Accounting and Finance Assignment Essay Example | Topics and Well Written Essays - 2500 words

Accounting and Finance Assignment - Essay Example For instance; in â€Å"the general theory of finances† there are two definitions of finance and accounts: 1. Finances of the socialistic state represent economical (cash) relations, with the help of which, in the way of planned distribution of the incomes and savings the funds of money sources of the state and socialistic manufactures are formed for guaranteeing the growth of the production, rising the material and cultural level of the people and for satisfying other general society requests†. 2. â€Å"Finances characterise the formation of centralized ad decentralized money sources, economical relations relatively with the distribution and usage, which serve for fulfilment of the state functions and obligations and also provision of the conditions of the widened further production†. This definition is brought without showing the environment of its action. We share partly such explanation of finances and think expedient to make some specification. The system of creation and usage of necessary funds of cash resources for guarantying socialistic widened further production represent exactly the finances of the socialistic society. And the totality of economical relations arisen between state, manufactures and organisations, branches, regions and separate citizen according to the movement of cash funds make financial relations†. Just to more simplify the term â€Å"Accounts†, Accounts are simply established to provide a record of individual business transactions as they apply to a certain area or item. Your personal checking account is established in order to provide a record of individual personal financial transactions you create when you write a check. All of the accounts are listed in a general ledger. Today, the actual ledger book has long since been replaced by accounting software that creates a general ledger on the computer. The concept however has not been altered. The general ledger is the central location for maintaining all your accounts.

The Importance of Parking Lots, and Why Parking is Already So Much Essay

The Importance of Parking Lots, and Why Parking is Already So Much More - Essay Example They take up a significant amount of space and a prevalent wherever a person travels, at least in developed countries. However, in his argument, Ben-Joseph does not take into account the necessity of parking spaces, or the cost of the changes that he argues for. Before a suggestion like his is implemented, our society needs to become less dependent on cars and learn to use the parking spaces that we do have more efficiently. It is true that there are more parking spaces than cars, and Ben-Joseph’s figure of three times as many is probably very accurate. However, does this actually suggest that there are too many? The difficulty that is associated with finding parking at a popular venue suggests otherwise. For example, a parking space study in Bristol, Virginia found that the city needed more parking spaces in its downtown area. Furthermore, the study recommended that a parking building be created that had up to 240 spaces (McGee 2012). The stress and difficulty in finding a pa rking space in some cities is so bad that smartphone applications have been developed to help motorists find a space effectively (Gonzales 2011). These two examples suggest that the current number of parking spaces that are available is not enough in some places, rather than there being an excessive amount, as Ben-Joseph suggests. Another aspect of parking that Ben-Joseph does not take into account is the difference between parking spaces and parking lots. He suggests that there are approximately 800 million parking spaces in the United States, and extrapolates this to mean that parking spaces cover 4,360 square miles. This is not completely true. One only has to look at city streets to see that a large number of parking spaces are not part of parking lots, but are on the side of the road. Often, these are the most important parking spaces to people trying to get somewhere specific. While these spaces do take up the same amount of physical area as a parking space within a lot, remov ing these would not result in more available space. The impression that Ben-Joseph gives of parking lots sprawling across the country, blotting the landscape and taking up substantial amounts of space may be true. However, the level at which this occurs is not as dire as he suggests. As a potential solution to the ‘problem’ of parking lots, Ben-Joseph argues that parking lots themselves need to be transformed. He considers that there needs to be a greater focus on appearance, public uses and the environment. However, there are two problems with this proposed solution. The first is the associated cost. The way that parking lots are created is largely due to the relatively low cost. In terms of both time and money, it is much cheaper to create a flat, paved lot with the required lines, markers and other components, than it would be to create one that is more aesthetically pleasing. Even the simplest approach of landscaping the area would cost. The second problem is that r evamping car lots in this way would also decrease the number of parking spaces that they provide. This is a significant problem, as parking spaces are an important component of our society, and many people rely on them in order to store their car while they work. An alternative solution to the perspective that Ben-Joseph proposes a two-pronged approach, where the use of parking spaces is optimized and transportation via cars is decreased. The smartphone application for determining

Case Report: Topiramate Induced Myopia

Case Report: Topiramate Induced Myopia G.Srinivasagopalan Gopalsamy, Murali Mohan Mohan, Sudhakar Sankar Tamilnadu, India Abstract Topiramate (sulfamate-substituted monosaccharide) is a broad spectrum newer anti-convulsant. It is also used in prophylaxis of migraine, cluster headache, bipolar affective disorder, post traumatic stress disorder, post herpetic neuralgia , relapse prevention in alcohol dependence syndrome, add on treatment for antipsychotic induced weight gain. Acute Myopia and angle closure glaucoma are some of the rare side effects of topiramate. This case highlights the development of myopia in a middle aged patient with alcohol dependence syndrome while he was on topiramate therapy. Keywords: Topiramate, alcohol dependence syndrome, angle closure glaucoma, myopia. INTRODUCTION Topiramate is a sulfamate substituted monosaccharide, a broad spectrum anticonvulsant acting on voltage dependent sodium channels, enhancement of gamma amino butyric acid (GABA), decrease in glutamate and inhibition of carbonic anhydrase. We (the psychiatrists) use topiramate to treat migraine, cluster headache, bipolar affective disorder, post traumatic stress disorder, post herpetic neuralgia , relapse prevention in alcohol dependence syndrome, add on treatment for antipsychotic induced weight gain1. Some of the rare side effects of topiramate are acute myopia and angle closure glaucoma. We report a case of topiramate induced transient myopia in a patient who had been started on topiramate for relapse prevention in alcohol dependence syndrome. CASE REPORT A 35 year old married male, lower middle socio economic status from rural background, working in a private company presented to the outpatient services of our department of psychiatry with 10 years history of alcohol use amounting to dependence and two weeks history of blurred vision and headache. Patient was diagnosed as a case of alcohol dependence syndrome – uncomplicated withdrawal state (F10.30) as per International Classification of Diseases (ICD) ‑10 criteria. He was admitted for detoxification and on eliciting history; it was found that he had been commenced on oral topiramate 50 mg/day 3 weeks previously by a private psychiatrist for his alcohol use. The patient had no history of hypertension, diabetes or glaucoma, he had never worn glasses and there was no history of injury to eyes or head and no history of withdrawal seizures. He was referred to department of ophthalmology for blurred vision. Ophthalmic opinion on the day of admission suggested refractive err ors bilaterally with left eye myopia of -2.5 diopters and right eye myopia of -3.5 diopters with shallow anterior chamber and normal pupils and lens on slit lamp examination and normal intra ocular pressure on tonometry. After this ophthalmologic report, topiramate was stopped immediately by us thinking that it could have induced myopia. Other routine investigations were normal and detoxification with oral lorazepam and thiamine supplementation continued along with motivation enhancement sessions by psychologist. Patient reported gradual clinical improvement in his vision. Repeat ophthalmologic consultation on the 7th day of admission showed significant improvement in visual acuity and refraction with left eye myopia of 0.75 diopters and right eye myopia of 0.75 diopters .Because of our early intervention, angle closure glaucoma was averted in our case. DISCUSSION The most frequently reported side effects for Topiramote are dizziness, mental slowing, somnolence, ataxia, impaired concentration and confusion2. Most of these are transient and observed during the initial weeks of therapy and can be reduced by slow titration of the dose. Anorexia and mild weight loss has been observed during the therapy. Metabolic acidosis, and nephrolithiasis are the other reported side effects. WHO Causality Assessment3 suggests abnormal vision, acute secondary angle closure glaucoma, acute myopia and suprachoroidal effusions are complications of Topiramate therapy. This case highlights and aims to raise awareness that topiramate can cause acute myopia and angle closure glaucoma. Both are reversible with immediate discontinuation of the drug4. Various authors have also reported these serious complications due to topiramate[4][5][6]. The mechanism for topiramate induced angle closure glaucoma is by ciliochoroidal effusion with forward displacement of the lens â₠¬â€œ iris diaphragm and anterior chamber shallowing, resulting in acute myopia and angle closure glaucoma4]. Topiramate’s weak carbonic anhydrase inhibitor activity and prostaglandin mediated effects have also been postulated as possible mechanisms7. Acute myopia up to -9.0 diopters can occur in a matter of hours after starting topiramate, but might take weeks to fully resolve. Whenever a case of myopia with angle closure glaucoma and a shallow anterior chamber is encountered, ciliochoroidal effusion syndrome induced by drugs should be considered in the differential diagnosis. Drug induced myopia has also been associated with promethazine, spironolactone, tetracycline, corticosteroids etc.5. Pupils should not be dilated to prevent further angle closure and possible rise in pressure. Paediatric and developmentally delayed patients who have been started on topiramate should be closely monitored during the first 2 weeks of treatment. It is important for the clinician to educate the patients about this serious adverse effect while prescribing topiramate and advise them to report immediately in the event of visual disturbance. REFERENCES 1V. Shivakumar, N. Jayaram, N. P. Rao, and G. Venkatasubramanian, Successful Use of Add on Topiramate for Antipsychotic Induced Weight Gain, Indian J Psychol Med, 34 (2012), 85-6. 2Y. Mikaeloff, A. de Saint-Martin, J. Mancini, S. Peudenier, J. M. Pedespan, L. Vallee, J. Motte, M. Bourgeois, A. Arzimanoglou, O. Dulac, and C. Chiron, Topiramate: Efficacy and Tolerability in Children According to Epilepsy Syndromes, Epilepsy Res, 53 (2003), 225-32. 3S. A. Zaki, Adverse Drug Reaction and Causality Assessment Scales, Lung India, 28 (2011), 152-3. 4J. E. Craig, T. J. Ong, D. L. Louis, and J. M. Wells, Mechanism of Topiramate-Induced Acute-Onset Myopia and Angle Closure Glaucoma, Am J Ophthalmol, 137 (2004), 193-5. 5T. C. Chen, C. W. Chao, and J. A. Sorkin, Topiramate Induced Myopic Shift and Angle Closure Glaucoma, Br J Ophthalmol, 87 (2003), 648-9. 6H. A. Sen, H. S. OHalloran, and W. B. Lee, Case Reports and Small Case Series: Topiramate-Induced Acute Myopia and Retinal Striae, Arch Ophthalmol, 119 (2001), 775-7. 7C. M. Desai, S. J. Ramchandani, S. G. Bhopale, and S. S. Ramchandani, Acute Myopia and Angle Closure Caused by Topiramate, a Drug Used for Prophylaxis of Migraine, Indian J Ophthalmol, 54 (2006), 195-7.

The Psychology of The Gambler Essay -- Fyodor Dostoyevsky The Gambler

The Psychology of The Gambler    In Fyodor Dostoyevsky's The Gambler, we are presented with a novel whose protagonist is what we would call today a problem gambler.   The gambling mania of the story's hero, Alexei Ivanovitch, is a mirror of Dostoyevsky's own gambling compulsion.   The heroine, Polina Alexandrovna, represents a woman Dostoyevsky had as a real lover.   Polina is the stepdaughter of the General, who Alexei works for as a servant.   The General shows paranoia over gambling from the outset of the story.   He censures Alexei with respect to his care of the children, "I suppose you would like to take them to the Casino to play roulette?   Well, excuse my speaking so plainly, but I know how addicted you are to gambling.   Though I am not your mentor, nor wish to be, at least I have a right to require that you shall not actually compromise me" (Dostoyevsky 1-2).   The theme of gambling and its psychological impact on the characters pervades The Gambler.   Because of his own gambling addicti on and his intimate knowledge of the class-conscious casino society of his era, Dostoyevsky does an excellent job of showing the psychology that compels the problem gambler. BODY Using diary entries as his literary vehicle, Dostoyevsky takes us inside the minds of his characters in a way that makes us voyeurs because of his realistic portrayal and honest disclosure of human emotion and sentiments.   The story revolves around Roulettenberg, a German spa town where the rich gamble.   We get the inner life of Alexei as it is portrayed in his diaries.   He is poor but educated, and he is very aware of his class in society.   He is conflicted, however, because he both covets and ridicules the lifestyle of the aristocracy with all its pretensi... ...ostoyevsky 70).   Thus, Dostoyevsky does an excellent job at showing how individual consciousness and the environment in which it develops both lead to problem gambling. WORKS   CITED Anonymous.   Easy come, easy go...Maybe.   The Wager.   Vol. 5, No. 43, Harvard Medical School, Nov 1, 2000: 1-3. Dostoyevsky, F.   The Gambler, (1866).   Trans. By C. J. Hogarth.   Project Gutenberg.   Jun 30, 2000: 1-101. McKay, C.   The Gambler, (Review).   eGambling.   Available: http://www.camh.net/egambling/issue6/review, 1-5. Note:   All numbers, symbols, letters, etc. found within parenthesis are actual page numbers from the hard copy of the source.   Numbers following are the electronic page numbers from that source as it prints from the World Wide Web (WWW)   If there are no page numbers in parenthesis then only electronic page numbers are available at the Internet site.

Mechanics Of Cricoids Pressure Health And Social Care Essay

Cricoids force per unit area is used to temporarily obstruct the upper terminal of the gorge. Cricoids force per unit area was described by Sellick in 1961 as a method to cut down the hazard of aspiration during exigency anesthetic initiation and has become the standard attention during rapid sequence initiation. Before the everyday usage of cricoids force per unit area, maternal decease from inspiration of tummy contents was the taking cause of decease from anesthesia in England and Wales[ 2 ]. After Sellick ‘s article, cricoids force per unit area was incorporated into overall attack to minimising the hazard of aspiration. Evidence that cricoids force per unit area is effectual came a decennary subsequently from four corpses ‘ surveies and from instance studies of regurgitation seen on release of cricoids force per unit area after tracheal cannulation. Cricoids force per unit area should be performed during resuscitation when endotracheal cannulation is delayed or non possible, peculiarly when patients are manually ventilated via bag and mask. Cricoids force per unit area should be performed during initiation of anesthesia for both exigency surgery ( full tummy ) and for elected surgery when lower oesophageal sphincter is likely to be unqualified, ( e.g. last half of gestation or gastro oesophageal reflux disease possible ) , and in patients with delayed gastric voidance ( e.g. diabetic autonomic neuropathy ) .[ 3 ]Mechanicss of Cricoids PressureThe cricoids gristle is the lone upper airway cartilaginous construction that is a complete ring. The lower part of the cricoids gristle is where the gorge begins. In executing cricoids force per unit area, one must use backwards force per unit area on gristle that will compact the gorge to its implicit in vertebral organic structure ( normally C5 ) . Theoretically, this will obstruct the o esophageal lms, forestalling the transition of regurgitated stomachic contents into throat and subsequent aspiration into the pneumonic tree[ 4 ]. Based on several surveies, 44 N ( 9.81 N = 1kg = 2.2lbs ) has become accepted as the gilded criterion for the bar of regurgitation in grownups[ 5 ]while the force per unit area suggested to be applied in kids is between 22.4 and 25.1 N[ 6 ].ApplicationSellick1 described the patient place for the application of cricoid gristle force per unit area as supine with the caput somewhat down and with the caput and cervix to the full extended as if positioned for tonsillectomy. The anterior convexness of the cervical spinal column in this place may help oesophageal occlusion but can do laryngoscopy hard[ 7 ]. One-hand Method The standard cricoids force per unit area as described by Sellick was carried out as a individual handed technique with anterior force per unit area being applied maintaining the index finger on the gristle with pollex and in-between finger on either side of the gristle at that place by forestalling sidelong motion of the cricoids1. The disadvantage of this technique is that the drawn-out cervix will be given to fall in the arch and leas to flexure of the caput on the cervix. The position of glottis is therefore reduced and lingua blocks the throat[ 8 ]. Another individual handed method has been described by Cowling where the thenar of the manus was placed on the breastbone and cricoids force per unit area was applied by index and in-between finger[ 9 ].These alterations still did non win in forestalling deformation of the laryngoscopy position, hence a two-handed cricoids force per unit area was proposed and was described by different writers. Two-hands / Bimanual Method Baxter suggested that the two handed technique would increase the efficaciousness of esophageal occlusion[ 10 ]. The cricoids force per unit area is performed as with the unassisted technique except the helper ‘s other manus provides antagonistic force per unit area beneath the cervical vertebrae thereby back uping the neck8 in the absence of a pillow. The purpose is to increase the support of the drawn-out arch of vertebral column so as to acquire an optimal laryngoscopic position every bit good as maintain effectual cricoids force per unit area. But there were grounds stating that the glottis position may besides be interfered therefore taking to technique alteration. Williamson placed the left manus behind the patient ‘s caput[ 11 ]while Wraight hold the patient ‘s caput in extension[ 12 ].Brimacombe5 et al suggested the usage of a contra-cricoid-cuboid assistance to ease extension of the cervix.The Cricoid YokeTo assist clinicians use the equal sum of force per unit area on the cricoids gristle and to maintain the helper ‘s custodies off from the laryngoscopic field, Lawes et Al[ 13 ]has developed the cricoids yoke. This device was applied to the cricoid gristle via a moulded sponge shock absorber, and gently depressed against the patient without custodies, to increase the incidence of decently applied cricoids force per unit area. The yoke when used by persons with no anaesthetically experience produced consequences that were equal to consequences seen when experient operators applied manual cricoids force per unit area. The use besides will avoid inordinate forces or compaction of the incorrect anatomical site. Lawes13 besides indicated no laryngeal deformation, even in bad patients when the cricoids yoke is in usage. But, the handiness and cost among other factors were the grounds why the cricoid yoke did non derive popularity and manual cricoids force per unit area has become the pillar of pattern[ 14 ].Contraindications3There ar e several contraindications to the usage of cricoids force per unit area including injury to anterior cervix which may interfere with specifying the landmarks. Unstable cervical spinal column hurt could increase hazards of neck motion but can be performed if a bi-manual technique has been practiced. Using cricoids force per unit area might non be suited with patient actively purging as it will increase the hazard of oesophageal rupture. Harmonizing to The International Liaison Committee on Resuscitation ( ILCOR ) guidelines, the cricoid force per unit area is merely to be applied every bit shortly as an excess ( 3rd ) savior arrives where if merely one or two saviors are present, airway and take a breathing are higher precedences. Cricoids force per unit area sometimes could do hard cannulation as it may curtail laryngoscopic position, particularly likely if applied falsely.THE DILEMMAComplicationsThe inauspicious effects range from minor effects like sickness, purging, minimum haem odynamic changes to severe complications like esophageal rupture, complete air passage obstructor and break of the cricoid cartilage14. Based on Risk Benefit Analysis by Ellis et al4, there were grounds saying the complications still could happen despite using the force per unit area, but there are no definite grounds on why this is happening ( either due to improper applications of the techniques, or the techniques itself ) . Failed to forestall Aspiration 11-14 % of anesthesiologist[ 15 ]and 11 % of operating section helpers and anesthetic nurses[ 16 ]had witnessed regurgitation with cricoids force per unit area applied Medico-legal claim in United States reported that aspiration occurred in 67 instances despite the application of cricoids force per unit area in 17 of these[ 17 ] Anatomically Displaced 49 % of the CT scan reappraisal retrospectively indicated sidelong supplanting of the gorge[ 18 ] 53 % of the MRI scans review prospectively showed sidelong supplanting of the gorge[ 19 ] Effectss on Mask Ventilation Based on 10 published articles, cricoids force per unit area did cut down tidal volumes, addition extremum inspiratory force per unit area or prevented airing There are besides 2 instance studies depicting complete air passage obstructor with cricoids force per unit area.[ 20 ]21 Effectss on Insertion and Function of LMA Brimacombe concluded that cricoids force per unit area reduces successful interpolation ( from 94 % to 67 % ) and besides impedes tracheal cannulation through LMA ( from 76 % to 40 % ) 5 In patient with can non cannulate and can non air out state of affairss, release cricoids force per unit area is recommended Ruptured gorges Ralph and Wareham reported a instance of oesophageal rupture in 81 years-old adult female who began purging against the force of cricoids force per unit area applied before the patient lost consciousness[ 22 ]. Vanner and Pryle observed oesophageal rupture in 3 corpses ( 30 % )[ 23 ] Cricoids Cartilage Fracture 3 reported instances with 1 instance led to fatal airway obstructor while the other 2 instances caused supplanting of cricoids gristle with known old hurt[ 24 ],[ 25 ],[ 26 ] Cervical Spine Movement 2 surveies reported a important motion of the spinal column[ 27 ],[ 28 ]Confusions, Knowledge, Attitude of CliniciansIn a national postal study on the pattern of RSI, of 220 respondents ( staff anesthesiologists 60 % , occupants 40 % ) , wholly reported to utilize cricoids force per unit area during rapid sequence initiation[ 29 ]. It shows the cosmopolitan credence of the cricoids force per unit area use, but in really variable manner of making it. Confusions The Pressure ( N ) The standard force per unit area to be applied on the cricoids gristle is still a large argument. With the less usage of the cricoids yoke, the manual cricoids force per unit area application brings a broad assortment to clinicians in finding how much force per unit area to set on. The initial force of 44 N was recommended by Wraight et al12. Vanner so came with preciseness of 20 N to be applied before patient loss consciousness and full force ( 40 N ) at the oncoming of anesthesia[ 30 ]. But in 1999, Vanner and Asai recommend 10 N for the awake patient and increasing to 30 N one time the patient is unconscious[ 31 ]. The Technique Cricoids force per unit area should non be confused with optimum external laryngeal use ( OELM ) or rearward upward right force per unit area ( BURP ) on the thyroid gristle which is used to better visual image of the vocal cords when intubating3. Cognition Several survey-based surveies have examined the cognition of clinicians towards the applications of the cricoids force per unit area, theoretically and practically. These surveies has come to conclusion demoing that the bulk doctors, nurses and other forces related to rapid sequence initiation are unable to use cricoids force per unit area right. For illustration, a survey by Koziol et Al showed that merely 5 % of 102 perioperative nurses could indentify the right sum of force to use while the other 78.5 % and 16.5 % were underestimated and overestimated, severally[ 32 ]. Attitude Despite giving preparation to the clinicians, a followed-up survey showed that clinicians are unable to retain the improved accomplishments after 3 months post developing[ 33 ].DecisionThe individual publication by Sellick changed anaesthetic direction worldwide. In many parts of the Earth, cricoid force per unit area is considered compulsory portion of a rapid sequence initiation particularly in high hazard of regurgitation patient. But the current evidence-based medical specialties do non supply a convincing support sing the widespread usage of cricoids force per unit area to forestall aspiration. On the other manus, there is besides no strong grounds to propose that cricoids force per unit area causes injury. More randomized controlled tests should be conducted to look at the necessity of cricoids force per unit area contraption. Meanwhile, confusions, cognition and attitudes of clinicians should be address clearly to supply a decently applied cricoids force per unit area to ease cannulation with rapid sequence initiation while waiting the definite reply towards cricoids force per unit area quandary.

Continuing Professional Development Essay

With the rapid pace of change, many people may find that their skills and knowledge, acquired over the recent past, are outdated. In order to update their members, many professional groups have introduced the concept of Continuing Professional Development (CPD). (Foot and Hooks, 2002). The Royal Town Planning Institute (2001) holds that CPD is the means by which members of professional associations maintain, improve and broaden their knowledge and skills and develop their personal qualities required in their professional lives. A guide for employers of the Institute of Marine Engineering, Science and Technology (IMarEST, 2001) states that CPD is the term that describes how employees maintain their competence in the workplace. CPD comprises of updating particular areas of competence, developing personal and management skills and broadening experience leading to new opportunities. The challenges and opportunities of the work experience provide the central mechanism for maintaining CPD and professional and other organizations should encourage and support their members to maintain their CPD. Here, CPD can be organized so that it can be carried out almost automatically. It is a continual process of planning, completing activities, assessment of those activities and review/feedback to the plan. A system that encompasses these four stages must be set up. Many employers have a system in the arm of the Human Resource Department and professionals should be encouraged to include their employers in the CPD process, as ideally, it should be a partnership that will benefit employee, employer and the company. The annual appraisal interview is the ideal time to plan development targets and assess progress. The details of CPD are very much the property of individuals and one should not rely on the company’s personnel system. If not maintained properly, it may be of no support to an employee if he no longer works for that particular company. The planning stage is the most important of the four core aspects of CPD. There should be an analysis of the current job, concentrating on knowledge and skills. Then, the same thing should be done for the job/position targeted. Consultation with a mentor at this stage may be helpful. A skills and knowledge gap analysis will identify appropriate learning and  development activities. Available opportunities and personal constraints, such as money availability, should be taken into account and targets should be high, practical, achievable and challenging, bearing in mind that the plan will change regularly. (Porter 1998). Relevant information such as technical subjects, foreseeable career opportunities and in – house or external development courses should be gathered. An outline plan stating objectives, priorities, target dates and appropriate activities must also be developed. If suitable, the plan should be agreed with interested parties such as colleagues, employer, and mentor or development specialist. The outline plan should be developed into a structured detailed plan to include such information as targets agreed resourced, agreed support, agreed control and responsibility. To meet development need and to achieve targets, a wide range of activities may be chosen and support of the employer may sought. Activities may be formal and structured, for example, as in courses, distance learning, conferences, presentations or research. The advantage of formal activities is that they will often offer tangible evidence that can be incorporated into a record of CPD, the disadvantage being that the employee may feel some of the cost, especially in the cases of external courses. CPD will be a combination of this formal structure as well as less structured activities such as work experience, assignments, on the job training or mentoring. Advantages derived here are the unexpected challenges and the professional contact leading to better learning. Successful development usually requires that learning activities be matched with practical applications. An important outcome of activities is the compilation of a detailed record of activities undertaken, which should show what activities have actually occurred and with what consequence. A suitable log/record book should include certificates of attendance at events, training syllabuses, completion certificates, performance appraisals as well as a personal development record. The review against the CPD plan must be measured in terms of new/improves  levels of competence. Some useful questions to ask at this stage include ‘ What added value was gained from this activity? What can I do now, do better, that I could not do before? How do I plan to use my new abilities? Am I making progress towards achieving my learning objectives? What lessons have I learned and what should I do next?’ As stated previously, CPD is a continuous process of planning, completing activities, assessment of those activities and review/feedback. Having completed the review and feedback stage, the plan must now be amended to start the process again. The benefit derived here is the regular updating of achievements, which will act as a useful historical record and a powerful document when in discussion with a current or potential employer. In terms of CPD, professional associations are particularly helpful in conducting a skills audit gap analysis, determining the knowledge and skills required for a particular job, setting development objectives and assessing learning experience. They also aid in deciding the next necessary steps and may offer encouragement and provide motivation to persist with a CPD activity, as well as suggesting other CPD activities. Advantages and disadvantages may arise from choosing professional associations from within and external to an organization. Benefits may include a structured plan being presented, mindful of deviations and credible certification. A downside from an internal association may be the training to a specific and specialized field, as in the case of Information Technology, thereby limiting employees. The advantages and disadvantages of CPD in relation to professional associations, employees and employers may best be shown by how CPD obligations affect those particular groups. CPD is important to employers because it involves the competence and efficiency of the workforce. Professionals aged under 30 ranked career development opportunities higher than salary, while those over 30 still place it high on their demands. (IMarEST 2001). Today, technology is  changing at such a rapid rate that individuals must keep up to date in order to remain competitive and employable, and, businesses must invest in their workforce in order to remain competitive and profitable. The crucial role played by people in a company is now widely recognized and now many firms are becoming involved with initiatives such as ‘ Investors in People.’ The employee who maintains his competence through CPD will be a highly valued member of the workforce, giving assurance to the truism that ‘ the investment in people appreciates, whilst investment in equipment depreciates.’ (IMarEST 2001). This investment by employers may be double edged, as people in the U K change their employers every 4.5 years on average, either voluntarily or compulsory, for example as a result of redundancy. Thus, one employer after investing in an employee’s CPD may find that he has prepared his employee for another employer. Investment in employee development provides a benefit to the company which result in ‘ bottom line profit.’ Even in the short run, payback can significantly exceed the outlay because when employees understand the processes they are working with, and appreciate the business objectives that they are working towards, their productivity and creativity improve. Individuals also gain greater job satisfaction which lead to a greater commitment to the company’s performance and therefore a lower rate of staff turnover, an advantage to employers. Employees should be encouraged to take a proactive role in deciding what training and development activities they should undertake, whilst employers should be helping and guiding such decisions to ensure that corporate goals are met. Individuals have a responsibility to themselves and their employers to consider what might be required in the future and to prepare themselves to be ready when opportunities occur and when changes are necessary. At the same time, employers have a responsibility to their company and their employees to provide an environment where people can develop the necessary skills and knowledge to take on new responsibilities as the need arises. (Christopher 1998). The days when we did a three to four year course and thought we’d been  trained for life have gone. Evolving technology, faster rate of product development and the need for employees to work across several disciplines, require everyone to be aware of the need to regularly update their skills. CPD offers a well recognized mechanism for all to update their technical competence, communication and management skills, and an appreciation of the commercial aspect of their industry. CPD will allow a person to spot opportunities and exploit new ideas effectively. From the point of view of not performing CPD, we can highlight some inherent disadvantages to all concerned parties. Clients are becoming more involved with their investments in terms of scrutiny. Vocal groups of shareholders may be ready to arm themselves with litigation, lobbying powers and letters whenever they feel professional standards may have slipped. CPD will be the proof of continued development and reviewing of professional standards, reducing an organization’s vulnerability to its professionalism being brought into question. Correctly maintained CPD will also have the benefit to review and explore one’s career and to discover strengths and weaknesses, holding to the adage ‘ to learn now ensures that you earn later.’ (Evans 1997). Every company need some form of career development program to produce a succession of motivated upward moving employees. Even employees who are destined to remain at the same level may need career development as their job change or become obsolete. Employers may invest in the CPD of their employees by some transparent actions. They need to clarify how business objectives may best be met by the investment in employees, and should use opportunities like annual appraisals to discuss individual development. They should listen to employees’ ideas and encourage them to consider personal goals, and setting realistic expectations, as there will be limited resources of time and money. Employers should persevere in CPD of employees, with regular review progress reports, as it will lead to tangible improvements in productivity and in the competitiveness of the business. A mentoring scheme should be established to assist in setting medium and long-term career goals. The wide ranges of activities that take place, daily, in the workplace provide many of the most important learning skills. People should be given the chance to experience different situations and develop a wide range of skills. In specific instances, formal, off the job training may be required. Employees should be encouraged to read widely to gain an appreciation of the wider issues related to their job. (Beer 1985). The professional development of staff should not be confined just to technical competence but should include the wider issues of environmental protection, health and safety, interpersonal skills, management techniques, and legal and financial knowledge, where necessary. Employers should actively encourage their employees to attend events organized by local groups of professional institutions and similar relevant organizations. These meetings offer both technical updating, by means of formal lectures, and the opportunity for discussion with other professional people working in related fields. Encouraging staff to network in this way is a key means of increasing competitiveness. It is of great benefit to employees to have help in reviewing their progress and guidance in choosing which routes to follow. Managers within a company should be aware of the importance of individual development and be able to guide those for whom they are responsible. They should be aware not only of development goals, but also of the different types of training requirements that different people have. (Bernardin and Russel 1993). It is strongly recommended that, where possible, a fellow professional act as a mentor to facilitate the CPD of employees, as helping individuals improve their performance will improve overall business results. There are no hard and fast rules for the amount of time to be spent on staff development. It is the benefit of an activity to a particular employee rather than the activity itself that is important and all learning opportunities, however informal, should be seized when they arise.