Fracking: Water Quality and Hydraulic Fracturing

Our Future3 REFERENCE: www. epa. gov www. wikipedia. com Documentary: â€Å"GASLAND† Josh Fox 2010 Our Futurejoe cool OUR FUTURE Joe cool Intro. 105 ? Our Future1 Hydraulic fracturing is the propagation of fractures in a rock layer caused by the presence of a pressurized fluid. (wiki 2011). This occurs naturally in nature, but the Hydraulic fracturing that I will speak of in this paper is a process being used by gas companies nationwide. Fracking is currently regulated by the EPA under the clean water act of 2005 (EPA. ov). However, this only partially governs the methods of injecting fluids and the retrieval of such fluids into the earth. It does not govern the types of chemicals that are being allowed to be used, or how much fresh water is wasted (millions of gallons per â€Å"Frack job†) and it does not carry stiff enough penalties for spills or irreversible damage to community’s water supplies. For those of you, who are unfamiliar with this practice, allow me to paint a picture for you. Big gas corporations have researched and found giant fields of natural gas in a layer of rock eight thousand feet deep in the earth’s crust known as the Marcellus shale line, and it is in four different regions in the U. S. spread over thirty states. Historically gas companies would drill for their gas, but in recent history have developed a process of Hydraulic Fracturing which at one job can use one million gallons of fresh water, and over nine hundred chemicals, to include Benzene and various heavy metals (Gasland). Once this mixture is forced ight thousand feet into the earth’s crust it destroys the shale and releases the natural gas. It is a fact that the companies can only recover forty percent of the fluid that is sent into the below. The rest is absorbed by the porous Marcellus shale. It is now being learned that this process is destroying ecosystems and making fresh water tables completely unusable. I don’t know where any of you live and I don’t k now whether you like where you live. But try and imagine if tomorrow you found out that twenty miles away there was a frack site, and the people of your community began getting sick. What would you do? Who would you look to for help? The Our Future2 government is of no use because there are no safeguards in place. What do you do? The only thing you can do is run, but I ask you fellow scholars, what happens when there is nowhere else to run? It is a fact that in Wyoming they are finding contamination in water tables as far away from fracking as forty miles. You tube videos of people igniting their tap water are numbered in the hundreds. These gas companies are poisoning our environment and destroying people’s entire way of life just to make money. Now most of us on some level are concerned about the environment, you don’t have to live in a tree and only eat organic fruits and vegetables to care about the future of earth. You just have to open your eyes and become comfortable to the fact that big corporations dictate government. These people live to make money, at all costs. Through my research on this paper I learned that in the same mountain range that a windmill project is being utilized there is also fracking going on. It is a humbling experience to stand under a windmill and see a frack site. The reason green energy is not being explored further? There’s no money in it.

Online hotel reservation Essay

1. Introduction Currently the World is going to be come in once. The introduction of modern computers since 1940’s changing the way people live, learning their environment and the way they gather information, process, and store data and communicate accurate and timely information in their daily activities.  Therefore without using recently technological products especially computers, it is impossible to think about social, cultural and economically development. So in this century using information and communication technology especially the sophisticated and amusing machine known as computer and modern information handling in any aspect is a question of survival. The group member will try the best way to make the complicated process of Online Yeha Hotel as simple as possible using Structured & Modular technique & Menu oriented interface. The members are going to design the software in such a way that user may not have any difficulty in using this package & further expansion is possible with out much effort. Even though the group members cannot claim that this work to be entirely exhaustive, the main purpose of our exercise is perform each employee’s activity in computerized way rather than manually which is time consuming. 1.2 BACKGROUND OF THE ORGANIZATION Yeha Hotel is one of the business units managed and controlled by BT Digital Business Bridge PLC. It was established in 1993 G.C at Tigray Regional State, Aksum town. The Hotel is a three star hotel located in the outskirts of the city of Aksum on the historic route. 1.3. STATEMENT OF THE PROBLEM Currently the management system of Yeha Hotel is computerized. But, the system is not well developed .It doesn’t include all function like; from where the customer comes, amount of payment for reservation ,what they are doing currently .It the hotel is under several problems that negatively affects the reliability, performance, efficiency and effectiveness of day to day activities. Some of the major problems are:- User cannot reserve things (bed rooms on line) well that they want. The hotel cannot well advertise the service that they give. Users cannot access hotel information. Difficult to insertion& retrieve data faster. Difficult to generate report. Delay of information in collecting & processing of customers’ data. To solve the above problems the group members are going to develop a  computerized system to manage the hotel service effectively and efficiently. 1.4. OBJECTIVE OF THE PROJECT 1.4. 1. GENERAL OBJECTIVE The general objective of this project is to solve the above problems by designing and developing an automated dynamic website that can enhance online in case of Yeha hotel. 1.4.2. SPECIFIC OBJECTIVE To change the manual file handling system in to advanced method of computerized system To reserve bed rooms and other services online To access the hotel information To solve complicated problems that faced to record the manual system To solve the time, cost and man power needed to job performance To provide efficient service to the new customers To solve data redundancy To keep data security and reliability To need fast data insertion & retrieval 1.5. Methodology 1.5.1. SYSTEM DEVLOPMENT METHODOLOGY The team members use waterfall approach since it provide great opportunity for user to participate in the development process, has extensibility feature. Programming tools HTML (Macromedia Dreamweaver 8) JSP (Net Beans IDE 7.1.1) Microsoft Office Notepad Microsoft windows7 Different browsers (e.g. Mozilla Firefox, Google chrome and internet explorer) HARDWARE USED Computer Digital camera Flash disc 1.5.2. FACT FINDING METHOD During information gathering the group members have used a number of  techniques that helps us to get full information about the system. These techniques are:- 1.5.2.1. OBSERVATION The team members have observed physically by going to the place. Also the team has seen that there was no any well-developed computerized system in the hotel and also information about the hotel and the service that the hotel provides were not available easily. The team also observes that reservation is only by face to face or by using phone. 1.5.2.2. INTERVIEW The other most important method that helps us to get most important and critical information about the general view of the hotel is by interviewing manager of the hotel and receptionist of the hotel. (Example:-how do you work currently? 1.5.2.3. DOCUMENT ANALYSIS The form that is used currently has significant importance in crating easiest way of analyzing the newly developed system. 1.6. SCOPE OF THE PROJECT Yeha hotel gives several services like, generate report, employee payment, making reservation, and give guaranty for the customer property, food order, and employee selection, introduce hotel service, security for the garden, check availability. But for now we only focuses on making reservation, Check availability, and reserved, room information, introduce hotel service and register customer. LIMITATION OF THE PROJECT Due to different reasons like shortage of time, lack of materials (hardware and software), and others, our project do not implement the whole services. These services are: Employee selection Don’t include branch hotels Employee payment 1.8. OUTPUT OF THE PROJECT After finishing the project it will give a lot of advantages for the hotel as well as the customer and the society. Those advantages include the following things:- Well organized documentation for the hotel Well-developed web site 1.9. OUTCOME OF THE PROJECT The outcome of the project can be seen in many directions as: – The society able to get fast and better service Well organized administration Easy to access information from the hotel Introduce the hotel as internationally Avoiding conflict between workers 1.10 PROJECT MANAGEMENT 1.10.1 ECONOMIC FEASIBILITY Our project is feasible because there is no lose of collections of data To reduce number of employee or worker in the system as result it reduces the outcome (money) in the system.

The Effect of Clinical Simulation on Student Self-Efficacy in learning Dissertation - 1

The Effect of Clinical Simulation on Student Self-Efficacy in learning - Dissertation Example Cases like these point to the value of clinical simulation in nursing education to help empower such students in being able to handle challenging tasks and situations in their own practice. Clinical simulation is defined by Waxman (2010) as a teaching methodology that provides students with learning experiences closely resembling real-life circumstances that they are likely to encounter in their professional practice. â€Å"Simulated clinical experience requires immersing students in a representative patient-care scenario, a setting that mimics the actual environment with sufficient realism to allow learners to suspend disbelief† (p.29). Specific to nursing education is the utilization of a lifelike high-fidelity manikin which provides a high level of interactivity and realism to nursing students during their simulation proceedings (Jeffries, 2007). The integration of simulation in the nursing education curricula is welcomed by nurse educators as a new and effective method tha t promises to prepare the students better for a future in the nursing profession as competent and confident health workers. Setting up a clinical simulation situation takes much time, planning and effort that draws its information from theories and professional experiences (Waxman, 2010). The complexity of clinical simulation raises the question if it does improve a student’s self-efficacy to be a more efficient professional or leave the student overwhelmed with the probable challenges he or she will face in practice. Self-efficacy is one indicator of an individual’s perception of how well prepared he or she is in being able to successfully accomplish tasks (Bandura, 1977, 1986). Further, Bandura (2004) explains that: â€Å"Efficacy beliefs influence goals and aspirations. The stronger the perceived self-efficacy, the higher the goals people set for themselves and the firmer their commitment to them. Self-efficacy beliefs also determine how obstacles and impediments a re viewed. Those of high efficacy view impediments as surmountable by improvement of self-management skills and perseverant effort† (p. 145). Topic This study will explore clinical simulation as a new method of learning in nursing education. It will discuss the corresponding cognitive and affective processes that the student undergoes during the simulation and follow through if it is indeed an effective strategy in the improvement of student efficacy. The research problem The research problem posed for this study is â€Å"How does clinical simulation affect a student’s self-efficacy in learning in Nursing education?† Background and justification. The current demands of health care necessitate more aggressive training of health care professionals in order to address the growing needs of an industry that is besieged with a multitude of illnesses. More and more diseases come up with symptoms that may be unusual. These may pose a huge challenge to new nurses who have been trained in the traditional approaches of lectures, discussions, role-play and laboratory practice, as these may no longer be effective (Waxman, 2010). A nurse needs to be thoroughly trained in various areas and has amassed enough experiences to be able to carefully discern his or her next moves. Such moves may be crucial to the treatment and safety of the patient and thus,

Sculptures of Ancient India and Greece Essay Example | Topics and Well Written Essays - 750 words

Sculptures of Ancient India and Greece - Essay Example It is evidently clear from the discussion that if one takes a look at the ancient statutes of gods that both cultures produced, one will be able to see that there are some similarities between them. Zeus of Artemisium and Shiva of Brahmaputra Valley show the deities in positions that feature the perfect balance of posture. Indeed, while Zeus is standing firm and his feet, Shiva is dancing. However, each posture is elegant. On the other hand, these two sculptures also show the differenced between the approaches. Thus, Zeus is shown as an athletic middle-aged man, while Shiva is depicted as having eight arms. Nevertheless, it would not occur to the Ancient Indians that having eight arms is not realistic. Now, it may be advantageous to turn to the analysis of the sculptures that depict people. The two examples that will be used are the famous Discobolus and Dancing girl from Mohenjo-daro. As for the similarities that these two works of art possess, one might suggest that they give the r ights proportions of the human body create an adequate image of a person. However, there is a significant difference: while the body in Discobolus is shown in all correct anatomic details, Dancing girl provides only a general appearance of the body, allowing the audience to focus on the spiritual message that it sends. This means that the Greek statue is similar to the contemporary photo, but is made in marble, while the art of Ancient India is more concerned with the meaning than with the actual form. As one can clearly see, the differences in the depiction of gods and men that were explored in the paragraphs above might be easily explained if one recalls the cultural values and ideas that were dominant in Ancient India.

Issues currently occurring in the hospitality industry Article

Issues currently occurring in the hospitality industry - Article Example The author discusses the different approaches of research and their implications in organizational science and provides guidelines as to the ways of improving the credibility and value of research. The second article discusses the importance of competence in frontline management and the different methods of assessing the level of competence among students and managers with respect to frontline management in hospitality sector. The major issues faced by the global hospital industry are the changing demographics of the world which are impacting the trends within the travel industry. The emerging markets across the world, the shortage of labour and skills, innovations in technology, availability of capital, restrictions imposed in the travel industry, the increasing costs of constructions, balancing the expenses with the immediate need of increasing the rates and distribution revolution are the major factors affecting the global hospitality industry. Article 1: The importance of research tools and methods are critical in deciding the success of the hospitality industry, especially in the light of the changing global scenario. The various factors affecting the major changes in the trends of the hospitality industry can be effectively analysed through the use of different research tools and an increased level of collaboration between the research of academicians and practitioners (Dougherty and Westley, 2001). The author indicates that the proper use of research can create value for the hospitality industry. An approach of research through the practitioners is especially critical as the practitioners have a first-hand experience and can strongly indicate the customer satisfaction factors. Using a careful balance between the theoretical and practical aspects of a research work is necessary to create value for the research. The practitioners can contribute to the practical approaches to

Criminal and Racial Profiling Term Paper Example | Topics and Well Written Essays - 2500 words

Criminal and Racial Profiling - Term Paper Example expectation that their communities will be safe, that individuals who commit crimes will be prosecuted, that freedom of mobility within the United States and outside its borders will be safeguarded and that the federal government’s primary responsibility must always be to protect the national security of the country. These expectations are uniformly held by Americans and transcend political affiliation, socio-economic status, ethnicity or geographic location. A major legal and constitutional question concerns how we reconcile the protection of the rights of American citizens and those who legally enter the country with the public official’s duty to act in the national interest of the United States. Two current events have triggered a renewed national debate on this very issue. The first concerns the powers granted to the President and Secretary of Defense under the Patriot Act. The second issue pertains to the recently enacted law in Arizona that permits law enforcement officials to question the ethnicity and immigration status of individuals who are suspected of being in the United States illegally (SB 1070). This paper examines the issues surrounding racial and criminal personality profiling and provides a comparative analysis of the two investigative strategies. It defines both terms and examines what types of behaviors and activities constitute criminal personality and racial profiling. The paper delves into some of the complex legal, constitutional and methodological factors that are fueling the public debate on the issues. The paper concludes with a discussion of what alternatives, if any, are available to the professionals who are charged with the protection of our national security. The term profiling actually has its origins in a sub-field of mathematics. Statisticians utilize probability to apply a single observation to a general population. The profile is accurate within an acceptable level of error (Antanovics & Knight, 2009). The following

Business Trend analysis Essay Example | Topics and Well Written Essays - 2500 words

Business Trend analysis - Essay Example The essay "Business Trend Analysis: Celebrity Endorsements for Adolescent Product Marketing" is a profound analysis of the recent trends in the Product Marketing. Researcher focuses on the link between celebrity culture and consumer capitalism is evident in all forms of mass communication. All advertisers know that when used properly, celebrities can be very powerful marketing tools and help amplify the effects of an ad campaign. At the same time they must be very cautious in the current market to utilize this strong influence in an appropriate manner with carefully screened or ‘foolproof’ endorsers to avoid the kind of negative repercussions felt by products recently endorsed by such Hollywood embarrassments as Paris Hilton, Brittney Spears or Lindsey Lohan. Advertising agencies must decide by what method to utilise celebrities for a campaign. Agencies are cautious of potential downsides much more than potential upsides if the campaign has a long-term strategy. Celebrit ies alone do not guarantee success as consumers understand advertising, know what advertising is, and how it works. People know celebrities are being paid a lot of money for endorsements and this knowledge leads them to cynicism about celebrity endorsements. Particularly within the adolescent market, where potential endorsers are teenagers themselves and thus highly susceptible to the kinds of sensationalistic headlines as those produced recently, it is wise to avoid celebrity endorsement as often as possible.

Developing the Professional Coursework Example | Topics and Well Written Essays - 3500 words

Developing the Professional - Coursework Example Reference List 15 Appendices 17 Appendix A 17 Appendix B 18 Skills and Character Audit In this essay, I will shed light on my personal skill set and try to create a framework with which I can develop my existing skill level up to a greater extent. This document will also try to analyze my character and skill set that I developed during Masters Programme. After auditing my present skill set, I will conduct a personal SWOT analysis (Strengths, Weaknesses, Opportunities and Threats) in order to identify critical skill areas which I need to improve in order to ensure my academic and professional development. Before going to the discussion about my skill level, I will try to shed light on the question that why personal skill development is an essential part for a management professional or for a student pursuing management course? Wilson (2009) pointed out that students in the management course should be encouraged to write reflective essays and such reflective writing helps them to identify their skill gaps. Ertmer and Newby (1996, p. 18) defined importance of reflective skill auditing as â€Å"reflection is critical for transforming the knowledge gained in and on action into knowledge available for action.† ... halyi (1996) and Maani and Maharaj (2004) defined intellectual skills as the combination of linear thinking approaches such as empirical testing, analytic thinking, imagination and visualization, creativity, intuition, holistic evaluation and emotional intelligence. However, I cannot boast myself for having all the above mentioned linear intellectual skill sets but I believe that at present, I am complemented with certain level of intellectual skills. Losada and Heaphy (2004) and Vance et al. (2007) stressed on the fact that modern managers use non-linear dynamic pattern of intellectual thinking in order to solve complex business problems. Hence, it is evident from the discussion that developing intellectual skill plays vital role for a modern day managers. In such context, auditing my intellectual skill set will definitely help me to judge whether I am competent enough to handle corporate world challenge or not? Intellectual (thinking) skills Strongly Agree Agree Disagree Strongly D isagree 1. I am a creative person who can adapt my thinking to circumstances 2. I am able to organise my thoughts, analyse, synthesise and critically appraise situations 3. I can identify assumptions, evaluate statements in terms of evidence, detect false logic or reasoning, identify implicit values, define terms adequately and generalise appropriately The first skill set is identifying my capability of being flexible and creative enough to adapt to the situational demand. I believe that my instinct works in well balance manner when it comes to being creative or develop new thinking. For example, during my MSc program in Management from University of Glamorgan, I got the opportunity to showcase my creative when it comes to preparing project with team members or solving a business case study

To what extent is internet banking safe Essay Example | Topics and Well Written Essays - 1000 words

To what extent is internet banking safe - Essay Example Hackers look for online retailers with large customer base and poor security to obtain their usernames and passwords to access their financial information. Most customers fall prey to emails that appear to be send by their bank but steal the customers’ passwords by leading them to fraudulent websites. Keylogging is a process through which all strokes of a password are tracked by a virus while the password is being entered. It can breach personal computers’ defences. Ordinary web users can fend off such software with having latest versions of anti-virus software installed and extra-thick internet firewalls. Hackers use latest technology to surpass their barriers and many users overlook regular computer checks. In order to deal with these threats, online banks avoid connecting to the internet directly. Instead, they use firewall technology to protect their computer system from unauthorized access. Many online banks hire outside security experts so as to ensure that their systems are secure internally and externally against the experts’ attempts to make unauthorized attacks. If a user forgets logging off while the banking session has been inactive for a certain duration which is usually few minutes, the online bank ends the session for the user. The information can thus not be accessed in the terminated account. The user needs to give the User ID and Password to resume the banking session again. Security systems commonly employed by online banks can be categorized into two types; software based systems and hardware based systems. In the software based systems, information is coded and decoded with the help of specialized security software. These systems are in abundance in the market because of their ease of distribution and portability. Security systems based on software employ encryption as the main method. Encryption modifies information so that it becomes unreadable till the process is reversed. Online banks use Secured Socket Layer (SSL) encryption to provide their users with safe online transaction services. Messages in each session are encrypted with a unique master key. Encryption is a process of communication in which the private information is scrambled to deter unauthorized access during the transmission of information from the user’s browser to the bank. The master key used for a particular session is wasted once the user has signed off because it was only meant for one session. Users need an internet browser which supports the encryption of 128 bits before they can login to the internet banking (FirstBank, 2013). This ensures use of the highest security level. Some examples of the current encryption technology include digital signature, pretty good privacy (PGP), and Kerberos (Yang, 1997). A digital signature transforms a signed message so that the sender is recognizable to the reader. A private key is used to sign the messages which are then verified with a public

MIH512-Demography and Health (Module 3-SLP) Essay

MIH512-Demography and Health (Module 3-SLP) - Essay Example This population increase lead to the societal changes proposed by Durkheim, namely that an increase in population would lead to a more dense society with more specialization. This in turn would then influence future patterns of population growth or decrease. The growth in both countries is very similar. Rapid population growth in the late 18th and early 19th centuries was caused by an influx of emigrants. Neither one of these nations has experienced any significant amount of out-migration. Traditionally they have been the destination for immigrants. Both countries also show aspects of the Theory of Demographic Transition. The projected population shows a leveling of growth over the next few decades. This growth is then shown to decrease indefinitely for some time afterwards. The burning question is can these countries sustain continued growth for the next few decades before an overall decline is realized, or are we already at the threshold of the carrying capacity of our ecosystem. Some neo-Malthusians would argue that the greatest hope for humanity is an increase in the death rate, thus slowing the growth of the population. Canada and Brazil are both countries with vast natural resources and lots of open space. The advanced economy of Canada and the growing economy of Brazil seem to indicate that they will be able to provide growth and a high standard of living for much of their population into the near future. But as Eberstadt points out in his article, population growth or decline is largely determined by culture, so projections of growth or decline are tricky to make (Eberstadt, 2003). According to the Rule of 69, Canada’s population is expected to double in about 68 years. This is calculated based on the current change in population change from 2007-2008 of 1.01%. Brazil is expected to double its population in about 73 years based on an annual growth of .96%. It does not seem likely that this doubling will

Abolitionist movement Essay Example for Free

Abolitionist movement Essay With the enlightenment and awareness of people regarding human rights came the abolitionist movement. Slavery was something that violated the basic tenet of human rights and dignity, and so it had to be abolished. Northern states have begun to pass acts which declared that all men were born free and equal. Several movements that involved religion and political movements highly influenced the strength and expanse of abolitionist ideals throughout the country. The movements that supported abolitionism varied in method and degree. Some were pacifist, as they tried to use the legal system and passed legislation seeking to make slavery illegal. Others utilized literature and the press like Harriet Beecher Stowe, the author of the famous novel Uncle Tom’s Cabin. Religious movements declared slavery to be sinful and un-Christian, to discourage believers from keeping and owning slaves. Only a minority of abolitionists used to armed revolt and instigation of unrest and anger among the slaves as the main machinery to further their cause. The movement continued its stride to abolish slavery, but its strongest anchor point came with the election of a known contester of slavery, Abraham Lincoln, as president. With the head of state holding this position of opposition of slavery, the south felt that their way of life was endangered and threatened. Economic repercussions will be felt by their planters in the cotton, tobacco and sugar farms if the hands that worked in the plantations were to be set free. The zenith of the tensions between the south and the north was the American Civil war. It broke out when the south organized and removed themselves from the control of the American government. Rise of Abolitionism Historian James McPherson defined an abolitionist as a person who has fought for the abolition of slavery in the United States before the Civil war. American abolition started early on, as there were several groups already fighting for the liberation of slaves, such as the Society of Relief of Free Negroes Unlawfully Held in Bondage, and there were several institutions which prohibited slavery already. Several states had passed laws that completely prohibited slavery in their territories. Those who joined the American Anti-Slavery Society or other groups were abolitionists. These movements were not unified, and so could not boast a unified strength. Vermont was the first territory to make slavery illegal, and Pennsylvania was the first state to abolish slavery in 1780. Then several states followed Pennsylvania’s example while some states chose to limit slave trading. Many of the states in the south retained the institution of slavery as it was the region’s life line in their plantations. Their strong adherence to the institution drove them to take a defensive stance against the rising popularity of the abolitionist movement. Many abolitionist writers distributed many anti-slavery writings and literature to the south to help spread the ideologies. Novels, pamphlets and other forms of writing began to circulate not just in the north, but also in the southern region. Southern officials were enraged at the act, and thus moved to ban all types of literature that might instigate rebellion and changes in the south. Violence was even employed to stop the circulation of antislavery media in the south. Elijah Parish Lovejoy, the editor of an abolitionist newspaper was murdered by a mob of pro-slavery southerners. His printing press was also destroyed. Abolitionists recognized the fact that slavery needed to be abolished everywhere in the country, but the north cannot interfere with the affairs of the south because of federal ruling. Because of this, many abolitionists focused on liberating the north and skipping the southern states. Some abolitionists were frustrated and did not like this idea, as they believed that every state should be free of slavery. The movement was further fortified by the support of free African-Americans and their church. With the issue of the constitution, the American Abolitionist movement split up into two groups, the Garrisonians, led by William Garrison and Wendell Phillips and another camp led by Spooner and Gerrit Smith. The Garrisonians believed that the constitution promoted slavery while Spooner’s group believed the constitution to be antislavery. Since slavery was unconstitutional, it could be abolished with the blessing of the law. More divisions in the abolitionist movement arose, but because of the social classes of the abolitionists themselves. The artisans and elites divided themselves on the issue of slavery as well. The Underground Railroad was used as a venue by many abolitionists to become more active in the cause for abolition of slavery. Many of the fugitive slaves were illegally transported away from their masters to be free men via this rail. But the railroad was made illegal by the passing of the Fugitive Slave Law of 1850. But this did not stop the abolitionists from providing shelter and transporting slaves to freedom. After the Emancipation Proclamation of January 1, 1863 was done, many abolitionists moved to liberate slaves in the slave states. There were also movements to improve the social and living conditions of African-Americans all over the country. The Thirteenth Amendment finally ended all slave subjugations in the country.

Cetuximab Antibody Production

Cetuximab Antibody Production Cancer has been studied widely for many decades and is a major part of ongoing research worldwide. During the research a new generation of so-called targeted therapies have been produced to target specific molecular processes that promote cancerous tumour growths. The research lead to development of the drug called Cetuximab which is used to treat head and neck cancers and colon and rectum cancers including large bowel. It is produced under the brand name of Erbitux which is produced by Merck Serono company which is located in Dublin 24 in Ireland. Cetuximab is widely produced in US by several pharmaceutical companies such as Imclone, Bristol Myers Squibb and in UK as well. The treatment with Erbitux is very expensive and the reason for that is because it is a chimeric monoclonal IgG1 antibody which is produced in a mammalian cell line by recombinant DNA technology which requires cost expensive labour and ingredients. (http://www.medicines.ie/medicine/12082/SPC/Erbitux+5mg+ml+solutio n+for+infusion/ 2010) One of the widely studied areas is molecular targets such as epidermal growth factor receptor (EGFR) which lead to development of Cetuximab which works on these molecular targets. Cetuximab works by inhibiting activation of epidermal growth factor receptor (EGFR). Cetuximab was approved by (FDA) Food and Drugs Administration for the use in the treatment of head and neck squamous cell carcinoma (HNSCC) using the combination of radiotherapy and for metastatic colorectal cancer (mCRC) as single drug or in combination with chemotherapy. (Bruno Vincenzi, Gaia Schiavon, Marianna Silletta, Daniele Santini, Giuseppe Tonini, 2008) Cetuximab is a recombinant chimeric human murine immunoglobulin G1 antibody that binds to the extra-cellular domain of epidermal growth factor receptor with a higher affinity than either endogenous ligand. This binding inhibits receptor phosphorylation and activation and it leads to receptor internalization and degradation. Several studies have shown that cetuximab is able to inhibit growth of epidermal growth factor receptor (EGFR)-expressing tumour cells in vitro. Moreover, treatment with cetuximab results in a marked inhibition of tumour growth in nude mice bearing xenografts of human cancer cell lines. These results are linked to cetuximab biological effects as inhibition of cell cycle, tumour progression, neo-angiogenesis, invasion and metastatization, as well as increase and activation of pro-apoptotic molecules. Additionally, cetuximab potentiates, in combination, the effects of chemotherapy and radiation therapy in eradicating well-established tumours in nude mice and it may even reverse the resistance to some cytotoxic agents in these xenografts. Moreover, numerous clinical trials demonstrated cetuximab efficacy in different tumour types. It has been approved by Food and Drugs Administration in the treatmen t of metastatic colorectal cancer as single agent or in combination with chemotherapy, in locally and regionally. (Bruno Vincenzi , Gaia Schiavon, Marianna Silletta, Daniele Santini, Giuseppe Tonini 2008) Cetuximab is a chimeric human murine derivative IgG1 monoclonal antibody (mAb) that binds extra-cellular domain of the EGFR. This binding inhibits activation of receptor tyrosine kinase and the associated downstream signalling that includes the mitogen-activated protein kinase (MAPK), phosphoinositide 3-kinase (PI3K)/Akt and the Janus kinases (Jak) signal transducers and activator of transcription pathways. Furthermore cetuximab induces antibody-mediated receptor dimerization, internalization and degradation leading to receptor down-regulation. In addition, it can determine antibody-dependent cellular cytotoxicity (ADCC) that could contribute to its antitumoural effect. EGFR is expressed on normal and malignant epithelial cells and it plays an important role in tumour biology. In fact, it promotes proliferation, metastatization, angiogenesis and inhibition of apoptosis. (Bruno Vincenzi, Gaia Schiavon, Marianna Silletta, Daniele Santini, Giuseppe Tonini, 2008 p. 94) The most common EGFR alteration in tumour cells is its over-expression that may lead to ligand-independent receptor dimerization. EGFR is frequently over-expressed in human tumours including breast cancer, lung cancer, glioblastoma, bladder carcinoma, head and neck cancer, ovarian carcinoma, colorectal cancer and prostate cancer. Overexpression of EGFR determines the rate of disease progression and aggresivness of cancer. The rate of expression of EGFR can give an overall picture on diagnosis and prognosis of cancer. Table 1 Rate expression of EGFR in different tumour types Tumour type Rate of EGFR expression Head and neck 90‚100% Breast Up to 91% Renal Up to 90% Cervical Up to 85% NSCLC Up to 80% Colon Up to 89% Ovarian Up to 77% Prostate Up to 47% Glioma Up to 63% Pancreas Up to 95% Bladder Up to 72% EGFR: epidermal growth factor receptor, NSCLC: non-small cell lung cancer. (Bruno Vincenzi , Gaia Schiavon, Marianna Silletta, Daniele Santini, Giuseppe Tonini, 2008 p. 95) The mechanisms through which cetuximab expresses its antitumour activity are numerous and not completely understood yet. Different studies demonstrated that cetuximab mediates cell cycle arrest in various tumour cell lines, leading in some cases to apoptosis (programmed cell death). Numerous studies has proven that cetuximab decreases tumour cell production of angiogenic growth factors such as vascular endothelial growth factor (VEGF), bFGF and interleukin-8 (IL-8). The decrease in angiogenic growth factors, in turn, correlates with a significant decrease in microvessel density and an increase in apoptotic endothelial cells in human tumour xenografts. Angiogenesis is a complex process through which new blood vessels arise from existing vasculature. It is tightly regulated by balance between pro-angiogenic and antiangiogenic factors and it involves autocrine and paracrine signalling. (Bruno Vincenzi, Gaia Schiavon, Marianna Silletta, Daniele Santini, Giuseppe Tonini, 2008 p. 97) Both in vitro and in vivo experiments have proven that cetuximab inhibits the invasive and metastatic ability of different tumour types. Tumour invasion is a complex process that needs active interactions between tumour cell, the extra-cellular membrane (ECM) and other stromal elements Different coordinated events are required for cell invasion: firstly, changes in cell‚ cell and cell‚ matrix adhesion, secondly, degradation of ECM, and finally, cell migration, cytoskeletal rearrangement and acquisition of enhanced proteolytic potential. (Maria Luisa Veronese, Peter J. ODwyer, 2004) Cetuximab has been shown to inhibit the expression and activity of several MMPs (Matrix Metalloproteinase enzymes related to tissue healing/remodeling and cancer cell metastasis) including the gelatinase MMP-9. Several studies correlated this antibody-mediated reduction in MMP production with both a significant reduction in in vitro tumour-cell invasion and the inhibition of tumour growth and metastasis in nude mice. Compared with its inhibitory properties, cetuximab immunologic mechanisms have not been extensively studied. Cetuximab may be trigger an ADCC reaction, leading to an indirect antitumour activity by the recruitment of cytotoxic host effector cells such as monocytes and natural-killer cells. Cetuximab ADCC (antibody-dependent cellular cytotoxicity) activity has been described against several tumour cell lines expressing wild-type or mutant EGFR. (Bruno Vincenzi , Gaia Schiavon, Marianna Silletta, Daniele Santini, Giuseppe Tonini 2008 p. 98) Cetuximab, the medicinal ingredient of Erbitux, is a recombinant, human/mouse chimeric monoclonal antibody that binds specifically and with high affinity to the extracellular domain of the human epidermal growth factor receptor (EGFR). Cetuximab functions as a competitive antagonist that inhibits the binding of ligands to EGFR which results in the inhibition of growth and survival of tumour cells that express EGFR. Cetuximab is produced by recombinant DNA technology in a mouse myeloma derived cell line. The manufacture of cetuximab is based on a master and working cell bank system, where the master and working cell banks have been thoroughly characterized and tested for adventitious contaminants and endogenous viruses in accordance with the ICH guidelines. Results of these tests confirmed cell line identity and absence of adventitious agents/viral contaminants. Genetic characterization (restriction endonuclease mapping and copy number analysis) also demonstrated genetic stability of the master cell bank ranging from storage to production at the limit of in vitro cell age. The manufacture of cetuximab comprises a series of steps which include cell culture, harvest, and purification. The purification is performed via a combination of chromatographic and viral inactivation/removal steps. The consistency of the manufacturing process is ensured through defined production procedures, critical quality tests, in-process limits and cetuximab certificate of analysis specifications. Microbial control is maintained throughout the manufacturing process by testing for bioburden as well as for bacterial endotoxins. In-process controls performed during manufacture were reviewed and are considered acceptable. The specifications for the raw materials used in manufacturing the drug substance are also considered satisfactory. The Erbitux manufacturing process consists of adjusting cetuximab formulated bulk concentration and filling into vials using proper aseptic process techniques, and conventional pharmaceutical equipment and facilities. Erbitux is manufactured within the lab which obeys GMP (Good Manufacturing Practise). One-hundred percent of the patients in the pivotal trial experienced an adverse event (AE). Eighty percent of these were grade 3 or 4 in nature. The most commonly reported AEs in order of frequency were asthenia, diarrhea, nausea, abdominal pain and acne. Based on the data from this trial, the AE profile of the combination of irinotecan and cetuximab is the aggregate of the AE profile of each individual agent. There was no evidence that the addition of either agent exacerbated the AE profile of the other agent, nor was there any evidence of frequently occurring new AEs. The most common AEs associated with irinotecan were less frequent than in other trials with irinotecan in CRC. Similar results were observed in the non-pivotal studies. (http://www.hc-sc.gc.ca/dhp-ps/prodpharma/sbd-smd/phase1-decision/drug-med/sbd_smd_2007_erbitux_088225-eng.php 2007) The treatment with Erbitux is very expensive and the reason for that is because it is a chimeric monoclonal IgG1 antibody which is produced in a mammalian cell line by recombinant DNA technology which requires cost expensive labour and ingredients. Erbitux is available in injectable form only and contains 5mg/ml solution for infusion. Erbitux is a colourless solution. Cetuximab is available for injections in different vial sizes: vial of 10 ml contains 50 mg cetuximab vial of 20 ml contains 100 mg cetuximab vial of 50 ml contains 250 mg cetuximab vial of 100 ml contains 500 mg cetuximab Cetuximab is used for the treatment on patients with epidermal growth factor receptor (EGFR)-expressing, KRAS wild-type metastatic colorectal cancer in combination with chemotherapy. It can also be used for the the treatment of patients with quamous cell cancer of the head and neck in combination with platinum-based chemotherapy for recurrent metastatic disease. Patients who receive treatment first time must receive treatment with corticosteroid and antihistamines in order to avoid allergic reaction to the drug and body attacking the drug. It is also recommended to receive treatment with corticosteroids and antihistamines for all subsequent infusions. For all types of treatments Erbitux is administered once per week. The starting dose is 400 mg of cetuximab per m2 body surface area. All subsequent weekly doses are 250 mg cetuximab per m2 each. Cetuximab can be used in patients with colorectal cancer as a single drug or in combination with chemotherapy. For patients with squamous cell cancer of neck and head it is used together with radiation therapy. Allergic skin reactions are very common with Cetuximab patients which occur in more than 80% of patients, the reason for that is because Cetuximab is a chimeric monoclonal antibody drug. The majority of allergic skin reactions will develop within the first 3 weeks of treatment. These include dry skin, skin rash, eczema, nail disorders, in some severe cases skin necrosis. These skin problems generally resolve once the treatment is ceased. Sometimes Cetuximab can cause skin lesions and patients with sensitive skin may develop superinfections like MRSA, or in other cases cellulites, sepsis, or scalded skin. (http://www.medicines.ie/medicine/12082/SPC/Erbitux+5mg+ml+solution+for+infusion/ 2010) Cetuximab works in many different ways : it inhibits cell cycle progression metastatization and invasion, angiogenesis, increase and activation of pro-apoptotic molecules. When cetuximab is used in combination with chemotherapy and radiotherapy its effects are synergic. Effectivenes is much higher if when used in combination rather than separately. Cetuximab is relatively new drug and it is not fully understood its working mechanisms and new types of drugs like cetuximab promise effective treatment against cancer.

Abnormal Uterine Bleeding (UAB) In Gynaecological Practice

Abnormal Uterine Bleeding (UAB) In Gynaecological Practice INTRODUCTION Abnormal uterine bleeding (AUB) is a common complaint in gynaecological practice, represents a major proportion of out patients attendence. One, in 20 women in UK consulted their GP for menorrhagia. [1] A menstural cycle of fewer than 21 days or more than 35 days or a menstural flow of less than two days or, more than seven days is considered abnormal. [2] AUB can be categorized as excessive menstural bleeding, irregular, bleeding intermenstural including, postcoital bleeding. [3] Different terms, used to describe AUB are: oligomenorrhea (bleeding occurs at intervals of > 35 days usually caused by, prolonged follicular phase). Polymenorrhagia, (bleeding occurs at intervals of 21 days may be caused by a luteal phase defect). Menorrhagia, (bleeding occurs at normal intervals (21 to 35 days)but with heavy flow (80 ml) or duration (7 days). Menometrorrhagia, (bleeding occurs at regular, non cyclic intervals with heavy flow (80 ml). (2) Abnormal uterine bleeding, includes both DUB bleeding from structural causes. Dysfunctional bleeding can be anovulatory, which is characterized by heavy but regular periods. (I-e, menorrhagia). Structural causes include: fibroids, polyps, endometrial carcinoma pregnancy complications. Abnormal bleeding can also results from contraceptive methods. (4) In peri postmenopause women, it is essential to exclude endometrial carcinoma. In younger women, endometrial hyperplasia anatomical anomalies: such as uterine fibroids, comprise the main pathology. (5) Perimenopause is the period, 2 8 years preceding menopause 1 year after the final menses. (WHO). However, a better practical definition is, the phase preceding the onset of menopause, generally occurring around 40-50 years of age, during which the regular cycle of a women transition to a pattern of irregular cycles. (6) A variety of methods, have been used to investigate patients with AUB, such as, endometrial cytology, transvaginal ultrasound, hysteroscopy, D C and endometrial biopsy . (7) The recommendation regarding, investigation of AUB is that women, over the age of 45, should be investigated with endometrial biopsy. Frequently, this is performed as an inpatient procedure with the biopsy being obtained by uterine curettage (D C). (5)This is the most common procedure used, to evaluate the endometrial cavity of a patient with AUB. (8) However, the value of endometrial curettage is great, in the establishment of histopathologic diagnosis. (6) The operation involves a G. A often a two day stay. Originally, the procedure was thought to have a therapeutic effect or AUB, But studies have failed to support this. This procedure is performed for diagnostic purposes, to exclude endometrial malignancy. (9) REWIEW OF LITERATURE ABNORMAL UTERINE BLEEDING Abnormal uterine bleeding (AUB) is a symptom it is not a disease, but is a common debilitating condition. Dysfunction uterine bleeding (D. U. B) is the diagnosis, given to women with AUB in whom no clear etiology can be identified. [10, 11]. An approach accurate diagnosis depend on recognizing the following types: Menorrhegia: is cyclic bleeding at normal intervals, which is excessive is larger than 7 days o and amount more than 80 ml frrom normal secretory endometrium after normal ovulation is caused by conditions affecting the uterus. (10, 11) Polymenorrhea: is cyclical bleeding which is normal in amount but which occurs at too frequent intervals of Polymenorrhegia: is cyclical bleeding which is both excessive too frequent. Eg: 9/20-12/20. It implies a disturbance in the hypothalamic pituitary ovarian uterine axis. (10) Metrorrhegia: It is bleeding of any amount whch is cyclical which occur irregularly or continuously in between normal cycles. It is caused by benign or malignant growth with ulcration. (10) Dysfunctional Uterine Bleeding continuously occurs at the extreme of reproductive (adolesence perimenopausally). The abnormalities of ovarian activity may be classified as follows. Upto 90% of cases of DUB result form menstrual cycles in which ovulation does not occur (anovulation) (Dodds). The remainder of cases arise from problems associated with ovulation such as dysfunction of the corpus luteum or prolonged progesterone secretion. (12) Anovulatory Occasionally anovulatory cycles occur in all women. Upto 90% of cases of D. U. B result from menstural cycles in which ovulation does not occur(anovulation. The remainder of cases arise from problems associated with ovulation such as dysfunction of the corpus luteum or peolonged progesterone secretion. Chronic anovulation in associated with an irregular unpredictable pattern of bleeding ranging from short cycles with scanty bleeding to prolonged period of irregular heavy loss. In anovulatory cycles, the endometrium is unable to produce factors whose sysnthesis is controlled by progesterone, eg. PGF2a (Smith et al, 1982). This may account for the painless bleeding. Anovulatory bleeding may be associated with cystic glandular hyperplasia of the endometrium. This occurs in some older women also in peripubertal girl, where unopposed oestrogen secretion occurs. Endometrial hyperplasia may cause excessive bleeding, anaemia, infertility even endometrial carcinoma. (13) Ovulatory: (idiopathic bleeding) It appears that there are a number of endometrial products, which alters the degree of vadoconstriction thus may effect the volume of menstrual blood loss. In the mid 1970s, a relationship b/w prostaglandins (PG) production menorrhegia was suggested by work showing that total endometrial PG content was proportional to menstrual loss. It appears that a shift in endometrial conversion form the vasoconstrictor PGF20( to the vasodilator PGI2 occurs. Another important factor is endothelin, which is very potent vasoconstricter, produced within the endometrial vessels. Marshs group showed reduced endothelin immunostaining in the endometrium of women with monorrhegia , implicating this peptide in the pathophysiology of increased menstural blood loss. (Marsh 996) (13) Etiology of Abnormal Uterine Bleeding Before Menarche: Malignancy, trauma sexual abuse or assault are potential causes of abnormal uterine bleeding before menarche. Child bearing years: Pregnancy is the first consideration in women of childbearing age who present with AUB. Potential causes of pregnancy related bleeding includes miscarriage, ectopic pregnancy , placenta previa, abrutio placentae trophoblastic disease. Next, iatrogenic causes of AUB should be explored. Bleeding may be induced by medication, including anticogulants, selective serotonin reuptake inhibitors, antipsychotics, cortiosteriods, hormonal medication, tamoxifen (Nolvadex). Herbal substance including ginseng, ginko, soy supplement, may cause menstrual irregularities by altering estrogen levels or clotting parameters. (14), (15) Systemic Disorders: Includes thyroid, hematologic, hepatic, adrenal, pituitary, hypothalamic conditions menstural. Irregularities are associated with both hypothroidism (23. 4% of cases) hyperthyroidism (21. 5% of cases). Coagulation Disorders: Inherited coagulopathy may be the underlying cause of AUB in 18% of white women 7% of black women with menorrhagia. Others causes include polycystic ovary syndrome or diabetes mallitis present with obesity, acne, hirsutism acanthosis nigricans. Genital tract pathology may be associated with intermenstural, postcoital and heavy menstural bleeding, Any history of abnormal Papanicolaou (Pap) smear, sexually transmitted disease, gynaecologic surgery, trauma or sexual abuse should be elicited. Uterine fibroids, endometrial polyps, adenomyosis, endometrial hyperplasia and atypia and endometrial cancer should be excluded. [14, 15] Differential Diagnosis Pregnancy complications: Threatened abortion   Incomplete abortion   Ectopic pregnancy Nonuterine bleeding: Cervical ectropion/erosion   Cervical neoplasia/polyp   Cervical or vaginal trauma   Condylomata   Atrophic vaginitis   Foreign bodies Pelvic inflammatory disease (PID): Endometritis   Tuberculosis Local factors: Endometrial polyps   Endometrial neoplasia   Adenomyosis/endometriosis   Uterine myomata (fibroids)   Intrauterine device (IUD) Uterine sarcoma Coagulation disorders: Thrombocytopenia, platelet disorders   von Willebrand disease   Leukemia   Ingestion of aspirin or anticoagulants   Iatrogenic Causes: Anticoagulants Antipsychotics Corticosteroids Herbal other supplements(ginkgo, soy) Hormone replacement intrauterine devices Oral contraceptive pills Thyroid hormone replacement PATHOPHYSIOLOGY OF ABNORMAL UTERINE BLEEDING: The hallmark of normal menstrual bleeding is the final result of fluctuations in the hypothalamic-Pituitary-Adrenal-Ovarian axis leading to predictable denudation and slough of the endometrium. Hemorrhage followed by prompt hemostasis and repair causes stabilization and regrowth of the endometrium. Physiologically, constant flow levels of estrogen prime the endometrium. Normal secretion of progesterone from the corpus luteum stabilizes the endometrium, decreases vascular fragility and supports the endometrial stroma. Patients with menorrhagia typically have an imbalance of prostaglandins levels and increased fibrinolytic activity . Specifically, women with heavy bleeding often have elevated levels of plasminogen activators compared to those with normal menstruation. [16] An intact coagulation pathway is important in regulation of menstruation. Mensturation disrupts blood vessels and in the face of normal hemostasis, the injured blood vessels are rapidly repaired . Restoration of blood vessels requires successful interaction of platelets and clotting factors. Defficiency of platelets, abnormal platelet function and an intact coagulation pathway may be associated with profound changes in the menstrual ctcle. [16]. Anovulatory D. U. B is usually due to failure of the corpus luteum to sustain the developing endometrium. The decline of inhibin levels and rise in FSH levels reflect the loss of follicular activity and competence as the perimenopausal transition occurs, [16]. Ovulatory D. U. B occurs when ovulatory cycles coexist with intracavitary lesions including polyps, endometrial cancer or fibroids which cause erractic bleeding, [16]. NATURE OF ABNORMAL UTERINE BLEEDING: The studies have shown mean menstrual blood loss to be ~ 30 ml per cycle in most societies, with loss > 60-80 ml per month being associated with an increased tendency towards iron deficiency and anaemia( Hallberg ET AL, 1996 ;Code et al, 1971). An upper limit of 60 ml may be more appropriate clinically. [17]. The duration of normal menstruation also varies greatly, with an average of 5 days and the heaviest loss usually on the first 2 days(Matsumoto at al, 1962 ; Rubin and Crosignani, 1990). Duration of flow is considered abnormal when it lasts 7 days. [17]. Abnormal uterine bleeding may involve any disturbance of regularity, frequency, duration or volume of menstrual flow and the causes may be physiological, pathological or pharmacological (Fraser and Sngertekin, 2000), [17]. MECHANISM S INVOLVED IN AUB: MENORRHAGIA: Menorrhagia is caused by certain pelvic diseases. The mechanisms by which these conditions cause excessive bleeding are poorly understood, but evidence suggest that large , thin walled and fragile surface vessels underlies the menorrhagia occurring with myomata and endometrial carcinoma. This disturbed angiogenesis is most likely a consequence of unco-ordinated release of angiogenic factors from the tumor themselves(Jane and Harris, 1998), s/a VEGF, bFGF, TGF-beta( Stewart and Nowak, 1996)[17]. The mechanism of increased blood loss with copper IUCDs is thought to be due to a combination if increased cytokine- producing endometrial leukocytes ( Sheppard, 1987), increased local fibrinolytic activity and epithelial surface erosion due to contact with the device(Shaw et al, 1979_. Release of PG and activation of mast cells and macrophages may be the underlying mechanisms. [17]. A quantitative reduction in platelets s/a in autoimmune thrombocytopenia or chronic renal failure can lead to increased menstrual loss. DYSFUCTIONAL UTERINE BLEEIDNG: Dysfunctional uterine bleeding accounts for ~50% of all cases of excessive uterine bleeding, 9Barley, 1972)[17] Anovulatory Dysfuctional Uterine Bleeding: The exact mechanisms behind anovulatory bleeding are unknown(Fraser et al, 1996) but it is known that unopposed estrogen can lead to excessive endometrial proliferation and hyperplasia with increased and dilated draining veins and suppression of spiral arterioles ( Beilby et al , 1971). Large thin walled, tortuous, superficial endometrial vessels can often be demonstrated on the surface of hyperplastic endometrium(Hamou, 1985) and increased fragility is a probable contribution to increased blood loss. Unopposed estrogen has a direct effect on the uterine blood supply by reducing vascular tone (Fraser at al, 1987) and possibly an indirect effect through inhobiting vasopressin releae( Akerlund et al, 1975) leading to vasodilation and increased blood flow. Unopposed estrogen also stimulates stromal VEGF expression which may contribute to disturbed angiogenesis ( Zhang at al, 1995 ; Smith , 1998). [17]. Ovulatory Dysfunctional Uterine Bleeding: The main defect in ovulatory DUB appears to be in the control of processes involve in the regulation of the volume of blood lost during menstrual breakdown of the endometrium, primarily the processes of vasoconstriction and haemostasis. [17] Endometrial glandular and stromal estrogen and progesterone receptor levels may be increased in the late secretory phase in women suffering from DUB (Gleeson et al, 1993 )[17] There may be some role of endothelins, which increase in at the time of normal menstruation. ( Cameron et al , 1992)[17] Reduced levels of endothelins may lead to an increase in the volume of blood lost. An increase in total PG release and disappropriate rise in PGE2 have been demonstrated in ovulatory DUB (Smith et al, 1981 ). It also has been shown that there is an increase in PGE2 and PGI2 receptors predisposing to vasodilation, in women with menorrhagia ( Adelantado et al, 1988 )[17] Prevention of platelet aggregation by PGI2 release may be an important contributing factor in ovulatory DUB ( Smith et al, 1981 ) as may increased endometrial tPA content, increased local fibrinolytic activity ( Bonner et al, 1983;Casslen et al, 1996;Gleeson et al, 1993 ) and excessive endometrial heparin like activity ( Paton et al , 1980 )[17} Endometrial lysosomal enzyme activity in women with ovulatory DUB is increased, and this activity is also observed in women with menorrhagia secondary to IUCD use (Wang , 1994 ){17 ) Matrix metaloproteinases may be important in contributing to abnormal endometrial breakdown and abnormalities of menstrual bleeding ( Salamonson et al, 2000 ){17, 18 ]. Granulated stromal lymphocytes, macrophages and othe migratory leukocytes may contribute to mechanisms of excessinve loss. [18] In DUB, delayed or incomplete endometrial repair could prolog menstrual bleeding episodes, but nothing is known about such mechanisms. [18] SIGNS AND SYMPTOMS OF ABNORMAL UTERINE BLEEDING: Frequent complaint include: heavy or prolonged menstural flow, social embarrassment, diminished quality of life, sexual compromise and alteration in life style. Pain is not a common presenting symptom unless associated with passage of large blood clots. Prolonged menstrual blood loss can be associated with anaemia. Typical complains of anaemia include fatigue, unusual desire of eating starch or dirt and headaches. Severe anaemia may cause fainting, congestive cardiac failure, exercise induced fatigue, shortness of breath. Hemorrhagic shock death are rare sequelae for DUB. [16] EVALUATION OF AUB IN PERIMENOPAUSAL WOMEN: 1.  History: History focuses on identifying the type of AUB:ovulatory, anovulatory or anatomic in order to guide treatment. Ovulatory bleeding is more common, usually cyclic, and can be associated with mid cycle pain, premenstrual symptoms and dysmenorrhea. Anovulatory bleeding occurs more frequently at the axtremes of reproductive age and in obese women. It is usually irregular and often heavy. Any history of easy bruising and tendency to bleed suggests coagulopathy. History of jaundice and hepatitis gives the evidence of liver sisease. [19] 2. Physical Examination: Physical examination includes looking for evidence of systemic disease. Pelvic and bimanual examination are done to detect disease in the genital tract. Cervical cytology analysis should be current and normal and cervical and vaginal swabs should be assesses to rule out infection. [19] 3. Laboratory tests: Beta subunit human chorionic gonadotropin for pregnancy. Complete blood count with platelet count for coagulopathy LFT, PT for liver disease. TSH for hypothyroidism and hyperthyroidism. Free testosterone for ovarian or adrenal tumor. [19] 4. Assessment of the uterine cavity: The main indications for assessment of the uterine cavity is to exclude pathology, most often seen in women over 45 years of age with anovulatory cycles. [19] A wide variety of methods are available for endometrial assessment including: Ultrasonography Endometrial Biopsy Hystroscopy Dilatation and curettage Sonohysterography Hysterosalpingography 1. Ultrasonography: Ultrasonography to look for ovarian or uterine disease. Transvaginal ultrasound is 80% sensitive and 69% specific for fibroids and polyps and is superior to transabdominal ultrasound. If possible, transvaginal ultrasound should be performed on days 4-6 of the menstrual cycle. [19] 2. Endometrial Biopsy: Endometrial biopsy is a simple office procedure that can be done by family physicians, [19]despite its convenience , cost effectiveness and safety, it is a blind endometrial sampling procedure. [20]It is a useful method to exclude malignancy in perimenopausal women. The annual incidence of endometrial cancer is 19. 5 per 100, 000 women. One in 4 cases of endometrial carcinoma occurs before menopause, so biopsy should be considered for high risk premenopausal patients, even in the presence of fibroids. Endometrial biopsy produces an adequate sample more that 85% of the time and detects 87-96% of endometrial carcinoma. [19] 3. Hysteroscopy: Hysteroscopy permits direct visualization of the cercical canal and uterine cavity, enabling observation of intrauterine abnormalities. Hysteroscopy is considered an accurate gold standard in uterine cavity evaluation. Despite the lack of adequate information about the diagnostic accuracy, it is used in many studies with and without endometrial sampling as a reference standard, [21] Hysteroscopy was reported to have sensitivity, specificity, negative predictive value (NPV) and positive predictive value (PPV) of 94. 2, 88. 8, 96. 3 and 83. 1% respectively, in predicting normal or abnormal endometrial histopathology (Garuti et al, 2001). The highest accuracy of hysteroscopy was in diagnosing endometrial polyps, where as the worst result was in estimating hyperplasia. In a recent study the sensitivity and PPV of hysteroscopy without endometrial biopsy in diagnosing endometrial carcinoma was only 58. 8 and 20. 8 % respectively (Lo and Yuyen, 2000 ). There, since the incidence of focal lesions in patients with AUB is 46-74% (Nagele et al, 1996;Pal et al, 1997 ), it seems that the most cost effective approach is to proceed with hysteroscopy complemented by endometrial biopsy, early in the assessment of AUB. [22] 4. Dilatation Curettage: Dilatation is a common surgical procedure done on women to scrape and collect the tissue from inside the uterus. Dilatation is a widening of the cervical passage. This is done using smoothy conical and tapered, graduated metal rods of various sizes and these appropriately called the dilators, which dilates the tight cervical passage slowly. Curettage is the second part of the procedure and is done to scrape the inside contents of the uterus. For this, a sharp spoon like instrument called curette is used. The procedure is usually performed under general anaesthesia. [23, 24, 25] Indications:[23, 24, 25]s Dialtation and curettage may be done as a diagnostic or a therapeutic procedure. Diagnostic: Diagnose conditions by collecting tissue samples for biopsy. To diagnose endometrial cancer. To investigate the causes of infertility. To investigate the cause of abnormal bleeding in postmenopausal women taking HRT. Therapeutic: Treat intermenstural bleeding To remove polyps in the endometrial or inner lining of the uterus. To treat irregular and heavy bleeding. To remove an embedded IUD used for contraception. To perform abortion in the early stages of pregnancy. To evacuate spontaneous abortion product. [23, 24, 25] Preoperative procedure: It is recommended that the patient take nothing by mouth, for at least 6 hours. Pain killers and antibiotics may be prescribed before the procedure. A sedative may be useful to relieve the anxirty of srgery. The genital area may be shaved and prepared for the surgery. An enema may be administered to clear the bowels. [23] Anaesthesia: General Anaesthesia: Most D Cs are done under general anaesthesia. The procedure is normally very short and the general anesthetic can be quickly reversed, with the patient going home soon afterwards. Spinal Anaesthesia: The advantage of spinal anaesthesia is that the patient is awake but at the same time does not have any sensation below the waist. It avoids all the complications of general anaesthesia. Local Anaesthesia: Occasionally, D C s are done under local anaesthesia, if the patient is not ready for general or spinal anaesthesia. [23, 25] Procedure: The vagina and cervix are cleaned with an antibacterial solution that may be iodine or alcohol based. The cervix is visualized using an instrument that is locatedin the vagina called the speculum. Lights are so adjusted to visualize the cervix so that its upper lip can be grasped with a special curved forceps called the Vulsellum. This helps both in stabilizing and bringing the cervix down towards the vaginal opening to ease with rest of the procedure. Dilatation is next done using sequential metal round tapered dilators and the opening to the uterus is gradually widened to about the size of a large pencil. Once this dilatation has been completed, the curette is inserted into the uterine cavity and is used to gently scrape the lining of the uterus. When the surgeon feels the gritty layer of cells just above the muscle of the uterus, then he/she knows that the scrapping has gone deep enough to sample the tissue adequately. This scrapping is done throughout the uterus and the tissue is sent to histopathologist. [23, 24, 25, 26] Post operative care: There may be mild abdominal discomfort after a dilatation and curettage, if pain is severe, consult a doctor. Medication should be taken as advised by doctor. Ensure to take antibiotics. Avoid the use of any contraceptive device or sexual intercourse for a week. Use sanitary napkins during this time period. If there are any signs of infection s/a fever , pain or discharge, consult the doctor immediately. [23, 24, 25] Contraindications: If a patient is too ill to undergo surgery. If the patient is unable to move her legs apart, s/a with severe arthritis in the hips. If the patient has problem with clotting mechanism of the body. [23] Complications: Complications are usually rare: Anaesthetic Complications: Reactions to anaesthetic medications. Breathing difficulties. Surgical Complications: Perforation of the uterus. Laceration of the cervix. Scarring of the endometrium. Infection of the uterus or other pelvic organs. Hemorrhage. [23, 24, 25] 5. SONOHYSTEROGRAPHY: Sonohysterography is being used more frequently for evaluation of women with many gynaecologic conditions. In 1992, it is reported the use of sonohysterography for detecting endometrial polyp in 14 of 148 infertility patients. In 13 of the women, polyps were asymptomatic. [27]This procedure is to be done by use of saline infused through a catheter into the endometrial cavity provides slight distention and separation of cavity walls, allowing the better visualization of uterine cavity. [28] Sonohysterography not only aids in diagnosis of intrauterine pathology but also in decision regarding surgical versus medical management of patients and and directs the approach and instrumentation required when surgical treatment is warranted. [28] It can be performed in any phase of cycle but the best time is during the first phase of the cycle especially when the indication is sterility or thickened endometrium at transvaginal sonography. [28] 6. HYSTEROSALPINGOGRAPHY: Hysterosalpingography requires the use of radiations and iodinated contrast material. It is expensive and provides indirect information about the uterine cavity. One can delineate fibroids and polyps but cannot comment on endometrial thickness. [28] 7. MEGNETIC RESONANCE IMAGING: Magnetic resonance imaging , an expensive modality provides excellent images of the uterus and myometrial pathology disrupting the endometrium, however, intracavitary lesions are not well demonstrated. [28] EMBRYOLOGY OF THE FEMALE GENITAL SYETEM Although genetic sex is determined at fertilization, gender is not apparent until approximately the 12th week of embryonic life. By the 6th week embryonic life, both male and female embryos start to develop the following structures on either side of the midline. :[29, 30] Genital ridge (proliferation of coelomic epithelium ) Mesonephric (wolffian )duct (lateral to the genital ridge ). Paramesonephric ( mullerian ) duct which consists of: Upper vertical part lateral to the wolffian duct. Middle horizontal part crosses in front of the wolffian duct ( both upper and middle parts form the fallopian tubes ). Lower vertical part fuses with the similar part of the opposite side to form the uteri-vaginal canal (the upper part forms the body and cervix of the uterus while the lower part forms the upper 4/5 of the vagina ). The lower 1/5 of the vagina develops from the sino-vaginal bulbs in the posterior wall of the uro-genital sinus. [29] Origin and derivatives of the Mullerian Ducts: Mullerian ducts persists, in females to develop into the fallopian tubes, the uterus and part of the vagina. [31]. Mullarian duct grows , at first it is solid, but later it becomes canalized. It deviates more and more medially till it meets its fellow of the opposite side. The septum between the two mullerian ducts disappear. The proximal parts of the mullerian ducts form the fallopian tubes, while the distal parts meet together to form the body and cervix of the uterus and the upper 4/5th of the vagina. The stroma and muscles develop from the surrounding mesoderm. The fusion of the two mullerian ducts brings together two peritoneal folds which become the broad ligaments. [29] Ovary: Development of the ovary passes into three phases: Migration of the germ cells from the yolk sac to the posterior body wall at level of 10th thoracic level to enter the genital ridge The germ cells differentiate into oogonia then primaryoocytes and become arrested until puberty. Descent of the ovary to reach the pelvis along a ligamentous cord called the gubernaculums that is attached inferiorlyot the inguinal region. The gubernaculums becomes incorporated into the uterine wall at the point of entry of the fallopian tube and persists in the adult as the ovarian ligaments and the round ligament. [29] External Genitalia: Clitoris develops from the genital tubercle (by slight elongation ). Labia minora develops from the genital folds (by remaining separate ) Labia majora develop from the genital swelings (by enlarging greatly ). Vestibule develops from the lower most part of the urogenital sinus. [29]. ANATOMY AND HISTOLOGY OF FEMALE GENITAL TRACT Uterus: The uterus is a fibromuscular organ and is a hollow and pear shaped highly vascular organ present in the pelvis between the bladder and the rectum. It is about 8 cm long and 5 am broad, within which fetal development occurs. Uterus is usually divided into a lower cervix and an upper corpus of uterine body. 1. Cervix; The cervix is narrow region at the bottom of the uterus that leads to the vagina. It has a convex round surface with a circular or slit like opening (the external os ) into the endocervical canal, ehich is approximately 2 -3 cm in length and opens proximally into the endometrial cavity at the internal os. [30, 32, 33] Histologically, the cervical mucosa generally contains both stratified squamous  epithelium (exocervix) and mucus secreting columnar epithelium (endocervix). The mucus secreting glands are confined to the endocervix. The area where the two types of epithelia meet is called the squamocolumnar junction. [30, 34]. Cervical mucus secreted by the mucosa layer of the cervical canal serves to protect against bacteria entering the uterus from the vagina . [33]. In the cervix, the stroma is firmer, more fibrous and less cellular. [34] 2. Uterine Corpus: The body of the uterus varies in size. At birth , the cervix and corpus are approximately equal in size, in the adult women, the corpus has grown to 2-3 times the size of the cervix. The uterine corpus is divided into different regions: Isthmus: where the endocervicla canal opens into the endometrial cavity. Uterine cornu: Funnel shaped area on each side of the upper uterine body receives the insertion of the fallopian tubes. Fundus: The portion of uterus above uterine cornu. [30] Histologically, the wall of the uterus consists of the following three layers: Perimetrium: It is serous membrane that covers the outside of the uterus. Myometrium: It consists of several layers of smooth muscles and imparts the bulk of the uterine wall. Contractions of these muscles during childbirth help to force the fetus out o

The Eye And Laser Eye Surgery Essay -- essays research papers

A Functioning Eye (Emmetropia) The eye is the organ of sight. It is used in almost everything we do, from playing sport to reading. A normal and well functioning eye can focus objects and images, both near and far, perceive depth and adapt to changes in light. The perception of depth is due to having two separate eyes creating two separate images, while the ability to adapt to light change is attributed to the iris and the dilator muscles. However these two aspects of the eye are not involved in laser eye surgery and will not be discussed in reference. The focusing of objects and images is very much part of laser eye surgery. In order for a clear visual image to be formed the image must come to a point on the retina. Light rays do not normally travel toward each other, usually the light rays either travel outwards or almost parallel, for this reason the light rays must be refracted. The cornea is the primary place of refraction, the â€Å"bent† light rays then travel through the aqueous humor and the pupil to the lens. Here the light is one again refracted even closer together, the light then goes through the vitreous humor and is projected onto the retina. The focus of the lens should be aimed at the fovea centralis (a tiny pit in the middle of the macula). It is in this region that vision is most sharp. For this reason, instead of simply staring at one point the eye must constantly â€Å"scan† the area to focus the whole object or image. In order to accommodate the changing distances of the object or image the lens in the eye has to adjust, becoming thinner to focus distant objects and fatter to focus near by objects. This process, of changing the lens thickness is known as accommodation. In order for this to occur the ciliary muscles contract and relax. The contraction fattens the lens and the relaxation stretches the lens. The eye functions on much the same principle as a camera. The iris, or coloured portion of the eye, acts as a shutter to regulate the amount of light admitted to the eye. The cornea (the clear window at the front of the eye) and the lens (located behind the pupil) serve to focus light rays from the object viewed onto the retina at the back of the eye. The retina then transmits the "picture" of the object viewed to the brain where the object is "seen". Clear vision is the result of light rays passing through the cornea,... ...ubstantially reduced. 3) Post-operative visual acuity is restored within a few days rather than weeks. 4) Less corneal scarring in the long term, less change due to healing (regression) and thus greater stability of the correction. When comparing only the benefits of Lasik over PRK the first impression is that Lasik has the potential to be a superior procedure. There is however, a very significant list of potential complications or risks and these include: 1) Failure of automated instrument to leave a hinge on the corneal flap, with the first incision. 2) Loss of the corneal flap during the operation. 3) Loss of the corneal flap after the operation. 4) Slipping of the flap and healing off center. 5) First incision too deep (perforation of the eye) or too shallow, causing a hole in the flap. 6) Invasion of the surface tissue into the central tissue of the cornea. 7) Infection of the cornea. 8) Loss of visual acuity - from scarring or from decentration of the PRK. 9) Technical problems with complex and finicky automated diamond-cutting devices. 10) The procedure is much more dependent upon surgeon's operating skills, than the computerized precision of the PRK procedure.

If you were directing the play a view from a bridge what Essay

If you were directing the play "a view from a bridge" what advice would you give to the actor playing Eddie about his character? Use quotations and close reference to the text. "A view from a bridge" is a play with five main characters. Eddie and Beatrice are married whilst they adopt Catherine, who is Eddie's niece. Marco and Rudolfo are their cousins who come to stay from Sicily. They are both illegal immigrants. A situation in the play occurs where Eddie becomes possessive of Catherine while Rudolfo plans to marry her. From the director's point of view advice to the actor playing the part of Eddie is complicated, but crucial. If I was the director looking for an actor to play Eddie it would have to be a man in his forties because that is most likely to be approximately the age of a man who has a niece the age of seventeen. Eddie is a longshoreman in the play and it would make sense if the actor was well built. In the film we watched Eddie had no real muscle definition. Also the play we watched Eddie seemed to sit in the same seat all the time. This shows that the character of Eddie was perceived as lazy, I did not think this was the case because of his active job. I would tell the actor to be more dynamic, energetic and move about the stage more, especially when he gets frustrated. The play was set in the nineteen fifties so Eddie would be told by me to dress appropriately. Eddie should wear old rugged clothes because of the limited income provided by his job. This brings me to Catherine who, in the film we watched was definitely overdressed and too clean for the circumstances she lives in. Another big aspect I would give advice to the actor about is his relationships with other characters. In the play we watched it was hard to comprehend the part where Eddie's innermost feelings for Catherine were exposed. This was the scene where Eddie came home drunk and found Rudolfo in Catherine's room. To make the scene more believable Eddie should show more love for Catherine. He should do this through body language. His facial expression should show over concern and love for Catherine or he could stare gapingly at her body. The play we watched the actors face was expressionless and all he did was say his lines whilst sitting in a chair. That was not enough. Although curiosity should be put across to the audience it should... ...s when he has the urge to be a macho and man of the house. Also respect is the most important thing and is greatly valued, this explains Eddie's behaviour towards the end of the play. I think that the background culture should be kept in mind because part of the specification is a strong macho man capable of a convincing accent and not slouching or looking lazy. In the play we watched Eddie sat in the same chair too much so either a younger is needed or an actor that looks dynamic at least. Also a good point is to advise the actor to walk about the stage when Eddie seems to struggle to express feelings through his limited vocabulary. Eddie's character shows stubbornness. He shows that attribute throughout the play and does not expect his family to correct him on anything he has already stated. I also think that when he releases bottled up emotions, like in the situation when he comes home drunk the actor should exaggerate his facial expressions. In the play we watched Eddie's face was expressionless showing poor acting, which was disappointing. As the play progresses Eddie seems to lose his mind, and also at one point he loses his sense of Sicilian justice.

Gang Violence Essay -- Argumentative Persuasive Gangs Teen Essays

Gang Violence Gangs are becoming a growing problem in American society. More young people are turning to gangs to solve problems in their lives. When youths join gangs they drop social activities with family, friends and school. Members fall behind their classmates in school and do not try. A study shows that less than 1% of gang bangers is literate1. Gangs destroy teenager lives and destroy their chances for a good education and happy life. Gangs are now a haven for rats.   Ã‚  Ã‚  Ã‚  Ã‚  Teenagers are joining gangs every day. They join gangs for many reasons. A former gang member known as G-Ball was very young when he joined a his gang. He and a friend would play a game. They would pose as gang members to be cool. Then police arrested him and other gang members for stealing cars. G-Ball never wanted to be a gang member he wanted to act and dress like one.   Ã‚  Ã‚  Ã‚  Ã‚  Another former gang member, Alonzo, age 17 wanted to join a gang because he had nothing to do after school. Both he and G-Ball joined a gang by choice. Keith, age 17 was forced into a gang. If he didn't join, he'd be hunted down and killed by the gang members. When older family member already in a gang, younger siblings are often forced in.   Ã‚  Ã‚  Ã‚  Ã‚  Many gangs use graffiti to show their power and to mark their turf. "Everywhere you go you see graffiti." Professor Allen Walker Read of Columbia University said, "The pen is mightier than the sword." Gangs in Parma are very active with the pen. They "tag" their property buildings and houses everywhere. Police want to know where all the parents are. Why aren't they doing anything about this? Many people in Parma want to know the answer to the same questions.   Ã‚  Ã‚  Ã‚  Ã‚  Cincinnati also has active gangs. "Graffiti is a creeping problem in every neighborhood and in and on public buildings" said Mayor Roxanne Qualls of Cincinnati said. Graffiti is so bad that Star Bank has donated $25,000 to have students to help clean up all the graffiti.2 The city made a group called the "E-Racers". These people are ready to clean up all the graffiti. The gangs set school buses on fire, tear-up park benches, and drive across lawns including the police station lawns.   Ã‚  Ã‚  Ã‚  Ã‚  Graffiti comes in many forms. Pictures are used to mark property (turf) but you may also see strange writing below it. They say to other gangs that they're the best, the number 1 gan... ...30 Jun. 1994. Breckenridge, Tom. "Gang graffiti makes its mark on Parma." The Plain Dealer 26 May 1994. Clinton, William J. "National Gang Violence Orivencion Week, 1994." The White House: Office of the President of the United States Sept. 10,1994 Internet. Delgado, Robert. "Anti-Gang Movement" Doug's Home Page Sept. 28, 1995. Internet. Gillispie, Mark. "Chicago gangs still thrive in the city of their birth" The Plain Dealer 12 Jan. 1992. Gillispie, Mark. "Federal agencies shift concentration to gangs" The Plain Dealer 19 Jan. 1992. Gillispie, Mark; Shepard, Paul. "Former gang members recall `gentler times`." The Plain Dealer 12 Jan, 1992. Gillispie, Mark; Shepard, Paul. "Suburban police hoping to nip gangs in the bud." The Plain Dealer 17 Jan 1992. Horswell, Cindy. "Gangs get a dressing down." Houston Chronicle 28 March 1992:1A+ Marrison, Benjamin. "Mayor seeks `New Cleveland`." The Plain Dealer 1 Feb., 1992. Neff, Jon. "On-line Guide to Gang Signs and Graffiti" Highway 51 1995 Internet Phoenix Police Department -- G.R.E.A.T. Phoenix Police Department Home Page 1994 Internet. Welson, Roger. "Off the wall" Natural History May 1993

A World Class Education Ch 3

The bigger the change, it seems, the more difficult the task. Education is one of the most important things in a child’s life, so what happens when someone decides to present new challenges to our way of thinking? Vivian Stewart attempts to bring some very good points to light in chapter three of her book A World Class Education. Most successful systems tend to have the same basic elements when it comes to education.Strong leadership with ambitious vision is necessary for a profitable future in American instruction. High quality teachers and administrators who focus on global and future orientated goals help guide their students toward a more equitable state. Teacher accountability is also extremely significant; the nation board standard number four states that teachers should strive to strengthen their skills as an educator and critically examine their practice in order to improve their performance.Lastly, teachers should always keep an open mind for the future and continuous ly learn new ways to develop curriculum. This relates to national standard number five. In physical science, students are required to manipulate mathematical equations in order to solve for a range of variables. Here in the United States, we use the English system as our standard for measurement: However, nearly everywhere else in the world, the metric system is used.I apply global orientation to my classroom by teaching my students the metric system and explaining why it is important for scientists to have the same system of measurement. We should be mindful of learning the way others do things and less consumed with the our own systems when we can all benefit from a unified structure. Stewart, V. (2012). A world-class education: learning from international models of excellence and innovation. Alexandria, Virginia: ASCD.

Music and no music condition Essay

The use of music seems to be a good way of operationalising the IV as many people do learn to the sound of music so therefore the difference between the music and no music condition should be marked. Also, getting the participants to write down the words is a good way of measuring the DV as it means it is easy to collect and analyse the data.  The study itself was quite simple and it seemed to measure what effects music has on learning. The independent variable was manipulated in such a way that it was hard for there to be anyway the results could have been affected significantly. Also because the measurement method was very simple there isn’t a chance that the results could be interpreted in the wrong way. As the study was a laboratory experiment it doesn’t have as high validity as a field experiment. Although the participants were not in a strange environment, the fact that they knew they were being studied may lower the ecological validity of the study.  Leading on from the fact that the study might have bad ecological validity, there is also the problem of the study having bad participant reactivity. Seeing as they know they are being studied and they know they have to learn the list of words given to them, they may try much harder than they normally would in their everyday life. There is the factor of social desirability and how some participants may deliberately try to recall fewer words. Improving Validity  Although it would be very difficult and expensive it could be possible to take the study outside the laboratory to increase the ecological validity of the study. You could monitor the participants while they are learning for something at home and while they are playing their own music in their rooms. They could then be tested unknowingly at school by one of their reachers.  However, even if these changes were made, the results would probably still stay the same. It has been proved before by numerous studies done by different scientists that music does help when trying to learn. This is why students are encouraged to listen to wordless music when revising for exams. These changes would also help improve participant reactivity if they are studied in a familiar environment. It would give them a sense of security and the need to look ‘cool’ is not needed anymore and there is no extra pressure put on them to learn because they don’t have the feeling they are being examined.  So, these changes could actually change the results slightly if only with a few participants. It might be found that there is higher recall in both conditions though but the difference may still stay the same. Reliability  The study is very easy to replicate as there is many references to other studies similar to it. Also because the study is quite simple in itself and very cheap to do there are very rarely any problems in recreating it for different purposes.  One possible confounding variable was introduced by the fact that there were four researchers in the room at the time of the study and they all knew the hypotheses. They may have tried give the participants help in recalling the words by giving hints and clues so that the results were more conclusive. This may have led to unreliable comparisons between conditions. As the study was a laboratory experiment it meant the researchers had good control over the study. The words that were chosen were all unambiguous so the participants would not have interpreted them in different ways. Also the test had been severely standardised. The words were shown on an over head projector so they were all looking at the same thing when learning was taking place. Also the testing was completed in the same room and at the same time of day for each condition so the participants were not feeling more tired in one condition than the other. Improving reliability  The only possible way to improve reliability was to keep researcher contact to a minimum or have a person in the room that was unaware of the hypothesis so they couldn’t alter the study in any way. This would be difficult though because once they are in the room it does become quite obvious what the study is about.  This could be controlled for by using an outside civilian to be the one person giving the participants instructions on what they have to do. There could be one person chosen for each condition so that they don’t guess what the study is about.  Even if these changes did increase the reliability of the study the only difference they might make to the results is to decrease the differences found between the two conditions.

CanGo Analysis Essay

1. CanGo has too many activities without having specific goals or setting priorities. As they find something that needs to be accomplished, it is always as soon as possible without setting definite time deadlines. Setting priorities is one way to insure that the tasks which need immediate attention are worked on first, while other task can be delayed because they are not as important. Being able to schedule people to complete specific task requires careful planning while know what resources are available. According to the Business Dictionary, a resource is â€Å"an economic or productive factor required to accomplish an activity† (Resource, 2013). CanGo needs to make a chart showing what its resources are which includes how much time each employee is able to work, how much money they can spend or invest, and what needs to be done by when. This can be accomplished in a number of different methods depending on the personnel who will be responsible for compiling the data. As shown on the Adaptive Path website, one method would be to use a spreadsheet which shows three major criteria and then apply a scale to them graphing the results. Equally important, once the priorities are determined, is setting specific deadlines for completion of task so that the employees know exactly when a report is needed, or when another department needs a specific resource if a resources needs to be shared or allocated, such as an employee working on multiple tasks. When setting the times, it is also important to know if one task needs to be completed before another on starts or if tasks can be worked on by different employees concurrently.  Setting up a written schedule or calendar, for example in Microsoft Outlook which everyone can view would be a good tool so each employee knows who is working on what and when it needs to be done. 2. CanGo needs to find out their customer base so that they can market to current customers and bring in new customers. There are a few ways to find their customer base. This first step to help find a customer base is to make the company a brand name. They need to make the company known to everyone for the great services and products offered. This will make the company more noticeable on any search engine or social media. Another step to finding the base would be to use onsite analytics. Google is the best known option for this. This will analyze the sites traffic patterns. It shows what websites they come from, how long they stay on your site and each individual page. This can even determine what page the customers get to and then leave (Staff Editor). If there is a certain page that customers’ get to and then leave the site, than this is the page that needs to be looked over and re-done. CanGo should also take advantage of social media. If CanGo used a social media outlet such as Facebook, their fans could leave comments and say what they like and dislike about the company. This can help fix any problems within the company. The final step in reaching a good customer base is to make sure their website is user friendly. Make sure the homepage has the most important content on it and that it has easy to understand menus for the customers to navigate. The company should also make sure to look at the reviews both good and bad and leave all of them on there. By showing that you are not trying to hide anything the customers will have more respect for the company. . CanGo wants to implement a new technology that involves a new layout that incorporates barcoding and automated storage and retrieval systems (ASRS). Jack is proposing this new implementation by contrasting the new technology versus CanGo’s current technology. Jack assures Juan that every cost has been included in the detailed analysis, but when Juan asks about how they are going to deal with the IT department, Jack replies that they need to make sure that the entire department is focus about 70 % of their time to this project in multiple locations. He also remarks that the department has to be pulled off from their current projects, so this implementation can be a priority. Prior to make the final decision of purchasing ASRS technology, there needs to be some deeper discussion as to what would happen to the security of the company’s network if the IT department had to spend more time on data integration. According to Ehow website, â€Å"the information technology department in an organization is responsible for the architecture, hardware, software and networking of computers† meaning that putting the IT department full time on the implementation of ASRS technology, can cause improper function of the mainly IT department functions, for instance, server maintenance (Kelchner, n. d. ). Agreeing to Wisegeek website statement, â€Å"if maintenance is not conducted on a computer network, regardless of whether the network is small or large, pplication software usually will not run as well as expected. In some cases, a network may even experience total or partial network failure if proper maintenance is not conducted. † Jack’s proposal can cause CanGo extra costs that have not been accountable for and put the entire company’s network at risk (server maintenance, n. d. ). In other to make this analysis effective, Jack should meet up with the IT department first and discuss how the implementation of this new technology will impact IT’s current work schedule. Jack and the IT department need to come with a plan that includes a work schedule for the new implementation without interrupting current projects. Therefore, if extra hours are demanded to complete the implementation whether CanGo will pay overtime to the IT department employees or temporary IT employees will be hired, this cost has to be added to the analysis. When choosing a strategy, every single department that is involved in the implementation should be contacted and informed about the project prior to present the final analysis.  It seems that Jack didn’t contact or discuss the implementation of ASRS technology with the IT department. 4. CanGo consumer buying process is in question when one of CanGo’s employee shares an elevated statistic that reveals over 75% of online shoppers don’t end up buying the products that they have selected in the website; as a result, Andrew replies that CanGo’s website mirrors the consumers choice by applying product recognition, informative search, alternating evaluation, etc. It seems that CanGo does not have an ongoing method for tracking hits vs. purchases on their website. The problem is that CanGo is not evaluating their consumer buying process properly. Andrew clearly wonders if that high statistic applies to CanGo clients. According to Aspire website, â€Å"using website metrics and tracking your leads and conversions should play a vital role in measuring what’s working and what’s not on your company’s website. Building up a history of metrics will enable you to identify trends and opportunities, analyze your traffic data to consistently improve your site’s effectiveness, and monitor your lead generation process, conversion rates, and your return on investment. CanGo should invest in website metrics because this will allow CanGo to conduct proper follow up that will confirm if the implemented consumer buying process is satisfactory (Website metrics, n. d. ). 5. CanGo needs to monitor the changes in purchases so that they can modify their marketing strategy. There are a few ways that CanGo can monitor changes. The company should start using web bugs on their site. A web bug is a graphic in a website or a graphic-enabled e-mail message. The Web bug can confirm when the message or page is viewed and record the IP address of the viewer (Privacy Rights Clearinghouse). This can help determine how many people are viewing their homepage and any other page on their site. CanGo can also apply direct marketing to their site. Direct marketing is a sales pitch targeted to a person based on prior consumer choices (Privacy Rights Clearinghouse). An example would be if the customer buys a romantic novel, then there will be suggestions for other romantic novels in a similar nature. Another method CanGo can use is behavioral marketing. Behavioral Marketing is the practice of collecting and compiling a record of individuals’ online activities, interests, preferences, and/or communications over time. Companies engaged in behavioral targeting routinely monitor individuals, the searches they make, the pages they visit, the content they view, their interactions on social networking sites, and the products and services they purchase (Privacy Rights Clearinghouse). After they have done the tracking they are able to show advertisements to the customers based on their behavior. This type of marketing is used through cookies, flash cookies, device fingerprinting and many other technologies. Whenever the customer goes to websites or social media that have advertisements on the side, the company’s ad would be there if the services were something that interested the customer. 6. CanGo seems to lack knowledge of unfamiliar territory. Since the online entertainment market is becoming saturated with entrepreneurs entering the industry, CanGo can definitely benefit from researching this particular market before they enter it. There are many reasons for any company that’s entering a new market to research it first. One reason is because it’s a way of keeping up with market trends, and in today’s fast paced world it’s paramount to stay on top of the industry and business trends. Lacking knowledge of unfamiliar territory can be extremely costly to an organization. Expanding into a new market involves a great deal of market research in addition to target customers. CanGo needs to develop an in-depth understanding of market growth rates, forecasted demand, competitors, and potential barriers to entry. CanGo isn’t entering a relatively undefined market, however, its new territory for the company. Needless to say maintaining a competitive edge is an important aspect of management today because organizations exist in a more global environment than in the past. Within most industries organizations compete with other companies that are able to provide the same goods and services. According to Steve Jobs, â€Å"Some people say, ‘give the customers what they want. ’ But that’s not my approach. Our job is to figure out what they’re going to want before they do. I think Henry Ford once said, ‘if I’d asked customers what they wanted, they would have told me, ‘A faster horse! ’’ People don’t know what they want until you show it to them. That’s why I never rely on market research. Our task is to read things that are not yet on the page. † This was a pretty controversial quote but it was how he actually felt. Unfortunately, although he was extremely successful and considered a genius by many there we’re times in his career where understanding customers’ wants could have led to even more success, such as with his computing company NeXT. There are both and cons to researching a market before entering but the pros definitely outweigh the cons. researching your market is also very vital to understanding your target market and increasing sales. There are many reasons for CanGo to conduct research on a market they’re entering, for instance, identifying potential customers. It’s important who will be using your product or service. Are they male or female? How old they are? and so on. It’s also important to understand CanGo’s existing customers such as; why would customers choose their product over their competition. A market should be prioritized based on the strategic fit and the ability for CanGo to serve them. CanGo should be able to answer questions like: Are there gaps in this marketplace that can be filled? If so can they do better than their competitors? What value can they deliver to this market and how much are they willing to pay for it? (Isaacson, 2011).