What were the causes of the Second World War Essay

What were the causes of the Second World War - Essay Example Hitler desired the living space to be self-reliant. He wanted to overpower the world and Europe. The Treaty of Versailles had to be invoked if Hitler had his ways, paving the way to the Second World War. The aggression of Allied forces also led to the Second World War. In Italy, Mussolini propagated Fascism and wanted to establish a Roman Kingdom in the Mediterranean and Africa, to quote his attack on Abyssinia in 1935. Another Allied power Japan desired a Nipponese rule in the Pacific, leading to China and Australia, as is evident from Japan’s attack on Manchuria in 1931. All the three Allied nations, namely Germany, Italy, and France were against Communism of the USSR, thus, sowing the seeds of war among nations. Another cause of the Second World War was the passivity of the Democratic powers. USA was detached while France was not willing to stand in opposition to Germany. France could not depend on Britain and America for support. Britain had a soft corner for recuperation of Germany between 1934 and 1937 and pacified Germany between May 1937 and March 1939. The Democratic powers could have hindered the path of Fascism before 1939 but preferred to remain in low-profile. The League of Nations failed in distancing the warring nations. Not a single factor could be blamed for the Second World War, as stated above but Hitler’s expansionism was the sole reason to cause the Second World War. Fascism was also a leading reason, as bent on expanding and the inability of democratic countries to stop Mussolini from his beliefs in Fascism. There were 9 causes of the Second World War, which are discussed in detail below. 1. The Rearmament of Germany It happened during the Geneva Disarmament Conference held in 1932-4 wherein Hitler made it clear that because other countries were not reducing their military strength to that of Germany, Germany would increase its military power to their level. Till 1935 the process of rearmament of Germany was ongoing by establ ishing conscription and munitions factories. France reacted to the rearmament of Germany by strengthening the Maginot line built earlier between 1929 and 1934 because rearmament of Germany created insecurity in the region. The Maginot line was made of steel and concrete mixture for added strength from Belgium to Switzerland; it was known as ‘a gate without a fence’, which Germany would not crossover and attack France through Belgium. Without the support of Britain, France never appeared on the front foot. Britain, on the other hand, was friendlier towards Germany than it was with France to actively support it. The Anglo German naval Treaty (June 1935) was the result of the sympathetic behavior of Britain towards Germany, which permitted the German Navy to be 35% of the size of the British Royal Navy. Hitler supported Franco in the Spanish Civil War (1936-9) with the ammunition at its disposal. Hitler sent the Condor Legion of the Luftwaffe to attack Guernica on 26th Apr il, 1937. Guernica was eliminated and Franco marched ahead winning the Basque areas of Spain. Hitler had used Spain as a testing ground. 2. The Remilitarization of the Rhineland (1936) Hitler attempted breach of the Versailles Treaty once again after committing a breach once by marching to Cologne on 7th March 1936 with 30,000 soldiers. France could not gather the courage to come face-to-face with Germany militarily although amassing troop strength of 250,000 because Britain was not at its support. Britain expressed the opinion that Germany was ‘marching into her own back yard.’ Hitler held a plebiscite on remilitarization to prove the support of its people, which was vehement to 98.8% in favor of Hitler’s policy on militarization. This prompted Hitler to create his own defensive fortification, the Siegfried Line. 3. The

Book Report on Pigeons at Daybreak Essay Example for Free

Book Report on Pigeons at Daybreak Essay The story entitled â€Å"Pigeons at Daybreak† by Anita Desai of India is a representation of love and acceptance. Mr. Basu is the man who is unable to perform his task on his own because of the different illnesses that developed into his body. Otima, the wife of Mr. Basu has the selfless love towards him. She takes care of her husband despite of all the problems and complications that emerged in their situation. Otima used to read the newspaper for Mr. Basu. Because Mr. Basu could not able to read the newspaper due to poor eyesight, Otima produced deeper patience and love for her husband.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   From the time when their house had no electricity due to electric problems, the two went to the terrace and decided to stay there until the electricity comes back but when the electricity went back, Mr. Basu refused to go back inside the house for it was the time of preparation of leaving. Mr. Basu accepted the fact that his life will soon vanish and become part of heaven. The pigeons in the terrace where Mr. Basu died symbolize his spirit and his journey in the next life.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The story is simple yet attackable. Its tragic situation brought life to the whole story. Then, with a swirl and flutter of feathers, a flock of pigeons hurtled upwards and spread out against the dome of the sky – opalescent, sunlit, like small pearls (Desai 228). This ending part of the story compressed the entire claim of the story. It means that the ending of the story signifies life as its wondrous creation but soon will end because every one of us will leave the world in beauty and a new journey will begin. Reference Desai, A. (date). Pigeons at Daybreak. pp.220-228

Faith and Reason within the Holocaust Essay -- Essays Papers

Faith and Reason within the Holocaust One of the greatest horrors of the 20th Century was the extermination of over 6 million Jews and 5 million others during the Holocaust. In the face of this atrocity many have wondered how such a tragedy transcended in a supposed "civilized" European society. What role did religious institutions play in the prevention or lack of prevention of the horrors inflicted by the Nazis? How did the German government create, within a reasoning public, acceptance and even support for the extermination of a people who previously were considered equals? The inhumanity of the Holocaust was procured with effective use of propaganda on the German people who were willing to support anyone who could return Germany to the thriving time prior to World War I. The Holocaust was able to sustain vitality during the war because of the Westà ­s ignorance and indifference of the horrendous reality that was the Holocaust. The murder of millions at extermination camps such as Auschwitz and Dachau was the end result of a series of events that did not develop through extraordinary circumstances, but rather from an educated German and Western societiesà ­ abandonment of their responsibility to the minority. Ordinarily, one would expect that any acts of injustice to a person would be found morally wrong by religious institutions. However, in Europe, Jews historically had a difficulty functioning within a Christian society. The vision that people could live together peacefully despite religious differences was a New World concept that had not found its way into Europe during the 1930à ­s. A great deal of Germanyà ­s population was Protestant; furthermore, they were Lutherans. As followers of Lutherà ­s principleà ­s... ... this widespread lack of compassion for the other Jews, the Nazis were able to fulfill one of their goals before their final fallà ³the extermination of over 75% of the German Jewish population. In the hours before his suicide, Hitler consoled himself with this while the rest of the world questioned how such an atrocity had manifested. Endnotes: 1. Rita Steinhardt Botwinick, A History of the Holocaust: From Ideology to Annihilation (Upper Saddle River: Prentice Hall, 1996), 19. 2. Adolf Hitler. The Jewish Peril. Rpt. in Rogers, 396. 3. Rita Steinhardt Botwinick, 84. 4. Rita Steinhardt Botwinick, 76. 5. http://serendipity.nofadz.com/cda/niemoll.html> 6. Joseph Goebbels. The Jews Are to Blame. Rpt. in Rogers, 405. 7. Christopher R. Browning, Ordinary Men (New York: Harper Perennial, 1992), 179.

Maintain Medicare Essay

Like it or not we are all aging! It is a scary thought for some. However, knowing that my grandparents, parents, and one day myself will have the option to obtain Medicare is very comforting. Medicare is a federal health care program that was put in place by Congress in 1965 to provide health insurance to Americans sixty-five and above. Medicare was then expanded in 1972 to also cover younger individuals who are disabled (Kaiser, 2012). Traditional Medicare provides coverage to all Americans sixty-five and older without taking into account income. Prior to Medicare a whopping fifty percent of seniors lacked health coverage (Center for Medicare Advocacy, 2009)! To think of all the individuals who could not afford health care or had preexisting health problems and where unable to be cared for is simply unacceptable. Private insurances felt taking care of those with prior illnesses and people sixty-five and older would be too costly. Medicare has put a stop to that issue. With this federal health care program Americans have a stable sense of security knowing that their insurance will not revoke their benefits if an illness arises or too many claims come about. It is my strong belief that after working forty years or more Americans have earned the right to have health care insurance. People deserve to reap the benefits of having paid their taxes for at least ten years. As a result of the new health reform there will be some changes happening to Medicare. To improve early detection there will be annual well-visit checkups, colorectal cancer screenings, mammograms, and colonoscopies covered by Medicare (Health Policy Briefs, 2010). Due to early detection of chronic illnesses which inevitably cost billions, such as heart disease and diabetes will be lowered. The initial goal of Medicare still stands today, â€Å"to provide fair access to health care, through a stable unified program (Center for Medicare Advocacy, 2009).† It is imperative that we stick together as a nation to maintain Medicare for our future. Health Care Costs: A Primer (2012). Retrieved from www.kff.org/insurance/7670.cfm Health Policy Briefs. (2010). http://www.healthaffairs.org/healthpolicybriefs/brief.php?brief_id=17. Center for Medicare Advocacy. (2009). http://www.medicareadvocacy.org/InfoByTopic/Reform/10_07.29.Medicares45thAnniversary.

Domin Sizzles with Pizza Tracker Essay

This paper explores the different kind of Information System, Domino’s Sizzles used to avoid losing its market share. The Transaction Processing System, Management Information System, and the Decision Support System. Each of this Information System has been proved very useful in increasing the customer’s satisfaction towards Domino’s Sizzles service. Along with these systems, they also have software named â€Å"Pulse† which helps them to increase their sales. This software maintains and manages functions in each of the restaurant of the Domino. Another strategy Domino did is by developing Online Tracking System with an Online Ordering System in it. DOMINO’S SIZZLES WITH PIZZA TRACKER 3 DOMINO’S SIZZLES WITH PIZZA TRACKER This case study discuss about Domino’s pizza and how information systems have helped in development of its business. Many pizza shops have introduced home  delivery system and Domino’s pizza. When a survey was conducted about home delivery system, Domino’s pizza home delivery was considered the worst among all others. Domino has had the largest market share of pizza in any U.S chains, so it was worried about losing its market share due to its competitors. Therefore, it has planned various strategies to improve its business. It has used different kinds of information systems as follows:- 1) Transaction processing system: †¢The point of sales system captures purchases and payment at a location where goods and services are bought and sold using computers and other digital devices. The customers’ order is the input, it is stored in the database, and size, order of pizza, and delivery information and customer information are the outputs. 2) Management information system:- †¢Input is from TPS and its processed and the output is amount of ingredients used, time taken to make a pizza, delivery distances, customer demographic data and employee performance etc. DOMINO’S SIZZLES WITH PIZZA TRACKER 4 3) Decision support system †¢Input is from TPS and external sources, it analyzed, and output is sales data per menu item and analyzing the past sales data to the present one. OBJECTIVES AND ITS USES These systems have helped Dominos in increasing its sales. Pulse is software developed for this purpose was an important asset in maintaining consistent and efficient management functions in each of its restaurants. It has proved clear and analysts’ accept the fact that technology is working to cut costs and improve customers’ satisfaction. Dominos’ has also developed online tracking system, which also includes an online ordering system in it. The system allows customers to watch a stimulated photographic version (graphically also) of pizza with size and toppings and sauces used of their desire. Once customer places an order, he can track its delivery using online tracker. As dominos’ completes each step of its order fulfillment a section of its bar becomes red. Even customers who placed order through can track their pizza using the tracker online. In 2010 dominos’ has introduced  an online polling system to get feedback from its customers regarding pizza and employee services provided and many other things from its stores. DOMINO’S SIZZLES WITH PIZZA TRACKER 5 CONCLUSION Finally, these systems have proven to be useful in increasing customer’s satisfaction and business too. These systems have improved to execute its operations faster than its rivals in the market. Even though pizza hut and papa johns have online ordering system they lack in online pizza trackers and simulated pizza tracker system which dominos’ has implemented successfully. Today online ordering in dominos account for 20% which shows an increase compared to less than 15% in 2008. This shows that the information systems implanted in dominos has led to development and sustainability among its rivals in the market. DOMINO’S SIZZLES WITH PIZZA TRACKER 6 References †¢http://www.google.com.ph/url?sa=t&rct=j&q=&esrc=s&source=web&cd=3&ved=0CEEQFjAC&url=http%3A%2F%2Fwww2.sta.uwi.edu%2F~anikov%2Finfo1500%2Ftutorials%2F02-IITF-interactive-session-Domino%27s-Sizzles-with-Pizza-Tracker.pdf&ei=da4QUq_kEMiHrgf9o4DABQ&usg=AFQjCNE4RLiUp__XKUY2VNACrnRABuTwdg&sig2=lMglI0CO8OZo671hwB2T_w †¢http://share.pdfonline.com/025da56a16c44e53a700535781d1fced/ISM%20CASE%20STUDY%28DOMINOS%20AND%20MERU%29%20SUMMARY.htm †¢http://www.sefmd.org/Abstracts/SampleAbstracts.htm †¢http://writing.wisc.edu/Handbook/presentations_abstracts_examples.html DOMINO’S SIZZLES WITH PIZZA TRACKER 7 Appendix Founded in 1960, Tom Monaghan together with his brother started the company by purchasing a single store in Ypsilanti Michigan. The company slowly grow,  and by 1978, Domino’s had 200 stores. Today, the company is headquartered in Ann Arbor, Michigan, and operates almost 9,000 stores located in all 50 U.S states and across the world in 60 international markets. In 2009, Domino’s had $1.5 billion in sales and earned $80 million in profit. With its great progress, Domino’s was involved in a heated battle among prominent pizza chains, including Pizza Hut, Papa John’s, and Little Caesar. Pizza Hut is the only chain larger than Domino’s in the U.S., but each of the four has significant market share. Domino’s also competes with local pizza stores throughout the U.S. To gain a competitive advantage, Domino’s needs to deliver excellent customer service, and most importantly, good pizza.

Politics Of Plato And Aristotle Essays - Ancient Greek Philosophers

Politics Of Plato And Aristotle Essays - Ancient Greek Philosophers Politics of Plato and Aristotle To compare the political theories of two great philosophers of politics is to first examine each theory in depth. Plato is regarded by many experts as the first writer of political philosophy, and Aristotle is recognized as the first political scientist. These two men were great thinkers. They each had ideas of how to improve existing societies during their individual lifetimes. It is necessary to look at several areas of each theory to seek the difference in each. The main focus of Plato is a perfect society. He creates a blueprint for a utopian society, in his book The Republic, out of his disdain for the tension of political life (Hacker, 24). This blueprint was a sketch of a society in which the problems he thought were present in his society would be eased (Hacker 24). Plato sought to cure the afflictions of both human society and human personality (Hacker 24). Essentially what Plato wants to achieve is a perfect society. Aristotle, unlike Plato, is not concerned with perfecting society. He just wants to improve on the existing one. Rather than produce a blueprint for the perfect society, Aristotle suggested, in his work, The Politics, that the society itself should reach for the best possible system that could be attained (Hacker 71). Aristotle relied on the deductive approach, while Aristotle is an example of an inductive approach (Hacker 71). Utopia is a solution in abstract, a solution that has no concrete problem (Hacker 76). There is no solid evidence that all societies are in need of such drastic reformation as Plato suggests (Hacker 76). Aristotle discovers that the best possible has already been obtained (Hacker 76). All that can be done is to try to improve on the existing one. Plato's utopia consists of three distinct, non-hereditary class systems (Hacker 32). The Guardians consist of non ruling Guardians and ruling Guardians. The non-rulers are a higher level of civil servants and the ruling is the society's policy makers (Hacker 32). Auxilaries are soldiers and minor civil servants (Hacker 32). Finally the Workers, are composed of farmers and artisans, most commonly unskilled laborers (Hacker 32). The Guardians are to be wise and good rulers. It is important that the rulers who emerge must be a class of craftsmen who are public-spirited in temperament and skilled in the arts of government areas (Hacker 33). The guardians are to be placed in a position in which they are absolute rulers. They are supposed to be the select few who know what is best for society (Hacker 33). Aristotle disagrees with the idea of one class holding discontinuing political power (Hacker 85). The failure to allow circulation between classes excludes those men who may be ambitious, and wise, but are not in the right class of society to hold any type of political power (Hacker 85). Aristotle looks upon this ruling class system as an ill-conceived political structure (Hacker 86). He quotes "It is a further objection that he deprives his Guardians even of happiness, maintaining that happiness of the whole state which should be the object of legislation," ultimately he is saying that Guardians sacrifice their happiness for power and control. Guardians who lead such a strict life will also think it necessary to impose the same strict lifestyle on the society it governs (Hacker 86). Aristotle puts a high value on moderation (Hacker 81). Many people favor moderation because it is part-liberal and part-conservative. There is so much of Plato's utopia that is undefined and it is carried to extremes that no human being could ever fulfill its requirements (Hacker 81). Aristotle believes that Plato is underestimating the qualitative change in human character and personality that would have to take place in order to achieve his utopia (Hacker 81). Plato chose to tell the reader of his Republic how men would act and what their attitudes would be in a perfect society (Hacker 81). Aristotle tries to use real men in the real world in an experimental fashion to foresee how and in which ways they can be improved (Hacker 81). Both Plato and Aristotle agree that justice exists in an objective sense: that is, it dictates a belief that the good life should be

Free Essays on Origins Of Dance

Name of Dance: Belly Dance Origin: Cadiz? Date: 500's AD Creator/choreographer: n/a Correct term :â€Å"Raks Sharki†. Belly Dancing by definition is a Middle Eastern dance in which the dancer makes sensuous movements of the hips and abdomen. After researching the dance I’ve read that the dance does not only include movement of the â€Å"belly†, it is actually involves more parts of the body. Belly dancing is usually done as a solo dance, with undulating hips and a body that gyrates shakes and rolls, all the while the feet can be syncopating and moving about. Stamping of the feet and jumping can be apart of the dance as well. Many belly dancers can and do use the finger cymbals while dancing. A good belly dancer can be judge by how well she moves her shoulders and not her pelvis. Belly dance is a physical art, which combines fitness and elegant dance movements. It emphasizes strength and grace of all that is feminine It is uniquely designed for women, which can only be mastered by the passionate ones Whether you are a housewife, a career woman, or still a student, who is worn out by li fe’s tasks, dancing will help you push away your regular image, and let that hidden woman take over. It is an occasion to bring out that veiled actress or even a dance performer. Name of Dance: Heel & Toe Origin: America? Date: 1880s Creator/choreographer: Bohemian ... Free Essays on Origins Of Dance Free Essays on Origins Of Dance Name of Dance: Belly Dance Origin: Cadiz? Date: 500's AD Creator/choreographer: n/a Correct term :â€Å"Raks Sharki†. Belly Dancing by definition is a Middle Eastern dance in which the dancer makes sensuous movements of the hips and abdomen. After researching the dance I’ve read that the dance does not only include movement of the â€Å"belly†, it is actually involves more parts of the body. Belly dancing is usually done as a solo dance, with undulating hips and a body that gyrates shakes and rolls, all the while the feet can be syncopating and moving about. Stamping of the feet and jumping can be apart of the dance as well. Many belly dancers can and do use the finger cymbals while dancing. A good belly dancer can be judge by how well she moves her shoulders and not her pelvis. Belly dance is a physical art, which combines fitness and elegant dance movements. It emphasizes strength and grace of all that is feminine It is uniquely designed for women, which can only be mastered by the passionate ones Whether you are a housewife, a career woman, or still a student, who is worn out by li fe’s tasks, dancing will help you push away your regular image, and let that hidden woman take over. It is an occasion to bring out that veiled actress or even a dance performer. Name of Dance: Heel & Toe Origin: America? Date: 1880s Creator/choreographer: Bohemian ...

The Murder of Taylor Behl

The Murder of Taylor Behl What Happened to Taylor Behl? Taylor Behl, a 17-year-old freshman at Virginia Commonwealth University in Richmond, left her dormitory room Sept. 5, 2005 to give her roommate some privacy with her boyfriend. She took with her a cell phone, some cash, a student ID and her car keys. She was never seen alive again. Two weeks later, her 1997 Ford Escort was found a mile and a half from the VCU campus with stolen Ohio license plates. Her body was found in an indentation in the ground 75 miles east of Richmond on Oct. 7. Taylor Marie Behls Childhood Years Taylor Behl was born on October 13, 1987 to Matt and Janet Behl (now Janet Pelasara). By age five, Taylors parents were divorced, and Janet was remarried to a Royal Air Force officer. She and her new husband and Taylor lived in England and Belgium. Taylor became a seasoned airline passenger before the age of six, making unescorted international trips between Europe and the U.S. By the age of 11, Taylors mother was divorced again and the two returned to northern Virginia. Pretty, Popular and Savvy Taylor Behl was pretty, popular and had an air of well-traveled sophistication. She had attended 15 different schools abroad by the age of 17 when she graduated from Madison High School in the well-off Washington, D.C., bedroom community of Vienna, Virginia. She carried the outward appearance of having developed a savvy independence that would prepare her for her next life adventure of attending her first year of college at the Richmond, Virginia based Virginia Commonwealth University (VCU). Janet Pelasara said Taylor selected VCU because of the diversity she would find at the college with its 30,000 students. It seemed like a safe choice, located only one and a half hours away from both her mother and father. In August 2005, at age 17, Taylor Behl packed up her belongings, as did thousands of other college-bound students, and headed to her new home at Gladdings Residence dorm on West Main St. in Richmond, Virginia. Taylors Internet Personality - Bitter One important aspect of Taylor Behls life was her participation on Myspace.com. The website is designed so individuals can create profiles for themselves and interact with others in a social-type environment. On Taylor Behls profile she created during the summer of 2005, she used the name Bitter and posted: I just graduated from high school and now Im off to Richmond for college. Im looking forward to meeting people that are in Richmond because I only know a few people down there. Later in her profile she added, Who would I like to meet? Someone who is kind. Taylor posted regularly on the site and continued to do so while at VCU. Taylor Meets Ben Fawley Unknown to Taylors parents, Taylor met a man in Feb. 2005, while touring VCU as a prospective student. He was Ben Fawley, a 38-year-old amateur photographer who had a history of dating young college girls. It is believed that Taylor and Fawley developed an online friendship after meeting and the relationship became sexual at some point. There are conflicting reports concerning when or if Taylor ended the physical relationship, but when she arrived at VCU, their friendship continued. Taylor Vanishes On Sept. 5, Taylor returned to Richmond after visiting her family in Vienna over the holiday weekend. She called her parents to let them know she made it back to VCU safely. She then had dinner at The Village Cafe with an old boyfriend. Afterwards, Taylor returned to her dorm room, but left to give her roommate and her boyfriend privacy. With her car keys, cell phone, student ID and a little cash, she told her roommate she was going skateboarding and would be back in three hours. Timeline: Taylor Behl was never seen alive again. It was not until Sept. 7, that Taylors roommate made a missing persons report to the VCU campus police. On Sept. 15, the Richmond Police took over and an 11-member task force, including FBI agents, was formed to help find the missing student. Sept. 17, 2005:  Taylors car, a 1997 white Ford Escort, was found locked and parked on a quiet neighborhood street almost a mile and a half from campus. The license plates had been switched to Ohio plates that had been reported stolen in Richmond two months earlier. Neighbors in the area told police the car had not been there the entire time Taylor was missing. A K-9 dog picked up two distinct scents in the car. One belonged to Taylor and the other to 22-year-old Jesse Schultz. During police questioning, Schultz denied knowing Taylor and denied ever being in her car. He was arrested on drug possession after police discovered drugs during a search of his home. On Sept. 21, 2005:  Police reported that 38-year-old, Ben Fawley was one of the last known people to see Taylor alive. Fawley told police that Taylor had come over to borrow a skateboard and he walked her back to her dorm around 9:30 p.m. During a police search of his home, police discovered child pornography and he was arrested on 16 child pornography charges. Fawley, a father of two girls, was arraigned and ordered to remain in jail with no bond. On October 5, 2005: Fawleys ex-girlfriend led police to a house in a photograph displayed on one of Fawleys Internet web sites. The location was an old farm located on her parents property. The police searched the remote Mathews County farm and discovered the decomposed body of Taylor Behl laying in an indentation in the ground. Taylor Behl was buried on October 14, a day after she would have turned 18. Ben Fawley Convicted of Second-Degree Murder In February, 2006 Ben Fawley was charged with second-degree murder of Taylor Behl.  In August he was sentenced to 30 years in prison after entering an Alford plea in the case, which means he did not admit guilt, but accepted the fact that prosecutors had enough evidence to convict him of the crime.

Using the criteria outlined in Chapter 15, evaluate the range of Assignment

Using the criteria outlined in Chapter 15, evaluate the range of distribution options available to the cluster of products and services within Thailand - Assignment Example The choice distribution channel for tourism functions to convey marketing communication. These communications assist clients in booking for accommodations, making payment and obtaining various tourism goods and services that the tourists may require. According to Berger (2014), there exists two basic options for contact; a two-way response which conveys information directly between the prospective client and the produce. On the other hand, indirect response is the case when third parties are involved in channeling information to clients, p.275. Indirect marketing involves the use of intermediaries. Experts declare that when intermediaries are used, they facilitate the buying of commodities in advance. In addition, the channel is very efficient when bringing about promotions and discounts. Furthermore, it is significantly important for businesses dealing with tourism products and services to be strategically positioned. It is vital for both micro businesses and large tourism businesses to ensure that their offices are strategically located so as to attract large clientele base. The choice location should ensure a correct system of reservation, effective payment and information system and physical accessibility, Berger (2014,

Characteristics of a homeless man Essay Example | Topics and Well Written Essays - 500 words

Characteristics of a homeless man - Essay Example As he saw me, he shouted. Beggar: Oye, watch what you are doing man. You just twisted my leg and I have got it fractured for sure. Owoo†¦owooo.ooo. It hurts. You owe me several hundred dollars. I gotta go and get it fixed. Owooo†¦owoo. Oh my God, I thought! One moment ago, I adored the beauty of the Arch, and one moment later, I curse having visited it. Does the Arch make home to such people? I could never think of it. And this beggar, this liar, is indeed a big threat to my bank account. All of these thoughts suddenly flashed in my mind with instincts. I was dumb-founded. I talked to the beggar in reply. Me: I owe you nothing. Its your fault if you are sleeping in a common walkway, with your leg extended in the middle of the path. And I was too conscious to put complete weight over my foot as soon as I realized there was something underneath it. You lie. I did not fracture your leg. Indeed, you are perfectly alright. This is indeed, a new way of begging in the town, isn’t it? Me: Oh my God, you liar, you cheat. You have had your leg fractured ever since this report was made, and you intend to sue me for that? And then you show me the report as well. You know what? I pity you! Here†¦take

Employment Testing and Human Resource Management Article

Employment Testing and Human Resource Management - Article Example The researcher states that while Ajila and Okafor give a detailed and informative account of employment testing, the relevance of such testing in Human Resource Management is given only superficial treatment. Ajila and Okafor define Human Resources Management, its objective in matching organizational goals with employee skills, and the use of employment testing as a step in any â€Å"comprehensive screening program†. The authors present an in-depth account of the origin and nature of employment testing, beginning with its roots in the tests of Francis Galton in 1883, and its evolution over the decades: from Alfred Binet’s scales, the Stanford-Binet test, and the Army Tests used in World War I. Ajila and Okafor go on to define psychological tests, and analyze employment testing in terms of validity and reliability. As personnel selection is one of the most significant features of Human Resource Management, the authors explore validity (accuracy, legitimacy) and reliabili ty (dependability or consistency) in terms of measures used to assess the â€Å"attributes related to success on the job†. The authors give a comprehensive report of the various types of tests used in personnel screening and selection, based on cognitive ability, mechanical ability, motor and sensory ability, aptitude, personality, and knowledge. By providing examples of each kind of test, the authors further elucidate the nature of employment testing and the purpose and use of the different tests. Ajila and Okafor conclude with the unequivocal assertion that employment testing should definitely be a part of the process of personnel selection. While the authors give a commendably detailed analysis of the history of psychological testing, and a comprehensive list of the types of tests, the article does not make a strong enough case for the inclusion of such testing in the personnel selection process. Ajila and Okafor do not quote any studies or research to back their stand tha t employment testing is a reliable and valid method of personnel selection.

Trade without borders Essay Example | Topics and Well Written Essays - 750 words - 1

Trade without borders - Essay Example It can also be stated that tariffs and trade in the national territories of these two economies have profoundly affected their business activities through various channels of commodity specifications, technology assistances as well as the benefits of influx socio-cultural diversities (Hornok, â€Å" Trade Without Borders: Trade Effect of EU Accession by Central and Eastern European Countries†). The paper intends to discuss on the advantages and disadvantages of trade without borders by analyzing the available relevant information in relation to the trade affairs performed within Canada and the US. The paper also aims to provide recommendations to small business owners in obtaining the complete benefits of trade liberalization. Undoubtedly, in the present day context, international trade activities play a crucial role in determining economic growth through capital inflows. Cross-border trade liberalization has also been considered as strongly influencing in relation to the labor migration activities and business cycles of the economy. From a critical perspective, the initiatives to eradicate borders when liberalizing trade render greater opportunity of growth to the traders in a less risky business environment. This in turn serves as a supportive attribute towards economic growth and sustainability at large (Caporale and Girardi, ‘Business Cycles, International Trade and Capital Flows: Evidence from Latin America’; LSE, ‘International Trade and International Capital Flows: A Theoretical Perspective’). The liberalized trade activities practiced in the developed economic structure of Canada can be illustrated with reference to increasing amount of exports to various regions of the US, especially from the small business sector of the nation. Stating precisely, the survey conducted by Canadian Federation of Independent Business (CFIB) also stated that trade practices are mostly performed by small business

Sense and Sensibility Essay Example | Topics and Well Written Essays - 500 words

Sense and Sensibility - Essay Example Taking up the theme of hypocrisy we can see how women in that century were generally side-lined even by their own flesh and blood as demonstrated by Henry Dashwood when he turns over his entire estate to his son knowing fully well that his wife and daughters would be left destitute and commiserating with them on their fate. John Dashwood, too turns out to be a bigger hypocrite for after having shamefully neglected his sisters, he comes to seek Elinor’s sympathy and says, â€Å"†¦..for otherwise we both wished very much to have invited you and Marianne to be with us, while your kind friend there was attending her daughter. And now to be so rewarded! I wish, with all my heart, says poor Fanny, in her affectionate way, that we had asked your sisters instead of them." (Austen, 228) And has the gall to wait to be thanked, which the cordial Elinor does. Lucy acts disgracefully and lays open her hypocritical nature when she claims that she had asked Edward to end their engageme nt as it would not be a very happy one (after Edward had been disinherited) and that Edward had refused when in fact, it was Lucy who had refused to end the engagement earlier. Both John and Lucy are epitomes of hypocrisy because they profess to be concerned about others’ welfare or are effusive in their praise for someone while all the time they are plotting how to take advantage of them. Lucy is a person who cannot restrain herself from her selfishnessâ€Å"†¦.. and secretly resolved to avail herself, at Delaford, as for as she possibly could, of his servants, his carriage, his cows, and his poultry." (Austen, 253) even towards someone who had been of such help to her. The characters in Austen’s novel are generally very aware of the importance of money and though people like Elinor take it in the right spirit (not underestimating or

Rewrite Essay Example | Topics and Well Written Essays - 500 words

Rewrite - Essay Example Customer satisfaction is seen as our companys top most priority. Our company responds and adapts quickly to customer requirements. Not only that, but our company goes beyond the expectation of defect and error reduction, merely meeting specifications, and minimizing customer complaints. Prestige International, Inc. works to constantly improve product and service attributes that meet basic requirements. This helps them to gain a competitive advantage. Ongoing improvement of all operations, activities and tasks is highly valued by Prestige International, Inc. Once it is realized that a product’s top quality is demanded by a customer, continuous development is immediately put into effect to assure the highest level of customer satisfaction. We also recognize that the quality of our product is a direct result of the process involved. As a result, there is a strong focus on continuous improvement of our companys processes. Improvement cycles are encouraged and maintained for all the companys activities like, product development and the proper management of customer relationships. Eliminating waste is another component of the continuous improvement approach. The customer-driven approach helps to prevent errors, decrease mistakes, and achieve defect-free production. Prestige International, Inc. adopted TQM as a code of life for the company. It was introduced and directed by top management where commitment, dedication and personal involvement has always been a top priority of theirs. This has efficiently helped in creating and deploying clear quality values and goals consistent with the objectives of the company while at the same time ensuring and deploying well-defined systems, methods and performance measures for achieving those goals. These systems and methods put in place actively guide all quality activities and encourage employee participation. Prestige International,

Sense and Sensibility Essay Example | Topics and Well Written Essays - 500 words

Sense and Sensibility - Essay Example Taking up the theme of hypocrisy we can see how women in that century were generally side-lined even by their own flesh and blood as demonstrated by Henry Dashwood when he turns over his entire estate to his son knowing fully well that his wife and daughters would be left destitute and commiserating with them on their fate. John Dashwood, too turns out to be a bigger hypocrite for after having shamefully neglected his sisters, he comes to seek Elinor’s sympathy and says, â€Å"†¦..for otherwise we both wished very much to have invited you and Marianne to be with us, while your kind friend there was attending her daughter. And now to be so rewarded! I wish, with all my heart, says poor Fanny, in her affectionate way, that we had asked your sisters instead of them." (Austen, 228) And has the gall to wait to be thanked, which the cordial Elinor does. Lucy acts disgracefully and lays open her hypocritical nature when she claims that she had asked Edward to end their engageme nt as it would not be a very happy one (after Edward had been disinherited) and that Edward had refused when in fact, it was Lucy who had refused to end the engagement earlier. Both John and Lucy are epitomes of hypocrisy because they profess to be concerned about others’ welfare or are effusive in their praise for someone while all the time they are plotting how to take advantage of them. Lucy is a person who cannot restrain herself from her selfishnessâ€Å"†¦.. and secretly resolved to avail herself, at Delaford, as for as she possibly could, of his servants, his carriage, his cows, and his poultry." (Austen, 253) even towards someone who had been of such help to her. The characters in Austen’s novel are generally very aware of the importance of money and though people like Elinor take it in the right spirit (not underestimating or

Employment Business Law Coursework Example | Topics and Well Written Essays - 250 words

Employment Business Law - Coursework Example w their workers should spend their off hours from duty, the fact that the airline did not act from the previous cases of sexual harassment proves their liability in this case. Other New York torts of negligent hiring, retention and supervision of employees find the employer liable. Though the hotel rooms were not a property of the airline, the fact that they rent the hotel rooms for their employees proves their liability (England, 2012). It is evident that the woman was discriminated against because of her faith. Everyone has a right to worship in a religion of his or her wish and this should not be resulted into discrimination by others who do not believe in that religion. Thus, the court should decide that the company compensates the woman and gives her the job back. The reason is the manager and assistant manager of the store discriminated against her due to her Wiccan faith. They violated the law of religious discrimination and work situations in the title VII of the civil rights act of 1964. It states that under no circumstances should a worker be discriminated against in any aspects of hiring, pay, firing and any other aspects of employment. The manager terminated her job that inconvenienced the woman in question. It is important for an employer to give their employees a reasonable notice of termination. The fact that the store manager never formally disciplined the woman for her wearing the Wiccan medallion s howed that there was nothing wrong with it. However, they had to terminate her for allegedly missing a scheduled day at work that she was not aware of. The action was a way of eliminating the woman from the store due to her Wiccan

Human sexuality Essay Example for Free

Human sexuality Essay Incestuous inbreeding is the act of mating or having any sexual relations between two beings of close kinship. In people, this is prohibited by law to marry and engage in any sexual activity with any member of a person’s own family and with his/her relatives up to the second degree of consanguinity. Aside from it being a legal prohibition, it is also a considered a social taboo in most cultures. However, the considerations for incest are different depending on the beliefs and customs of these cultural groups. Some have more liberal qualifications for the situation to be called incest, and others are more conservative in the sense that people could not marry even those who are adopted into the family. Nevertheless, there are also some places wherein they permit this kind of familial setup to preserve their royal lineage. There are various kinds and forms of incest. The most common and considered a kind of abuse is the father-daughter incest and other forms of parental incest. However, there are also other forms such as sibling incest and other matches which usually come unreported. Although most cases of incest are born out of coercion, consensual incest also exists in some societies. The rationale behind the incest taboo must have stemmed from social group processes in ancient civilized and uncivilized societies. As studied by anthropologists, older cultures follow the rule of exogamy which enables families and groups to merge with others to form alliances. If incest was allowed, this rule would be violated. Religious groups and sects also have their various takes on this issue and most of them push that incest must not be tolerated and patronized. In modern societies, this legal prohibition now has scientific basis. It was found that since the two people involved in incestuous inbreeding have the same genetic makeup, their offspring would contract inherited congenital malformations. In the event that this becomes the result, future generations would be at risk of catching the same genetic defects. As a product of incestuous inbreeding, an offspring has a tendency to develop recessive disorders such as mental retardation, deaf-mutism, congenital ichthyosis, retinitis pigmentosa, adiposogenital syndrome, and homocystinuria. Previous studies show that more than half of the children born out of incest acquire some abnormality. The reason behind this is that there in an increase in homozygosity in the offspring’s genes, which means that there would be â€Å"the same allele at the same locus on both members of a chromosome pair† (â€Å"Incest,† n. d. ). In other words, if the parents of the child belong to the same family, there is a greater tendency for the child to get a defective gene from both parents. Because of this, it is assumed that there is a specific biological mechanism which prevents species from engaging in incestuous inbreeding. In detail, this mechanism could be more easily described in a comparison between incestuous inbreeding and mating between beings of different blood. Every human being carries some defective genes which are masked in a recessive expression. When two people belong in the same family, for example, as in the case of siblings, half of their genes are identical as they are from the same parents. This means that when they mate, there is a greater likelihood that the defective gene would be expressed in their offspring. However, for two people of no blood relation to each other, there isn’t any identical gene which means that it would be less likely for a genetic defect to be developed in their offspring. This biological constraint and medical risk is a consequence that incestuous inbreeding would bring. It would not only be harmful for the offspring because of the defects that would be acquired or a greater risk for mortality, nonetheless, it would also contribute to the deterioration of future generations. Finally, aside from these aforementioned medical considerations, it would also be appropriate to regard the psychological side effects as important in these situations. There are lots of cases which show that incest, especially those situations which could be considered as forms of abuse, result in psychological, mental, and emotional trauma. This probably might be because of the fact that it is established as a taboo and the behavior is a contradiction to that belief or attitude. Whatever the case may be, there would always be a negative outcome when two people engage in incestuous relations and inbreeding. References Children born as a result of incest. (1981). British Medical Journal Vol. 282. p. 250. Incest. (n. d. ) In Cambridge encyclopedia. Retrieved April 14, 2008, from http://encyclopedia. stateuniversity. com/pages/10516/incest. html The Columbia encyclopedia (10th ed. ). (2007). New York: Columbia University Press.

Welfare to Work Advertisement :: Advertising Marketing

Welfare to work This advertisement claims that most people on welfare truly do not wish to be living this way. The advertisement claims that the new welfare reform laws have helped to get many people off of welfare and into jobs. With the help of companies who will employ these job-seekers, the advertisement states that million of others can do the same. People who receive welfare according to this advertisement, are not looking for a handout, but are actively seeking jobs, so they can become more self-sufficient. This advertisement implies that the public perception of welfare recipients is a negative one. Unfortunately, in our society, there is an attitude toward welfare clients because many people apparently believe, according to the Ad council, that these clients are taking money from those who work hard for it themselves, calling this a hand-out. Our society appears to believe that welfare clients wish for, and have, an easy life, free of having to work. The reality of this concept is that people on welfare are not content to just get a check. This service announcement works toward changing this close-minded suggesting that most welfare clients wish to take control of their lives. They paint a very different picture of what these clients truly wish to achieve, rather than what is apparently expected of them by the public. In addition, they try to place a human face on the problem by stating from the beginning that most people on welfare want jobs and being sympathetic but direct. Supporting their claims, the advertisement present factual evidence of the millions of people who, last year alone, worked to get themselves off of welfare and into working for a regular paycheck. These people believe that even more companies and welfare clients would benefit if everyone would open their doors to those not seeking just a handout. The most effective part of this advertisement may be its use of a common message, scratched out in order to be replaced with a more positive message. By showing the difference between perception and reality, the writers of this advertisement hope to encourage others to change their views. Their primary focus on the companies who can benefit by hiring someone off of welfare. The goal is to help change public perception and to open new doors for welfare clients, targeting companies who presently do not hire these clients. Welfare to Work Advertisement :: Advertising Marketing Welfare to work This advertisement claims that most people on welfare truly do not wish to be living this way. The advertisement claims that the new welfare reform laws have helped to get many people off of welfare and into jobs. With the help of companies who will employ these job-seekers, the advertisement states that million of others can do the same. People who receive welfare according to this advertisement, are not looking for a handout, but are actively seeking jobs, so they can become more self-sufficient. This advertisement implies that the public perception of welfare recipients is a negative one. Unfortunately, in our society, there is an attitude toward welfare clients because many people apparently believe, according to the Ad council, that these clients are taking money from those who work hard for it themselves, calling this a hand-out. Our society appears to believe that welfare clients wish for, and have, an easy life, free of having to work. The reality of this concept is that people on welfare are not content to just get a check. This service announcement works toward changing this close-minded suggesting that most welfare clients wish to take control of their lives. They paint a very different picture of what these clients truly wish to achieve, rather than what is apparently expected of them by the public. In addition, they try to place a human face on the problem by stating from the beginning that most people on welfare want jobs and being sympathetic but direct. Supporting their claims, the advertisement present factual evidence of the millions of people who, last year alone, worked to get themselves off of welfare and into working for a regular paycheck. These people believe that even more companies and welfare clients would benefit if everyone would open their doors to those not seeking just a handout. The most effective part of this advertisement may be its use of a common message, scratched out in order to be replaced with a more positive message. By showing the difference between perception and reality, the writers of this advertisement hope to encourage others to change their views. Their primary focus on the companies who can benefit by hiring someone off of welfare. The goal is to help change public perception and to open new doors for welfare clients, targeting companies who presently do not hire these clients.

Father of the Bride Speech with Humor, Sentiment, and Love

Father of the Bride Speech with Humor, Sentiment, and Love (Stand up, mobile phone in hand)† Well thank you vicar it is a bit inconvenient at the moment I am just about to start the speeches." I’m afraid there's been a bit of a hiccup in the proceedings; the vicar has just phoned to say that we have to do the registry signing all over again. It appears that the groom’s pen wouldn’t work so he borrowed the vicar’s. He was still having problems so the vicar said. "Put your weight on it†(To the bride) I’m afraid that you are now Mrs. 179 lbs. I'm only going to speak for a couple of minutes because of my throat. If I go on too long my wife has threatened to cut it. I've tried to memorize this speech, which isn't easy when you have the memory retention of a goldfish. So forgive me if I resort to my notes every five seconds. When the happy couple announced that they were going to get married, I asked them what that entailed for me and my daughter said that I would have to give her away. To those of you who know me well, that came as a bit of a shock as I am not used to giving things away. Selling maybe, but giving away, I ask you. However, I did a deal with the groom, your tickets for a Wimbledon tennis match for my daughter. I hope you’ll agree that he came out best. My wife and I would like to welcome the groom's parents and all relatives and friends of both families to this very happy occasion. There are also several people who I. wish could have been here but aren't and hopefully they are keeping an eye on proceedings from afar. I would like to thank the beautiful bridesmaids for looking after the bride, the vicar for a lovely service, his boss for the great improvement in the weather and the staff at the h... ...u in the bar after the speeches. (Be very careful with this joke. It backfired on me. My sister-in-law, who I love dearly, was dressed all in scarlet!) Anyway, I would like to finish off, by giving a few words of advice, to the newly weds. You must always consider the words of Oscar Wilde. "Women are meant to be loved, not understood.† Marriage will bring to you main things—loyalty, self restraint, obedience, a sense of fair play, and a whole host of other virutes that you wouldn't need had you remained single. Put the seat down after you. And remember those two invaluable words â€Å"Yes dear.†. And finally some musical adiue. (Play the first couple of verses of Bobby Vee’s version of â€Å"Take Good Care of My Baby†) And now, at long last, I hear you say, it gives the great pleasure to propose the toast of long life and happiness to the bride and groom. Father of the Bride Speech with Humor, Sentiment, and Love Father of the Bride Speech with Humor, Sentiment, and Love (Stand up, mobile phone in hand)† Well thank you vicar it is a bit inconvenient at the moment I am just about to start the speeches." I’m afraid there's been a bit of a hiccup in the proceedings; the vicar has just phoned to say that we have to do the registry signing all over again. It appears that the groom’s pen wouldn’t work so he borrowed the vicar’s. He was still having problems so the vicar said. "Put your weight on it†(To the bride) I’m afraid that you are now Mrs. 179 lbs. I'm only going to speak for a couple of minutes because of my throat. If I go on too long my wife has threatened to cut it. I've tried to memorize this speech, which isn't easy when you have the memory retention of a goldfish. So forgive me if I resort to my notes every five seconds. When the happy couple announced that they were going to get married, I asked them what that entailed for me and my daughter said that I would have to give her away. To those of you who know me well, that came as a bit of a shock as I am not used to giving things away. Selling maybe, but giving away, I ask you. However, I did a deal with the groom, your tickets for a Wimbledon tennis match for my daughter. I hope you’ll agree that he came out best. My wife and I would like to welcome the groom's parents and all relatives and friends of both families to this very happy occasion. There are also several people who I. wish could have been here but aren't and hopefully they are keeping an eye on proceedings from afar. I would like to thank the beautiful bridesmaids for looking after the bride, the vicar for a lovely service, his boss for the great improvement in the weather and the staff at the h... ...u in the bar after the speeches. (Be very careful with this joke. It backfired on me. My sister-in-law, who I love dearly, was dressed all in scarlet!) Anyway, I would like to finish off, by giving a few words of advice, to the newly weds. You must always consider the words of Oscar Wilde. "Women are meant to be loved, not understood.† Marriage will bring to you main things—loyalty, self restraint, obedience, a sense of fair play, and a whole host of other virutes that you wouldn't need had you remained single. Put the seat down after you. And remember those two invaluable words â€Å"Yes dear.†. And finally some musical adiue. (Play the first couple of verses of Bobby Vee’s version of â€Å"Take Good Care of My Baby†) And now, at long last, I hear you say, it gives the great pleasure to propose the toast of long life and happiness to the bride and groom.

Forecasting the Adoption of E-Books Essay

Question 1 The size of the market for e-books in the long-run: 293. 7 million x 46. 7% x 8% = 10. 973 million (Total US population x percentage of US population reading literature x Percentage of traditional paper books purchased online in 2003) It will take 10 years to reach 95% penetration of the potential market. Question 2 I predict that the sale of the e-book when it first became available is 0. 751milion (pm) (Assumption: each innovator buy one book. ) Question 3 The long-run total adoption of e-books would be 10. 973 million. (Total US population x percentage of US population reading literature x Percentage of traditional paper books purchased online in 2003) Question 4 I do expect the market for e-books tend to be guided by imitators rather than innovators. According to the table above, I found that the weighted average for e-book of q (0. 0684) is larger than p (0. 2990). In addition, the word of mouth takes an important role in the adoption of e-books. The information about the e-book from the innovators contribute much to the adoption of e-books since people tend to hesitate to change their old reading habit. Question 5 S(t)=[p+(q/m)N(t-1)][m-N(t-1)] Year 1: [0. 0684+(0. 2990/10. 973) X (0)][10. 973-0] = 0. 751 million Year 2: [0. 0684+(0. 2990/10. 973) X (0. 751)][10. 973-0. 751] = 0. 908 million Year 3: [0. 0684+(0. 2990/10. 973) X (1. 659)][10. 973-1. 659] = 1. 059 million Year 4: [0. 0684+(0. 2990/10. 973) X (2. 717)][10. 973-2. 717] = 1. 176 million Year 5: [0. 0684+(0. 2990/10. 973) X (3. 893)][10. 973-3. 893] = 1. 235 million Question 6 The adoption of e-book will be very different from digital music obtained online. The adoption of e-books face more challenges when comparing to the adoption of digital music. To most of the listeners, there is not much difference in experience between listening to a song from an iPod and a CD player. Therefore, they have a relatively low switching cost and more willing to change their habits. On the contrary, to most of the readers, it is definitely very different from reading an e-book to reading a printed book. The feelings of holding a printed book and flipping over a physical book are irreplaceable. So readers are loyal to printed book and hesitate to switch from traditional books to e-books. Hence, it is reasonable to predict that the pace of adopting digital music is faster than the pace of adopting e-books. Question 7 I think both of the attitudes about reading and purchasing e-content have changed a lot in recent years. In the old time, people could read e-content via PC only. Nowadays, people are able to read e-content through various mobile devices. Therefore, they spend more time on reading e-content especially during leisure time and even commuting time. However, the quality of the reading effort is diminishing as the overload of e-content available on Internet. In addition, people tend to rely more on the e-content since it is very convenient, environmentally friendly, high mobility and high accessibility. For the attitude about purchasing e-content, more people are willing to pay for the e-content in recent years. The advanced online payment system plays an important role. People feel more secure and also convenient when dealing online ever than before. Moreover, more well-known and large-scale publishers offer more choices of e-content for readers. Besides, in the light of the prevalent of mobile device, people have more time and chances to read the e-content regardless of the time and places. Thus, people are more willing to spend on e-content than before. Question 8 The hardware plays a paramount important role in the adoption of e-books. No matter how amazing the e-content is, the e-books would not be popularized if the hardware were not user-friendly. However, a good hardware is very likely to boost sales of the e-books. It is because the hardware is a fixed cost while the e-books are the variable cost to the readers. A portable hardware with proper size of monitor and high capacity is very attractive to the readers. They no longer need to neither carry the bulky printed books nor spare some places for storage. Moreover, the hardware enables readers to read comfortably when comparing to read via PC or smart phone. It is good for the readers’ eyes. Last but not least, the hardware contributed to protecting the environment as it saves much paper. Only when the hardware preforms better than the tradition printed books, the adoption of e-books will be success. Question 9 I do expect the size and also the pattern of diffusion are quite different globally as compared to the United States. The size and the pattern of diffusion depend on many factors. Population, culture, attitude to new products, technology and even literacy could be one of the variables of the size and pattern of diffusion. Take Africa as an example; though the population size of Africa is much larger than The United States, the potential size of the market for e-books must be obviously different from the United States. So it is not difficult to understand that the size and pattern of diffusion of various places will not be similar to the United States.

Agriculture Education Essay

An interim development plan was prepared for undergraduate and postgraduate studies. It was agreed that the three existing courses in plant-breeding and genetics provided an adequate scientific background in this field and that priority should now go to fruit and vegetable production. To this end, two new courses should be added so that the overall course would include: vegetable growing, vegetable production (two courses) and seed production. – 5- 19. In vegetable growing, in addition to the existing areas of definition, classification, soil and climatic requirements, the Faculty should add rotation, green manuring and kitchen garden cultivation. The two courses in vegetable production would give time for major crops to be dealt with in greater detail and for more practical training. The area in Sind under vegetable cultivation is increasing steadily as farmers realise its value for cash crops, but the yield is still very low. This is due mainly to lack of knowledge and experience (which the agricultural extension services could provide) and a lack of good seed. 2 0. A course in vegetables, fruit and ornamental plant seed production should be offered. Students would learn how to collect, harvest, clean, dry, pack and store seeds and they would study seed dormancy, germination and treatment, together with methods of breeding self and cross-pollinated crops. Postgraduate Curricula 21. The present postgraduate curricula cover horticultural plant nutrition, plant propagation and fruit production (two p arts). This last should be replaced by two new courses : (a) the soil and water relations of horticultural plants; (b) temperature and water relations of horticultural plants. Optional courses should be introduced for M. Sc. students to supply them with additional information needed in their fields of study. Options could include courses on major horticultural crops and general courses on the improvement of horticultural plants, on growth† regulators and on protected cultivation. As most research experiments on vegetables must be conducted at the Agricultural Research Institute at Mirpurkhas, 30 miles away, it was decided that priority should be given to raising vegetable crops at Malir, the university Farm,to provide the Horticultural Department with the facilities needed for research. Vegetable Crops (1) Objectives and Methods 22. The main objectives of the Horticultural Department in growing vegetable crops were to provide practical training for staff, students and labourers; to become familiar with problems of vegetable production in Sind; to evaluate crops and varieties, and seed production. It was planned to start by using two acres in the horticultural garden for growing most of the vegetable crops for practical training, and four acres at Malir Farm for a four-year crop rotation. Winter vegetables, carrots, radishes, turnips, cauliflowers, spinach and beet, were grown in the garden. The local varieties were identified, evaluated, weighed and measured. Promising varieties of radish, carrot and onion could be improved by breeding. All peas and spinach were of poor quality, most of the peas being dwarf types, with an average plant height of only ten – twelve inches. – 6- The spinach varieties were prickly-seeded and, during the shortest winter days, started flowering early. The seed stalks had an extreme male-type of inflorescence. Seed of selected suitable varieties of peas and spinach should be imported. (2) Growing Methods (a) Trailed Tomatoes; 2 4. Trailing tomatoes were tried in the open; local and imported varieties were planted and supported by iron stakes, galvanised wire and plastic string. Students and labourers were trained to tie the vines to strings, to pinch and remove auxiliary shoots and to apply fertilisers. The trial was successful, the plants standing well throughout the season and bearing -heavily. Later, owing to virus diseases on some vines, all plants were removed and burnt. A second trial was begun in the summer, the tomato vines being shaded by luffa plants – ridge gourd (luffa acutangula) and sponge gourd (luffa aegyptica) – the small luffa fruit being edible. (b) Soil-level mulches: 2 5. Cucurbits – bitter gourd (mermodica charanta), tinda or Indian squash (citrullos vulgaris, var fistulosa), tori (luffa s p. ), cucumber and cantalope were grown- early. Seeds were planted on December 21st in hillocks on raised beds covered with clear polyethylene film to form soil-level mulches. Two weeks later, seed emergence was observed, with a minimum temperature o f 6 C. Minimum and maximum temperatures and germination percentages were recorded. (c) Plastic tunnels: 2 6. Plastic walk-in and mini-tunnels were† made of local materials. The mini-tunnels were used for raising nursery plants and for getting tomato, pepper and egg-plant seedlings†¢ They gave high germination percentages and well-established seedlings. The walk-in tunnels were used for trailed tomatoes and for cucumbers, temperature and humidity data being recorded.

Genetic Testing For Haemophilia Health And Social Care Essay

MFA presented to the day care of the Paediatric section with left mortise joint swelling for one twenty-four hours after hitting his mortise joint on a rock while playing in the flushing one twenty-four hours prior to admittance. There was hurting and bruising seen at the mortise joint articulation after the injury. The swelling increased in size and became more painful throughout the dark. His parents so brought him to the day care early the following forenoon. Physical scrutiny revealed swelling and tenderness at the left ankle joint every bit good as decreased scope of motion on both inactive and active motion due to trouble. There were besides multiple ecchymosis in different phases seen at the upper and lower limbs. A diagnosing of haemarthroses of the left mortise joint articulation was made. MFA was transfused with 200IU of Factor VIII. The hurting and puffiness were reduced in badness but persisted throughout the twenty-four hours. MFA returned to the day care the following twenty-four hours for more Factor VIII. He was given Factor VIII transfusion 200 IU twice daily for the following two yearss. The hurting and puffiness subsided after 3 yearss. MFA was diagnosed with terrible Haemophilia Angstrom when he was eight months of age. The diagnosing was made at the national blood bank. Familial testing besides done at the national blood bank revealed that his female parent was a haemophilia cistron bearer. MFA receives transfusion of Factor VIII when he develops haemarthroses or shed blooding due to trauma. He requires factor transfusion on an norm of one time every three months. He has had repeated hospital admittances with an mean continuance of stay for three to four yearss. MFA has good household support and is a member of the haemophilia society. He and his household have adapted good to his unwellness. Student Name: Tan Hai Liang ID NO: M0409146 Name OF SUPERVISOR: Dr Kyin ROTATION: PediatricssPATIENT ‘S DETAILSI/C NUMBER: ( B ) 630902-01-6092 Age: 9 old ages old Sexual activity: Male DATE OF ADMISSION: 23/04/09 R/N NUMBER: N/A2 ) CLINICAL HISTORYChief ailment: MFA is a nine twelvemonth old male child who was diagnosed with haemophilia A since eight months old. He presented with swelling in the left mortise joint for one twenty-four hours. History of present unwellness: MFA was running in the field at school when he knocked his mortise joint against a big rock in the land on the eventide of the twenty-four hours prior to showing at the day care. There was hurting after he hit his mortise joint but he was able to bear weight and walk. There was some bruising but no hemorrhage at the site of hurt. The joint became more painful towards the dark and there was some puffiness, heat and inflammation which increasingly increased. The hurting increased in badness so much so that MFA was unable to bear weight and used a wheelchair belonging to his brother to travel about the house. The hurting caused him some uncomfortableness but he was able to kip. He did non take any analgesia for the hurting. The following twenty-four hours, MFA ‘s parents brought him to the day care of the pediatric section for a factor transfusion. Systemic reappraisal was everyday. MFA was foremost diagnosed with haemophilia A when he was 8 months of age. His parents noticed that he developed contusions at his custodies and articulatio genuss. This occurred when he was tilting to creep. A blood trial was done in the national blood bank, and his parents were told that MFA had terrible hemophilia A. His immediate household underwent testing and his female parent was found to be a bearer of the haemophilia cistron. MFA receives factor VIII transfusion on an norm of one time every three months. The transfusions are required when he develops haemarthroses or gum hemorrhage due to tooth decay. The joint most normally affected is his right articulatio genus articulation. He has non developed any contractures. He does non normally seek medical intervention for contusions which are a common happening. He has non had mucosal shed blooding as nosebleed or hematuria. MFA would sometimes necessitate hospital admittance for factor VIII transfusion. This is normally when he has hemorrhage or terrible hurting due to a haemarthroses or a hematoma. At other times he would have the transfusion at the day care and return place. His parents would convey him once more to the infirmary for the following dosage till the hurting and puffiness in the joint resolutenesss. If a transfusion were required at dark when the day care is non unfastened, MFA would travel to the pediatric ward where the medical officer would be able to administrate the factor VIII. His symptoms would better with the factor VIII transfusion. MFA is an active male child who likes playing and running about. However his instructors in school restrict his physical activity to non-contact athleticss such as badminton and running. He is besides discouraged from unsmooth drama with his classmates. He wears elastic guards around his cubituss and articulatio genuss to protect them from hurt. However the elastic guards do non assist much as he still develops haemarthroses at those articulations. MFA is presently casting his decidual dentition. As such he requires factor VIII transfusion screen prior to tooth extraction. MFA is under followup at the pediatric clinic of Batu Pahat. He has defaulted the followup as his parents feel that nil much was done during the visits. He merely presents to the day care when necessitating factor VIII transfusion. MFA has besides been referred for physical therapy after episodes of haemarthroses which limit motion in the articulations. He has attended a few Sessionss of physical therapy in order to forestall contracture at articulations which have haemarthroses. He does non hold regular assignments. MFA is a member of the haemophilia society. His parents on a regular basis attend meetings where negotiations are given to educate parents on caring for haemophiliac kids. The members besides relate their experiences and promote one another. MFA has a medic qui vive necklace which says that he has haemophilia A. However, he rarely wears the medic qui vive. Past medical history MFA has non had any other infirmary admittances other than those due to haemophilia. Family history MFA is the youngest of three siblings. His senior sister is twenty old ages old and is good. His senior brother is 15 old ages old and has a bone cyst. He has undergone eight surgeries to mend the bone cyst every bit good as due to complications such as refractures. The wheelchair which MFA used at place was bought for his brother ‘s usage. MFA ‘s parents are good. There is no household history of hemophilia on his maternal side even though she is a bearer. MFA ‘s female parent has 3 brothers but all of them are good and do non hold hemophilias. There is no history of shed blooding upsets in the household. Social history MFA ‘s parents are both instructors. However they have to lose traveling to work frequently due to MFA ‘s status which necessitates frequent visits to the infirmary. As such, MFA ‘s female parent has a particular agreement with her schoolmaster which allows her to learn from 11 to 4 autopsy. As such, she is free in the forenoon to convey MFA to the infirmary when he needs it. His parents besides provide good support for MFA in that they frequently attend haemophilia meetings to update themselves on agencies to outdo attention for their kid. Birth history MFA was born at term in Hospital Batu Pahat. He was delivered through an elected cesarean delivery subdivision due to a breech presentation. There were no prenatal abnormalcies detected during everyday prenatal medical examination. There were no perinatal or station natal complications. He was nursed with his female parent after birth and discharged uneventfully. Developmental history MFA is presently in primary three of a spiritual school. He is an above mean pupil who finishes in the top 10 of his category. His instructors have no ailments about his school assignment. Developmental mileposts prior to this were all achieved at the appropriate times. Dietary history MFA is on an grownup diet now. He eats balanced repasts which are normally prepared by his female parent. He was breastfed till the age of seven months. Weaning was with porridge at the age of five months. Immunization history MFA has been immunized harmonizing to the immunisation agenda. After he was diagnosed with hemophilia A, his immunisations were done at the pediatric clinic under factor VIII screen. His last immunisation was at seven old ages of age. Student Name: Tan Hai Liang ID NO: M0409146 Name OF SUPERVISOR: Dr Kyin ROTATION: Pediatricss3 ) Findings ON CLINICAL EXAMINATIONOn general scrutiny, MFA was friendly and communicative. He was sitting in a wheelchair with a patch around his left mortise joint. There were some ecchymosis seen at his weaponries and thighs. He looked good nourished. He was non in terrible hurting. Anthropometric measurings: Weight: 24kg ( 10th to 25th centile ) Height:130cm ( 25th to 50th centile ) His critical marks were normal: Pulsation: 82 beats per minute Respiratory rate: 18 breaths per minute Blood force per unit area: 108/72 Temperature: 37 grades Celsius Examination of the lower limbs: There were ecchymosis seen on both lower limbs at the thigh every bit good as at the shin and calf. The left mortise joint was swollen and there was a contusion seen on it. It was stamp on tactual exploration but there was no addition in temperature. There was reduced motion of the left mortise joint articulation due to trouble. The right mortise joint articulation every bit good as both the left and right articulatio genus articulations were normal. There were no contractures seen. Examination of the upper limbs: There was besides some contusions seen on both the upper limbs. The cubitus and wrist articulations were normal on both custodies. The scope of motion for all the articulations on both upper limbs were normal. Examination of the cardiovascular and respiratory systems every bit good as scrutiny of the venters was normal. Student Name: Tan Hai Liang ID NO: M0409146 Name OF SUPERVISOR: Dr Kyin ROTATION: Pediatricss4 ) PROVISIONAL AND DIFFERENTIAL DIAGNOSES WITH REASONINGProbationary diagnosing: Haemarthroses of the left mortise joint articulation — — Evidence for: MFA has been diagnosed with hemophilia since the age of eight months. The articulations are a common site of shed blooding for hemophiliac. In add-on, MFA has had anterior episodes of hurting and puffiness in the joint similar to this episode. The hurting reduced when he was given factor VIII transfusion which farther supports this diagnosing. He besides has multiple contusions on his weaponries and legs which indicate that he has a hemorrhage upset. Differential diagnosing: 1 ) Juvenile Rheumatoid Arthritis The pauciarticular type of juvenile rheumatoid arthritis nowadayss with hurting and puffiness in the big articulations such as articulatio genuss, mortise joints and carpuss. It may show as symmetrical arthralgia or may merely impact one articulation. Evidence against: Juvenile rheumatoid arthritis normally nowadayss during childhood while MFA has been holding episodes of joint hurting and puffiness since he was an baby at eight months of age. Juvenile arthritic arthritis is besides associated with forenoon stiffness which MFA does non hold. MFA besides has easy contusing which is non a characteristic of juvenile rheumatoid arthritis 2 ) Septic arthritis Patients with damaged articulations are predisposed to infected arthritis. As such, a haemophiliac patient who has repeated haemarthroses may hold damaged articulations which are susceptible to infection. Evidence against: Patients with infected arthritis normally have fever while MFA did non. They are besides more common in patients who are immunocompromised. On physical scrutiny, there was no increased heat in the joint which would be more declarative of infected arthritis. 3 ) Ankle ligament hurt A sudden turn of the mortise joint may do a wrenching of the soft tissue and ligaments around the mortise joint doing hurting and puffiness. Evidence against: Master of fine arts did non writhe his mortise joint while playing. He simply knocked it against a stone. As such the mechanism of hurt does non propose that the ligaments were strained. He was besides able to bear weight after hitting his mortise joint and the puffiness and hurting bit by bit developed. This is contrary to what is expected in a sprained mortise joint where there would be immediate puffiness and hurting around the mortise joint. Student Name: Tan Hai Liang ID NO: M0409146 Name OF SUPERVISOR: Dr Kyin ROTATION: Pediatricss5 ) IDENTIFY AND PRIORITISE THE PROBLEMS1. Swelling at the left mortise joint MFA has hurting and puffiness at the left mortise joint articulation. He was in moderate hurting which he rates as 6 out of 10 on the hurting mark. Analgesics such as acetylsalicylic acid and NSAIDS are non recommended for him as they cause shed blooding in hemophiliac. As such the best agencies for rapid alleviation of the hurting and the swelling would be Factor VIII transfusion. 2. Hazard of joint devastation MFA is presently eight old ages old and is an active male child who enjoys playing with his friends. As such he is prone to injury from even mild injury. He has developed haemarthroses on an norm of every 3 months. Perennial haemarthroses at the same articulation could do devastation of his articulations taking to osteoarthritis, restriction in motion and development of contractures. A hold in intervention could besides do harm to the joint. As such, prompt and equal factor VIII transfusion is indispensable for MFA. He should besides be referred to the physical therapy section when the hurting has subsided. Physiotherapy would assist in forestalling the development of joint contractures 3. Hazard of shed blooding Due to his active nature, MFA is besides at hazard of terrible hemorrhage if he injures himself. He was last admitted to the infirmary for one hebdomad due to shed blooding when he fell while playing. There was terrible hemorrhage from his oral cavity and gums when he hit his face on a tabular array. MFA is besides presently casting his decidual dentition. As such, he is at hazard of gum hemorrhage from the site of tooth extraction. The most unsafe hazard is that of an intracranial bleeding 4. Hazard of perennial factor transfusions MFA requires frequent factor transfusion. As the factor VIII used in Batu Pahat is derived from human plasma, there is a hazard that MFA may acquire Hepatitis B, Hepatitis C or HIV infections. In add-on, MFA has non been screened for any of these infections. As such it is necessary for MFA to be screened as recommended by the Malaysian protocol for the direction of hemophilia. 5. Consequence of unwellness on school assignment and day-to-day activity MFA misses school for about a hebdomad on an norm of one time every three months. This may impact his public presentation in school. In add-on there is an addition demand for him to acquire good academic consequences as he would necessitate to believe about a hereafter with a calling that does non necessitate heavy physical activity due to his status. Trouble faced by caretakers MFA ‘s male parent and female parent are both working and frequently are forced to lose work in order to take attention of MFA when he develops episodes of hemorrhage. Both the parents are instructors who have understanding schoolmasters who sympathize with them and give them much leeway in order to care for their kid. However the uninterrupted emphasis of taking attention of a inveterate sick kid demands to be addressed. Support groups such as the haemophillia society would be able to assist the parents by giving them entree to other parents who face similar troubles. These parents would be able to promote one another and portion tips on caring for haemophilliac kids Student Name: Tan Hai Liang ID NO: M0409146 Name OF SUPERVISOR: Dr Kyin ROTATION: Pediatricss6 ) Plan OF INVESTIGATION, JUSTIFICATIONS FOR THE SELECTION OF TESTS OR PROCEDURES, AND INTERPRETATION OF RESULTSProbes done at 8 months of age by the national blood bank: 1. Curdling profile Justification: MFA presented with peliosis at his limbs which indicates that might hold a hemorrhage upset. As such a curdling profile would be utile to see if the curdling tracts are affected. Consequences: APTT prolonged. More than 90 seconds Interpretation: The drawn-out APTT indicates that the intrinsic tract is affected and that one of the factors in the intrinsic tract may be deficient. 2. Serum factor VIII degree Justification: To determine which specific factor that is lacking doing the hemorrhage upset. Consequences: Factor VIII degree: 0.6 % ( No inhibitors detected ) Interpretation: MFA has severe haemophilia A due to his Factor VIII degree being less than 1 % . He will react to factor VIII transfusion as there are no inhibitors to factor VIII detected. No probes were done for this presentation at the day care. I would propose the undermentioned probes: 1 ) A field radiogram of the ankle articulation AP and sidelong position Justification: In order to govern out other causes of the joint hurting such as infected arthritis or break at the joint. Possible grounds why it was non done: The clinical presentation of the patient did non propose that he has infected arthritis as he did non hold a febrility and the articulation was non ruddy. As the clinical image was typically implicative of a haemarthroses given that he is a hemophiliac, it would be unjust to the patient to subject him to an ten beam as this would intend he would be exposed to radiation every three months. 2 ) Full blood count Justification: A full blood count would be utile to see if there is an increased white cell count which may bespeak an infection. Possible grounds why it was non done: MFA is clinically good with no symptoms of infection such as febrility. As such a full blood count may non be necessary as it would likely be normal. There is besides a hazard of shed blooding or hematoma from venepuncture. Student Name: Tan Hai Liang ID NO: M0409146 Name OF SUPERVISOR: Dr Kyin ROTATION: Pediatricss7 ) Working DIAGNOSIS AND PLAN OF MANAGEMENT ON ADMISSIONWorking diagnosing: Haemarthroses of the left mortise joint due to Haemophilia A My proposed program of direction: I ) Factor VIII transfusion with a mark serum factor degree of 30 % eight hourly till the puffiness and hurting resolutenesss two ) Elastic patch and ice battalion around the left mortise joint three ) To rest the mortise joint articulation by non-weight bearing boulder clay swelling and hurting reduces four ) To analyze patient for joint malformation or contractures prior to dispatch from day care V ) Refer the patient to physiotherapy for joint rehabilitation of the affected articulation. six ) To educate the parents on attention for their kid and protective steps to forestall hurt. Student Name: Tan Hai Liang ID NO: M0409146 Name OF SUPERVISOR: Dr Kyin ROTATION: Pediatricss8 ) Summary OF INPATIENT PROGRESS ( INCLUDING MAJOR EVENTS, CHANGE OF DIAGNOSIS OR MANAGEMENT AND OUTCOMES )MFA was given 200 IU of Factor VIII transfusion. He was so asked to return the following twenty-four hours to be reviewed by the medical officer in charge. Merely one transfusion was deficient for the puffiness and MFA had to digest much uncomfortableness and hurting throughout the dark. This is despite the Malayan Paediatrics protocol recommendation that factor VIII is given every 8 to 12 hours. The ground for this could be the prohibitory cost of the factor. The following twenty-four hours MFA was given another 200 IU of Factor VIII transfusion in the forenoon and once more in the eventide, 12 hours apart. He was given two more transfusions on the 3rd twenty-four hours. The transfusions were given at the day care in the forenoons and at the pediatric ward at dark by the medical officer who was on call. The hurting and swelling resolved on the 4th twenty-four hours post hurt. He was examined by the medical officer and was told to merely return to the day care if he had another episode of joint puffiness or open hemorrhage. Student Name: Tan Hai Liang ID NO: M0409146 Name OF SUPERVISOR: Dr Kyin ROTATION: Pediatricss9 ) DISCHARGE PLAN, COUNSELLING AND MOCK PRESCRIPTIONDischarge program: I ) MFA was asked to rest him left mortise joint and to partly bear weight till it was wholly pain free. two ) Referral to the physical therapist for joint rehabilitation to be done Guidance: I ) MFA was advised to avoid athleticss which involve physical contact as the even minimum injury may do a bleed. two ) MFA ‘s parents were told to convey him back to the day care if there were any longer episodes of shed blooding into the articulations or self-generated hemorrhage. They were given a eventuality program to travel straight to the pediatric ward and see the medical officer on call if any hemorrhage were to go on when the day care is closed. three ) MFA and his parents were besides educated on complications that they need to look out for such as intracranial bleeding. They were taught about the marks and symptoms that they should be wary of. four ) MFA was encouraged to travel for physical therapy which he had antecedently defaulted. He was told about the dangers of joint devastation due to recurrent haemarthroses and how physical therapy may help in forestalling contractures. Student Name: Tan Hai Liang ID NO: M0409146 Name OF SUPERVISOR: Dr Kyin ROTATION: Pediatricss10 ) REFERRAL LETTER ( MANDATORY )Dr Tan Hai Liang, Paediatric Department, Hospital Batu Pahat Physical therapist, Physiotherapy section, Hospital Batu Pahat 27 May 2009 Dear sir, Patient ‘s name: Mohammad Faiz Affizuddin Patient ‘s I/c figure: ( B ) 630902-01-6092 Problem: Haemarthroses of the left mortise joint articulation Thank you for seeing this nine twelvemonth old male child who was diagnosed with Haemophilia A for the past eight old ages. He has had recurrent episodes of shed blooding into the articulations. The articulations most normally affected are the articulatio genus articulations and elbow articulations. His current presentation is for a haemarthroses of the left mortise joint articulation. Physical scrutiny: Inflammation and puffiness of the left mortise joint articulation. Tenderness on tactual exploration. Reduced scope of motion both active and inactive. He has been given Factor VIII transfusion which has reduced the puffiness and hurting. Kindly reexamine the patient and execute joint rehabilitation for him. He has good household support and his household could besides be taught exercisings to forestall joint contractures that can be done at place in position of his recurrent shed blooding into the articulations. Thank you. Yours genuinely,______________( Dr Tan Hai Liang ) Student Name: Tan Hai Liang ID NO: M0409146 Name OF SUPERVISOR: Dr Kyin ROTATION: Pediatricss11 ) Learning ISSUES IN THE 8 IMU OUTCOMES1 ) Family and community issues in health careHow are parents affected by holding a hemophiliac kid? I had the chance to speak to MFA ‘s parents and inquire them about the challenges faced when caring for him. They related many of their experiences and confided that many alterations to the life style of the household were done in order to accommodate to populating with and caring for a hemophiliac. Both parents have had to lose work on a regular basis due to MFA ‘s frequent infirmary admittances. Family activities besides are limited to light physical activity with minimum hazard of hurt. Furthermore MFA ‘s female parent admitted to ab initio experiencing guilty as she was the bearer of the cistron that leads to his status. As such, I wondered if hemophilia had an impact on parent ‘s quality of life in visible radiation of the many accommodations that they had to do to their life style. A survey by Beeton et al [ 1 ] involved 12 parents of kids with hemophilias whose age ranged from 18 months to 16 old ages of age. The parents were interviewed and qualitatively assessed on their experiences in caring for a kid with hemophilia. It found that medical direction often focused on assisting the hemophiliac adjust to his or her status with small accent on the wider household web. The early old ages of the kid ‘s life after diagnosing were characterized by the parents missing experience and feeling uncertain. This is coupled with the frequent demand of factor transfusion and the associated trouble in venous entree in babies and immature kids. Quality of life at the early old ages post diagnosing was found to be hapless due to parents experiencing ‘out of control ‘ . Parents caring for a hemophiliac kid besides reported that the manner in which they engaged with the people around them had changed. There was a necessity in being more self-asserting in order to protect their kid. This was confirmed by MFA ‘s female parent who relates that she had statements with the infirmary manager and schoolmaster of MFA ‘s school in order to take a firm stand on particular steps to be put into topographic point to better MFA ‘s quality of life. The survey besides found that female parents normally took up a greater duty in caring for the kid. Fathers who were at work during the twenty-four hours did non hold the same degree of experience and this could be a beginning of struggle between parents. Parents were besides found to hold higher degrees of emphasis and anxiousness. However the degree of the emphasis and anxiousness was dependent upon on the phase that parents had achieved in pull offing the status every bit good as successful version. Another survey by Bullinger et al [ 2 ] showed that the quality of life for patients and households with hemophilia was higher when compared to patients with other chronic unwellnesss such as asthma. This shows that households with hemophiliac are able to populate a comparatively normal life with good quality of life if certain stairss were taken to accomplish successful version. The survey found that betterment in quality of life can be attained by supplying an environment in which patients and parents experience understood and good informed. In decision, I learned that hemophilia has a profound consequence, non merely on the kid who has the disease but besides on his primary caretakers which are his parents. As such I need to besides ask about how parents are get bying and offer professional aid such as reding if necessary.2 ) Critical thought and researchIs coagulating factor dressed ore prophylaxis effectual in the direction of patients with hemophilias?A paper by Ljung [ 3 ] proposed that direction of a patient with hemophilia should travel off from concentrating on the upset itself and alternatively look towards keeping a healthy kid. This means that patient ‘s should non be repeatedly managed with factor transfusions when they present with shed blooding but alternatively be kept healthy by forestalling the hemorrhage from go oning in the first topographic point. As such the writer proposed that primary contraceptive therapy should be the gilded criterion in the direction of patients with hemophilias. However is coagulating factor dressed ore prophylaxis effectual in pull offing patients with hemophilias, and what are the associated factors which prevent this direction from being a practical option? I looked at a Cochranre reappraisal by Stobart et Al [ 4 ] which analysed four separate surveies affecting 37 patients. The consequences of the reappraisal showed that there was a statistically important difference in the decrease of shed blooding episodes in patients who were given standard prophylaxis when compared to a placebo. It besides found that secondary results such as clip loss to school and employment due to the unwellness was statistically significantly reduced among those having primary prophylaxis compared to a placebo. The reappraisal besides quoted one survey which showed that a twice hebdomadal extract of higher dosage of factor dressed ore had a statistically important advantage in cut downing the figure of bleeds a twelvemonth when compared to a lower dosage and less frequent disposal of transfusion. However the writers concluded that there was deficient grounds from randomized control tests to urge the usage of primary contraceptive factor extract in the direction of patients with hemophilias. An independent retrospective survey by Khoriaty [ 5 ] showed that primary prophylaxis has some promise. The survey recruited 133 patients with Haemophilia A and B with a average age of 27.93. It compared the 91 patients who were on primary prophylaxis and the staying 42 patients having on-demand intervention when they developed shed blooding. The survey found that there was a statistically important decrease in the figure of self-generated shed blooding per twelvemonth. Patients on primary prophylaxis were found to hold 3.2 bleeds per twelvemonth while those who received on-demand therapy bled 5.7 times per twelvemonth. It found no statistical difference between the two groups in footings of hemorrhage after injury. However the consequences for this survey needs to be read with attention due to the big age scope. Further surveies need to be done for the pediatric age group due to differences such as a higher leaning for injury and hurt in active kids compared to grownups who are better at caring for themselves. One ground why primary prophylaxis is non used in the intervention of haemophiliacs despite its promise is the high cost of the factor VIII. One phial of 200 IU costs in the part of RM 800. As such it may non be cost effectual for primary prophylaxis to be carried out particularly in the context of the Malaysian health care system with its limited budget. A cost effectivity analysis by Miners et al [ 6 ] in England showed that it would be & amp ; lb ; 547 to forestall one episode of shed blooding from go oning. This cost is mostly prohibitory in the Malayan context. In decision I found that there is grounds that primary prophylaxis has much promise in the bar of shed blooding among haemophilia patients but extra surveies need to be carried out particularly in the local environment in order to determine the cost-effectiveness of primary prophylaxis.3 ) Self directed life long larningWhat is the hereafter in footings of direction of hemophilia? The direction of hemophilia is presently with factor transfusions which aim to halt hemorrhage when it has already happened. The other option is primary prophylaxis with regular factor extracts to forestall hemorrhage. However this attack is dearly-won and does non cover with the job of patients developing inhibitors which make transfusions uneffective. As such, research workers are looking into a agency for a remedy of hemophilia. This remedy is by utilizing cistron therapy. The aim of cistron therapy is to redact a faulty cistron sequence to accomplish complete reversion of disease phenotype in the life-time of the patient. Haemophilia is seen as the ideal campaigner for cistron transportation therapy as foremost there are many cell types which are able to synthesise biologically active coagulating factor. Second, there is a broad remedy window which makes it unneeded to hold rigorous cistron look. Third there are big and little animate being theoretical accounts that permit the survey of safety and efficaciousness prior to induction of human tests. [ 7 ] Phase 1 clinical tests are presently being done utilizing largely viral vectors to infix the cistron. Retroviruss have shown promise in this therapy. The cistrons are inserted via developing hepatocytes or hematopoietic root cells. Presently safe long term look of coagulating factors has been successfully achieved in big carnal theoretical accounts of hemophilias utilizing multiple cistron transportations. [ 8 ] Gene transportation therapy nevertheless still faces many obstructions before it can be seen as a feasible therapy for hemophilia. There is hazard of experimentation in worlds in order to formalize this therapy. Many inquiries besides remain unreciprocated such as inhibitor development after the interpolation of the cistron and besides the transmittal of the extra cistron to the kids of the patient who receives the cistron therapy. One paper suggested a generous timeline of at least 20 to 30 old ages before the potency of cistron therapy can even be considered. These issues are ‘merely medical ‘ issues. Religious and ethical issues besides have to be taken into consideration before prosecuting this direction. In decision, I learned that though there is much potency in this field of cistron therapy, much research still has to be undertaken to determine its safety every bit good as efficaciousness. However it has been a valuable experience in larning about new modes of intervention and to catch a glance of what the hereafter holds. This has taught me to go on larning as there are ever new sentiments and therapies available in the direction of any unwellness. 4 ) Professionalism, moralss and personal development What are the ethical deductions of familial proving for haemophilia? After MFA was diagnosed with haemophilia, his immediate household underwent familial testing. The proving revealed that his female parent was a bearer and that his senior brother and senior sister were normal. The familial testing was done voluntarily. There is no recommendation in the Malayan Paediatric protocol for familial testing to be done. Familial testing is normally done in patients with no clear household history in order to determine which parent is a bearer so that farther stairss of direction can be carried out. These farther stairss may include offering familial testing to the siblings of the bearer parent and besides reding about hazard of holding extra kids. However familial testing besides raises many ethical inquiries. First there is guilt, heartache and ego incrimination when a female parent with no known household history of hemophilia discoveries that she was the cistron bearer that passed it on to her kid. A paper by Thomas et al [ 9 ] on attitudes towards familial proving in an Australian community found that female parents who were ‘sporadic ‘ bearers ( no known household history of hemophilia ) were had feelings of guilt. Performing familial testing to determine that a female parent of a haemophiliac kid is a bearer would merely be of value if extra stairss were taken such as offering familial testing to the female parent ‘s siblings. This in itself would raise inquiries of confidentiality and revelation since offering the testing would necessitate the physician to unwrap to the other household members that the female parent is a bearer. This revelation could so take to stigmatisation. In this specific instance, MFA ‘s female parent was found to be a bearer. She related that she felt anguished at ‘causing ‘ her boy to endure much hurting. The cognition that the female parent was the bearer who had passed on the cistron to her boy did non change the direction of MFA. As such there was small virtue in executing the familial testing in this instance. A 2nd consideration of familial testing is the deductions that it has on a individual ‘s determination of whether or non to hold kids. This is once more more relevant for female bearers. Carriers should be counseled that there is a 50 per centum opportunity that their kid would hold hemophilias if he were a male child. However the ethical issue arises when there is no agency of correlating between the genotype and phenotype. [ 10 ] Just because the kid may hold hemophilia does non foretell the grade of badness of the hemophilia. The lone means to cognize for certain about the position of a foetus in footings of whether he would hold hemophilias and the grade of badness is by making antenatal familial proving such as chorionic villi sampling. Prenatal familial proving itself is associated with many ethical issues such as the deductions of transporting out such a trial. Would the foetus be terminated? There is legal leeway for expiration if it can be proven that the kid ‘s unwellness would convey about mental hurt to the female parent. Where do we pull the line to make up one's mind that such a foetus has excessively terrible a haemophilia so as to justify expiration? Who makes the determination? In the instance of MFA, the parents decided non to hold any more kids due to the hazard of holding another hemophiliac kid. It ca be seen that the familial testing had a profound impact on their determination. However proper and thorough familial guidance was non given to the parents. In decision I learned that familial proving for hemophilia is fraught with many ethical considerations. It should merely be offered when proper followup such as guidance, support and options can be offered to those undergoing the trial. In the absence of proper model of support, it may be better to keep back familial testing.