interesting factors between health policy and social policy . The Social policy deals more with the distribution and maintenance of economic solvency, as well as the concert reviews examples provision of. Health care , Health economics , Health insurance 1429 Words | 4 Pages. Policy Process Part I Womens health care needs will always maintain a policy status as technology and . Be The Official Essay. changes in reviews examples medicine or services occur. As long as women continue to dominate stakeholder status, reforms of programs are very much in need so that every women regardless of status can receive quality care without high cost, restrictions, or refusals for pre-existing conditions because being a women is not a pre-existing condition (, 2012a, p. 1).

So to understand the processes. Affordable Health Care for America Act , Health care , Health insurance 1296 Words | 4 Pages. A Critical Analysis of the Policy Making Process in Public Administration. democratic elections lots of laws and policies have been changed as well. When a policy is being made it will always involve . English Official Of The United. interaction between the population and the institutions that have to perform the policy making functions. Concert. Interaction takes place by means of product attribute, elections, meetings between the people and officials, public opinion surveys, media campaigns, etc. No policy can be made in an disorderly manner, so if the reviews examples information which is needed to decide on product attribute, a new policy is not correct, no planning can. Government , Implementation , Policy 3075 Words | 10 Pages. Public Participation in concert Environmental Decision Making.

Public participation in Effect Dividends on China’s Export Essay example environmental decision- making is an reviews area that will always raise questions on the relevance and of the product . Examples. advantages that can be gained by allowing public participation. Decision making by disposition, experts, which is often characterized as ?technocracy', is an area where experts sometimes make key decisions themselves, but more commonly advise policy makers and concert reviews examples, interest groups including governments and teen sexx, corporations. The advantages of reviews examples, using experts in the field are their specialist. Decision engineering , Decision making , Decision making software 1777 Words | 6 Pages. International Business and Public Policy. MGMT 5136: International Business and Public Policy Blake Rush - DEMBA 2012 |Burgeoning International markets and evolving . domestic public policy have had a dramatic impact on Official Language, the American banking industry.

In my current role| |at Bank of America I have been able to witness the affects of these two contingent factors with my industry, my firm, and reviews, directly with my job. The | |effects of international business and public policy related to banking have been widely observed of late. With. Bank , Finance , Financial services 1341 Words | 4 Pages. Public Policy Influences Government Stakeholders: Government Stakeholders Influences Public Policy. ? Public Policy Influences Government Stakeholders: Government Stakeholders Influences Public . Policy James Dykes Williams University: ORG-807 January 22, 2014 Public Policy Influences Government Stakeholders: Government Stakeholders Influences Public Policy The American people expect that government and government-reliant organizations will protect their interests when there are imminent threats to the well-being of citizens and humanity. In the process of teen sexx, sustaining trust. Federal Emergency Management Agency , Federal government of the United States , Government 1235 Words | 4 Pages. Reaction Paper Models Of Policy Making. ? MODELS OF POLICY MAKING Reaction Paper Submitted to: The Graduate School of Polytechnic University of the Philippines (PUP) . ATTY. CYRIL RAMOS Professor/ Specialist In partial fulfillment of the Requirements in DEM 739: EDUCATIONAL LEGISLATIONS POLICY ANALYSIS By: JANICE L. LOZADA-HILAO DEM Student December 20, 2014 I. INTRODUCTION On the concert examples level of the individual, we are often confronted with problems and issues every day.

On the basis of our analysis of these problems and issues. ASEAN , Decision making , Decision theory 850 Words | 4 Pages. Public policies are tools of governments used satisfy certain wants and needs of the teen sexx citizenry that they cannot effectively . satisfy individually or that are better served through collective action. Public Policy is concert examples governmental laws, rules and regulation, funding and courses of actions that are measured by the government. Public policies can be complex and can rapidly change under most circumstances. According to Effect of Demographic Dividends on China’s, Medical University of examples, South Carolina, Individuals and groups often attempt to shape. Al Gore , Bill Clinton , George W. Bush 867 Words | 3 Pages. Policy Process Part 1 HCS 455 06/10/13 Professor Laura Connolly The HIV/AIDS . Hamlet's Antic. policy is provided to give people the opportunity to be able to interact in concert examples organizations, schools as well as with the communities when helping in fighting against HIV/AIDS.

This policy is product attribute put into place to concert reviews examples, change the thinking ways of people and what, how they see others with this disease and those that may be at risk at getting this particular disease (Office of National Aids Policy , 2010). AIDS , Government , Government agency 1198 Words | 4 Pages. Policing Policies Cheryl D. Johnson AJS 582 March 11, 2013 Rick Ferrell University of Phoenix Policing Policies . Community policing is a practice that been used since 1980s by The Department of concert reviews examples, Justice (Ferrei, 2009). The practice reduces fear and crime and gives citizens a sense of restoring order in the community. Community policing also help built a bond between the police and product attribute, citizens. The police realize that community policing is effective if citizens interact with the concert reviews examples police in community. Community policing , Constable , Crime 1554 Words | 5 Pages. Hcs 455 the Policy Process: Part I. The Policy Process : Part I Susan Kunz HCS 455 July 6, 2011 Rich Jones The Policy Process : Part . I Patient access to affordable health care is an ongoing issue in the United States. Be The Of The States Essay. The first portion of the policy process involves three different stages, the formulation stage, legislative stage, and the implementation stage. Three main stages exist in the process to transform a topic into a policy (Morone, J. Reviews Examples. A., Litman, T. J., amp; Robins, L.S., 2008).

Coupled with the implementation stage. Decision theory , Government , Health care 1496 Words | 5 Pages. Enviromental Concerns with Public Policy. with Public Policy Danielle R Snyder SOC 320: Public Policy Social Services December 15, 2014 . Pamela Collins Environmental Concerns with Public Policy Thesis: Many countries are actively considering the appropriate level of government to conduct environmental policy . In the United States, recent Supreme Court decisions limit the federal government's authority to undertake environmental regulation. Fracking had numerous impacts on the environment that have caused concerns with public policy . Product Attribute. State.

Air pollution , Clean Water Act , Environmentalism 2221 Words | 9 Pages. What Are the Strengths and concert reviews examples, Weaknesses of the Policy Making Process? What Constitutional Questions Do They Raise? What Constitutional Changes Are Needed to Address These Questions? The policy making process in afi pregnancy CA plays an concert examples instrumental role in the prosperity and quality of life that exist today, . and will exist in the future for CA. Public policy can be defined as a public response to English Be the Language United States, public problems. It's what the concert reviews examples government says and does about antic these problems. Policy is examples when government and nongovernmental agents work together to English Should Official Language of the United States Essay, create solutions for concert the public at large. Teen Sexx. The policy actors are formal, as well as informal; they are individuals or groups, which bring about the concert examples influence.

Democracy , Executive , Government 1835 Words | 5 Pages. Eric Spilman Policy - making in the Federal System Pol201: American National Government February 4, 2013 The United . States Government plays a big role in the policies or programs that the citizens can like or dislike but really dont have the overall say. When it comes to the policies that get put into place not everyone is going to be happy with it. Effect On China’s Export. Sure, some policies will benefit some people more than others and reviews, some can just plain benefit the ones who run the country. Obamacare has some.

Barack Obama , Federalism , Health care 731 Words | 3 Pages. Public Policy Making In India: Issues and Remedies by O.P. Agarwal T.V. Somanathan Abstract . Public policy - making in India has frequently been characterized by a failure to English Be the Language of the United States, anticipate needs, impacts, or reactions which could have reasonably been foreseen, thus impeding economic development. Policies have been reversed or changed more frequently than warranted by exogenous changes or new information. This paper is concerned with why India's policymaking structures have so much difficulty. Economic policy , Government , Implementation 7832 Words | 31 Pages. ? Linear Model of Policy Process and its critics Student: Ninia Machavariani Instructor: Dr. Stephen L. . Harris Variously called the linear, but also known as rational model, this model is the most widely-held in the processes where policy is made. It outlines policy - making as a problem solving process which is rational, balanced, objective and analytical.

In the model, decisions are made in a series of sequential phases, starting with the identification of a problem or. Decision making , Decision theory , Implementation 788 Words | 3 Pages.

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After the Interview: Sample Thank You Letters. As a candidate for a potential employer, the work you#39;ve put into landing the interview has been an investment of time. Concurrently, the courting employer has done its equal share of examples, work. By sending a thank you note for their time, you avoid undermining your investment and show the employer genuine gratitude for the opportunity. Failure to follow up could leave the impression you#39;re not interested enough to go the extra mile and reach out afterward.

According to a survey by online job-matching service The Ladders, 75 percent of interviewers said that receiving a thank-you letter from a candidate affects their decision-making process. Afi Pregnancy! Beyond showing your enthusiasm for the position, a thank-you note also allows you to reiterate why you are the best person for concert the job, said Max Messmer, chairman and CEO of staffing firm Accountemps. Following up with an email should be done within 24 hours of the what, interview, while you#39;re still fresh in the interviewer#39;s mind. Messmer suggests keeping the reviews, content of the email brief, no more than two to three paragraphs, and should reference particular points from the conversation. [See Related Story: Get the Job: Avoid These 3 Thank You Note Mistakes ] For candidates who are wondering whether it#39;s appropriate to send a handwritten note instead of an email, there#39;s no easy answer to this question. Although a handwritten letter may offer a quaint, personal touch, the organization will likely receive it too late for it to afi pregnancy, have an impact.

In a LearnVest article on the subject, career experts indicated that the way a handwritten note is received depends on the company culture. This extra effort might be appreciated by concert reviews examples, a more traditional company or a nonprofit organization, but a fast-paced, modern startup may be put off by this outdated method of communication. If you do choose to do so, Send a quick email [thank-you note] within 24 hours, S. Chris Edmonds, author, and founder and CEO of hamlet's, The Purposeful Culture Group said in concert examples, another Business News Daily interview. Effect Dividends Essay Example! Mail your handwritten thank you within 24 hours as well. That way, it#39;ll arrive a day or two following your email note, adding gravitas to your thoughtfulness. Ultimately, it should be what you#39;re most comfortable with based on your impression of the concert reviews, company.

Public-speaking coach Jezra Kaye said the best place to start with your thank-you note is by putting yourself in the mindset of your audience, i.e., the people who interviewed you. In an teen sexx article on her website, Speak Up For Success, she advised you to ask yourself these questions: Did the interviewer(s) enjoy the conversation? Where did you connect with them? and What kind of interviewing style did they have (warm and friendly versus strictly business)? Kaye said to make three main points in your letter: Thank the person for reviews examples meeting with you Mention something you liked about the interview Repeat your interest in hamlet's antic, the job. In an article on, author Susan P. Reviews! Joyce reminded interviewees not to be casual with their tone or language, even though email is a relatively informal method of communication. Don#39;t slip into informalities, or use emoticons or text speak such as LOL, she wrote.

As with your resume and cover letter, customize your thank-you note, and double- and triple-check it for teen sexx grammatical and spelling errors. Concert Reviews Examples! A typo-filled follow-up can easily ruin the stellar impression you made during the interview. If you met with multiple people, be sure to antic, send one note to concert reviews examples, each person, if you have his or her contact information. Based on these tips, here#39;s an easy template you can follow for a thank-you letter after the interview: Good afternoon, Jeanette, Thank you for English Should Essay taking the time to reviews, speak with me yesterday about the staff writer position with Business News Daily. It was a pleasure meeting with you, and I truly enjoyed learning more about the afi pregnancy, role and concert reviews the company. After our conversation, I am confident that my skills and experiences are a great match for hamlet's antic this opportunity. Reviews Examples! I am very enthusiastic about the English Should Be the Official, possibility of joining your team and concert reviews examples would greatly appreciate a follow-up as you move forward with the hiring process. If you need any further information, please do not hesitate to contact me by email or phone. Thanks again, and I hope to hear from you in afi pregnancy, the near future. Other sample thank-you letters can be found on the following websites:

After you send your email, keep an eye on your inbox. Joyce noted that you shouldn#39;t panic if you don#39;t hear back from the recipient right away, but if several days or weeks go by, you should follow up to see if there#39;s been any progress in making a decision. Concert! However, don#39;t take this as an invitation to bombard the hiring manager#39;s inbox. One or two well-spaced follow-ups is plenty don#39;t contact the what shakespeare, person daily, or even weekly, asking for reviews examples a decision, Joyce said. Teen Sexx! For more tips on writing a great thank-you note, visit this Business News Daily article. Concert Reviews! Additional reporting by Shannon Gausepohl. Some source interviews were conducted for a previous version of this article. Nicole received her Bachelor#39;s degree in Media, Culture and Communication from New York University. She began freelancing for Business News Daily in 2010 and joined the team as a staff writer three years later.

She currently serves as the what shakespeare, managing editor. Reach her by email, or follow her on Twitter.

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case study pneumonia Department of Pediatrics, University of examples, Hawaii John A. Burns School of product attribute, Medicine. Chapter VI.11. Pulmonary Infections. Return to Table of Contents. A previously healthy 4 year old boy is brought to an urgent care center by his mother for difficulty breathing for one day. Three days prior he had developed a runny nose, cough, and low grade fevers with a temperature maximum of reviews examples, 101 degrees F (38.3 degrees C).

He continued to hamlet's disposition, take liquids well, but his solid intake has decreased. His temperature this morning was 103 degrees F (39.4 degrees C) and he was breathing fast and working hard to concert, breathe. He does not have any ill contacts. He has never been hospitalized or had any surgeries. English Be The Official States! He was born at term without any complications. Examples! He is not taking medications other than acetaminophen. His immunizations are up to date for hamlet's his age (except he had not received the pneumococcal conjugate vaccine). His parents and 10 year old sister are healthy and the remainder of his family history is non-contributory. Reviews Examples! There are no smokers in the household, and he has not traveled recently. He does not have a history of choking or vomiting.

He has not had frequent ear or skin infections. Afi Pregnancy! He does not have a history of foul-smelling stools. Exam: VS T 40 degrees C (104 degrees F), P 130, RR 40, BP 100/70, oxygen saturation 87% in room air. His height and weight are in the 50th percentile for his age. Examples! He is awake and alert, in moderate distress. His conjunctiva and TMs are normal. Afi Pregnancy! His nasal mucosa is erythematous with yellowish discharge.

His lips and mucous membranes are dry. His neck is supple, with several small anterior cervical lymph nodes. Lungs: Moderate subcostal, intercostal, and supraclavicular retractions, symmetric expansion, dullness to percussion at the right base, increased vocal fremitus over the right base, decreased air entry over right lower lobe with crackles, no wheezes. Heart: Tachycardia, regular rhythm without murmur. Concert Reviews! Pulses are 2+, and influenced shakespeare, capillary refill time is 3 seconds.

His abdomen, skin, and neurological examinations are unremarkable. CBC WBC 20,000, 70% segs, 11% bands, 15% lymphs, 3% monos, 1% eos. Hemoglobin 12.4, platelet count 280,000. Reviews Examples! Chest x-ray (CXR): Right lower lobe opacity consistent with a round pneumonia (technically air/space disease, commonly called infiltrates by most physicians). Because of the hypoxia, he is English Be the Official of the Essay, given supplemental oxygen (with subsequent improvement in oxygen saturation), as hospitalization arrangements are made. Concert Reviews! A 20 cc/kg infusion of normal saline was given through an intravenous (IV) line and then maintenance fluids are started. A blood culture is teen sexx, obtained and he is started on IV cefuroxime. He improves over the next day. His respiratory distress slowly resolves and he is weaned off supplemental oxygen over the next two days.

His blood culture shows no growth. He is concert reviews examples, discharged home on high dose amoxicillin for a total of 10 days of therapy. His discharge diagnosis is probably pneumococcal pneumonia. Acute childhood respiratory infections cause significant morbidity and mortality worldwide. Mortality is high in developing countries with up to what influenced, one-third of deaths in children less than 5 years caused by acute respiratory infections (ARI) (1). The disparity in mortality is examples, due to the severity of attribute, infection (perhaps due to differences in nutrition, overall health, immunization practices, and medical care availability) since the incidence of acute respiratory infections is similar between developed and developing countries with infants experiencing about reviews 4-8 episodes per year (1).

In the US, mortality from what shakespeare ARIs has declined since 1968 (1,2). There are 2 basic classification systems used for acute respiratory tract infections: the reviews, case-management classification system used by the World Health Organization (WHO) and the traditional clinical classification system (1). Product! The case management system divides ARIs by symptoms (i.e., stridor, wheezing, and no wheezing) and reviews, their severity (i.e., mild, moderate, severe, and very severe). The traditional system classifies ARIs by upper respiratory tract infections (e.g., acute otitis media, pharyngitis), middle respiratory tract infections (e.g., croup and epiglottitis), and lower respiratory tract infections (e.g., bronchiolitis, bronchitis, pneumonia). Therefore, studies evaluating ARIs are not uniform and use different definitions from clinical findings alone to clinical findings in combination with other various ancillary tests (e.g., chest radiography). Of the acute respiratory infections, pneumonia has the highest mortality rate accounting for of Demographic on China’s approximately 70% of the reviews examples, worldwide 4.5 million deaths from acute respiratory infections (4).

Although mortality from pneumonia in children in the United States has declined by 97% between 1939 and attribute, 1996 (5), pneumonia continues to concert, be a leading cause of morbidity in children. The risk of attribute, acquiring pneumonia is highest in children less than 5 years of age (1). The etiology of pneumonia varies and depends on: the age of the child, where the pneumonia was acquired (i.e., community vs. Examples! nosocomial), local epidemiology (e.g., influenza epidemics), host factors (e.g., immunologic status, recent or intercurrent antibiotic use, vaccination, and overall health status of the child), and environmental factors (e.g., travel, season of the year, daycare, or crowded living conditions) (4,6-9). Antic Disposition! Determination of the precise etiology of pneumonia often requires invasive testing (e.g., lung biopsy), and therefore, this is done infrequently. Rather the etiology of pneumonia is reviews, usually based on product, generalizations in concert reviews, the relevant clinical setting.

In the neonatal period, the most common cause of bacterial pneumonia is group B beta-hemolytic streptococci (GBS) and what shakespeare, gram negative enteric bacilli (e.g., E.coli), the reviews examples, same organisms associated with neonatal sepsis (4). In infants and afi pregnancy, children outside of the neonatal period, viruses are the most common cause of pneumonia (4,6,10-11) and respiratory syncytial virus (RSV) is one of the most common causes in infancy, especially in premature infants (9,12). Of the bacterial pathogens, Streptococcus pneumoniae (pneumococcus) occurs most frequently (6,9,11,13); however, the studies isolating S. pneumoniae were performed prior to the licensure of the pneumococcal conjugate vaccine (6). Outcome analysis of the 7-valent pneumococcal conjugate vaccine demonstrated that up to 33% of concert examples, chest radiograph confirmed pneumonia were prevented in immunized patients compared to those who were not immunized (14). Teen Sexx! Therefore, a different bacterial pathogen may supersede S. pneumoniae as the most common cause of bacterial pneumonia in the coming years. Other organisms to consider are Chlamydia trachomatis in concert examples, infants 3-19 months of age (4) and product attribute, Mycoplasma and Chlamydia pneumoniae in children and reviews examples, adolescents (8-9,11-12). In special cases, for example, patients with neuromuscular impairment and impaired swallowing, aspiration pneumonia with anaerobic bacteria should be considered (15). The etiology of pneumonia varies in Should Be the Official Essay, other conditions including immunosuppressed patients, nosocomial infections, cystic fibrosis patients, and anatomic airway anomalies (e.g., tracheostomies). In addition, the etiology of pneumonia is complicated since mixed infections (e.g., viral-bacterial) can occur in 16-34% of patients (7,11,13). The lower respiratory tract in healthy persons is sterile (16).

Bacteria access the respiratory tract by inhalation, microaspiration, or by hematogenous spread. If bacteria gain access to alveoli, host immunologic systems begin to work on concert examples, eliminating bacteria. There are 2 major mechanisms by which lung defenses work to teen sexx, keep the airways sterile: physical defenses (i.e., mucociliary clearance and lymphatic drainage) and mechanisms that destroy bacteria (i.e., opsonization, specific immunoglobulin G antibody (IgG), alveolar macrophage ingestion, or complement mediated bacterial lysis) (17). If these mechanisms fail, polymorphonuclear leukocytes (PMNs) are recruited with a resultant inflammatory response. Perpetuation of this inflammatory response leads to pneumonia. Concert Reviews Examples! There are 4 major histologic steps seen in what influenced, pneumococcal pneumonia described by Tuomanen, et al (18): engorgement, red hepatization, grey hepatization, and resolution. Engorgement is associated with presence of bacteria in the alveoli and an associated serous exudate.

This then progresses to red hepatization secondary to leakage of erythrocytes into the alveoli. The next phase, grey hepatization, results from leukocyte migration to the affected area with intravascular fibrin deposition disrupting perfusion to the area. The final phase results in resolution, with phagocytosis of pneumococci and clearance of fibrin and other debris. Outside of the neonatal period, pneumonia is suspected in patients with clinical signs and concert reviews examples, symptoms suggestive of impairment of the lower respiratory tract. Distinguishing bacterial from hamlet's disposition other causes of pneumonia cannot be accomplished by clinical findings alone (7). Symptoms of pneumonia are nonspecific and include: fever, ill appearance, cough, fatigue, decreased appetite and sometimes, abdominal pain. Signs of lower respiratory tract involvement include: tachypnea (greater than 50 breaths/minute in reviews examples, children less than 12 months, and greater than 40 breaths/minute for older children) (4), cyanosis, increased work of breathing (i.e., use of accessory muscles, grunting), pleuritic pain, and abnormal auscultatory findings. These signs do not differentiate a viral from what influenced shakespeare bacterial process. A chest radiograph is used to verify the clinical suspicion of pneumonia and reviews, characterize the disease process, but may not be performed on every patient. Viral respiratory tract infections are often associated with hyperinflation, perihilar peribronchial infiltrates, segmental or lobar atelectasis, and hilar adenopathy (19). Lobar consolidation and fluffy alveolar infiltrates with air bronchograms are more characteristic of bacterial infection (13).

However, there is overlap between these two groups (13). Computed tomography and ultrasound of the chest are used in product attribute, special circumstances (e.g., evaluate for pleural effusion, adenopathy, improved imaging of lung architecture) but these are not routinely obtained (4). Examples! Commonly used screening laboratory tests such as white blood cell count with differential, erythrocyte sedimentation rate (ESR), and the C-reactive protein (CRP) are not accurate in differentiating between bacterial, viral, mixed, or idiopathic causes of childhood pneumonia (7). Determination of precise etiology of teen sexx, pneumonia is difficult due to reviews examples, the lack of sensitive and specific tests. Many clinicians treat pneumonia empirically with minimal laboratory or radiographic evaluation and teen sexx, thus up to 80% of non-bacterial pneumonia may be treated with antibiotics (6).

This approach is satisfactory when clinical risk is deemed to be low. When a more precise diagnosis is required, more invasive techniques are required. Bacteria found in the blood, pleural fluid (thoracentesis), or lung tissue is considered diagnostic in a patient presumed to have pneumonia (4). Concert Reviews Examples! Blood cultures are only positive in 1-8% of pneumonia (11) but continue to be recommended (4). Teen Sexx! Some question the necessity of concert reviews examples, blood culture after cost-based analyses (6, 11).

Transthoracic needle aspirates, transtracheal aspirates, and open lung biopsy (the gold standard for diagnosis) are rarely performed due to the risk involved for these procedures (11,20), except in severe cases or in immunocompromised hosts (4). Sputum is often contaminated with organisms unrelated to the specific etiology (16) and is difficult to obtain in children less than 8 years old (4). A sputum sample that may be helpful is of Demographic example, characterized by many polymorphonuclear cells and a bacteria of single morphology on gram stain (4). Bronchoalveolar lavage from bronchoscopy is difficult to interpret as well. The results are non-specific (i.e., higher neutrophil counts than lymphocyte counts in patients with infection) and the organism found may or may not be the etiologic agent (16). Bacterial serology and concert examples, bacterial antigen testing are often difficult to interpret (4,6). Language States Essay! Bacterial cultures of the nasopharynx or throat correlate poorly with lung tissue cultures and are not helpful in concert examples, establishing a diagnosis (16). Specific viral antigen testing, along with cultures for suspected pathogens, serologies for Mycoplasma and Chlamydia, and teen sexx, PPD skin testing for tuberculosis may be helpful (6). Pneumonia is treated with antimicrobials when the clinical suspicion for bacterial etiology is concert reviews, high. Greater pneumonia severity and findings that are consistent with bacterial pneumonia (e.g., lobar consolidation, leukocytosis, high fever) are more likely to warrant antimicrobial treatment.

Young infants, unreliable parents, poor access to medical care, and more severe infections often require hospitalization. Treatment of influenced, pneumonia is often empirically based and thus, information on antibiotic resistance patterns and mechanisms of resistance is reviews, important to determine the most appropriate treatment. For S. pneumoniae, the most common mechanism of afi pregnancy, resistance to penicillins is alteration of penicillin-binding sites that can be overcome with higher doses of the concert reviews examples, drug (6). For macrolides, alteration to the 50S ribosomal binding site of the macrolide inhibits binding of the antibiotic and afi pregnancy, thus, prevents protein synthesis inhibition (6). In addition, there is reviews examples, also an English Should Official of the States increase in efflux pumps for macrolides and this property can be overcome by using macrolides that achieve high tissue concentrations at the site of infection (e.g. azithromycin) (6). Penicillin resistant pneumococci are often resistant to multiple drugs including macrolides and trimethoprim-sulfamethoxazole (21).

Therefore, high-dose amoxicillin and/or azithromycin are recommended for empiric treatment of community-acquired pneumonia in children (6,8-9,11-12,20). Some clinicians will use clinical factors and concert reviews examples, ancillary tests in aggregate such as age, exposures, CXR pattern, fever, and leukocytosis, to stratify the product attribute, risk to favor pneumococcus (high dose amoxicillin would be better) or Mycoplasma/Chlamydia (macrolide would be better). For those children requiring hospitalization, a second or third generation cephalosporin, occasionally in combination with a macrolide, is generally recommended (8,20). Most treatment regimens are continued for a total of concert reviews examples, 7-14 days although this is based on little evidence (4). Pneumonia due to Staphylococcus aureus is uncommon, but particularly severe. S. English Should Be The Official Language United! aureus pneumonia usually results from inhalation of organisms, but it may also occur in patients with a cutaneous source (e.g., impetigo, boils, abscesses) with hematogenous spread or staphylococcal bacteremia from another source (e.g. Concert Examples! osteomyelitis, central line infection). If S. aureus pneumonia is suspected, vancomycin should be started empirically. Culture and sensitivity data permits changing to Be the of the States Essay, an alternate antibiotic later.

Pleural effusion (empyema), pneumothorax, and reviews, pneumatoceles often complicate S. aureus pneumonia. Pleural effusions can be classified in several ways. They can be a transudate or an exudate based on their protein content. A subpulmonic effusion versus an empyema is more clinically relevant. The former implies a transudate which is usually sterile, while the term empyema is usually used to describe pus (purulent exudate) with a positive gram stain and culture. The overall outcome in teen sexx, children with pneumonia is excellent. The majority of children will recover without complications (11). Follow up chest radiographs are not required routinely, but should be performed for patients with complicated pneumonia, persistent respiratory problems, pleural involvement, and examples, neonates (4,22).

About 80% of infiltrates on CXR will resolve by 3-4 weeks and Language United States, the remainder will usually resolve by concert reviews, 3 months (22). Effect Dividends Essay Example! Recurrent pneumonia with radiologic clearance between episodes requires further evaluation (e.g., immunodeficiencies, gastroesophageal reflux, pulmonary anomalies, etc.) (4). Bronchiolitis is the leading cause of hospitalization for concert reviews examples respiratory tract infections in young children (4,23-25). Respiratory syncytial virus (RSV) is the primary cause of bronchiolitis, but parainfluenza virus, human metapneumovirus, and adenovirus may also cause bronchiolitis (23-24). In the United States, the majority of influenced, RSV infections occur during the months of November to March (4,23). Concert Reviews! RSV infections account for a significant amount of Effect, morbidity and health care expense in the young age group (24). RSV is transmitted by direct contact with large droplets or fomites. Transmission can be limited by good handwashing (23). RSV bronchiolitis results from the concert examples, spread of RSV to the lower respiratory tract after an incubation period 2-8 days where the virus undergoes replication in the nasopharynx (23).

The infection results in infiltration of the respiratory epithelium with resultant inflammation and necrosis, sloughing of the epithelium and increased mucus production causing airflow limitation in the small airways leading to the hallmarks of the disease (23). Thus, affected infants have signs of airflow limitation including hyperinflation, atelectasis, and wheezing. The diagnosis is often made on clinical grounds during the product attribute, RSV season. Diagnostic testing can be done by immunofluorescence and enzyme-linked immunoabsorbent assay (ELISA) tests if the diagnosis is unclear. Therapy is often supportive which may include: supplemental oxygen, fluids, and reviews, upright positioning. Aerosolized ribavirin is the antic disposition, only known proven therapy for RSV infection, but its expense, potential toxicity, difficulty of administration, and lack of conclusive evidence for its efficacy (24,26) limit its use. The use of bronchodilators and corticosteroids are controversial and may only be mildly effective at best (i.e., not been proven to be highly efficacious) (24-26).

For those with moderate to severe disease, helium-oxygen mixtures or nasal continuous positive airway pressure may be beneficial in improving gas-exchange and symptomatology (27-30). Montelukast, a leukotriene antagonist, has recently been reported to make a difference in future wheezing episodes (31). Concert Examples! Prophylaxis with palivizumab (RSV monoclonal antibody) or RSV-IVIG is given to select pediatric populations recommended by the American Academy of Pediatrics during RSV season to reduce RSV infection risk (32). Growing premature infants and infants with congenital heart disease and other chronic lung conditions are at increased risk for RSV pneumonia, apnea and respiratory failure. Healthy term infants with RSV usually develop mild bronchiolitis. Older children, teens and adults with RSV will usually have cold symptoms.

Bronchiolitis is afi pregnancy, usually a self limited disease and concert reviews, complete resolution takes about 4-8 weeks. In neonates and young infants, bronchiolitis may present with apnea and minimal respiratory symptoms, but the apnea is usually short-lived (33). Although bronchiolitis self-resolves, patients with RSV bronchiolitis may be predisposed to future episodes of wheezing (34). RSV infection can recur since there is an incomplete and poorly sustained immune response (23). In summary, bronchiolitis and hamlet's antic, pneumonia significantly impact the pediatric population. Determining likely etiologies of pneumonia and understanding effective treatment modalities will improve patient outcomes. Acknowledgments: I would like to thank Edward Fong, MD, Leslie Barton, MD and John Mark, MD for their critical review of the chapter. 1. Which of the following is the most common cause of pneumonia outside of the neonatal period? 2. S. pneumonia resistance to penicillins is due to: . . . Concert Reviews Examples! . . Teen Sexx! a. Production of beta-lactamase.

. Reviews! . . . . b. Alteration of penicillin binding proteins. . . Afi Pregnancy! . . . Concert! c. Increased efflux pumps. . . . . . d. Low tissue bioavailability. 3. True/False: Nasopharyngeal and throat cultures are useful in determining etiology of bacterial pneumonia. 4. True/False: Lobar consolidation on chest x-ray provides conclusive evidence for bacterial pneumonia. 5. Which factor does not appear to on China’s Export, affect the etiology of pneumonia?

. . . . Concert Reviews! . Influenced! b. Reviews Examples! Vaccination status. . . Effect Of Demographic! . . Concert Reviews! . c. Current antibiotic use. 6. The most common cause of bronchiolitis is: . . . . . a. Respiratory syncytial virus. . . Be The Language United Essay! . . Examples! . b. Human Metapneumovirus. 7. True/False: Bronchiolitis may initially present with apnea and minimal respiratory symptoms. 8. Teen Sexx! Treatment of bronchiolitis should include all of the following except: a. Supplemental oxygen for infants with hypoxia. b. Intravenous fluids and examples, close monitoring of nutritional status. c. Good handwashing. d. Antibiotics. 9. Disposition! True/False: Corticosteroids and bronchodilators are highly efficacious therapies for RSV bronchiolitis. Pneumonia case presenting with abdominal pain: Yamamoto LG. Abdominal Pain with a Negative Abdominal Examination. In: Yamamoto LG, Inaba AS, DiMauro R (eds).

Radiology Cases In Pediatric Emergency Medicine, 1994, volume 1, case 3. Available online at: Staph pneumonia case: Yamamoto LG, Young LL. Tachypnea and Abdominal Pain. In: Yamamoto LG, Inaba AS, DiMauro R (eds). Radiology Cases In Pediatric Emergency Medicine, 1995, volume 2, case 5. Available online at: Series of examples, pediatric chest radiographs: Yamamoto LG. Test Your Skill In Reading Pediatric Chest Radiographs. In: Yamamoto LG, Inaba AS, DiMauro R (eds). Radiology Cases In Pediatric Emergency Medicine, 1995, volume 3, case 20. Available online at:

Another series of pediatric chest radiographs: Yamamoto LG. Test Your Skill In Reading Pediatric Chest Radiographs. In: Yamamoto LG, Inaba AS, DiMauro R (eds). Radiology Cases In Pediatric Emergency Medicine, 1996, volume 4, case 5. Afi Pregnancy! Available online at: 1. Concert Reviews Examples! Graham NMH. The Epidemiology of what, Acute Respiratory Infection in Children and Adults: A Global Perspective.

Epidemiol Rev 1990;12:149-178. 2. Examples! National Center for Health Statistics. National Vital Statistics report ( 2001;49(1):14. 3. Dixon RE. Economic Costs of Respiratory Tract Infections in the United States. Am J Med 1985;78(6B): 45-51.

4. Miller MA, Ben-Ami T, Daum RS. Chapter 39-Bacterial Pneumonia in Neonates and Older Children. Effect Of Demographic On China’s Export Essay Example! In: Taussig LM, Landau LI (eds). Pediatric Respiratory Medicine, first edition. 1999, St. Louis: Mosby, pp. 595-664. 5. Dowell SF, Kupronis BA, Zell ER, Shay DK. Reviews Examples! Mortality From Pneumonia in Dividends, Children in the United States, 1939 Through 1996. N Engl J Med 2000;342(19):1399-1407.

6. Bradley JS. Management of Community-Acquired Pediatric Pneumonia in an Era of Increasing Antibiotic Resistance and Conjugate Vaccines. Concert! Pediatr Infect Dis J 2002;21(6):592-598. 7. Nohynek H, Valkeila E, Leinonen M, Eskola J. Erythrocyte Sedimentation Rate, White Blood Cell Count and Serum C-reactive Protein in Assessing Etiologic Diagnosis of Acute Lower Respiratory Infections in Children. Pediatr Infect Dis J 1995;14(6): 484-490.

8. Nelson J. Community-Acquired Pneumonia in Children: Guidelines for Treatment. Pediatr Infect Dis J 2000;19(3):251-253. 9. Heiskanen-Kosma T, Korppi MN, Jokinen C, et al. Etiology of Childhood Pneumonia: Serologic Results of a Prospective, Population-Based Study. Pediatr Infect Dis J 1998;17(11):986-991. 10. Teen Sexx! McIntosh K. Community-Acquired Pneumonia in Children. N Engl J Med 2002;346(6);429-437. 11. Ruuskanen O, Mertsolon J. Childhood Community-Acquired Pneumonia.

Sem Resp Infect 1999;14(2):163-172. 12. Concert! McCraken, GH Jr. Etiology and Treatment of Pneumonia. Pediatr Infect Dis J 2000;19(4):373-377. 13. Korppi M, Kiekara O, Heiskanen-Kosma T, Soimakallio S. Comparison of Radiological Findings and Microbial Aetiology of Childhood Pneumonia. Acta Paediatr 1993;82: 360-363. 14.

Overturf GD, Committee on Be the Language of the United, Infectious Diseases, American Academy of Pediatrics. Technical Report: Prevention of Pneumococcal Infections, Including the Use of reviews examples, Pneumococcal Conjugate and Polysaccharide Vaccines and Antibiotic Prophylaxis. Pediatrics 2000;106(2):367-376. 15. Brook I, Finegold SM. Bacteriology of Aspiration Pneumonia in Children. Pediatrics 1980;65(6):1115-1120. 16.

Laurenzi GA, Potter RT, Kass EH. Bacteriologic Flora of the Lower Respiratory Tract. N Engl J Med 1961;265:1271-1278. 17. Green GM, Kass EH.

The Role of the Alveolar Macrophage in the Clearance of Bacteria from the Lung. Antic! J Exp Med 1964;119:167-175. 18. Tuomanen EI, Austrian R, Masure HR. Pathogenesis of Pneumococcal Infection. N Engl J Med 1995(19);332:1280-1284. 19. Wildin SR, Chonmaitree T, Swischuk LE.

Roentgenographic Features of Common Pediatric Viral Respiratory Tract Infections. Am J Dis Child 1988;142:43-46. 20. Hart CA, Duerden BI. Respiratory Infections. J Med Microbiol 2002;51:903-914. 21. Whitney CG, Farley MM, Hadler J, et al.

Increasing Prevalence of Multidrug-Resistant Streptococcus Pneumoniae in the United States. N Engl J Med 2000;343(26):1917-1924. 22. Grossman LK, Wald ER, Nair P, Papiez J. Roentgenographic Follow-Up of Acute Pneumonia in Children. Pediatrics 1979(1);63:30-31. 23. Concert! Hall CB.

Respiratory Syncytial Virus and Parainfluenza virus. N Engl J Med 2001;344(25):1917-1928. 24. Greenough A. Respiratory Syncytial Virus Infection: Clinical Features, Management, and Prophylaxis. Curr Opin in attribute, Pulm Med 2002;8:214-217. 25. Jartti T, van den Hoogen B, Garofalo RP, et al.

Metapneumovirus and Acute Wheezing in Children. Lancet 2002;360:1393-1394. 26. Patel H, Platt RW, Pekeles GS, Ducharme FM. A Randomized Controlled Trial of the Effectiveness of Nebulized Therapy with Epinephrine Compared with Albuterol and Saline in Infants Hospitalized for Acute Viral Bronchiolitis. Concert! J Pediatr 2002(6);141:818-824.

27. Product! Hollman G, Shen G, Zeng L, et al. Helium-Oxygen Improves Clinical Asthma Scores in Children with Acute Bronchiolitis. Crit Care Med 1998;26(10):1731-1736. 28. Examples! Martinon-Torres F, Rodriguez-Nunez A, Martinon-Sanchez JM. Heliox Therapy in Infants with Acute Bronchiolitis. Of Demographic Dividends Export Essay! Pediatrics 2002(1);109:68-73.

29. Beasley JM, Jones SEF. Continuous Positive Airway Pressure in Bronchiolitis. British Medical Journal 1981;283:1506-1508. 30.

Soong W, Hwang B, Tang R. Examples! Continuous Positive Airway Pressure by Nasal Prongs in teen sexx, Bronchiolitis. Pediatr Pulmonol 1993;16:163-166. 31. Concert Reviews! Bisgaard H for the Study Group on Montelukast and Respiratory Syncytial Virus. A Randomized Trial of Montelukast in English Should Language, Respiratory Syncytial Virus Postbronchiolitis. Am J Respir Crit Care Med 2003;167:379-383. 32. Halsey NA, Abramson JS, Chesney PJ, et al.

American Academy of Pediatrics: Prevention of Respiratory Syncytial Virus Infections: Indications for the Use of Palivizumab and Update on the Use of concert reviews examples, RSV-IGIV. Pediatrics 1998;102(5):1211-1216. 33. Bruhn FW, Mokrohisky ST, McIntosh K. Apnea Associated with Respiratory Syncytial Virus Infection in Young Infants. J Pediatr 1977;90:382-386.

34. Sigurs N, Bjarnason R, Sigurbergsson F, Kjellman B. Respiratory Syncytial Virus Bronchiolitis in Infancy is an Important Risk Factor for Asthma and Allergy at Age 7. Am J Respir Crit Care Med 2000;161:1501-1507. Answers to questions. 1.c. Overall, viruses cause the majority of Dividends on China’s Essay example, pneumonias in children; however, the incidence of viral pneumonia decreases with age, becoming less common in older children and adolescents.

4.False. Lobar pneumonias are more likely to be of bacterial etiology, but this is not definitive since some lobar pneumonias will still be viral.

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