Why Do Most Rural Construction Projects Fail Construction Essay

Why Do Most Rural Construction Projects Fail Construction Essay A research on the construction projects Is done on rural areas to see why rural construction projects fail, reasons for rural project failure are found to be, poor communication, lack of skills to the people who engaged in a project. Rural construction failure is affecting the economy since there is more money spent on the projects and people from rural areas need to be developed, as we know that rural areas where neglected so they were not privileged enough , so government is trying to develop the rural areas by proving the projects that will help community to develop. The research conducted on construction projects failure is valuable since it will help people to know how to overcome project problems, The report will give knowledge to the community and the professional team in how to avoid rural projects failure. PREFACE Many of the construction projects influential clients do not recognize the project management is an essential ingredient for use with any system of procurement of a new facility. This report is key guidance compiled under the active direction of a multi- disciplined working group. Project management, as a professional disciplined, has been the subject of numerous definitions and considerable confusion in the construction industry. The aim of this report is to provide reader and all members of the construction team with definitive strategy for any project from outset, defining the responsibilities of all concerned to achieve completion on time, to the specification defined by the brief and within budget. The report has been prepared as a definitive document which will enable a reader to understand the role and responsibilities of the project manager on any major or minor project. The report is a practical document and will allow the team to practice the art to gain an understanding of the process involved and techniques employed. Similarly, readers will be able to explore and complete range of project management activities. Since inception of democracy in 1994, the government of the Republic of South Africa has been introducing policies and programmes to ensure economic empowerment. The Black Economic Empowerment initiative was introduced to combat and or reverse past economic inequalities. The main focus of the programme was to empower black in general, Africans in particular. South Africa is predominantly occupied by rural areas; hence the centre of attention is shifted to rural development in terms of empowerment. However, this initiative has been succeeding but there are challenges facing the programme in the sense that those challenges are outweighing the benefits. For example, we have tender entrepreneurs, youth and women who are actively involved in the project or business world and are contributing positively to economic development that will lead to economic growth of the country. Even though we are gradually succeeding in this initiative but the triple challenge still exists which is poverty, unemployment and inequalities. In conclusion, failure to implement projects properly leads to a programme failure hence the need to identify project weaknesses and come up with effective mechanisms is of paramount important. There are many reasons why the rural construction projects fail; these reasons are discussed as follow: 1.1 Financial capacity Lack of capital contributes immensely to project failure. For example, black entrepreneurs are experiencing problem when it comes initiating a project. The majority of these entrepreneurs are entirely depending on ceding their rights to acquire financial assistance from Financial Institutions. 1.2 Lack of Training There are no practical structures in place that deals with a training of these entrepreneurs in the sense that they entirely depending on their talent or calling to execute the project thoroughly. They lack the aptitude to understand the project principles and actual practically implement those principles which are critical to project success. Even if there is a functioning structure, the maximum participation is inadequate from the side of participants. 1.3 Lack of Accountability From the side of the community no one is informed enough to question the standard of the project under implementation in the sense that the project leader does his or her will in term of implementing the project. In contrary, there is a lack of monitoring on the side of the government to hold the project leader or implementer accountable. 1.4 Human Resources There is lack of skilled labourers to implement project successfully. For example, the project entirely depends on the unskilled labourers for implementation. Therefore, it makes life of the project to be difficult. For instance, to an unskilled person it is normally not to question the opinion of the superior, even though he or she knows beyond the reasonable doubt that the opinion is impractical for the project execution. 1.5 Physical Resources Most of the natural resources that exist are never tested to check the viability before the execution in the sense that they are executed with a no prior testing to check their effectiveness. For example, natural resources such as soil to be used for agricultural cooperatives are used with no prior testing to check their suitability for planting. As result, most of crops do not yield returns because of the above mentioned short coming. 2. To identify the impact of project failure to economic growth 2.1 Increase in the level of poverty Failure to execute the project successfully will minimise the opportunities of self-sustainability to communities. For example, in the agricultural projects that are meant for cooperatives, failure on the part of the project leader to execute the project successfully will lead to community inability to sustain itself. As a result, the poverty levels will increase as community members will have to purchase from the retailers instead of doing it themselves. 2.2 Increase in the level of unemployment If the opportunities arise for project execution in a particular location, local labourers from that particular community have exceeding expectations for employment. Therefore, that means at the inception of the project more people will be employed, but as the project gradually fails to be completed those who were employed will be retrenched or redundant. 2.3 Increase in the level of Inequalities The existence of the project especially the empowerment project is to bridge the gap between those who have and those who have not. Therefore, that means those who have not will have something if the project succeeds, but if the project fails an opposite is applicable or vice visa. CHAPTER 3 CRITICAL RESEARCH QUESTIONS 1. Why rural construction projects often fail? Rural construction projects often fail for many reasons. Firstly, rural communities lack participation and knowledge to hold project leader or executor accountable. Secondly, there are no monitoring systems in place in the part of government to monitor the progress of the project until completion and hold the project implementer accountable in case of non-performance. Finally, project leaders sometimes produce substandard performance due to lack of expertise and experience to execute the project until its completion. 2. How do we then deal with these rural project failures? Firstly and foremost, through campaigns for public awareness the level of public participation level will be improved because the public will be aware that they own these projects, the success of the project will be dependent on their active involvement. Secondly, if communities are well trained to improve the level of their competency they will become watch dogs and watch every move of the project that is taken by the contractor to ensure that the standard quality of project is achieved. Thirdly, on the monitoring part of the project there should be a continuous a level of training to familiarize those responsible for monitoring with the development so that they are updated. Finally, on the side of the contractor, there should an alignment of the expertise and the scope of works to ensure that maximum quality is achieved. CHAPTER 4 SIGNIFICANT OF THE STUDY Firstly, community participation and involvement in a project is one of the key elements of action research, by proactively and systematically working towards improving the levels of involvement in the various stages of a project, the outcomes are more likely to suit local circumstances and ensure community ownership, and increase the sustainability of a project. However, developing and maintaining the participation of stakeholders can often be a challenge requiring various strategies and considerations. Secondly, on the government side the significant of the research helps to identify problem areas and arrive at the corrective measures in order to combat inefficiencies within the system in as far as monitoring is concerned. Finally, the same situation will apply on the part of the contractor or project leader as above in terms of identifying problematic areas that will have an impact on the progress of the project and come up with mechanisms to combat non-performance at an earlier s tage of the project. CHAPTER 6 RESEARCH METHODOLOGY The research was conducted with several Client Departments such as Department of Roads and Public Works (DRPW), Department of Education (DOE), Health Department (DOH), Social Development Department, Local Government and District Municipality in Alfred Nzo Region, Eastern Cape. The Department of Roads and Public Infrastructure Managers, Eastern Cape were interviewed on what could be the cause of rural construction project failure such as schools, ECDC (Early Childhood Development Centres, Clinics and Roads since the department does their infrastructure projects in the Eastern Cape Province and District Municipality Infrastructure Programme Managers were also interviewed based on the failure of projects they render to the communities. IDP meetings are held every month and the District Municipality Infrastructure Programme Manager invites all Interdepartmental Infrastructure Programme Managers to come and report on projects which are either on planning or implementation. Articles were also used to find other possible ways of minimizing the failure of our rural construction projects. CHAPTER 8 CONCLUSION The success of this initiative is entirely dependent on identifying the problematic areas that are there to hamper the progress of the rural projects. Therefore, positively identifying these problematic areas and effectively coming up with creative mechanisms will ensure the rural project success. In addition, the rural project success will ensure that the government initiative achieves its objectives of ensuring economic development that will ultimately lead to the economic growth. As a result, this growth in economy will positively address the triple challenge that is facing our democratic South Africa. TERMINOLOGY DRPW Department of Roads and Public Works DOE Department of Education DOH Department of Health DM District Municipality DOT Department of Transport IDP Infrastructure Development Program

Triple Vessel Ischemic Heart Disease Treatment Case Nursing Essay

Triple Vessel Ischemic Heart Disease Treatment Case Nursing Essay Mr. MS is a 58-year-old Malay male who was previously diagnosed with hypertension, gout and triple vessel ischemic heart disease. He first presented with chest pain in March 2010 where he was diagnosed with ischemic heart disease. He was unable to complete an exercise stress test and an angiogram done in Hospital Sultanah Aminah found him to have triple vessel disease. He was told angioplasty was not possible due to the severity of the blocks and was counseled for CABG but he was not keen. Meanwhile, he has had angina attacks 2 to 3 times per week every week since his initial diagnosis for the last 3 months, usually relieved by sublingual GTN and was currently admitted for the 4th time for chest pain not relieved by GTN. ECG done 2 hours after onset of chest pain showed ST depression of 2mm at leads I, aVL, V3 V6 and left axis deviation with no Q waves. Trop T was positive (2.75 ng/ml) at 4 hours after onset and other cardiac enzymes were also raised significantly. He was diagnosed with NSTEMI and treated with aspirin 300mg, IV morphine 2.5 mg, sublingual GTN 3 tablets and subcutaneous clexane 60mg BD for 3 days as well as continuing his current medication regime of simvastatin, metoprolol, cardiprin, ISDN, amlodipine and GTN. Following admission, he was well in the ward with no recurrence of chest pain and did not develop any new complaints. He was discharged after 3 days of inpatient treatment with instructions to attend his follow-up appointment at the cardio clinic in HSAJB on the 16th of June 2010 to make an appointment for surgery. Following this episode of chest pain, which he says is the worst so far, he is now quite keen for CABG. 2) CLINICAL HISTORY Chief Complaint Chest pain for 1 day. History of Present Illness Mr. MS is a 58-year-old Malay male who was previously diagnosed with gout, hypertension and ischemic heart disease with triple vessel disease. He was awoken from sleep at about 10pm due to a central chest pain of sudden onset. He described the character of the pain as crushing in nature and radiated to his neck. This episode of chest pain was the most severe since he was first diagnosed with ischemic heart disease. The pain was associated with profuse sweating, body weakness and was not relieved by rest. However, it was relieved by sublingual GTN, of which he has a supply of. His discomfort was made worst by exertion so he lay in bed to recover. Despite this, he had another episode of chest pain 30 minutes later. He took the sublingual GTN again but this time, the pain did not resolve. He was then brought to the emergency department of Hospital Batu Pahat by his son. This is Mr. MSs fourth admission for chest pain since March 2010. Since his diagnosis of ischemic heart disease in March, he has experience angina attacks two to three times per week, especially on exertion such as when straining while passing motion. During these attacks, he uses sublingual GTN to relieve his symptoms and normally feels much better after that. He only comes to the hospital when GTN does not work to relieve his symptoms. Systemic Review Mr. MS does not experience symptoms such as palpitations, dizziness, headache, nausea, vomiting, orthopnoea, paroxysmal nocturnal dyspnoea, epigastric pain, shortness of breath, fever, and had no syncopal episodes. He also does not have loss of appetite or loss of weight. Bowel and urinary habits are normal. His sleep has not been affected until this current episode whereby he was awoken by the chest pain. Past Medical History Mr. MS was diagnosed with hypertension 6 years ago when he had an episode of headache. He has been on medication since and was on regular follow-up with KK Rengit. He was diagnosed with gout 5 years ago when he had a left big toe swelling which resolved after some medication. He is not on long term medication for gout. Mr. MS was admitted for the first time 5 years ago in 2005 when he had bilateral renal calculi. He was subsequently referred to Hospital Sultanah Aminah for further management of this problem and it has since resolved and does not have follow-up anymore. Mr. MS was diagnosed with ischemic heart disease in March 2010 when he presented with chest pain for the first time. Following his recovery, he underwent a stress test in Hospital Batu Pahat but according to him, was unable to complete the procedure due to chest discomfort. He was referred to the cardiology unit in Hospital Sultanah Aminah for further management where an angiogram was performed and he was told to have triple vessel disease. He was also told that angioplasty was not possible due to the severity of the blocks. He was recommended to have Coronary Artery Bypass Grafting (CABG) but as of yet, no appointment has been made as he was still unsure of going through with the procedure. Following this episode of chest pain, Mr. MS has decided that going for the CABG is the only thing that will keep him alive. His current medications include: Tab Simvastatin 20mg OD Tab Metoprolol 75mg BD Tab Cardiprin 100mg OD Tab Isosorbide Dinitrate (ISDN) 5mg TDS Tab Amlodipine 10mg OD Sublingual Glyceryl Trinitrate (GTN) PRN He is compliant to his medication regime. Mr. MS is not known to have diabetes or hyperlipidemia. He also does not have any known food or drug allergies. Family History Mr. MS is the 3rd of 9 siblings. His father had hypertension and passed away a long time ago due to unknown causes. His mother and other siblings are healthy. None of them have hypertension, diabetes, ischemic heart disease or malignancy. Social History He lives in a kampung in Rengit with his wife and 5 children. Mr. MS does not smoke nor consume alcohol. He works in a palm oil plantation. The distance from his house to Hospital Batu Pahat is about half an hour. On further enquiry, Mr. MS says that the cost of the CABG is about RM1000, which he can afford. 3) FINDINGS ON CLINICAL EXAMINATION (Mr. MS was examined by me 9 hours after onset of chest pain) Mr. MS was alert, conscious, and communicative. He was not in obvious pain or respiratory distress. He was lying down comfortably on his bed. There were no tendon xanthomata, xanthelasma, pallor, corneal arcus or pedal edema. His JVP was not raised. His clinical parameters are: Blood Pressure : 158/94 mmHg Heart Rate : 94 beats per minute. Regular rhythm Respiratory Rate : 20 breaths per minute Temperature : 37Â °C SpO2 : 97% under room air On examination of the precordium, the apex beat was located at the 5th intercostal space on the midclavicular line and was normal in character. Parasternal heave was not felt and there were no thrills. First and second heart sounds were heard. There were no murmurs or added heart sounds. On examination of the chest, there was no deformity and chest expansion was equal on both sides. Percussion and tactile vocal fremitus was normal and equal on both sides. On auscultation, vesicular breath sounds were heard throughout all lung fields with good air entry. There was no wheezing or crepitations heard. On examination of the abdomen, it was soft and non-tender. There were no masses felt. Bowel sounds were heard and normal. 4) PROVISIONAL AND DIFFERENTIAL DIAGNOSES WITH REASONING Provisional Diagnosis Acute myocardial infarction with underlying triple vessel ischemic heart disease and hypertension With a history of diagnosed triple vessel ischemic heart disease with multiple episodes of angina attacks since the initial diagnosis, it is highly likely that Mr. MS is presenting with an acute coronary event and this should be a priority until proven otherwise. This is evidenced by the presentation of central, crushing chest pain of sudden onset that radiated to the neck and associated with profuse sweating and body weakness which is classical of a myocardial infarction. Mr. MS will require immediate investigations such as an electrocardiogram and cardiac enzymes to differentiate the acute coronary syndromes so that the appropriate management may be instituted for him e.g. if he has an ST-segment elevation myocardial infarction (STEMI), he will require myocardium-saving thrombolytic therapy to disrupt the ischemic event. As Mr. MS did not present with features such as acute shortness of breath, loss of consciousness and severe palpitations, it seems that he does not have complicati ons of acute myocardial infarction but these developments should be watched out for throughout his admission as complications may arise later. Differential Diagnosis Pulmonary embolism Pulmonary embolism is a possibility that can be considered when a patient presents with an acute chest pain that is accompanied by shortness of breath, hemoptysis, tachypnea, fever and even cyanosis and collapse in severe cases. Furthermore, the chest pain is of a pleuritic nature, of which it is worsened on breathing, and a pleural rub can be heard on auscultation of the chest. However, Mr. MS did not present in such a way. At the same time, Mr. MS did not have risk factors such as a deep vein thrombosis, prolonged immobilization or recent surgery. It is still highly likely that Mr. MS has suffered an acute myocardial infarction, and an ECG would help to differentiate between the two as pulmonary embolism might show the classic S1Q3T3 pattern of right axis deviation or right bundle branch block. Either way, the diagnosis should be made quickly so treatment may be instituted before his condition becomes worse or complications develop. Aortic dissection Aortic dissection presents as an acute onset chest pain that is tearing in nature, and often radiates to the back. It is often confused with myocardial infarction due to its presentation but differences include the lack of profuse sweating, signs of heart pump dysfunction and a normal ECG. Risk factors are usually uncontrolled hypertension, connective tissue disorders or chest trauma. Mr. MS has hypertension, but is under control, and does not have the other risk factors. A diagnosis of myocardial infarction should be the priority as thrombolytic therapy is vital, but if there is any reason to doubt that diagnosis, then further investigations should be performed. 5) IDENTIFY AND PRIORITISE THE PROBLEMS 1. Acute chest pain Mr. MS has acute chest pain with features very suggestive of a classical picture of myocardial infarction as he presents with crushing central chest pain that radiates to the neck and associated with profuse sweating and weakness. Given that he is known to have triple vessel ischemic heart disease and that he has suffered many angina attacks since his initial diagnosis, it is highly likely that he is having an acute myocardial infarction. Without further a due, he needs an electrocardiogram (ECG) and cardiac enzymes tested to distinguish between the different acute coronary syndromes so that the appropriate treatment protocols may be initiated for him as soon as possible to disrupt the ongoing ischemia. As Mr. MS is having severe chest pain that may overstimulate his sympathetic system and cause further ischemia, he will require immediate supportive therapy such as effective pain medication and oxygen therapy. 2. Triple vessel ischemic heart disease awaiting CABG Mr. MS was diagnosed with triple vessel ischemic heart disease when he first presented with chest pain in March 2010 and has since experienced many episodes of angina. Given his diagnosis and disease pattern, he is at a very high risk of developing a severe acute coronary event that may prove fatal if the infarction is too extensive or if complications develop. As percutaneous revascularization with a stent or balloon was not possible for him, he will require a CABG to both relieve his symptoms and reduce his mortality risks in the long term. He was unsure of going ahead with the operation previously, therefore no appointment date was given for surgery. However, now that he has changed his mind, every effort should be made by both the doctors in charge of him here in Hospital Batu Pahat and in the cardiology unit of Hospital Sultanah Aminah to arrange for his surgery as soon as possible, given the circumstances of his condition. 3. Compliance to medication Mr. MS is on several medications for his triple vessel ischemic heart disease and will require revascularization surgery soon in order to decrease his mortality risks. However, waiting for a CABG in the government setting may take some time, even under dire circumstances due to the nature of the system. Therefore, it is extremely crucial that Mr. MS is compliant to his medication regime while awaiting a CABG to prevent another episode of infarction. He should be counseled to fully understand this and the situation of his ischemic heart disease. It is also the responsibility of his doctors to ensure that he is taking the right combination of medications with the aim to prevent another acute cardiac event. Meanwhile, a sufficient supply of sublingual GTN should be provided for Mr. MS in cases of angina attacks at home. He should come to the hospital immediately if GTN fails to relieve his symptoms. 4. Regular screening for comorbid diseases Mr. MS has not been diagnosed with diabetes or hyperlipidemia previously but these diseases are strong risk factors for the long term implications of his ischemic heart disease. Therefore, Mr. MS should be screened regularly e.g. twice yearly during his follow-up appointments. Early detection of diabetes is necessary so that treatment can start as soon as detected in order to prevent his ischemic heart disease from becoming worst than it already is. As for his lipid control, if his lipid profile is found to be outside the normal limits, the dosage of his medication can be increased as necessary. Following his CABG, he will need to maintain a healthy lifestyle of a good, well-balanced, low-salt and low-fat diet and regular exercise within his limits. 6) PLAN OF INVESTIGATION, JUSTIFICATIONS FOR THE SELECTION OF TESTS OR PROCEDURES, AND INTERPRETATION OF RESULTS 1. Electrocardiogram (ECG) To look for any changes that may indicate an ongoing ischemic event, such as ST elevation or depression and T wave inversion in order to support the diagnosis of an acute myocardial infarction so appropriate treatment can be started. Differentiation of ST segment elevation or depression is also crucial in initiating treatment as thrombolytic therapy is only indicated for ST-elevation myocardial infarction. Results: ECG on admission (2 hours after onset) shows sinus rhythm with ST depression at leads I, aVL, V3 V6 with left axis deviation. T wave was present and normal. Interpretation: The ST depression in the leads above indicate an ischemic event at the anterolateral sections of the heart. The lack of ST elevation concludes a diagnosis of either unstable angina or NSTEMI, depending on the levels of cardiac enzymes. There is no sign of old infarction. 2. Cardiac Enzymes To look for elevated levels of cardiac enzymes such as troponin T, creatinine kinase (CK), lactate dehydrogenase (LDH) and aspartate transaminase (AST) that will indicate myocardium ischemia and necrosis. If elevated, a diagnosis of NSTEMI can be made in accordance with the ECG changes. However, cardiac enzymes when done too early after onset may not show any rise in levels 1. This does not mean that necrosis has not taken place and the test should be repeated once more at 6 hours after onset 1. Results: Troponin T (4 hours after onset) 2.75ng/ml ↑ (12 hours after onset) (60 hours after onset) Normal Range (U/L) CK 997 ↑ 263 ↑

Triple Vessel Ischemic Heart Disease Treatment Case Nursing Essay

Triple Vessel Ischemic Heart Disease Treatment Case Nursing Essay Mr. MS is a 58-year-old Malay male who was previously diagnosed with hypertension, gout and triple vessel ischemic heart disease. He first presented with chest pain in March 2010 where he was diagnosed with ischemic heart disease. He was unable to complete an exercise stress test and an angiogram done in Hospital Sultanah Aminah found him to have triple vessel disease. He was told angioplasty was not possible due to the severity of the blocks and was counseled for CABG but he was not keen. Meanwhile, he has had angina attacks 2 to 3 times per week every week since his initial diagnosis for the last 3 months, usually relieved by sublingual GTN and was currently admitted for the 4th time for chest pain not relieved by GTN. ECG done 2 hours after onset of chest pain showed ST depression of 2mm at leads I, aVL, V3 V6 and left axis deviation with no Q waves. Trop T was positive (2.75 ng/ml) at 4 hours after onset and other cardiac enzymes were also raised significantly. He was diagnosed with NSTEMI and treated with aspirin 300mg, IV morphine 2.5 mg, sublingual GTN 3 tablets and subcutaneous clexane 60mg BD for 3 days as well as continuing his current medication regime of simvastatin, metoprolol, cardiprin, ISDN, amlodipine and GTN. Following admission, he was well in the ward with no recurrence of chest pain and did not develop any new complaints. He was discharged after 3 days of inpatient treatment with instructions to attend his follow-up appointment at the cardio clinic in HSAJB on the 16th of June 2010 to make an appointment for surgery. Following this episode of chest pain, which he says is the worst so far, he is now quite keen for CABG. 2) CLINICAL HISTORY Chief Complaint Chest pain for 1 day. History of Present Illness Mr. MS is a 58-year-old Malay male who was previously diagnosed with gout, hypertension and ischemic heart disease with triple vessel disease. He was awoken from sleep at about 10pm due to a central chest pain of sudden onset. He described the character of the pain as crushing in nature and radiated to his neck. This episode of chest pain was the most severe since he was first diagnosed with ischemic heart disease. The pain was associated with profuse sweating, body weakness and was not relieved by rest. However, it was relieved by sublingual GTN, of which he has a supply of. His discomfort was made worst by exertion so he lay in bed to recover. Despite this, he had another episode of chest pain 30 minutes later. He took the sublingual GTN again but this time, the pain did not resolve. He was then brought to the emergency department of Hospital Batu Pahat by his son. This is Mr. MSs fourth admission for chest pain since March 2010. Since his diagnosis of ischemic heart disease in March, he has experience angina attacks two to three times per week, especially on exertion such as when straining while passing motion. During these attacks, he uses sublingual GTN to relieve his symptoms and normally feels much better after that. He only comes to the hospital when GTN does not work to relieve his symptoms. Systemic Review Mr. MS does not experience symptoms such as palpitations, dizziness, headache, nausea, vomiting, orthopnoea, paroxysmal nocturnal dyspnoea, epigastric pain, shortness of breath, fever, and had no syncopal episodes. He also does not have loss of appetite or loss of weight. Bowel and urinary habits are normal. His sleep has not been affected until this current episode whereby he was awoken by the chest pain. Past Medical History Mr. MS was diagnosed with hypertension 6 years ago when he had an episode of headache. He has been on medication since and was on regular follow-up with KK Rengit. He was diagnosed with gout 5 years ago when he had a left big toe swelling which resolved after some medication. He is not on long term medication for gout. Mr. MS was admitted for the first time 5 years ago in 2005 when he had bilateral renal calculi. He was subsequently referred to Hospital Sultanah Aminah for further management of this problem and it has since resolved and does not have follow-up anymore. Mr. MS was diagnosed with ischemic heart disease in March 2010 when he presented with chest pain for the first time. Following his recovery, he underwent a stress test in Hospital Batu Pahat but according to him, was unable to complete the procedure due to chest discomfort. He was referred to the cardiology unit in Hospital Sultanah Aminah for further management where an angiogram was performed and he was told to have triple vessel disease. He was also told that angioplasty was not possible due to the severity of the blocks. He was recommended to have Coronary Artery Bypass Grafting (CABG) but as of yet, no appointment has been made as he was still unsure of going through with the procedure. Following this episode of chest pain, Mr. MS has decided that going for the CABG is the only thing that will keep him alive. His current medications include: Tab Simvastatin 20mg OD Tab Metoprolol 75mg BD Tab Cardiprin 100mg OD Tab Isosorbide Dinitrate (ISDN) 5mg TDS Tab Amlodipine 10mg OD Sublingual Glyceryl Trinitrate (GTN) PRN He is compliant to his medication regime. Mr. MS is not known to have diabetes or hyperlipidemia. He also does not have any known food or drug allergies. Family History Mr. MS is the 3rd of 9 siblings. His father had hypertension and passed away a long time ago due to unknown causes. His mother and other siblings are healthy. None of them have hypertension, diabetes, ischemic heart disease or malignancy. Social History He lives in a kampung in Rengit with his wife and 5 children. Mr. MS does not smoke nor consume alcohol. He works in a palm oil plantation. The distance from his house to Hospital Batu Pahat is about half an hour. On further enquiry, Mr. MS says that the cost of the CABG is about RM1000, which he can afford. 3) FINDINGS ON CLINICAL EXAMINATION (Mr. MS was examined by me 9 hours after onset of chest pain) Mr. MS was alert, conscious, and communicative. He was not in obvious pain or respiratory distress. He was lying down comfortably on his bed. There were no tendon xanthomata, xanthelasma, pallor, corneal arcus or pedal edema. His JVP was not raised. His clinical parameters are: Blood Pressure : 158/94 mmHg Heart Rate : 94 beats per minute. Regular rhythm Respiratory Rate : 20 breaths per minute Temperature : 37Â °C SpO2 : 97% under room air On examination of the precordium, the apex beat was located at the 5th intercostal space on the midclavicular line and was normal in character. Parasternal heave was not felt and there were no thrills. First and second heart sounds were heard. There were no murmurs or added heart sounds. On examination of the chest, there was no deformity and chest expansion was equal on both sides. Percussion and tactile vocal fremitus was normal and equal on both sides. On auscultation, vesicular breath sounds were heard throughout all lung fields with good air entry. There was no wheezing or crepitations heard. On examination of the abdomen, it was soft and non-tender. There were no masses felt. Bowel sounds were heard and normal. 4) PROVISIONAL AND DIFFERENTIAL DIAGNOSES WITH REASONING Provisional Diagnosis Acute myocardial infarction with underlying triple vessel ischemic heart disease and hypertension With a history of diagnosed triple vessel ischemic heart disease with multiple episodes of angina attacks since the initial diagnosis, it is highly likely that Mr. MS is presenting with an acute coronary event and this should be a priority until proven otherwise. This is evidenced by the presentation of central, crushing chest pain of sudden onset that radiated to the neck and associated with profuse sweating and body weakness which is classical of a myocardial infarction. Mr. MS will require immediate investigations such as an electrocardiogram and cardiac enzymes to differentiate the acute coronary syndromes so that the appropriate management may be instituted for him e.g. if he has an ST-segment elevation myocardial infarction (STEMI), he will require myocardium-saving thrombolytic therapy to disrupt the ischemic event. As Mr. MS did not present with features such as acute shortness of breath, loss of consciousness and severe palpitations, it seems that he does not have complicati ons of acute myocardial infarction but these developments should be watched out for throughout his admission as complications may arise later. Differential Diagnosis Pulmonary embolism Pulmonary embolism is a possibility that can be considered when a patient presents with an acute chest pain that is accompanied by shortness of breath, hemoptysis, tachypnea, fever and even cyanosis and collapse in severe cases. Furthermore, the chest pain is of a pleuritic nature, of which it is worsened on breathing, and a pleural rub can be heard on auscultation of the chest. However, Mr. MS did not present in such a way. At the same time, Mr. MS did not have risk factors such as a deep vein thrombosis, prolonged immobilization or recent surgery. It is still highly likely that Mr. MS has suffered an acute myocardial infarction, and an ECG would help to differentiate between the two as pulmonary embolism might show the classic S1Q3T3 pattern of right axis deviation or right bundle branch block. Either way, the diagnosis should be made quickly so treatment may be instituted before his condition becomes worse or complications develop. Aortic dissection Aortic dissection presents as an acute onset chest pain that is tearing in nature, and often radiates to the back. It is often confused with myocardial infarction due to its presentation but differences include the lack of profuse sweating, signs of heart pump dysfunction and a normal ECG. Risk factors are usually uncontrolled hypertension, connective tissue disorders or chest trauma. Mr. MS has hypertension, but is under control, and does not have the other risk factors. A diagnosis of myocardial infarction should be the priority as thrombolytic therapy is vital, but if there is any reason to doubt that diagnosis, then further investigations should be performed. 5) IDENTIFY AND PRIORITISE THE PROBLEMS 1. Acute chest pain Mr. MS has acute chest pain with features very suggestive of a classical picture of myocardial infarction as he presents with crushing central chest pain that radiates to the neck and associated with profuse sweating and weakness. Given that he is known to have triple vessel ischemic heart disease and that he has suffered many angina attacks since his initial diagnosis, it is highly likely that he is having an acute myocardial infarction. Without further a due, he needs an electrocardiogram (ECG) and cardiac enzymes tested to distinguish between the different acute coronary syndromes so that the appropriate treatment protocols may be initiated for him as soon as possible to disrupt the ongoing ischemia. As Mr. MS is having severe chest pain that may overstimulate his sympathetic system and cause further ischemia, he will require immediate supportive therapy such as effective pain medication and oxygen therapy. 2. Triple vessel ischemic heart disease awaiting CABG Mr. MS was diagnosed with triple vessel ischemic heart disease when he first presented with chest pain in March 2010 and has since experienced many episodes of angina. Given his diagnosis and disease pattern, he is at a very high risk of developing a severe acute coronary event that may prove fatal if the infarction is too extensive or if complications develop. As percutaneous revascularization with a stent or balloon was not possible for him, he will require a CABG to both relieve his symptoms and reduce his mortality risks in the long term. He was unsure of going ahead with the operation previously, therefore no appointment date was given for surgery. However, now that he has changed his mind, every effort should be made by both the doctors in charge of him here in Hospital Batu Pahat and in the cardiology unit of Hospital Sultanah Aminah to arrange for his surgery as soon as possible, given the circumstances of his condition. 3. Compliance to medication Mr. MS is on several medications for his triple vessel ischemic heart disease and will require revascularization surgery soon in order to decrease his mortality risks. However, waiting for a CABG in the government setting may take some time, even under dire circumstances due to the nature of the system. Therefore, it is extremely crucial that Mr. MS is compliant to his medication regime while awaiting a CABG to prevent another episode of infarction. He should be counseled to fully understand this and the situation of his ischemic heart disease. It is also the responsibility of his doctors to ensure that he is taking the right combination of medications with the aim to prevent another acute cardiac event. Meanwhile, a sufficient supply of sublingual GTN should be provided for Mr. MS in cases of angina attacks at home. He should come to the hospital immediately if GTN fails to relieve his symptoms. 4. Regular screening for comorbid diseases Mr. MS has not been diagnosed with diabetes or hyperlipidemia previously but these diseases are strong risk factors for the long term implications of his ischemic heart disease. Therefore, Mr. MS should be screened regularly e.g. twice yearly during his follow-up appointments. Early detection of diabetes is necessary so that treatment can start as soon as detected in order to prevent his ischemic heart disease from becoming worst than it already is. As for his lipid control, if his lipid profile is found to be outside the normal limits, the dosage of his medication can be increased as necessary. Following his CABG, he will need to maintain a healthy lifestyle of a good, well-balanced, low-salt and low-fat diet and regular exercise within his limits. 6) PLAN OF INVESTIGATION, JUSTIFICATIONS FOR THE SELECTION OF TESTS OR PROCEDURES, AND INTERPRETATION OF RESULTS 1. Electrocardiogram (ECG) To look for any changes that may indicate an ongoing ischemic event, such as ST elevation or depression and T wave inversion in order to support the diagnosis of an acute myocardial infarction so appropriate treatment can be started. Differentiation of ST segment elevation or depression is also crucial in initiating treatment as thrombolytic therapy is only indicated for ST-elevation myocardial infarction. Results: ECG on admission (2 hours after onset) shows sinus rhythm with ST depression at leads I, aVL, V3 V6 with left axis deviation. T wave was present and normal. Interpretation: The ST depression in the leads above indicate an ischemic event at the anterolateral sections of the heart. The lack of ST elevation concludes a diagnosis of either unstable angina or NSTEMI, depending on the levels of cardiac enzymes. There is no sign of old infarction. 2. Cardiac Enzymes To look for elevated levels of cardiac enzymes such as troponin T, creatinine kinase (CK), lactate dehydrogenase (LDH) and aspartate transaminase (AST) that will indicate myocardium ischemia and necrosis. If elevated, a diagnosis of NSTEMI can be made in accordance with the ECG changes. However, cardiac enzymes when done too early after onset may not show any rise in levels 1. This does not mean that necrosis has not taken place and the test should be repeated once more at 6 hours after onset 1. Results: Troponin T (4 hours after onset) 2.75ng/ml ↑ (12 hours after onset) (60 hours after onset) Normal Range (U/L) CK 997 ↑ 263 ↑

Eudora Weltys A Worn Path Essay -- Eudora Welty Worn Path Essays

Eudora Welty's "A Worn Path" Throughout time, people have traveled the trodden course of life, overcoming obstacles along the way and grasping onto hope to strengthen their steps. In her short story â€Å"A Worn Path†, Eudora Welty communicates this timeless theme through the protagonist, Phoenix, who has traveled this path many times. Through her usage of dialogue and symbolism, Welty illustrates the lasting concept that people conquer hardships in life and ultimately prevail. Welty utilizes dialogue to portray how others belittle Phoenix and attempt to destroy her dignity in vain. Along her journey, Phoenix meets several people with look down on her for her old age. First, the Satan figure, the hunter calls her â€Å"Granny† and encourages her to return home. He also mocks her race when he claims he â€Å"know[s] you old colored people.† However, Phoenix is not discouraged by the hunter as evident in her fearlessness when the hunter carelessly points his gun at her. This is also obvious when she refuses to return home in the face of the hunter’s persuasion. Welty uses the hunte...

Computers Predicting the outcomes of cutting DNA :: Biology

The focus of this study is the interaction between DNA and I-Msol, an endonuclease. An endonuclease is a protein that cuts DNA at a certain sequence with a certain length; I-Msol cuts DNA at approximately 20-24 base pairs and is highly specific in what sequence it is designed to cut. The interaction between DNA and an endonuclease like I-Msol is difficult to determine just by looking at the amino acid sequence of the protein. The difficulty arises because of the many molecular interactions such as hydrogen bonding and electrostatic interactions are affected by how the protein specifically interacts with the DNA, 3-dimensionally. The best method of understanding these complexities is to create model that considers all these dynamics of the DNA/protein interaction. Thus, a I-Msol/DNA model was created in silico to study the areas of contact between the two macromolecules as well as what happened when changes were made to the base pairs of the DNA. In summary: * It is impossible to predict DNA and protein interaction by looking at the amino acid sequence * hydrogen-bonding and electrostatic interactions alter amino acid sequence * I-Msol is a endonuclease, which cuts DNA around 20-24 base pairs with high specificity * Preliminary testing resulted in determining many of areas of contact between I-Msol and the DNA molecule * The researches made base pair substitutions that affected the interaction of the protein with the DNA Results After the protein-DNA contacts were redesigned, then, in this complex, the amino acids that were likely to cause disruption were changed. These amino acids were categorized on affinity for the designed protein for the new site and the decrease in affinity for the original wild type I-Msol enzyme As from the table, the largest predicted change came from the -6C*G, + 6 C*G, because this automatically prevents direct hydrogen bonding. Different amino acids had different disruption predictions. Using a formula, the binding energies were calculated by using the value of the wild type and then subtracting the facilitate comparison. A difference map represented certain values such as electron density for the new amino acids. A gel electrophoretic shift was done to observe the binding specificity. As the experiment indicates the experimental changes in binding affinities differed from the predicted ones. The results indicate that the future looks very bright for medicine and biochemistry as the redesign of the of DNA complexes is predicted to allow us to make mass breakthroughs in the future.

Police Use of Force Essay

Police use of force is a tool that is taught to every Officer to help diffuses a situation, it is not meant to do harm, but to ensure the safety of the Officer and the people that are involved in the situation. In some rare cases there are Officers that abuse their power and with the use of excessive use of force on individuals is an issue, Officers not thinking of what the effects it has on the victim, the alleged perpetrator or the community that it occurs in. The ethical or unethical use of force is determined by the community, society, and often a judge and jury. Today’s society there are often electrical devices that capture uses of force which are often used against Law Enforcement, these devices often capture a use of force that had gone bad like in the Rodney King case for example . The Misuse of authority like in the case against Chief Charlie Beck in the Los Angeles Police Department the outcome and concerns with a case like this. The cause and effects of Police use of force in our society and the ethical and unethical outcomes it has. Police Use of Force Use of force is the â€Å"amount of effort required by police to compel compliance by an unwilling subject.† (National Institute of Justice) Police are given this special tool to help enforce their safety and the safety of others when in a dangerous situation, they are taught this through education and training that is kept up yearly to ensure they are the best they can be at all times. The ways that an officer can use force is verbally, physical-restraint, less-lethal force, and when necessary lethal force. â€Å"Police officers should use only the amount of force necessary to control an incident, effective arrest, or protect themselves or others from harm or death.† (National Institute of Justice) Unfortunately, at times there are some police officers have felt that they are above this rule and have used excessive force in unnecessary situations. This is a problem both ethically and lawfully. One of the most famous cases where use of force was abused is the Rodney Kin g beating, this case was national news. This case was a use of force that had accrued in California with the LAPD. Their Police Chief Charlie Beck is being accused of letting officers who have used excessive force go unpunished. It is important for all law enforcement officers to only use force when absolutely necessary and all verbal commands have been expired. In today’s society there is always someone watching and often with some type of recording device recording all actions of Law Enforcement to catch them in an unfavorable situation. Violating use of force protocol is unethical because it does harm to people who do not deserve it, it’s not just the physical damage it can do but the mental as well. It would also be viewed as unethical because it is not for the greater good or overall happiness of everyone. It also appears to makes the police officer look untrustworthy and uncontrollable. This was what happen in the case for Rodney King, who had beaten by three police officers while their supervisor watched. Unfortunately Mr. King was beaten with metal batons, stomped on, and kicked as he lay on the ground defenseless. King was being arrested after sending police on a high speed car chase, that could have injured many innocent bystanders, but that does not justify the actions that were taken upon him. While the officers were trying to arrest him, Mr. King had put up a fight, resisting arrest, so the Officers, shot him twice with a stun gun, unfortunately still he resisted. When he finally rose to his feet, t his is when the beatings began. Unfortunately for the Officers but fortunately for Mr. King, all of this was caught on tape. Even though it was apparent what the Officers had done to be unethical when the case went to trial all of the officers were found innocent. This verdict caused such outrage with many people who followed the case that soon after the verdict was announced riots erupted all over Los Angeles. This is a perfect example of society losing faith in our Criminal Justice System they see the proof of what the Officers had done wrong yet they hw were not held accountable for their actions. When things like this are released it makes our justice system look sloppy, unprofessional, and most importantly unethical. It is understandable that the officers were probably upset that King had sent them on a dangerous car chase and resisted arrest; however, once he was subdued they should have put the cuffs on him, and placed him in the police car, and take him away. Instead, it looks like these officers took out their frustrations on Rodney King brought justice they felt he deserved into the street without a judge or his peers or a right to a fair trial. This would be seen as unethical because it was not for the overall happiness of everyone, it did not do any good, and the officers did not follow by the rules. They took themselves and placed themselves above what society feels to be acceptable and they broke that trust. Another ethical case involving use of force is also in Los Angeles, California. This is a recent problem involving the Chief of Police Charlie Beck. Beck is being accused of not punishing police officers who have used excessive force. â€Å"Since Beck took over as chief in late 2009, the commission has ruled on about 90 incidents involving officers who fired weapons or used other deadly force. In almost all of them, Beck concluded the officers used force appropriately and urged the commission to clear them of wrongdoing. The board followed his guidance most of the time.† (Rubin) However, four shootings that involved three people being killed and another three wounded by gunfire the commission did not agree with the Chief. This did not persuade Beck to invoke punishment to the officers involved in the shootings. He agreed that one of the officers had been wrong in his choice to fire, but still did not punish him. The commission fears that the lack of punishment toward officers who use excessive force could be sending out the wrong message to members of the LAPD. I would agree with the commission that Beck is sending out the wrong message. If an officer is already lacking good moral judgment when faced with a dangerous situation they may over-react to it if they know there are no consequences for their actions. â€Å"Every day, law enforcement officers face danger while carrying out their responsibilities this is something they decided to do take an oath and are to abide by what they have been taught and represent. When dealing with a dangerous—or unpredictable—situation, police officers usually have very little time to assess it and determine the proper response.† (United) We can make sure that when faced with these situations police officers make the right decision through proper training. Such training could include knowing the Use of Force Model. As taught this model is a guide to what use of force actions are appropriate for each situation and should be carried out in such a manner. For example, if someone is assaultive (trying to cause bodily harm) the officer should use defense tactics to subdue the individual first trying all verbal communication before resulting in a physical altercation. Another training guide that is used is the Police Training Model, which w as created in 1999 by PERF and the Reno Police Department. This model â€Å"addresses the traditional duties of policing in the context of specific neighborhood problems and includes several segments on the use of force.† (United) It is very important for police officers to make ethical decisions while in the field. It is important because it is their duty to protect and serve. It is also important because we as citizens look up to law enforcement and if they are caught doing something unethical it can ruin the respect and trust we have in law enforcement. When faced with dangerous or a tough situation police officers need to be trained to quickly make the best and most ethical decision possible. Police officers like those who beat Rodney King should be punished and made an example of. It is not ethical to hurt someone just because you have the power to. â€Å"The criminal justice system is designed to enforce moral rules that have been written into the criminal law. Aristotle believed that justice consist of giving each person his or her due† [ (Jay.S, 2013) ]. Maybe the Police Officers in both cases felt they had to take on the ethical teachings of Aristotle. When looking at today’s society and if you go back as far as there is written proof the court systems and law enforcement rules and regulations have grown and developed into more evolved court system and law enforcement for society to follow. At one time it was not unethical to flogged or whip a person, this was to deter them from committing future crimes, this is where Officers like the ones in these cases may have gotten by with physical abuse and unnecessary of force. Fortunately for us as citizens we have constitutional rights and there are laws in place to protect us from unnecessary use of force and the citizens of The United States of America are allowed their freedom, a speedy trial among a group of their peers fair, representation and the right not to be harmed by those who hold authority by law in which they represent. We have ethical responsibility s citizens to follow the rules and regulation of our count try and they s Law Enforcement Officers have n ethical obligation to lead by example. References 1. Harari, O. (1993). Lessons from the Rodney King tape. Management Review, 82(8), 20. 2. Jay.S, A. (2013). Professional Ethics In Criminal Justice Being Ethical when no one is looking. 3rd edition. In A. Jay.S, Professional Ethics In Criminal Justice Being Ethical when no one is looking. 3rd edition (pp. 1-153). Upper Saddle River : Prentice Hall /Pearson. 3. Jefferis, E., Butcher, F., & Hanley, D. (2011). Measuring perceptions of police use of force. Police Practice & Research, 12(1), 81-96. doi:10.1080/15614263.2010.497656 National Institute of Justice. â€Å"Police Use of Force.† National Institute of Justice. Office of Justice Programs, 20 Jan. 2012. Web. 19 July. 2013. . 4. Matheson, V. A., & Baade, R. A. (2004). Race and Riots: A Note on the Economic Impact of the Rodney King Riots. Urban Studies (Routledge), 41(13), 2691-2696. doi:10.1080/0042098042000294628 5. Rubin, J. (2012, 04 16). Beck facing rare criticism Improper use of force is tolerated too often, police panel says. Retrieved from Los Angeles Times : http://articles.latimes.com/2012/apr/16/local/la-me-beck-discipline-20120416 6. Rubin, Joel. â€Å"LAPD to Hold Meetings on Use-of-force Policies.† Los Angeles Times. Los Angeles Times, 10 Sept. 2012. Web. 21 July 2013. . 7. Stuart, F. (2011). Constructing Police Abuse after Rodney King: How Skid Row Residents and the Los Angeles Police Department Contest Video Evidence. Law & Social Inquiry, 36(2), 327-353. doi:10.1111/j.1747-4469.2011.01234.x 8. United States Department of

George Lucas Essay

No other 20th century filmmaker has had a greater impact on the film industry than George Lucas. His zeal for innovation forged a new relationship between entertainment and technology that revolutionized the art of motion pictures. His uncanny business acumen turned film licensing and merchandising into a multibillion-dollar industry. And his â€Å"Star Wars† trilogy ushered in the era of the Hollywood mega-blockbuster. Slide 2: In 1967, Lucas re-enrolled as a USC graduate student in film production. Working as a teaching instructor for a class of U.S. Navy students who were being taught documentary cinematography, Lucas directed the short film Electronic Labyrinth: THX 1138 4EB, which won first prize at the 1967–68 National Student Film Festival, and was later adapted into his first full-length feature film, THX 1138. Lucas was awarded a student scholarship by Warner Brothers to observe and work on the making of a film of his choosing. The film he chose was Finian’s Rainbow (1968) which was being directed by Francis Ford Coppola, who was revered among film school students of the time as a cinema graduate who had â€Å"made it† in Hollywood. In 1969, George Lucas was one of the camera operators on the classic Rolling Stones concert film Gimme Shelter. Slide 3: Lucas was born in Modesto, California, on May 14, 1944. As an adolescent who, as he says, â€Å"barely squeaked through high school,† Lucas aspired to be an auto racer. He changed his mind about a racing career, however, when a near-fatal accident crushed his lungs and sent him to the hospital for three months just days before his high school graduation. The experience changed Lucas. â€Å"I realized that I’d been living my life so close to the edge for so long,† he says. â€Å"That’s when I decided to go straight, to become a better student, to try to do something with myself.† Lucas enrolled at Modesto Junior College, where he developed a fascination with cinematography. Deciding on a career in film, he applied to the prestigious University of Southern California (USC) film school. USC was a milestone for Lucas. â€Å"Suddenly my life was film-every waking hour,† he says in a 1997 Playboy interview. He concentrated on making abstract science fiction films and mock documentaries, which caught the attention of director Francis Ford Coppola, who invited Lucas to sit in on the shooting of â€Å"Finian’s Rainbow.† Coppola also persuaded Warner Bros. to make a film of one of Lucas’ student movies. The full-length feature, â€Å"THX-1138,† a bleak Orwellian tale, was released in 1971 to modest reviews and a lukewarm reception at the box office. But studio executives were impressed with Lucas’ obvious talent. Slide 4: â€Å"THX-1138† had earned Lucas a reputation as a skilled but mechanical filmmaker devoid of humor and feeling. Founder Lucasfilm and released his second film, â€Å"American Graffiti,† which was based on his own coming of age in Modesto, would change that. Filmed on a shoestring budget of just $780,000, the film became a smash hit soon after its release in June 1973 and eventually grossed $120 million. The film got rave reviews and made Lucas a Hollywood sensation. It also proved to be a defining moment for Lucas, as both a filmmaker and a businessman. Studio honchos pulled rank and made changes to Lucas’ final version. The changes were minor, but the scars were lasting. â€Å"I’m very aware as a creative person that those who control the means of production control the creative vision,† he says. â€Å"It’s not a matter of saying ‘You’re going to let me have the final cut,’ because no matter what you do in a contract, they will go around it. Whereas if you own the cameras and you own the film, there’s nothing they can do to stop you.† And that’s exactly what Lucas set out to do. Industrial Light & Magic (ILM), which he created in 1975 when he couldn’t find an outside company to do special effects for â€Å"Star Wars.† ILM’s first breakthrough was a motion-control camera, which could revolve repeatedly around stationary objects while remaining in constant focus, thus simulating flight. To generate cash, Lucas turned ILM into a service company. Having created a market for special-effects-laden films, he began taking on work from other filmmakers. This way he could keep developing techniques while other people funded his research. Charging up to $25 million per movie, ILM was almost immediately profitable, supp lying the special effects for such blockbusters as â€Å"Jurassic Park† and â€Å"Twister.† Lucas funneled ILM profits into related businesses that sprang from his research. Skywalker Sound emerged as the industry’s top audio post-production company, then branched out to providing a digital sound system for theaters and homes under the name THX (in honor of his first film). And with the founding of LucasArts Entertainment, Lucas moved into video games, producing such top-sellers as the â€Å"Star Wars†-inspired Rebel Assault, X-Wing and Dark Forces. When negotiating with 20th Century Fox in 1975 for his next movie, â€Å"Star Wars,† Lucas cut his directing fee by $500,000 in exchange for things Fox regarded as nearly worthless: ownership of the film’s merchandising and all sequel rights. It turned out to be a brilliant move, one that assured Lucas the real independence and creative control he’d been seeking. â€Å"Star Wars† shattered all box office records, earning Lucas about $40 million in its initial release-merchandising would later bring him tens of millions more. Most important, Lucas owned the sequels, and thus a franchise. To maximize its value, he financed his first sequel, â€Å"The Empire Strikes Back,† himself, borrowing heavily to cover the $30 million production costs. Given the success of â€Å"Star Wars,† it was a good bet, but a huge risk-if the film bombed, Lucas would be bankrupt. â€Å"Empire† did exceptionally well, however, as did the third film in the trilogy, â€Å"Return of the Jedi,† which Lucas also financed. â€Å"Everybody has talent. It’s just a matter of moving around until you’ve discovered what it is.†-George Lucas No other 20th century filmmaker has had a greater impact on the film industry than George Lucas. His zeal for innovation forged a new relationship between entertainment and technology that revolutionized the art of motion pictures. His uncanny business acumen turned film licensing and merchandising into a multibillion-dollar industry. And his â€Å"Star Wars† trilogy ushered in the era of the Hollywood mega-blockbuster. Lucas was born in Modesto, California, on May 14, 1944. As an adolescent who, as he says, â€Å"barely squeaked through high school,† Lucas aspired to be an auto racer. He changed his mind about a racing career, however, when a near-fatal accident crushed his lungs and sent him to the hospital for three months just days before his high school graduation. The experience changed Lucas. â€Å"I realized that I’d been living my life so close to the edge for so long,† he says. â€Å"That’s when I decided to go straight, to become a bette r student, to try to do something with myself.† Lucas enrolled at Modesto Junior College, where he developed a fascination with cinematography. Deciding on a career in film, he applied to the prestigious University of Southern California (USC) film school. USC was a milestone for Lucas. â€Å"Suddenly my life was film-every waking hour,† he says in a 1997 Playboy interview. He concentrated on making abstract science fiction films and mock documentaries, which caught the attention of director Francis Ford Coppola, who invited Lucas to sit in on the shooting of â€Å"Finian’s Rainbow.† Coppola also persuaded Warner Bros. to make a film of one of Lucas’ student movies. The full-length feature, â€Å"THX-1138,† a bleak Orwellian tale, was released in 1971 to modest reviews and a lukewarm reception at the box office. But studio executives were impressed with Lucas’ obvious talent. â€Å"THX-1138† had earned Lucas a reputation as a skilled but mechanical filmmaker devoid of humor and feeling. His second film, â€Å"American Graffiti,† which was based on his own coming of age in Modesto, would change that. Filmed on a shoestring budget of just $780,000, the film became a smash hit soon after its release in June 1973 and eventually grossed $120 million. The film got rave reviews and made Lucas a Hollywood sensation. It also proved to be a defining moment for Lucas, as both a filmmaker and a businessman. Studio honchos pulled rank and made changes to Lucas’ final version. The changes were minor, but the scars were lasting. â€Å"I’m very aware as a creative person that those who control the means of production control the creative vision,† he says. â€Å"It’s not a matter of saying ‘You’re going to let me have the final cut,’ because no matter what you do in a contract, they will go around it. Whereas if you own the cameras and you own the film, there’s nothing they can do to stop you.† And that’s exactly what Lucas set out to do. When negotiating with 20th Century Fox in 1975 for his next movie, â€Å"Star Wars,† Lucas cut his directing fee by $500,000 in exchange for things Fox regarded as nearly worthless: ownership of the film’s merchandising and all sequel rights. It turned out to be a brilliant move, one that assured Lucas the real independence and creative control he’d been seeking. â€Å"Star Wars† shattered all box office records, earning Lucas about $40 million in its initial release-merchandising would later bring him tens of millions more. Most important, Lucas owned the sequels, and thus a franchise. To maximize its value, he financed his first sequel, â€Å"The Empire Strikes Back,† himself, borrowing heavily to cover the $30 million production costs. Given the success of â€Å"Star Wars,† it was a good bet, but a huge risk-if the film bombed, Lucas would be bankrupt. â€Å"Empire† did exceptionally well, however, as did the third film in the trilogy, â€Å"Return of the Jedi,† which Lucas also financed. Lucas further increased his fortune in the 1980s by producing the three Indiana Jones movies, for which he earned well over $100 million. Then, at the very top of his game, he largely abandoned moviemaking and poured his fortune into digital experiments that, he sensed correctly, would transform the movie business. Slide 5: * He quit an early career when he realized it wasn’t right for him (he wanted to be a race-car driver†¦until he almost got killed in a crash) * He made a type of product he loved and cared deeply about (movies) * He made–and learned from–lots and lots of different products (There were many Lucas movies before Star Wars) * He evolved (Lucas’s early movies were artsy non-commercial films) * He studied and learned from the best mentors (Francis Ford Coppola, among others) * He became friends with other extremely talented people in the industry (Steven Spielberg, among others) * He was shrewd (He sold his directing services to Fox Studios for Star Wars for cheap–but kept all the merchandise, licensing, and sequel rights, which Fox didn’t want) * He was very, very patient (Unlike many of today’s entrepreneurs and investors, Lucas wasn’t looking for a â€Å"quick flip.† Lucasfilm was founded in 1971, 41 years ago) Slide 6: There are three lessons to take away from reading about how George Lucas achieved success. One, grow a thick skin and be prepared for criticism and early failures. Every time you start a business, risks will be involved and sometimes things do not go your way. The key to a successful entrepreneur is how that person responds to the situation. Does he persevere through the tribulations? The second lesson is that every entrepreneur should know his or her strengths and weaknesses to give him or her the best chance at success. Knowing what skills need improvement will help limit potential pitfalls for you and your small business. The third lesson†¦just as Mr. Lucas was innovative in bringing out-of-this-world special effects to his films, entrepreneurs should also work hard to be innovative. What special effects can you use to amaze your customers?