Radiographic Quality of Root Canal Treatments

Radiographic Quality of Root Canal Treatments Title: Radiographic quality of root canal treatments performed by undergraduate dental students Authors: Masoud Saatchi1, Golshan Mohammadi2, Armita Vali Sichani3 Dental Research Center, Department of Endodontics, School of Dentistry, Isfahan University of Medical Sciences. Isfahan, Iran. School of Dentistry, Isfahan University of Medical Sciences. Isfahan, Iran. Department of Endodontics, School of Dentistry, Isfahan University of Medical Sciences. Isfahan, Iran. Summary: The aim of the present study was to evaluate the quality of root canal treatments performed by students of Isfahan University School of Dentistry between 2013 and 2015. Periapical radiographs from 784 root treated teeth including 1674 root canals were randomly selected and evaluated in terms of quality of root fillings (length and density of root fillings) and procedural errors (ledge, foramen perforation, root perforation, and fractured instrument). Descriptive statistics and chi square test were used for evaluation of the data (P Key words: dentistry, procedural errors, radiography, root canal treatment, undergraduate student Introduction Root canal treatment (RCT) is an important part of comprehensive dental care (1). High prevalence of apical periodontitis in endodontically treated teeth, as reported by epidemiological studies (2-4), reveals that outcome of RCT in many populations is poor, which as a health care problem can elicit medical, economical and ethical consequences (1). Outcome of primary endodontic treatment is reported to be associated with many factors (5). One of these factors is technical quality of RCT that is usually evaluated using radiographic method (3, 6). Its shown that the length of the root filling, relative to the radiographic apex, significantly affects the treatment outcomes (7). In addition, root fillings with an adequate density are strongly associated with a lower risk of periapical disease (8). Also, procedural errors such as ledges, zip and elbow formations, fractured instruments and perforations may accrue during the RCT. These errors may result in compromised cleaning and shaping, leakage through root filling or infection of the periradicular tissues and can jeopardize the endodontic outcomes (9). Recent studies accomplished in various population groups, show that undesirable quality is a common finding in RCTs performed by dentists and undergraduate dental students (Table 1). Therefore a worldwide enhancement in the quality of RCT is required (2) that could be achieved by means of education. Studies concerning quality of RCT are needed in order to appraise the efficiency of dental training, highlight the weaknesses and help with the planning for dental education. Thus, the aim of the present study was to evaluate quality of root canal treatments (quality of root fillings and incidence of procedural errors) performed by students of Isfahan University School of Dentistry between 2013 and 2015. Materials and methods In this cross-sectional study, a random sample of 1200 cases were selected from the records of patients who had received RCT by undergraduate students at School of Dentistry, Isfahan University of Medical Sciences, Iran, during 2013-2015. Records with missing or unreadable radiographs due to improper imaging or processing technique, or those with radiographs that didnt show the entire length of the root canals and 2mm of periapical area, were excluded. Finally, 784 treated teeth including 1674 canals were evaluated. The RCTs were accomplished by fourth, fifth and sixth year undergraduate dental students according to the fallowing protocol: after taking medical and dental history and diagnosis of palp and periapical disease, local anesthesia was injected and the access cavity was prepared. An aseptic technique with rubber dam isolation was applied and working length was determined using periapical radiographs. Canals were prepared using step back technique by means of stainless steel k-files of 0.02 taper (Dentsply, Tusla, USA or Mani, Tochigi, Japan). In some case Gates-Glidden drills (Mani, Tochigi, Japan) were used for preparation of coronal third of the canals. Canals were irrigated by 2.5% sodium hypochlorite. Obturations were carried out using lateral compaction technique with gutta-percha cones (Ariadent, Tehran, Iran) and a ZOE based sealer. Teeth were temporarily restored and referred for permanent restorations. For root canal treatment of each tooth, 4 periapical radiographs (preoperati ve, working length determination, master cone and postoperative) were taken by the bisecting-angle method using De Gotzen dental radiography machine (De Gotzen, Roma, Italy) and E speed size 2 intraoral films (Primax, Berlin, Germany). Developing solutions (Champion, Tehran, Iran) were used to possess the radiographs in a time-temperature technique. Endodontist academic stuff supervised all the treatment steps. Average academic stuff: student ratio has been 1: 6 at the time of the study. In order to evaluate the quality of each RCT, at least 3 radiographs including preoperative, working length determination and postoperative, were examined. Evaluations were made in a dark room under even illumination and 3x magnification. Radiographs were mounted in a cardboard slit to exclude the extraneous lights. Measurements were done using a transparent ruler of 0.5 mm accuracy. In cases that the radiographic images were taken with an alternation in horizontal angulation, it was supposed that they were exposed with a mesial angulation. Two individual investigators (GM and AV) securitized the radiographs of each record. The results were compared and in case of disagreement a third investigator (MS) was asked to examine the records, and a final agreement was achieved. Before the study, investigators were calibrated and Inter-examination agreement was determined by evaluating 30 radiographic records that werent included in the study. For establishing intra-examiner agreement, each investigator re-evaluated the same radiographs after 2 weeks. Evaluation of quality of RCTs was accomplished by examining radiographic quality of root fillings and detection of the procedural errors. Root canal was considered as the unit of evaluation. Quality of root filling in each canal was categorized as acceptable and unacceptable based on the following criteria: Acceptable root filling: root filling ending 0-2 mm from radiographic apex without any visible voids in the filling mass or between the filling mass and root canal walls. Unacceptable root filling: Overfilling: root filling that extends beyond radiographic apex. Undrefilling: root filling ending shorter than 2 mm from the radiographic apex. Inadequate density: root fillings with visible voids in the filling mass or between the filling mass and root canal walls. The criteria for the detection of procedural errors in this study, were as follows: A ledge was identified if the root filling in the final radiograph did not follow the curvature of the main canal path in working-length radiograph. Root perforations (including furcation perforation, strip perforation and lateral perforations of the root) were detected when extrusion of the filling materials was identified in any area of the root except the apical foramen. Foramen perforation was diagnosed when the apical termination of the filled canal appeared as an elliptical shape transported to the outer wall. Fractured instruments: was detected by observing a part of instrument in the root canal or in periarticular area in the final radiograph. Statistical analysis Data were analyzed using SPSS software version 21 (SPSS Inc., Chicago, USA). Descriptive analyzes were used for expressing frequency of radiographic criteria of quality of RCTs. Pearsons chi square test was used to compare the results among tooth types and locations and also academic year of students. P-values Results From 1200 collected records of endodontically treated teeth, 416 cases (34.7%) were excluded and 734 teeth including 1674 root canals were evaluated. 52% of treated root canals were in maxilla and 48% were in mandible. Canals of molar teeth comprised the most frequent treated root canals (68%), followed by canals of premolars (22%) and anterior teeth (10%) . 6th   year students performed RCTs on 49% of root canals. 5th and 4th year students treated 32% and 19% of root canals, respectively. Anterior teeth and premolars constituted the teeth treated by 4th year students while 5th and 6th year students treated premolars and molars (Table 2). Technical quality of root fillings According to length and density, acceptable fillings was found in 54.1% of root canals. From treated maxillary root canals, 56.2% and from treated mandibular root canals, 51.9% were acceptable. Rate of acceptable root fillings wasnt significantly different between the two arches (P=0.072). Among tooth types, canals of molar teeth exhibited lower ratio of acceptable root fillings (51.3%) compared to premolars (61.3%) (P=0.001). Rate of acceptable fillings in anterior teeth (57.7%) wasnt significantly different from molars (P=0.430) and premolars (P=0.128). Inadequate density, overfilling and underfilling was found in 34.6%, 11% and 8.3% of root canals, respectively. In both arches inadequate density consisted the most common cause for unacceptable fillings. In maxilla overfilling consisted the second frequent cause for unacceptable fillings, followed by under filling, However, underfilling was the second common cause of unacceptable fillings in mandible and overfilling was the least f requent cause (Table 3). From the root canals treated by 5th year students 46.1% had acceptable fillings which is significantly lower than canals treated by 4th year students (55.6%) (P=0.007) and 6th year students (58.8%) (Pth and 6th year students (P=0.339) (Table 4). Procedural errors: Procedural errors were found in 18.6% of root treated canals. Incidence of procedural errors between 5th year students (22.2%) and 6th year students (19%) wasnt significantly different (P=0.149). Students of 4th year had created less procedural errors (11.6%) than students of 5th year (Pth year (P=0.003). Ledge was the most frequent procedural error and was identified in 12.5% of root treated canals. Foramen perforation, root perforation and fractured instrument were detected in 2%, 2.4% and 2% of canals, respectively (Table 5). Incidence of procedural errors wasnt significantly different in canals of anterior teeth (12.3%) and premolars (9.5%) (P=0.341). These errors were significantly more frequent in canals of molars (22.5%) than anterior teeth (P=0.003) and premolars (P The k-value for inter-examiner agreement was 0.87 for detection of acceptable root fillings and 0.81 for identification of RCTs without procedural errors. For intra-examiner agreement k-values for detection of acceptable root fillings and identification of RCTs without procedural errors were 0.93 and 0.87 for first and 0.84 and 0.81 for second investigator, respectively. Discussion This study was designed to evaluate the quality of root canal treatments accomplished by undergraduate dental students at School of Dentistry, Isfahan University of Medical Sciences. Periapical radiographs taken during the RCT procedures were used for this investigation. Root fillings were considered acceptable if terminated 0-2 mm from radiographic apex and had no voids. This criteria is extensively documented to be associated with improved periapical health (4, 5, 8). In order to limit inter-examiner and intra-examiner erraticism, the radiographic criteria were strictly defined and two investigators were calibrated before the study. Its reported that great variations could exist between investigators regarding assessment of technical quality of RCT (22). In the present study, the k-value of 0.87 for detection of acceptable root fillings and 0.81 for identification of RCTs without procedural errors, exhibit good agreement between the investigators. Also values for intra-examiner agreement were found to be greater than 0.81, which shows reliability of each investigator. Acceptable root fillings according to length and density was found in 54.1% of investigated canals. Comparing this result to the findings of others is rather difficult due to differences in level of practitioners (undergraduate students, general practitioners, and endodontists), techniques and materials used for preparation and obturation of the canal and also evaluation criteria used to assess the quality of RCT. For example, in the study of Bierenkrant et al. (18) who investigated root canals treated by endodontists, 91% of root fillings had adequate quality which is greater than the present study and other studies investigating quality of RCT performed by undergraduate students and general practitioners (Table 2). Among the studies concerning quality of RCT performed by undergraduate students, frequency of acceptable fillings in the current study is comparable to the findings of Eleftheriadis Lambrianidis (14) (55.3%) and Khabbaz et al. (19) (54.8%). In the study of Er et al. (15 ), 33% of root fillings were acceptable which is less than the present study; thought, they used different evaluation criteria. Lynch and Burke (16) reported adequate fillings in 63% of RCTs, which is higher than the present study, however they only evaluated single rooted teeth. In the present study, inadequate density was the most common cause for unqualified root fillings. This is consistent with the findings of Balto et al. (20). Its believed that lateral condensation technique with gutta percha, could create voids in canals with insufficient flaring (14). No significant difference was found between quality of maxillary and mandibular root fillings. Also adequate root fillings in molars were less than premolars. This result was consistent with findings of Er et al. (15) and Khabbaz et al. (19) who report a lower quality of root fillings in molar teeth. This could be explained by posterior position and complex anatomy of these teeth. Students of 5th year had performed more unacceptable root fillings than 4th and 6th year students. This could be explained considering the fact that at Isfahan University School of Dentistry, first clinical encounter of undergraduate students with molar teeth, is at their 5th year of study. Iatrogenic errors were detected in 18.6% of root canals. These errors are more frequent in molar teeth. Balto et al. (20) and Khabbaz et al. (19) also reported a high prevalence procedural errors in molar teeth. The reason for this, could be explained by curved and narrow canals of molar teeth, which makes them challenging for undergraduate students. Furthermore, 5th and 6th year students had created more procedural errors than 4th year students. This is because 4th year students only perform RCTs on anterior teeth and premolars which are less challenging than molar teeth. In this study, ledge was found to be the most frequent procedural error and was detected in 12.5% of root canals. This finding is similar to incidence of ledged root canals in the study of Khabbaz et al. (19) and is less than study of Eleftheriadis Lambrianidis (14). Its shown that stainless steel hand files used by unexperienced undergraduate students could increase the incidence of ledge and other procedural errors (14). Radiographic images cannot illustrate all iatrogenic errors. For instance, over instrumentation which drives pulpal fragments and microorganisms beyond the apex into the periapical tissues, can only be radiographically diagnosed when it is followed by extrusion of filling material from the apex. The use of bisecting-angle technique for taking periapical radiographs, results in less accuracy in recognition of canal length, comparing to the parallel technique (23). It has also been shown that using only one orthoradial radiographic image for assessing the adaptation of the filling material to the root canal walls, isnt reliable. This adaptation has to be further investigated with at least one extra radiography of distal or mesial angulation in order to obtain more realistic estimate of density of root filling (24). Although radiographic quality of RCT is a significant determinant in predicting outcomes of primary endodontic treatment, the radiographic images can not reflect the general quality of treatment. Application of the antiseptic and aseptic techniques, material used and microbial circumstance of the canal are the predicting factors which are not investigated in radiographic studies. At Isfahan University School of Dentistry, Step-back preparation and cold lateral condensation techniques are being taught to the undergraduate dental student. Most universities teach these standard techniques to their students. Its shown that using rotary Ni-Ti instruments provide better canal shaping, reduce the procedural errors and are being taught in undergraduate curriculum in some dental schools (17). In many studied insufficient time allocated to clinical and preclinical training, the academic stuff: student ratio and evaluation methods are stated as reasons for low quality of RCTs in university clinics (14, 19, 20). Isfahan University School of Dentistry uses endodontic specialists and 3rd year post graduate students as training stuff. Also academic curriculum have been recently revised to increase preclinical training. Nevertheless, enhancing the time allocated to clinical training and increasing stuff: student ratio could lead to improvements in quality of RCTs performed by undergraduate students. In conclusion, findings of this study shows that 54.1% of root fillings performed by undergraduate students of Isfahan University School of Dentistry were acceptable. Thus, there a necessity to revise the educational programs in Endodontics in order to improve quality of root canal treatments. References: 1.Boucher Y, Matossian L, Rilliard F, Machtou P. Radiographic evaluation of the prevalence and technical quality of root canal treatment in a French subpopulation. Int Endod J. 2002;35(3):229-38. 2.Asgary S, Shadman B, Ghalamkarpour Z, Shahravan A, Ghoddusi J, Bagherpour A, et al. Periapical Status and Quality of Root canal Fillings and Coronal Restorations in Iranian Population. Iran Endod J. 2010;5(2):74-82. 3.Moreno JO, Alves FR, Goncalves LS, Martinez AM, Rocas IN, Siqueira JF, Jr. Periradicular status and quality of root canal fillings and coronal restorations in an urban Colombian population. J Endod. 2013;39(5):600-4. 4.Pak JG, Fayazi S, White SN. Prevalence of periapical radiolucency and root canal treatment: a systematic review of cross-sectional studies. J Endod. 2012;38(9):1170-6. 5.Ng YL, Mann V, Rahbaran S, Lewsey J, Gulabivala K. Outcome of primary root canal treatment: systematic review of the literature-Part 2. Influence of clinical factors. Int Endod J. 2008;41(1):6-31. 6.Craveiro MA, Fontana CE, de Martin AS, Bueno CE. Influence of coronal restoration and root canal filling quality on periapical status: clinical and radiographic evaluation. J Endod. 2015;41(6):836-40. 7.Sjà ¶gren U, Hà ¤gglund B, Sundqvist G, Wing K. Factors affecting the long-term results of endodontic treatment. J Endod. 1990;16(10):498-504. 8.Chugal NM, Clive JM, Spangberg LS. Endodontic infection: some biologic and treatment factors associated with outcome. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003;96(1):81-90. 9.Peters OA. Current challenges and concepts in the preparation of root canal systems: a review. J Endod. 2004;30(8):559-67. 10.Hayes SJ, Gibson M, Hammond M, Bryant ST, Dummer PM. An audit of root canal treatment performed by undergraduate students. Int Endod J. 2001;34(7):501-5. 11.Dugas NN, Lawrence HP, Teplitsky PE, Pharoah MJ, Friedman S. Periapical health and treatment quality assessment of root-filled teeth in two Canadian populations. Int Endod J. 2003;36(3):181-92. 12.Barrieshi-Nusair KM, Al-Omari MA, Al-Hiyasat AS. Radiographic technical quality of root canal treatment performed by dental students at the Dental Teaching Center in Jordan. J Dent. 2004;32(4):301-7. 13.Segura-Egea JJ, Jimenez-Pinzon A, Poyato-Ferrera M, Velasco-Ortega E, Rios-Santos JV. Periapical status and quality of root fillings and coronal restorations in an adult Spanish population. Int Endod J. 2004;37(8):525-30. 14.Eleftheriadis GI, Lambrianidis TP. Technical quality of root canal treatment and detection of iatrogenic errors in an undergraduate dental clinic. Int Endod J. 2005;38(10):725-34. 15.Er O, Sagsen B, Maden M, Cinar S, Kahraman Y. Radiographic technical quality of root fillings performed by dental students in Turkey. Int Endod J. 2006;39(11):867-72. 16.Lynch CD, Burke FM. Quality of root canal fillings performed by undergraduate dental students on single-rooted teeth. Eur J Dent Educ. 2006;10(2):67-72. 17.Moussaà ¢Ã¢â€š ¬Ã‚ Badran S, Roy B, Bessart du Parc A, Bruyant M, Lefevre B, Maurin J. Technical quality of root fillings performed by dental students at the dental teaching centre in Reims, France. Int Endod J. 2008;41(8):679-84. 18.Bierenkrant DE, Parashos P, Messer HH. The technical quality of nonsurgical root canal treatment performed by a selected cohort of Australian endodontists. Int Endod J. 2008;41(7):561-70. 19.Khabbaz MG, Protogerou E, Douka E. Radiographic quality of root fillings performed by undergraduate students. Int Endod J. 2010;43(6):499-508. 20.Balto H, Al Khalifah S, Al Mugairin S, Al Deeb M, Al-Madi E. Technical quality of root fillings performed by undergraduate students in Saudi Arabia. Int Endod J. 2010;43(4):292-300. 21.Yavari H, Samiei M, Shahi S, Borna Z, Abdollahi AA, Ghiasvand N, et al. Radiographic evaluation of root canal fillings accomplished by undergraduate dental students. Iran Endod J. 2015;10(2):127-30. 22.Lambrianidis T. Observer variations in radiographic evaluation of endodontic therapy. Endod Dent Traumatol. 1985;1(6):235-41. 23.Forsberg J. Estimation of the root filling length with the paralleling and bisecting-angle techniques performed by undergraduate students. Int Endod J. 1987;20(6):282-6. 24.Eckerbom M, Magnusson T. Evaluation of technical quality of endodontic treatmentreliability of intraoral radiographs. Endod Dent Traumatol. 1997;13(6):259-64.

Women in Euripides Alcestis, Medea, Andromache, and Bacchae Essays

Euripides portrayal of women in his plays has been somewhat bizarre. His female characters kill out of revenge, kill out of jealousy and kill because a god possessed them too. In Alcestis and Andromache Euripides does produce classic heroic female characters. The women in Medea and The Bacchae are not your typical heroines but serve to show the same theme of female liberation as the women in Alcestis and Andromache. While Alcestis is straight forward with its message, the other three plays mask their true intentions from the people they are created to oppose. Euripides might have been misinterpreted by his society because it was dominated by the very people he wrote his plays against. Euripides disguises some of his radical ideas to those who might oppose him and in Alcestis, Andromache, Medea, and The Bacchae shows his female characters being liberated from oppression. In Alcestis we have the heroic female character Alcestis. She dies as a sacrifice to Death so that her husband, Admetus, can escape his own fate when his time comes. A sign that women are oppressed is that Admetus picked his wife to die for him without giving it much thought. It was only after he realized how loving and caring this woman can be, did he regret his decision. Not only did he regret the decision made with the god Apollo, but Apollo himself goes and has a talk with Death. This switch in the opinion of Admetus in a way expresses the fact that women are not viewed as they should be. Women should not be treated as if they have no useful value, as was the case when Admetus first allowed his wife to be his sacrifice, a decision that he would not have made if he had known the woman for more time. Women therefore should be valued more than they are now,... ... have committed were done against men as of the results of mans oppression against women. Euripides could have been telling the truth about his time, the tales of murderous women who seek revenge on their husbands, and the men of the his time might have tolerated this view. The point that might have escaped the men of Euripides' time was that he was pointing the finger at them. This accusation of men was hidden in his plays. Euripides masked such accusations as rants by crazed females. In a culture where disrespecting woman was in the norm, Euripides highlighted what could go wrong with such disrespect. The only reason that the people of Euripides' time might have not understood his point was that they saw no wrong being done in disrespecting women. How can people be afraid of the results of a mistake if they do not realize they made the mistake in the first place?

Absolute Power Corrupts Absolutely animal farm

When the animals take over the farm the pigs become the animals’ leaders, as they are the smartest of the animals. Major starts out telling the animals about his dream and convincing them that’s how the farm should be like. The pigs encourage that all animals are equal and have 7 commandments to keep the farm in order. After the animals start to agree with Napoleon more and more, Boxer says â€Å"If Comrade Napoleon says it, it must be right† (Orwell 56) that is how Napoleon gained his motto as â€Å"Napoleon is always right†.The animals became intimidated by the pigs and were too afraid to ever question their decisions. None of the other animals were smart enough to think differently. When Napoleon realizes how much power he has, he starts to take advantage of it. Napoleon starts to tweak the commandments to his advantage. Napoleon creates a rule saying, â€Å"The milk and windfall apples should be reserved for the pigs alone† (Orwell 36). Napoleon has only made this rule to benefit himself and his kind. When Squealer says, â€Å"Surely there is no one among you who wants to see Jones come back?† he is trying to scare the other animals into thinking Napoleons doing the right thing. The pigs should not be treated any better than the other animals. This is what started Napoleons corrupt set of values. Napoleon continues to make corrupt changes to the commandments and rules as he gains more and more authority. When â€Å"Napoleon accepted, through Whymper, a contract for 400 eggs a week† (Orwell 76) it was really unfair to the hens and he should have no control over that. Napoleon did not give any sympathy to the hens even after they revolted.Napoleon started to traumatize the hens for declining to give their eggs. Napoleon brought the situation way out of proportion and brutally starved some of the hens to death to get the eggs on time. Napoleon has no right to put the hens through hell just to because he says so. Napoleon started off as a true leader keeping the farm under control but once his control got so immense he turned corrupt. Napoleon made and changed rules to benefit himself. Napoleon became very selfish and unfair to all the other animals.No other animal ever had the guts or smarts to question Napoleons power and decisions; which worsened the situation and made Napoleon become more corrupt. Napoleon had a stern set of rules but if he happened to break a rule his fellow pigs would use a euphemism by adding a few words to the rule to soften the true meaning. If everyone could quickly turn to page 109, last paragraph. The other animals were not very smart so they were fooled into thinking they had just remembered the commandments wrong in the first place.Napoleon had such corrupt morals that he thought any rule he broke he could simply alter it so he was no longer breaking the rules. Napoleon ends up changing the entire commandments after he had gained all the power and money he wan ted. In the end, the most corrupt thing Napoleon did is when he changed all the commandments to â€Å"All animals are equal but some animals are more equal than others† (134). This brought the farm back to exactly how it had started. This very corrupt decision made the animals think they could not question his unfair decisions simply because some animals are more equal than others.This took away all the freedom and equality that had kept the farm together. â€Å"Absolute power corrupts absolutely† this is exactly what happened to animal farm. Napoleon had started out so against humans and made rules against having any similarities with them. After Napoleon had become more and more corrupt he turned into exactly what he was against†¦ humans. Napoleon let his corrupt decisions get the best of him and alter his mind thinking he was above the rest. The animals were left with no power or leadership and all they had was a selfish, lying, corrupt dictator who acted just as a human.

sound of music essays

sound of music essays 25 pages in length. As the new millennium approaches, business and marketing strategies within all industries will continue to present inspired methods in order to reach for the highest profit margin in the twenty- first century. As a means by which to reach for the highest profit margin, and thus effectively represent idealistic philosophies, contemporary commerce has found that Internet-based businesses can, indeed, benefit a larger percentage of people than that of traditional commerce. Not unlike other enterprise that relies upon a positive bottom line to remain competitive, small and large companies alike are faced with ever-mounting competition in this day of high costs and an even higher competitive factor. Staying within the somewhat confined boundaries of industry, while at the same time attempting to focus on the ever-changing consumer market, is as much of a concern for modest companies as it is for any other conglomerate. Indeed, for businesses to thrive amidst global com petition, certain strategies must be approached. The writer discusses profitability of World Wide Web-based companies. Bibliography lists 21 sources. TLCbizwb.wps World Wide Websites and Small Businesses This 5 page report examines the opportunities available to small business through maintaining a website and marketing via the Internet. Bibliography lists 10 sources. Webiz.wps An 18 page paper discussing Dell's acsension to the number one producer of personal computers and the competitive pressures they face. Historically, Dell Computer has participated primarily in the hardware segment of the PC market, and has concentrated on government agencies and small business for the bulk of their sales. With the shift of focus among so many companies regarding just what the Internet might be able to do for them, both in terms of boosting sales of their own products and as a tool for developing intranets not dependent on physical location as Local Area N...

How to Use Transition Words Effectively

How to Use Transition Words Effectively Choppy! How is this related? Flow needs work! Have you ever received comments like these on your paper from professors or editors? If so, it is highly likely that you need to work on transition words and phrases to help bridge ideas and allow the flow of your writing to move in a more logical, coherent path. That coherency is what separates good writing from bad writing.Problems with transitions in writing often happen in the following scenarios:Youre working on a group project and need to combine chunks of writing from multiple students to make one paper or presentation. So, they give you their separate writing and leave it up to you to put it all together.You begin your writing without an outline to follow in the writing process.You write your paragraphs out of order when writing an essay or story, because you dont want to start with the hard stuff- hooks, introductions, and conclusions.So how do you fix the problem? Consider these tips for using transitional words and phrases the way theyre meant to be used.Know the purpose of transitions in writingI start with this tip because you have to know the purpose before you can learn the rules. Transitional words and phrases are not only a way to present your ideas logically- they are also a vital part of the writing process and cant be ignored. Whether youre writing for an academic assignment or writing a fictional novel, without mastering how to transition from one thought to another, or one paragraph to another, your writing will be confusing, at best. And this is regardless of the amount of time and effort you put into researching or preparation beforehand. At worst, a lack of proper transitioning between thoughts or steps will make your writing a jumbled, incomprehensible mess that is impossible for your reader to follow (and therefore likely to result in a less-than-stellar grade or college admission denial letter).Understand that logic is essential, especially in academic writingThe second point you need to know is that transition words (also known as conjunctive adverbs) are necessary in almost every genre of writing to form a logical narrative or argument. Really, theres no way to escape them. The only categories of writing that might not need transitions would fall into the poetry genre. As mentioned above, using the correct transition- whether in a single word or a phrase- is important for building logic into your paper or moving your story along.Even in our daily speech, we use transition words and phrases in our communication with others to change topics, tell a story, or even recount the events that occurred throughout our day. So then, and finally are just a few examples of commonly used transitions within our daily speech. Heres an example of a teenager accounting for his whereabouts:Mom: Where have you BEEN all day I was so worried.Teen: Mom, you have to listen, it wasnt my fault.Mom: So, whose fault was it?Teen: First, our bus was late leaving the school then we got caught i n traffic. There were wrecks or something blocking the freeway for miles. For that reason, we turned around and went back to the school; but there was traffic there too!As you can see from the underlined transitions, without them, the teen would surely be grounded.Realize that there are categories and learn themTransition words and phrases include several categories of transitions, and there are over 200 words and phrases that can be used for purposes of transitioning within your writing. These words are divided into categories based on the logical flow of your writing. There are different reasons for using transitions- sometimes to move the writing along, sometimes to show contrast, etc. For example, if you are using transition words to clarify, youd choose transitions like to put it another way, or to rephrase. If you are using them to move time along in a plot or research study, youd use words like then, once, next, etc.The differences between these categories and when to use eac h are nuanced, as are the differences between the words within each category. Expert writers might easily know which transition category and word/phrase to use. However, non-native writers are likely to have a less developed understanding of the nuances of each, simply because they have not had enough experience with the language to recognize the subtle differences. These things take time to learn.Below are the common categories in which transitional words and phrases are used, and some example words for each. If you use different sources, youll find that they may provide different categories (or arrangement of categories), but each place transitions into categories of purpose.Take the following example from the Writing Center at the University of Wisconsin- Madison.AdditionFurthermore, moreover, too, also, in the second place, again, in addition, even more, next, further, last, lastly, finally, besides, and, or, nor, first, second, secondly, etc.TimeWhile, immediately, never, after , later, earlier, always, when, soon, whenever, meanwhile, sometimes, in the meantime, during, afterwards, now, until now, next, following, once, then, at length, simultaneously, so far, this time, subsequentlyPlaceHere, there, nearby, beyond, wherever, opposite to, adjacent to, neighboring on, above, belowExemplification or illustrationTo illustrate, to demonstrate, specifically, for instance, as an illustration, e.g. (for example), for exampleComparisonIn the same way, by the same token, similarly, in like manner, likewise, in similar fashionContrastYet, and yet, nevertheless, nonetheless, after all, but, however, though, otherwise, on the contrary, in contrast, notwithstanding, on the other hand, at the same timeClarificationThat is to say, in other words, to explain, i.e. (that is), to clarify, to rephrase it, to put it another wayCauseBecause, since, on account of, for that reasonEffectTherefore, consequently, accordingly, thus, hence, as a resultPurposeIn order that, so that, to that end, to this end, for this purposeQualificationAlmost, nearly, probably, never, always, frequently, perhaps, maybe, althoughIntensificationIndeed, to repeat, by all means, of course, certainly, without doubt, yes, no, undoubtedly, in fact, surely, in factConcessionTo be sure, granted, of course, it is trueSummaryTo summarize, in sum, in brief, to sum up, in short, in summaryConclusionIn conclusion, to conclude, finallyDemonstratives acting as transitionsThis, those, these, thatTransition mistakes to avoidNow that you know the purposes and situations in which to use transitional words, lets take a moment to look at mistakes to avoid when writing. While transition words and phrases are necessary to make your writing coherent, the misuse of them can result in the exact opposite, leaving your reader confused and unable to understand your point (or story). Here are some common mistakes that professors and editors often find regarding the use of transition words.Illogical transiti onsIf the ultimate aim of using transition words is to bring logic to your writing, then using illogical transitions defeats the purpose. As I previously pointed out, each transition word or phrase has its own nuanced meaning and belongs to its own category. Using the wrong one can further confuse the point you are trying to make, or the relationship you need to show for it to make sense to your reader.Heres an example:Aliya was one of the most gracious hostesses I have ever met. However, she spoke with each person in the room, calling them by name, and smiling the whole time.In the above example, we can clearly see the use of the transition word however, followed correctly by a comma to separate it from the rest of the sentence. However, since the word chosen is a transition word denoting contrast, the lack of logic in these sentences creates confusion for the reader.Heres why. In the first sentence, we are given a statement about Aliya being a gracious hostess. In the second sente nce, we are given a reason why or example of why she deserves this praise. The use of the transition word however between the two causes confusion, because the second sentence illustrates the first, or provides an example of the first.Looking then into the Exemplification and illustration category of common transition words and phrases, we see that a better choice for transitioning between the two sentences would be for example, or to illustrate. The incorrect transition (however) doesnt fit because it belongs to the Contrast category, which means the second sentence is contrasting the first- which of course, isnt true in this case.Heres another example of this same mistake being made in an academic paper:The studys participants were chosen by the random sampling method and were given questionnaires about their experiences with social media. In other words, the sample population submitted their responses to be included in the data.As can be seen from the example above, the two sente nces are connected together by time, as in one event (the second sentence) occurring after the other (the first sentence). The transition word chosen, however, is from the Clarification category instead of the Time category, leaving the reader with a confusing statement to sort out.Transition overuseThe final mistake to avoid is overuse. Editors see this mistake often, mainly because the writers language skills are limited and do not yet include knowledge of the proper use of transitions. Using too many transitions can cause your writing to be difficult to read, since they are essentially road signs showing your reader how the content is moving forward. Using too many at once would be like coming to a 4-way stop that included hundreds of signs- some saying stop, some saying yield, but all putting out a different message.Heres an example of transition overuse:Arcadia was a town like any other. Therefore, the police patrolled the streets, the shopkeepers kept their shops, and children attended school on account of three weeks until summer break. For example, when a stranger walks through Arcadia, everyone notices; however, it was the secret to keeping their town well protected. In such, while adults spoke to each other in hurried conversations, at the same time, their eyes were always scanning to make sure things were going as normal there.So, what was the first thing you noticed while reading this passage? Was it the way the words interrupted the story unnecessarily? Did those transition words hurt instead of help make the paragraph clear and coherent?The mistake of using too many transitions and transitional phrases often occurs when someone is trying to beef up their writing. Transitions like however, for example, and in such seem somehow academic, and must make your writing sound more cultured or professional, right?Wrong.Overusing transitions creates distracting, incoherent writing that does not serve the intended purpose of the transitions in the first pla ce, which is to move the story along.

The Importance of Training and Development in the Tesco Plc Essay

The Importance of Training and Development in the Tesco Plc - Essay Example The main results of the research highlight the fact that training and development programs are required in every organization including Tesco Plc as it increases the productivity of the organizations. Training and development is the main focus of the research, which is the chosen topic for the study. It is an important part of the business growth that relates to the development of the overall performance of the company. An organization is bound to provide training programs to the employees to inject the culture of the company and develop their skills as per the requirement of the clients. The training programs also help in developing the future of employees and achieve the goal determined by the company. The research aims at elaborating the training and development programs of Tesco Plc and whether the programs can add value to the development of the company. Hence, Tesco Plc is the main target company, whose training and development programs are evaluated and recommendations are giv en pertaining to the best training practices in Tesco Plc that add value to its operation. The main reason for choosing Tesco Plc for the research as it is one of the best retailers in the world, which exercises excellent training system. Though the company is confident regarding its training and development programs the research will help Tesco Plc to access the success of the programs through empirical analysis. It is observed that there are few types of research pertaining to this topic in the past and the researchers do not provide enough information to the readers regarding the success of the practices. Thus, this research will be an important resource for the company as it explains the best way of engaging training and development activities to maximize its overall performance and reach the targeted goal.

SOCIOLOGY Essay Example | Topics and Well Written Essays - 500 words - 1

SOCIOLOGY - Essay Example A great deal of research work has shown that violence has deep and long lasting effects (Johnson, 2008). Psychologists admit the fact that children pass 13 hours in a week (boys) and 5 hours (girls) in playing video games. Dr. Anderson and his co-workers demonstrated that violent video games develop the feelings of hostility (Anderson et al, 2003). Theorist’s stress that people should wisely think and select what they want to watch on TV. Sociologists made research and found that whatever TV news broadcast or newspapers write is all based on their own thinking knowledge. TV news has influenced people in different ways .the news of terrorism, murder, thefts and crime makes people feel hostile and aggressive. Researchers found a relationship between the media and the conduct. The principal and the foremost effect is to copy what is being shown. Secondly, it makes people insensitive making them hard-hearted about rest of the world. Others say that violent news makes people dreadful about the problems and pains of others (Johnson, 2008). Conclusion: Psychologists unite about the effects of TV news while research in this are is quite difficult to measure. A psychologist mentioned is very difficult to prove the relationship between violent media and the conduct through specific methodology. Anderson, C.A., Berkowitz, L., Donnerstein, E., Huesmann, L.R., Johnson, J., Linz, D., Malamuth, N., & Wartella, E. (2003). The influence of media violence on youth. Psychological Science in the Public Interest, Vol. 4, pp.