The Search For The True Meaning Of Dreams And What They...

Filmmaker Frances Nkara was on the search for the true meaning of dreams and what they really entailed. She knew this imagery somehow correlated with reality and illustrated a story about the individual. Nkara was on the journey to connect these fantasies with what she thought the world was really about: emotions. On this new excursion to uncover the truth, Nkara met Robert Hall on a weekend meditation retreat. At this getaway, she was surprised about how freely Hall talked about his horrific experiences as a child. She found that at the age of 66, Robert discovered a way to cope with his trauma and not let it haunt him. What intrigued Nkara greatly is how confident Hall was when talking about his story, she was interested in how he reached such peace after the appalling events that occurred during his adolescence years. With immense curiosity, Nkara wanted answers from Hall himself. After meeting and speaking with him, Nkara decided to create a film about Hall’s struggle and how he came to truly love himself again. Nkara named the film Downpour Resurfacing due to all of Hall’s past troubles reemerging at 32. All of his unconscious thoughts began to flood his conscious mind and slowly started to dominate it. Hall was like an iceberg, his conscious mind being the 10% he was in touch with; while there was still 90% of himself that was suppressed and undiscovered. Frances Nkara is well known for her constant exploration of the unspoken, but got major recognition from thisShow MoreRelatedA Career as a Pediatrician Essay1632 Words   |  7 Pagesâ€Å"What do you want to be when you grow up?† As a child, we have all been asked this question; and as unrealistic children, we all had dreams of being a superhero, princess, cowboy, or astronaut. Later on in life, as time went by, and as we became more knowledgeable, our answers became more serious. Some of us wanted to be teachers, business owners, or a veterinarian. However, I have always wanted to be a doctor, but not just any doctor. For as long as I can remember, I have wanted to be a pediatricianRead More8th Habit Summary6493 Words   |  26 PagesStephen R. Covey CONTENTS The Pain, the Problem And the Solution Page 2 Discover Your Voice Page 3 Express Your Voice Page 3 The Leadership Challenge Pages 3, 4 What You’ll Learn In This Summary âÅ"“ The power of win-win thinking. When you’re willing to suspend your own interests long enough to understand what the other person wants most, you can collaborate on a new, creative solution. âÅ"“ How to increase your influence. Find out how to work on these three dimensions of yourself: ethosRead More John Coltrane Essay5593 Words   |  23 Pages quot;Ive got to keep experimenting. I feel that Im just beginning. 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His ruthlessness in killing Banquo and Macduffs family shows how perverted his idea of manliness really is. Macbeths degeneration is also seen in the collapse of his marital relationship. They are loving and have a mutual respect for one another at first. Lady Macbeth becomes more and more unimportant to her husband after killing Duncan, however.Read MorePlay Macbeth11985 Words   |  48 PagesMacbeth becomes paranoid, suffering from hallucinations and sleeplessness. He becomes less human as he tries over and over to establish his manhood. His ruthlessness in killing Banquo and Macduffs family shows how perverted his idea of manliness really is. Macbeths degeneration is also seen in the collapse of his marital relationship. They are loving and have a mutual respect for one another at first. Lady Macbeth becomes more and more unimportant to her husband after killing Duncan, howeverRead MoreMetz Film Language a Semiotics of the Cinema PDF100902 Words   |  316 Pagesdà ©coupage when used to describe the final stage of a shooting script. Michael Taylor also coined the expression mirror construction to translate construction en abà ®me, to describe embedded narrative structures like a film within a film. This is not really very accurate but I have not found any solution better than embedded structure; see his explanation on page 230. Single shot sequence is usually used to translate plan sequence rather than shot sequence. Simi ´ xi x A NOTE ON THE TRANSLATIONRead MoreOrganisational Theory230255 Words   |  922 PagesPerspectives John McAuley, Joanne Duberley and Phil Johnson . This book is, to my knowledge, the most comprehensive and reliable guide to organisational theory currently available. 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SolutionstoBullying Free Essays

GE problem for parents and teachers, because stopping bullying is a hard task and they often don’t know t he best ways to go about it. There are three key elements to stopping bullying: educating the bullies, Punic sighing the bullies, and protecting the victim. The reason that bullies must be educated is that many of them are not aware of exactly how much they are hurting their victim. We will write a custom essay sample on SolutionstoBullying or any similar topic only for you Order Now Most bullies wouldn’t want their victim to become as sushi deal as they have made them. Bullying can come in all sorts Of forms and one that affects girls in particular I s a group of scalded friends excluding them from everything. In cases like these if the bullies understood t hat they had become bullies picking on a victim, they may think twice. The second way to deal with the bullies is to punish them. This could be the o only thing that works for incredibly bad people, because they will only care when it begins to affect the m. Bullying often isn’t taken recourse enough, for example, if you punched a person in the middle of the s tree you would probably be arrested, but if it happens in a case of bullying, the perpetrator might only get a detention. The final main way to deal with bullying involves working with the victim. Victim ms of bullying need to their self worth so that they don’t just let people bully them. All in all, there is no one is Engle solution for bullying, but it’s not good enough to ignore it just because it’s hard to deal with. But by SSI nag a combination of these three tactics we maybe able to stop it. How to cite SolutionstoBullying, Papers

Distracted Drivers free essay sample

Who here has been involved in a car accident? Did you know that in 2012, 3,328 people were killed in distraction-related crashes and about 421,000 people were injured in crashes involving a distracted driver? I myself, didn’t know about these shocking statistics. Nothing grinds my gears more than drivers who unintentionally put themselves and others in danger when it can be avoided. So today, I hope to inform you about my pet peeve on distracted drivers.! ! I. ! ! Nothing is more inconsiderate than distracted drivers.! A. Drivers who use their cellphone while driving put themselves in danger as well as the other drivers around them! 1. Drivers should not talk on the phone while driving in the car.! 2. Using Navigation on your cell phone is not safe to use while driving. ! 3. It’s especially dangerous when the driver is texting while driving.! B. Drivers who use their vanity mirror for grooming while driving are at a greater risk of getting into a car accident. ! 1. Putting on makeup while driving is hazardous.! 2. Eating while driving is one thing, checking for food in your teeth after eating is another thing.! C. Which leads me to my experience that I encountered last Friday driving home from school.! 1. While driving home the other day I almost got into a car accident because of a distracted driver. ! As you have heard, distracted drivers are my biggest peeve because they put themselves in danger and everybody else. If you take anything away from this speech let it be this. I know we get sick and tired of parents and commercials saying dont text and drive and keep your eyes on the road but were not invincible even though we all like to think we are. I will leave you all with this, I know it can be hard to not use your phone or groom yourself while driving but don’t become a statistic. Thank you. ! ! ! ! ! ! ! ! ! ! ! W ! ho here has been involved in a car accident? Did you know that in 2012 alone, there were 3,328 people were killed in distraction-related crashes and about 421,000 people were injured in crashes involving a distracted driver? I myself, didn’t know about these shocking statistics. Nothing grinds my gears more than drivers who unintentionally put themselves and others in danger when it can be avoided. So today, I hope to inform you about my pet peeve on distracted drivers.! ! ! Nothing is more inconsiderate than distracted drivers. Drivers who use their cellphone while driving put themselves in danger as well as the other drivers around them. Drivers should not talk on the phone while they drive. Their main focus should be keeping their eyes on the road and making sure they get to the destination safely. According to distraction. gov drivers talking on a cell phone are 4x more likely to get into a car accident. Now, some may argue and say that using a headset or the bluetooth feature in the car would be a solution but headset cell phone use is not substantially safer than hand-held use. Having a hands-free conversation causes drivers to miss the important visual and audio cues that would ordinarily help you avoid a crash. ! ! ! At any given daylight moment across America, approximately 660,000 drivers are using cell phones or manipulating electronic devices while driving. Using Navigation on your cell phone is not safe to use while driving. Even though cell phones are useful to have for navigation it causes a distraction for the driver to pull out their cell phone or even type an address into the navigation system in their car. ! ! ! Now we all do it dont deny it but when we spend more time looking at our laps then the road thats when it becomes a real problem. This leads to another distraction while using a cell phone: texting while driving. Sending or receiving a text takes a drivers eyes off the road for an average of 5 seconds. 5 seconds doesnt seem like a long time to look away from the road but to put this in perspective, it is the equivalent of driving the length of an entire football ? eld, blind. I know I’m guilty of texting while driving but I think to myself I don’t want to end up on one of those commercials that says Ernil was sending a text saying â€Å"I’ll be home in a little bit. † when he killed three children. I know that sounds dramatic but it can happen. ! ! Next, drivers who use their vanity mirror for grooming while driving are at a greater risk of getting into a car accident. Grooming includes, using the mirror to put on makeup or even checking for food that may be left behind after eating at a restaurant. 87% of people said they have seen other drivers grooming themselves whereas only one out of ? ve (18%) report that they have done this. Grooming yourself while driving is extremely dangerous because you are not paying attention to the road. Which leads me to my experience that I encountered last Friday driving home from school.! ! ! ! ! ! ! While driving home the other day I almost got into a car accident because of a distracted driver. While I was driving, I noticed the car in front of me was swerving in and out of the lane they were supposed to be in and almost hitting the cars around them. I switched lanes and sped up to ? gure out what was going on and it turns out this girl was looking in her vanity mirror and applying make up to herself. I don’t know what was so important to her to apply make up at that time but she sure put herself and the others around her in danger. ! ! As you have heard, distracted drivers are my biggest peeve because they put themselves in danger and everybody else. If you take anything away from this speech let it be this. I know we get sick and tired of parents and commercials saying dont text and drive and keep your eyes on the road but were not invincible even though we all like to think we are. I will leave you all with this, I know it can be hard to not use your phone or groom yourself while driving but don’t become a statistic. Thank you. !

Use Of Force Essays - Fiction, Time Lords, The Doctor, Second Doctor

Use Of Force The Use of Force illustrates very well the feelings and emotions of a normally rational person, who, for any reason, is subjected to a situation that causes much frustration and anger. Most people have patience, but everyone has a breaking-point. The doctor found his breaking point. It was almost frightening to read what the doctor was going to do next to the little girl. What he did was no doubt justified, however, when he said "I could have torn the child apart in my own fury and enjoyed it," that shows a lack of self control. I believe this story is very much like everyday life in the past few years. People lose their tempers too easily instead of being patient and cooling off. A great example of this is the Jerry Springer Show; people go to that show already very angry, and they think that being on TV will aid them in resolving their conflicts. That is certainly not what happens, though. One person almost always becomes enraged and physically attacks another person. It's sick. I see it in the hallways of our school. People lash out at anyone for any reason-bumping into them. It is terrible. Just blow it off and calm down. The story The Use of Force shows the evil side of a person. The doctor had to do his job, but did not need to physically harm the little girl. His uncontrollable ferocity and belligerence are startling, but it is sadly a common occurrence in the present.

The History of Steam Engines

The History of Steam Engines Before the invention of the gasoline-powered engine, mechanical transportation was fueled by steam. In fact, the concept of a steam engine pre-dates modern engines by a couple thousand years as mathametician and engineer Heron of Alexandria, who lived in Roman Egypt during the first century, was the first to describe a rudimentary version he named the Aeolipile.   Along the way, a number of leading scientists who toyed with the idea of using the force generated by heating water to power a machine of some sort. One of them was none other than Leonardo Da Vinci who drew up designs for a steam powered cannon called the Architonnerre sometime during the 15th century. A basic steam turbine was also detailed in papers written by the Egyptian astronomer, philosopher and engineer  Taqi ad-Din  in 1551.  Ã‚  Ã‚   However, the real groundwork for the development of a  practical, working motor didnt come about until the mid-1600s. It was during this century that several inventors were able to develop and test water pumps as well as piston systems that would pave the way for the commercial steam engine. From that point, the commercial steam engine was then made possible by the efforts of three important figures. Thomas Savery (1650-1715) Thomas Savery was an English military engineer and inventor. In 1698, he patented the first crude  steam engine  based on Denis Papins Digester or pressure cooker of 1679. Savery had been working on solving the problem of pumping water out of coal mines when he came up with an idea for an engine powered by steam. His machine consisted of a closed vessel filled with water in which steam under pressure was introduced. This forced the water upwards and out of the mine shaft. A cold water sprinkler was then used to condense the steam. This created a vacuum which sucked more water out of the mine shaft through a bottom valve. Thomas Savery later worked with Thomas Newcomen on the atmospheric steam engine. Among Saverys other inventions was an  odometer  for ships, a device that measured distance traveled. To learn more about Thomas Savery the inventor, check out his biography.  Ive also written a description of Savery’s crude steam engine.   Thomas Newcomen (1663-1729) Thomas Newcomen was an English blacksmith who invented the atmospheric steam engine. The invention was an improvement over Thomas Slaverys previous design. The Newcomen steam engine used the force of atmospheric pressure to do the work. This process begins with the engine pumping steam into a cylinder. The steam was then condensed by cold water, which created a vacuum on the inside of the cylinder. The resulting atmospheric pressure operated a piston, creating downward strokes. With Newcomens enginee, the intensity of pressure was not limited by the pressure of the steam, a departure from what Thomas Savery had patented in 1698. In 1712, Thomas Newcomen, together with John Calley, built their first engine on top of a water filled mine shaft and used it to pump water out of the mine. The Newcomen engine was the predecessor to the Watt engine and it was one of the most interesting pieces of technology developed during the 1700s. To learn more about Thomas Newcomen and his steam engine, check out this biography. Photos and a diagram of Newcomen’s steam engine can be found at Niagara college’s professor Mark Csele’s website. James Watt (1736-1819) Born in Greenock, James Watt was a Scottish inventor and mechanical engineer who was renowned for the improvements he made to the steam engine. While working for the University of Glasgow in 1765, Watt was assigned the task of repairing a Newcomen engine that was deemed inefficient but the best steam engine of its time. That started the inventor working on several improvements to Newcomens design. The most notable improvement was Watts 1769 patent for a separate condenser connected to a cylinder by a valve. Unlike Newcomens engine, Watts design had a condenser that could be cool while the cylinder was hot. Eventually Watts engine would become the  dominant design  for all modern steam engines and helped bring about the  industrial revolution. A unit of power called the Watt was named after James Watt. the Watt symbol is W, and it is equal to 1/746 of a horsepower, or one volt times one amp.

Lets Look At Lest

Lets Look At Lest Let’s Look At â€Å"Lest† Let’s Look At â€Å"Lest† By Maeve Maddox Recently I’ve noticed some odd uses of the word lest. Some may be no more than typographical errors, but others appear to result from a misunderstanding of the meaning and function of the conjunction lest. Lest introduces a clause expressive of something to be avoided or guarded against. Here are some examples: In helping my son pack for college, I tucked in a newly framed photo of the family for him to take with him lest he forget what we all looked like. There’s a scene in the movie where the master chef - who’s in his eighties - explains that as a younger man, sushi  recipes would come to him in his sleep. And he would jump out of bed to write them down, lest he forget them by morning. Clip back any branches and remove any plants that will be in the way before you begin, lest you tread on them while erecting the fence. Another use of lest following a verb of fearing, or phrases indicating apprehension or danger, is to introduce a clause expressing what is feared. Here are examples of this usage: Im afraid  to open the door and check,  lest she  be sleeping and I wake her up.   Im afraid  to leave because I am  afraid  of walking past our building managers office,  lest she  realize  Im  unemployed. The chief errors I’ve noticed with lest are these: 1. Following lest with not: INCORRECT: Then Rubio pivoted to Obama, lest not alienate Republicans who like what Trump has to say. (Alex Leary, Tampa Bay Times,) CORRECT : Then Rubio pivoted to Obama, lest he alienate Republicans who like what Trump has to say. Lest is already negative, so it shouldn’t be used with not. Because lest introduces a clause, it should be followed by the subject of the clause that expresses whatever is to be avoided. 2. Introducing a sentence fragment with lest. INCORRECT: Lest he forget that 70% of American Jews voted for Obama and find the politics of the modern GOP repugnant.  (Wayne Besen, Falls Church News-Press) CORRECT : Netanyahu shouldn’t forget that 70% of American Jews voted for Obama and find the politics of the modern GOP repugnant.   Sometimes a sentence fragment is an effective stylistic choice, but not when it is introduced by lest. A clause introduced by lest needs to be attached to a main clause. The fragment â€Å"lest we forget† is frequently used in connection with memorial services, but a main clause is implied: â€Å"We build monuments and hold memorial services lest we forget the sacrifices of the departed.† 3. Confusing lest with the contraction let’s INCORRECT: And lest not forget Jeffersons role in the XYZ Affair where he sabotaged Adams negotiations with the French to avert a war.  (Education site called Reinvented Solutions) CORRECT : And let’s not forget Jeffersons role in the XYZ Affair where he sabotaged Adams negotiations with the French to avert a war.   Related post Least vs Lest Want to improve your English in five minutes a day? Get a subscription and start receiving our writing tips and exercises daily! Keep learning! Browse the Misused Words category, check our popular posts, or choose a related post below:Coordinating vs. Subordinating Conjunctions40 Synonyms for â€Å"Different†75 Synonyms for â€Å"Hard†

Islamic Banking and finance Essay Example | Topics and Well Written Essays - 4500 words

Islamic Banking and finance - Essay Example t, lack of technological support and sophistication for dealing with long drawn projects and existence of information asymmetry in relation to unique products offered by Islamic banks (Abduh and Omah, 2012). The paper is aimed at a detailed discussion of Islamic Banking development and foundations that lay the basis for their banking system. The paper attempts to understand critical aspects of the Islamic banking system and one of its critical schemes of profit and loss sharing mechanism within their lending process. Through an understanding of the PLS structure, the paper comprehends reasons for its unpopularity and reduced acceptance over other modes of finance, despite its evident advantages. The identification of problems also brings forth solution to problems associated with PLS finance. The paper makes recommendations to improve and revive the PLS finance based on such comprehensive analysis. With independence of Muslim community, it has been increasingly felt that modern financial institutions need to come into the Islamic Banking system and run in compliance with the Islamic sensitivity. The first degree of concrete steps towards combining modern day finance with Islam was seen in Egypt through Mit Ghamur project of savings in 1963 (Al-Alwani and El-Ansary, 1998). This project refrained from calling themselves to be Islamic in nature, yet there was an inherent culture of providing financial intermediation, as per teachings of the Islamic community. Dubai Islamic Bank was the first of its kind in commercial modern Islamic Banking and was founded in 1975 (Thomas, 2006). Out of a total of 176 Islamic banks as of 2006 that have been registered with Bankscope, 70% have been reported to be concentrated in Middle East. The remaining is split between South East Asia with 17% and Sub-Saharan Africa with 15% (Al-Hejailan, 2000). The report by Alvi (2010) also states that develop ment of organizational structures towards more sophisticated financial instruments like,

Nigeria and Canada are two places I have lived in, they are however so Essay

Nigeria and Canada are two places I have lived in, they are however so different in a lot of ways - Essay Example Some provinces have both Goods and Services Tax (GST) and Provincial Sales Tax (PST), some have just Provincial Sales Tax (PST) and yet some have the Harmonized Sales Tax (HST). The bottom line is that goods and services are taxable in Canada. Taxes are not paid on items purchased or on services utilized in Nigeria. It is only the actual price of the good or service that is paid for at any point in time. Nigeria operates a non-tax method of payment on goods and services. Canada and Nigeria are two countries that are so different in their methods of operation. One appears to be one extreme from the other in the way things are done. I have lived in both of them and have observed the clear differences. I think the differences have to do with the fact that Nigeria is a Third world country, while Canada is a developed country. I don't wholly accept the way Canada operates as compared to Nigeria and Vice Versa, I however, appreciate some policies of Canada and those of Nigeria. They are unique in themselves and prove to be very interesting places to

Whether Fair Value Should Be Retained In Financial Accounting Essay Example for Free

Whether Fair Value Should Be Retained In Financial Accounting Essay Fair value may also be called the justified or unbiased price. It is applied in both Economics and Accounting. Fair value accounting refers to the rational or unbiased estimate for the possible good’s, service’s and asset’s market price. Fair value in Accounting is aimed at presenting financial data in the most utilizable way possible. Financial statements will therefore represent the true and reasonable view of the financial information relating to any financial entity. Stakeholders will hence be able to make their investment and relationship decisions based on Accounts statements that have utilized the Fair Value Accounting principle. The Body: Fair value in Accounting considers objective factors like;   The acquiring, producing or distributing costs, replacing and costs for the closest substitutes, the exact utility for a particular level of social productive capacity development is of importance and the supply against the demand for any particular good, service or asset. Subjective factors to be considered include; Characteristics of risk, cost for and return or benefits on capital and the individual utility perception. Fair value accounting is essential in estimating the market value for assets or liabilities whose true value may not be determined due to lack of a sincere established asset’s or liability’s market. (Stephen, 2008 p.3-18) As per the Generally Accepted Accounting Principles (GAAP), Financial Accounting Standards (FAS) 157 dictates that, fair value is the sum of money for which assets can be purchased at a current transaction with willing parties   or moved to an equal or equivalent party, in a situation other than a liquidation case. All the direct and indirect production and operational expenses will be given consideration when trying to determine the most reasonable price for both the buyer and the purchaser. Traders will be expected to have all the information that is necessary for their transaction to be clear to all the related parties. (James, 2009 p.6-13) Fair value accounting is applicable to assets with a carrying value that is determined by market to another market valuation. For assets recorded at historical cost, the asset’s fair value may not be applicable. An example would be a university store whose cost of four million dollars was constructed ten years ago. In case the management was to give a fair value measure on the store, it will be a subjective measurement due to lack of an active market for this particular asset or assets that are close to this one. A different example would be, incase DEF Ltd bought a go down in nineteen ninety, for two million dollars, the financial statement in respect to historical cost will record the go down at two million dollars on its balance sheet. If GHI Ltd bought a similar go down in two thousand and ten for four million dollars, then the GHI Ltd will report the go down at four million dollars. Although the two assets are similar, DEF Ltd will report the asset at half the GHI’s asset value. Historical cost can not identify the two assets being similar. This issue   is compounded incase similar assets or liabilities are recorded historically, resulting in an undervalued balance sheet. Although if both DEF and GHI Ltd recorded the financial information as per fair value accounting the two would record the asset of four million dollars. (Gerald, 2009 p.24-31) The idea in fair value accounting is to represent the figures in the financial statements at amounts that they would fetch just in case an entity was to purchase them afresh. This is exactly that willing buyers are able to pay for the acquisition of such commodities. Adjustments made in determining fair values should consider the depreciation charge that the assets would attract. The disposable value is always of great interest in accounting at fair values. Fair value accounting produces information to investors whose interest is on the assets’ or liabilities’ current value but not their historical cost. It is known that stakeholders in a company use financial statements to make decisions as to whether their investments in the enterprise are worthwhile or not. Unbiased figures represented on the financial statements help investors predict their expected returns on their shares. Such reasonable figures will be helpful in determining the expected company’s growth and how their shares may increase in value in future. It will also be of use to investors to determine the extent of their rewards in case a company goes into liquidation or a receivership in future. The making of both short term and long-term decisions is made easy by the use of the true and fair view represented on the trial balance and balance sheet.

How To Write Using the APA Writing Style Essay -- APA Writing Style

The APA writing style is most commonly used to cite sources for psychology, education, and social sciences and is also the official writing style of the American Psychological Association. The General APA Organizational Guidelines are basic guidelines that explain how to write a research paper in the APA format. These guidelines ensure clear and consistent presentation of written material that differentiates from other writing styles because it concerns elements such as: Citations, punctuation, presentation of numbers, etc There are four major sections in an APA paper. They consist of the title page, abstract, main body, and references. The title page of an APA paper has recently been changed in the publication of the sixth edition of the APA Publication Manual. In the title page a writer should include the title of the paper, the writer’s name, and the school affiliation. It is suggested that the title should be no more than 12 words, and when writing ones name, not to include titles or degree info such as Dr. or Ph.D. Also the title page should include, at the top of the page, a running head that is flush left and a page number that is flush right. The abstract, one of the four major sections in an APA paper, is the section where one would summarize research that was conducted, the methods of which the thesis was tested, the findings of the research, the purpose of the research, the analysis of data, and conclusions. It should begin on a new page and already include the page header. â€Å"Abstract† should be centered on the first line of the abstract page with no bold, italics, underlining, or quotation marks. The abstract should be double-spaced and a single paragraph around 150 to 250 words. Keywords may be listed to h... ...ieved June 18, 2011, from http://psychology.vanguard.edu/faculty/douglas-degelman/apa-style/ Driscoll, D. (2010, April 21). Purdue OWL: Writing in Psychology: Experimental Report Writing . Welcome to the Purdue University Online Writing Lab (OWL). Retrieved June 22, 2011, from http://owl.english.purdue.edu/owl/resource/670/03/ Johns, J., Fox, T., & Silvia, R. (n.d.). APA Writing Style. DK Schools. Retrieved June 26, 2011, from dkschools1.org/Documents/apa%5B1%5D.pdf Mongan-Rallis, H. (2006, November 17). Guidelines for writing a literature review . University of Minnesota Duluth Welcomes You. Retrieved June 22, 2011, from http://www.duluth.umn.edu/~hrallis/guides/researching/litreview.html What is APA Style?. (n.d.). APA Style. Retrieved June 18, 2011, from http://www.apastyle.org/learn/faqs/what-is-apa-style.aspx?apaSessionKey=9E1D0F5CFDDB1694AFB05C302651AD48

Adolescent Sex

The prevalence of teenage pregnancy in the society and the alarming increase of such are often perceived to be caused by inadequate government and educational programs about sex. While most people continuously adhere to this idea, the role and responsibilities of parents in their child’s sexual quandaries, to some extent is set behind the veracity of the problem. Some parents even exhibit lack of authority over their children by allowing them to have sex at home.As a parent your basic instinct is to weigh the consequences when your child is already engaged in premarital sex or if his or her relationship is already progressing on that direction. On the affirmative side of the scale, today’s liberal society demonstrates that everyone is doing it and it is part of your child’s learning experience.The unconstructive scale on the other hand, carries out issues on morality, sexually transmitted diseases and pregnancy. Instead of allowing them to engage in premarital se x inside your home, provide your parental guidance by teaching them abstinence-only sex education which emphasizes morality and having sex within the boundaries of marriage (Religion and Ethics Newsweekly, Episode 823).This will establish a platform for your children to know that having sex at a very young age and outside the sanctity of marriage can result to heavy emotional and physical costs which are not only limited to diseases and pregnancy but is also a ground to bring into a halt their supposed bright future.Though, an open communication with your children regarding their sexual experiences is a great start to take a hold of them when they are already engaged in sexual activities, allowing them to do it in your home is improper and inappropriate decision to make as their parent and guardian.The foremost situation of your children living in your house and exclusively depending on you to fill their stomachs are substantial evidences that they still are not capable of taking ca re of themselves and their actions to include having premarital sex.ReferencesPBS, February 4, 2005 Religion & Ethics Newsweekly, Episode 823 Retrieved on 2009-21-02

Mia philippines Essay

The Philippines was first put on the map by Portuguese adventurer Magellan working for the Spanish throne on March 16, 1521. The Philippines had become a Spanish colony and was the first country to be named after a sovereign, Phillip II of Spain.1 Spanish rule had continued until 1898 when the Philippines had become an American colony following the Spanish-American War for the stately sum of $20 million. In 1942 during WWII, the Philippines had fallen under Japanese occupation and was liberated by American and Filipino forces under the leadership of General Douglas MacArthur in a fiercely contested battle that raged on between 1944 and 1945. The Philippines had attained its independence on July 4, 1946, and had a functioning democratic system. 2 The Philippines Archipelago consisted of 7,100 islands, covering an area of 299,735 square kilometers and was slightly larger than Arizona. The capital city of Manila was situated on the largest Philippine island of Luzon (see Exhibit 1). The Philippines had a gross domestic product (GDP) per capita of $3,400.3 The percentage of the population of the Philippines living below US$2 a day was 45.2 per cent in 2006.4 PHILIPPINE BUSINESS ENVIRONMENT Research conducted in 2009 showed that the Philippines was ranked 140th for ease of doing business and 155th for starting a business, out of a total of 178 countries. It took on average 15 procedures and a total of 52 days to complete business startup procedures in the Philippines compared to six procedures and 44.2 days and 5.8 procedures and 13.4 days for the same process in Asia and Organisation for Economic Cooperation and Development (OECD) countries, respectively.5 The Philippines had the second lowest savings and investment as share of GDP ratio in Asia6 (see Exhibit 2). PHILIPPINE FISHING INDUSTRY The Philippines has total territorial waters of 2.2 million square kilometers, of which coastal waters comprise 266,000 square kilometers and coastal reef area (10 to 20 fathoms deep, where reef fishing takes place) comprise 27,000 square kilometers.7 In 2003, the Philippines ranked eighth among the top fish-producing countries in the world with its total production of 3.62 million metric tons of fish, crustaceans, mollusks and aquatic plants (including seaweed). The production constituted 2.5 per cent of the total world production of 146.27 million metric tons.8 The fishing industry’s contribution to the country’s GDP was 2.3 per cent and 4.2 per cent, at current and constant prices, respectively. The industry employed a total of 1,614,368 fishing operators nationwide,9 of which the artisanal fisheries sector accounted for 1,371,676.10 Artisanal fishing operations were typically family-based and used smaller craft. There were a total of 469,807 fishing boats in the Philippines, of which 292,180 were non-motorized and 177,627 were motorized.11 Fish was not only an important source of nutrition, but as fishing did not require landownership or special permits it was an employment of last resort for people who had no other means of subsistence. MIA, DENMARK MIA was established in Denmark in 1975 by wealthy businessman Hagen Nordstrom, who dedicated the NGO to his wife Mia and made fighting poverty his life’s work. (MIA stood for â€Å"beloved† in Danish.) MIA had initially focused solely on poverty-alleviating projects in Africa and had expanded its operations to Latin America and the Caribbean only in the early 1990s. The grandson of Nordstrom, Gillis Nordstrom, had taken over as MIA chairman in 2004 on the eve of the Bander Aceh Tsunami of December 26, 2004, which devastated Southeast Asia and killed as many as 130,000 people.12 Nordstrom had taken initiative and redirected MIA to focus on disaster recovery and poverty alleviation projects in Southeast Asia. MIA had established an office in Manila in January 2006, and the young Danish development economist Borje Petersen was hired to manage the MIA Philippines office. Petersen was paid a starting salary of $75,000 a year plus housing, slightly below average for a comparable development economist position. Petersen knew that MIA’s attention was focused on Indonesia and Malaysia, which had been the hardest hit by the tsunami, and was anxious to carve out a position for MIA Philippines by designing an exceptional project. As the expansion into Asia was the pet project of MIA’s chairman, Petersen felt assured that funding would be easily appropriated and even expedited. Petersen knew that the average overseas posting for a development economist for MIA was two years and had quickly established contact with local and international stakeholders and set up numerous meetings with large development project counterparts such as the Asian Development Bank, the World Bank and the German development aid organization GFZ to get an expedited understanding of the Philippines and its unique needs. Based on the initial research, Petersen had decided that, whereas an agricultural project would be feasible, it would take a long time to realize and the outcome could be complicated given the Philippines’ proneness to be hit by typhoons. Petersen’s research had revealed that small-scale aquaculture projects had been successfully implemented in the Philippines in the past. However, there were hardly any projects to speak of directed at artisanal fishing and picking up on the vested opportunity and his desire to deliver fast results and prove himself worthy of the task that MIA and its chairman demanded, he had chosen to design a project helping artisanal fishermen. Petersen had researched the possibility of helping a fishing village close to Manila and the search for the ideal village had come to a successful ending when MIA’s driver, Vicente Tubo, had mentioned how some of his distant cousins fished for a living in a fishing village seven to nine hours by car from Manila. A factfinding mission to the village Barangay San Hagon was undertaken and the village was thus chosen as the beneficiary of MIA’s pilot project in the Philippines. BARANGAY SAN HAGON Barangay San Hagon boasted 125 households and had a resident population of 625. San Hagon lay on the south coast of Luzon, the largest island of the Philippines. The Barangay was the smallest administrative division in the Philippines and stemmed from the Spanish â€Å"Barrio.†13 Barangay San Hagon was administered by a local government unit (LGU) and consisted of seven Barangay council members and a chairman. The chairman of Barangay San Hagon was Rafael Buenaventura, age 59, who had held office for more than a decade. Fishing villages in the Philippines were very vulnerable to external risk, especially natural calamities such as typhoons, flooding and fish kills, which severely affected their financial situation.

The Heinkel He 111 or the Luftwaffe Bomber

The Heinkel He 111 or the Luftwaffe Bomber With its defeat in World War I, the leaders of Germany signed the Treaty of Versailles which formally ended the conflict. Though a far-reaching agreement, one section of the treaty specifically forbade Germany from constructing and operating an air force. Due to this restriction, when Germany commenced rearmament in the early 1930s, aircraft development occurred in secrecy or proceeded under the guise of civilian use. Around this time, Ernst Heinkel commenced an initiative to design and build a high-speed passenger plane. To design this aircraft, he hired Siegfried and Walter Gà ¼nter. The result of the Gà ¼nters efforts was the Heinkel He 70 Blitz which began production in 1932. A successful aircraft, the He 70 featured an elliptical inverted gull wing and a BMW VI engine. Impressed with the He 70, the Luftfahrtkommissariat, which sought a new transport aircraft that could be converted to a bomber in wartime, contacted Heinkel. Responding to this inquiry, Heinkel began work to enlarge the aircraft to meet the requested specifications and to compete with new twin-engine aircraft such as the Dornier Do 17. Preserving the key features of the He 70, including the wing shape and BMW engines, the new design became known as the Doppel-Blitz (Double Blitz). Work on the prototype pushed forward and it first took to the skies on February 24, 1935, with Gerhard Nitschke at the controls. Competing with the Junkers Ju 86, the new Heinkel He 111 compared favorably and a government contract was issued. Design Variants Early variants of the He 111 utilized a traditional stepped cockpit with separate windscreens for the pilot and copilot. Military variants of the aircraft, which began production in 1936, saw the inclusion of dorsal and ventral gun positions, a bomb bay for 1,500 lbs. of bombs, and a longer fuselage. The addition of this equipment adversely affected the He 111s performance as the BMW VI engines did not produce sufficient power to offset the additional weight. As a result, the He 111B was developed in the summer of 1936. This upgrade saw more powerful DB 600C engines with variable pitch airscrews installed as well as additions to the aircrafts defensive armament. Pleased with the improved performance, the Luftwaffe ordered 300 He 111Bs and deliveries commenced in January 1937. Subsequent improvements produced the D-, E-, and F-variants. One of the most notable changes during this period was the elimination of the elliptical wing in favor of a more-easily produced one featuring straight leading and trailing edges. The He 111J variant saw the aircraft tested as a torpedo bomber for the Kriegsmarine though the concept was later dropped. The most visible change to the type came in early 1938 with the introduction of the He 111P. This saw the entire forward part of the aircraft altered as the stepped cockpit was removed in favor of a bullet-shaped, glazed nose. In addition, improvements were made to the power plants, armament, and other equipment. In 1939, the H-variant entered production. The most widely produced of any He 111 model, the H-variant began entering service on the eve of World War II. Possessing a heavier bomb load and greater defensive armament than its predecessors, the He 111H also included enhanced armor and more powerful engines. The H-variant remained in production into 1944 as the Luftwaffes follow-on bomber projects, such as the He 177 and Bomber B, failed to yield an acceptable or reliable design. In 1941, a final, mutated variant of the He 111 commenced testing. The He 111Z Zwilling saw the merging of two He 111s into one large, twin-fuselage aircraft powered by five engines. Intended as a glider tug and transport, the He 111Z was produced in limited numbers. Operational History In February 1937, a group of four He 111Bs arrived in Spain for service in the German Condor Legion. Ostensibly a German volunteer unit supporting Francisco Francos Nationalist forces, it served as a training ground for Luftwaffe pilots and for evaluating new aircraft. Making their combat debut on March 9, the He 111s attacked Republican airfields during the Battle of Guadalajara. Proving more effective than the Ju 86 and the Do 17, the type soon appeared in larger numbers over Spain. Experience with the He 111 in this conflict allowed designers at Heinkel to further refine and improve the aircraft. With the beginning of World War II on September 1, 1939, He 111s formed the backbone of the Luftwaffes bombing assault on Poland. Though performing well, the campaign against the Poles revealed that the aircrafts defensive armament required enhancement. In the early months of 1940, He 111s conducted raids against British shipping and naval targets in the North Sea before supporting the invasions of Denmark and Norway. On May 10, Luftwaffe He 111s aided ground forces as they opened the campaign in the Low Countries and France. Taking part in the Rotterdam Blitz four days later, the type continued to strike both strategic and tactical targets as the Allies retreated. At the end of the month, He 111s mounted raids against the British as they conducted the Dunkirk Evacuation. With the fall of France, the Luftwaffe began preparing for the Battle of Britain. Concentrating along the English Channel, He 111 units were joined by those flying the Do 17 and Junkers Ju 88. Commencing in July, the assault on Britain saw the He 111 encounter fierce resistance from Royal Air Force Hawker Hurricanes and Supermarine Spitfires. The early phases of the battle showed a need for the bomber to have a fighter escort and revealed a vulnerability to head-on attacks due to the He 111s glazed nose. In addition, repeated engagements with British fighters showed that the defensive armament was still inadequate. In September, the Luftwaffe switched to targeting British cities. Though not designed as a strategic bomber, the He 111 proved capable in this role. Fitted with Knickebein and other electronic aids, the type was able to bomb blind and maintained pressure on the British through the winter and spring of 1941. Elsewhere, the He 111 saw action during the campaigns in the Balkans and the invasion of Crete. Other units were sent to North Africa to support the operations of the Italians and the German Afrika Korps. With the German invasion of the Soviet Union in June 1941, He 111 units on the Eastern Front were initially asked to provide tactical support for the Wehrmacht. This expanded to striking the Soviet rail network and then to strategic bombing. Later Operations Though offensive action formed the core of the He 111s role on the Eastern Front, it also was pressed into duty on several occasions as a transport. It earned distinction in this role during by evacuating wounded from the Demyansk Pocket and later in re-supplying German forces during the Battle of Stalingrad. By the spring of 1943, overall He 111 operational numbers began to decline as other types, such as the Ju 88, assumed more of the load. In addition, increasing Allied air superiority hampered offensive bombing operations. During the wars later years, the He 111 continued to mount raids against Soviet shipping in the Black Sea with the assistance of FuG 200 Hohentwiel anti-shipping radar. In the west, He 111s were tasked with delivering V-1 flying bombs to Britain in late 1944. With the Axis position collapsing late in the war, He 111s supported numerous evacuations as German forces withdrew. The He 111s final missions of the war came as German forces attempted to halt the Soviet drive on Berlin in 1945. With the surrender of Germany in May, the He 111s service life with the Luftwaffe came to an end. The type continued to be used by Spain until 1958. Additional license-built aircraft, constructed in Spain as the CASA 2.111, remained in service until 1973. Heinkel He 111 H-6 Specifications General Length: 53 ft., 9.5 in.Wingspan: 74 ft., 2 in.Height: 13 ft., 1.5 in.Wing Area: 942.92 sq. ft.Empty Weight: 19,136 lbs.Loaded Weight: 26,500 lbs.Maximum Takeoff Weight: 30,864 lbs.Crew: 5 Performance Maximum Speed: 273 mphRange: 1,429 milesRate of Climb: 850 ft./min.Service Ceiling: 21,330 ft.Power Plant: 2 Ãâ€" Jumo 211F-1 or 211F-2 liquid-cooled inverted V-12 Armament 7 Ãâ€" 7.92 mm MG 15 or MG 81 machine guns, (2 in the nose, 1 in the dorsal, 2 on the side, 2 ventral. These may have been replaced by 1 Ãâ€" 20 mm MG FF cannon (nose mount or forward ventral position) or 1 Ãâ€" 13 mm MG 131 machine gun (mounted dorsal and/or ventral rear positions)Bombs: 4,400 lb. in internal bomb bay

Word Choice Choose vs. Chose - Get Writing Tips with Proofed!

Word Choice Choose vs. Chose - Get Writing Tips with Proofed! Word Choice: Choose vs. Chose The difference between the present and past is important. After all, you’d never get anything done if you couldn’t tell the difference between today and yesterday. Or perhaps you’d think you’d already done it†¦ The point is that it’s confusing, which is also true if you mix up â€Å"choose† and â€Å"chose.† These are variations of the same word. â€Å"Choose† is a present tense verb; â€Å"chose† is a past tense verb. But how should you use them? Let us explain. Choose (Simple Present Tense) To â€Å"choose† (pronounced to rhyme with â€Å"shoes†) something is to make a decision. Since this is a simple present tense verb, we typically use it for generalizations and current actions: Many people choose to wear a hat in the summer. Many cacti, too. â€Å"Choose† can also be combined with â€Å"will† in the simple future tense or â€Å"would† to express a hypothetical: I will choose what to wear before I go out. If I were you, I would choose now. The first sentence here expresses an intention in the future simple tense. The second is a hypothetical scenario about making a choice. But in both cases, â€Å"choose† is the correct term. Chose (Simple Past Tense) If a decision has already been made, the word you’ll need is â€Å"chose† (pronounced to rhyme with â€Å"nose†). This is the simple past tense form of this word. For instance: When I saw the rain, I chose not to go out. Here, for example, the speaker is talking about a past decision. Choosing and Chosen (Present and Past Participles) There are two more variations of this word: the present participle â€Å"choosing† and the past participle â€Å"chosen.† We use present participles in the continuous (or progressive) tenses to describe an action that occurs over a period of time. For instance, we might say: I am choosing what to wear for the interview. This sentence uses the present continuous â€Å"am choosing what to wear† to show that a decision is currently being made. With a tie like this, I know Ill get the job! Past participles, meanwhile, are used in the perfect tenses. For example: She had chosen what to wear, but then she decided to stay home instead. Here, the past perfect â€Å"had chosen† shows a decision was made in the past (i.e., what to wear) before something else happened (i.e., deciding to stay home). Choose or Chose? The participle forms above are easier to remember because they look quite different written down, but it’s easy to mix up â€Å"choose† and â€Å"chose† if you’re not careful (even if it is just a typo). Our main tip is to proofread your work thoroughly (or ask a professional to do it). Keep an eye out for these words and make sure that each one is the correct tense for the sentence. Remember: Choose = Simple present tense Chose = Simple past tense

Oswestry Mutual Insurance Essay Example | Topics and Well Written Essays - 3500 words

Oswestry Mutual Insurance - Essay Example In 1991, the company decision-making process was highly centralized. The growth experienced by OMI in the mid to late 1980's and the need to become more responsive to the dynamics of the industry, top management decided to change the operating structure. In 1991, they reorganized into 6 sectional-regional profit centers. The branch offices remained at 68, each branch office reports to a specific sectional profit centre and sectional office. The sectional office is responsible for approving all policies written and claims filed through both branch offices and the independent agents located in that region. The head office's is suppose to establish overall corporate policy and provide support to 6 sectional offices. The head office in Oswestry and the sectional offices were organized on a functional basis. The functional units in all locations are: Premium Audit, Underwriting, Sales, Claims/Losses, Finance, Human Resources, Loss Monitoring and Support. However, even though the operational structure was decentralized, most of the information services still remain centralized in the head office, which includes related planning, control, budget authority and decision- making stays at the head office. Computers were used, at first, for financial and statistical report production: standard MIS reports included, profit/loss, operations, claim data, loss ratios, and marketing information. In the 1980's, it became painfully obvious to OMI that the companies method of processing policy and claim data needed a major overhaul. John Robson, at the time, director of Information Systems called for a serious review of information service operations. He wanted to know what data was being collected, processed, and how the information was being used by every department and branch office. In 1991, a committee was established. Representatives came from Information Systems, and the major functional area user groups. They studied current information system problems, determined future requirements, and developed specifications for new systems to meet their needs. The project was completed in 1993, implemented was: an automated policy-writing system which would issue policies, cancellations, changes and renewals, marketing and financial reports were regularly prepared, directly from the data already entered into the policy writing and claim system, an automated claim input system which automatically issue claims cheques, online retrieval of policyholder information became possible at all branch offices, online retrieval of claim information became possible at all branch offices Overall Process To Implement Change The new systems were not perfect, but was a great improvement. When a new application for insurance was received by the Underwriting department in a sectional office, relevant data was entered by a sectional office by a PPD clerk over a telephone line link into the company's large IBM 3090 central mainframe located in Oswestry. Data would then be processed in overnight batch mode to produce a policy which could be printed in multiple copies the next day in Oswestry, and on a remote printer in the sectional office. Also, an online policy-holder file would also be available the next day for retrieval on the sectional office terminal which was also connected to the 3090 in Oswestry. Prior to the systems development, work that took place between 1991-1993 and before, the establishment of the sectional offices, handling personal policy information was a semi-automated clerical

Lyrical Ballads and Hamlet Essay Example | Topics and Well Written Essays - 1000 words

Lyrical Ballads and Hamlet - Essay Example he genuineness of the actions taken by Gertrude as a female character, it is still evident that Shakespeare tries to create a realization of this character as a human being (Stephen 1). Therefore, this paper attempts to scrutinize the extent to which self-hood can be attained through the use of female characters as depicted by Shakespeare in Hamlet and The Female Vagrant by Wordsworth. The realization of the human nature in Gertrude is observed when she drinks the poisoned wine that was prepared by Claudius, her husband, for Hamlet. Looking at this incident critically, it is evident in Act 3 that Gertrude came to herself and felt the guilt behind all the evils she was doing. For instance, it is possible that Gertrude had an affair with Claudius even while she was still married to King Hamlet and probably this is why the marriage between her and Claudius worked out so fast after the King’s death. Moreover, it may still be possible that Gertrude participated actively in secrecy towards the murder of her husband since from the play; she does not seem to consider the claims of her son that his uncle murdered his father, the King of Denmark (Stephen 3). Some of the actions of Gertrude seem to be powered by her wish and ambition to retain her station in the palace and her status as the Queen of Denmark (Stephen 4). These are valid human ambitions, and every other human is bound to be filled with the desire to maintain a royal status. It is therefore not surprising that Gertrude would be willing to do everything to see to it that she retains her status as the Queen of Denmark. What makes this ambition all wrong is going to the extreme; being ready even to see her husband die and start having sex with another man even before long after her husbands death creates a lot of suspicions (Stephen 4). However, despite all the bad things that Claudius did, she finally admitted that she was wrong, although she did not use spoken language to regret her deeds, but her actions

Final Strategic Plan and Presentation Essay Example | Topics and Well Written Essays - 750 words

Final Strategic Plan and Presentation - Essay Example Strength includes all the positive factors of Dynasties Motors which will help in their future growth. Weaknesses are the shortcomings in the company. These are the internal factors which can be controlled easily. The external factors are the Opportunities and Threats. The opportunities show us all available opportunities for the company to grow. We need to utilize them. The threats are the dangers and the negativities that can harm us. We need to avoid them as we cannot control them. Our pricing strategy will be dependent upon focused Blue Book qualities (wholesale and retail) in addition to vehicle taking care of expenses. We wont surpass aggressive retail costs, and will endeavor to offer at wholesale in addition to a reasonable profit, for the most part 15-25%. Quality and value say a ton in regards to our vehicles. The vehicles that are uncommon or not promptly accessible to take care of demand will be estimated in like manner. The normal business imprint up for comparative vehicles is 20-30%. Sales payment is dependent upon a percent of profits. We will put satisfactory time and assets into preparing every part of the sales group and into great client relations. Salesmen will be paid a share of their pay dependent upon requisition. Great execution is compensated with expanded requisition and rewards. However honesty wont be relinquished for sales. Client fulfillment will keep on ing a top necessity. All potential sales will be attended to in a convenient manner and long haul salesperson-client relationships will overshadow sales conclusion. We anticipate that sales will build at a moderate rate for every month for every item in the first year. From June through September we need negligible development throughout our begin up period. October through December we anticipate that diminished sales due will chronicled patterns, and deterioration in quality dependent upon less request. February through August we want

Is Globalisation A Threat Or Opportunity Economics Essay

Is Globalisation A Threat Or Opportunity Economics Essay The term globalisation is often used however hardly ever defined. It refers to the rapid enhance in the share of monetary movement taking place across state limits. This goes further than just the international trade in goods and comprises the way those goods are produced, the delivery and sale of services, and the movement of resources. Globalisation is the result of a number of interrelated developments together with: The increase and relative consequence of foreign direct investment and multinational enterprises The internationalisation of financial markets The ongoing growth of communication and transport technology Deregulation and liberalisation Privatisation of public sector service (TSSA) This report includes about Globalisation and its impacts to consumers and also the benefits that both organisations and employees could take chance of it. Defining Globalisation Globalisation is the process by which the world is becoming increasingly interconnected as a result of massively increased trade and cultural exchange. The global economy is the machine that powers globalisation. This concept has been taking place for hundred of years, but has speeded up rapidly over the last decade. The factors that influence globalisation include the following. Communication: Technological products and services such as TV, Telephone and Internet have allowed information to travel so rapidly. An Australian business can have a call centre in Sri Lanka answering calls from Australian customers (BBC). Transport: This has become cheaper and people travel more than earlier days since the development of the transport industry such as Rail Transport, Air Transport and Sea Transport. The mode of transport has become more convenient than never before with the improvement of technology since customers can arrange their travel needs staying at their home and the services are delivered to their door step. Businesses can ship products and raw materials all over the world more easily making products and services from all over the globe available to their local customers (BBC). Trade Liberalisation: Laws restricting trade and foreign investment have been relaxed. Several governments even offer grants and tax incentives to convince foreign companies to invest in their country (BBC). When globalisation comes into existence there are two main policies that govern the process of globalisation, which is Privatisation and Deregulation. Privatisation is all about putting the government out of the business. Which means the free market will take control of the business which is managed by a private sector organisation. When the government is incompetent to run the economy they will let the free market to run it which will benefit the public. At this stage governments will sell their publicly owned business and assets to multinationals (MNCs) which are controlled and financed by public shareholders. In a country deregulation will take several forms. Government in a country would take off the trade restrictions and easing of government regulation in business will allow the business to run more efficiently. Therefore the best business will survive the competition to give the consumers a better standard of living. Dimensions of Globalisation Trade Trade is the key ingredient that receives more attention of globalisation. Trade liberalisation would minimise the formal trade barriers through the process of WTO and other regional bilateral agreements. Trade liberalisation receives much public inspection since it engages direct policy decisions by national government to reduce trade barriers. It involves legislation and concessions with other governments. Thus trade liberalisation is important to many countries economic in modern times. Many successive governments have delivered on commitments to reduce trade barriers (Harcourt, 2001). Investment There is less public debate about the role of investment despite the capacity of the capital which outstrips trade flows in this aspect of globalisation relative to trade. One of the reason behind this would be there are formal regulations of investment made by governments on an international scale equally there are trade regulations in the WTO. However the opening of the domestic economies to FDI is an important part of modern globalisation (Harcourt, 2001). 3.3 Organisational Change This dimension of globalisation related to organisational change in the corporate sector. Exploring trade and investment flows between countries may provide some suggestion to international economic integration but it may fail to spot key important developments of corporate restructure and firm behaviour that may have major affects. There have been intact changes in many organisations in terms of the nature of the firm due to globalisation of the production and distribution process. Today firms are part of global supply changes with extensive global networking which has led modern world management strategies such as outsourcing (Harcourt, 2001). According to Eslake (2000), For both corporations and governments, the drive to lower costs has in turn spawned a variety of management strategies such as outsourcing non- core activities to outside specialists, striving for economies of scale by acquiring and consolidating the operations of other businesses producing similar or compatible products, and shifting activities to locations where the most important inputs (such as labour or energy) may be obtained on the most favourable terms. For each of these strategies, reaching across national borders is a distinctly possible outcome. Corporate strategy might occur within in a nation where as in some instances it may not. Nevertheless, exporters and affiliates of international firms are often the first to implement organisational change within a country. Exporters tend to adapt international business practices much earlier than the domestic firm in the domestic market do will be a special characteristic. Therefore, practices like out-sourcing, benchmarking, business networking and contracting out are more likely to be pronounced in the exporting sector of the economy (Harcourt, 2001). Is Globalisation a Threat or Opportunity? Globalisation has the potential to create wealth and enhance living standards. The benefits are obvious for countries which comprised with products, skills and resources in order to take advantage of the opportunities provided by the global markets. Furthermore there are some major downsides particularly for those countries that dont fall into to this category (TSSA). In general globalisation is recognised as having increased the gap between the rich and poor. This is largely because of the policies that drive the globalisation processes have mainly focussed on the needs of the business. Moreover this concept has significant social and political implications which have brought the threat of elimination for large section of the worlds population creating unemployment, growing wage and income disparities. This concept globalisation which we all concern about has also made it difficult to deal with economic policies just as prominently in corporate behaviour which is purely within a nation (TSSA). Over the past years industrialised countries which are highly paid have seen their income rise much more faster than the average developing families in third world nations are dependent on insecure such as low paid jobs and less social benefits. Trade Liberalisation of trade which means and to reduce regulation including legal protection of workers has put on a negative impact on the lives of millions of people around the world. Several poor countries such as Sri Lanka are have been encouraged to enhance the production for exports and compelled to reduce inadequate spending on public services so that it will benefit the nation to repay their foreign depts. Consequently this has forced many people substantially in to a life of poverty and uncertainty (TSSA). Pros and Cons of Globalisation Positive: The utmost benefit that most of the developed countries get from globalisation is the availability of greater range of cheap goods to buy. Globalisation opens people to be alive to other cultures and all their creativity and to the flow of thoughts and ethics. Information and communication technologies have eased interaction among countries and peoples. Globalization has eased international trade and commerce, facilitated foreign investment and the flow of capital. Globalization has freed labour across boundaries. Globalization has set new rules that are integrating global markets. (Nsibambi, 2001) Negative: As cultures interact, some cultures are being diluted and/or destroyed at the expense of others and negative values are being spread all over the world with relative ease. The world is now divided between the connected, who know and who have a monopoly on almost everything, and the isolated, who do not know and who practically have nothing. Globalization has encouraged illicit trade in drugs, prostitution, pornography, human smuggling, dumping of dangerous waste and depletion of the environment by unscrupulous entrepreneurs. Globalization has facilitated the brain drain in developing countries, thus reducing further their human capacity. Globalization has set new global rules that have further marginalized poor countries and people, especially in areas of trade. (Nsibambi, 2001) Conclusion In order to sustainably serve the humanity there would be a different global economy that works in the real world. It is inevitable that the pain destruction caused by the global economy has affected the consumers in the poor countries at large but this how the global economy is designed. Employment deprivation, social breakdowns, and high personal stress levels are not a substance to mathematically calculated profit margins in todays business arena. The people of a nation as humans care about well being of their environment and society in which they belongs to. Most of the MNCs do not have such national sentiments to put in to practice as they would look ahead to give the world for a dominant market share and presently their concern is merely just doing what they want.

Death Penalty Essay: Barbaric Capital Punishment -- Argumentative Pers

Barbaric Capital Punishment      Ã‚   During the past three decades the issue of capital punishment has been very controversial inside the United States. During 1972 the U.S. Supreme Court decided in Furman v. Georgia that the death penalty was unconstitutional because it was a form of "cruel and unusual punishment." However, this decision did not last long; in July 1975 the Supreme Court ruled that capital punishment did not violate any parts of the Constitution. Executions as they had before 1972 resumed again. Since then 180 prisoners have been executed. The United States Supreme Court should abolish the death penalty because it is a form of "cruel and unusual punishment."    Under our current U.S. Constitution which has been around for over 200 years, prisoners of the government cannot be subjected to any kind of punishment which is deemed cruel and unusual. However all the forms of capital punishment that the government uses are questionable as to whether or not they are legal according to the Constitution. Forms of capital punishment that are still used in the United States include hanging, firing squad, electrocution, gas chamber, and lethal injection. With hangings a rope is attached to a persons neck proceeded with them being dropped from a certain height with the other end of the rope attached to something higher than them. The result is either strangulation which can take a while or complete decapitation. With the firing squad option a prisoner is tied to a chair and blinded. After this a firing squad composed most of the time of five individuals fires gun shots at a target attached to the prisoners chest (ACLU).    The most widely used form of execution has been electrocution. With this method of elect... ... obtain its goal. Because the death penalty fails its main objective and because of the reason stated above it should be abolished.    Works Cited American Civil Liberties Union. "Briefing Paper Number 8." gopher://gopher.pipeline.com:70/00/society/aclu/publications/papers/8. Associated Press. "PD Chiefs: Death Penalty Fails". news:death-penaltyURcb0_5FN@clarinet.com:Thu, 23 Feb 95 4:40:09 PST. Bedau, Hugo Adam. "The Case Against The Death Penalty". gopher://gopher.pipeline.com:70/00/society/aclu/issues/death/case_against. Blumstein, Alfred and Jacqueline Cohen. Deterrence and Incapacitation: Estimating the Effects of Criminal Sanctions on Crime Rates. National Academy of Sciences: Washington, D.C., 1978. Van den Haag, Ernest. Punishing Criminals: Concerning a Very Old and Painful Question. Basic Books, Inc.: New York, 1975.    Death Penalty Essay: Barbaric Capital Punishment -- Argumentative Pers Barbaric Capital Punishment      Ã‚   During the past three decades the issue of capital punishment has been very controversial inside the United States. During 1972 the U.S. Supreme Court decided in Furman v. Georgia that the death penalty was unconstitutional because it was a form of "cruel and unusual punishment." However, this decision did not last long; in July 1975 the Supreme Court ruled that capital punishment did not violate any parts of the Constitution. Executions as they had before 1972 resumed again. Since then 180 prisoners have been executed. The United States Supreme Court should abolish the death penalty because it is a form of "cruel and unusual punishment."    Under our current U.S. Constitution which has been around for over 200 years, prisoners of the government cannot be subjected to any kind of punishment which is deemed cruel and unusual. However all the forms of capital punishment that the government uses are questionable as to whether or not they are legal according to the Constitution. Forms of capital punishment that are still used in the United States include hanging, firing squad, electrocution, gas chamber, and lethal injection. With hangings a rope is attached to a persons neck proceeded with them being dropped from a certain height with the other end of the rope attached to something higher than them. The result is either strangulation which can take a while or complete decapitation. With the firing squad option a prisoner is tied to a chair and blinded. After this a firing squad composed most of the time of five individuals fires gun shots at a target attached to the prisoners chest (ACLU).    The most widely used form of execution has been electrocution. With this method of elect... ... obtain its goal. Because the death penalty fails its main objective and because of the reason stated above it should be abolished.    Works Cited American Civil Liberties Union. "Briefing Paper Number 8." gopher://gopher.pipeline.com:70/00/society/aclu/publications/papers/8. Associated Press. "PD Chiefs: Death Penalty Fails". news:death-penaltyURcb0_5FN@clarinet.com:Thu, 23 Feb 95 4:40:09 PST. Bedau, Hugo Adam. "The Case Against The Death Penalty". gopher://gopher.pipeline.com:70/00/society/aclu/issues/death/case_against. Blumstein, Alfred and Jacqueline Cohen. Deterrence and Incapacitation: Estimating the Effects of Criminal Sanctions on Crime Rates. National Academy of Sciences: Washington, D.C., 1978. Van den Haag, Ernest. Punishing Criminals: Concerning a Very Old and Painful Question. Basic Books, Inc.: New York, 1975.   

Marketing strategies Essay

Types of strategies Marketing strategies may differ depending on the unique situation of the individual business. However there are a number of ways of categorizing some generic strategies. A brief description of the most common categorizing schemes is presented below: Strategies based on market dominance – In this scheme, firms are classified based on their market share or dominance of an industry. Typically there are four types of market dominance strategies: Leader Challenger Follower Nicher According to Shaw, Eric (2012). Marketing Strategy: From the Origin of the Concept to the Development of a Conceptual Framework. Journal of Historical Research in Marketing., there is a framework for marketing strategies. Market introduction strategies â€Å"At introduction, the marketing strategist has two principle strategies to choose from: penetration or niche† (47). Market growth strategies  Ã¢â‚¬Å"In the early growth stage, the marketing manager may choose from two additional strategic alternatives: segment expansion (Smith, Ansoff) or brand expansion (Borden, Ansoff, Kerin and Peterson, 1978)† (48). Market maturity strategies â€Å"In maturity, sales growth slows, stabilizes and starts to decline. In early  maturity, it is common to employ a maintenance strategy (BCG), where the firm maintains or holds a stable marketing mix† (48). Market decline strategies At some point the decline in sales approaches and then begins to exceed costs. And not just accounting costs, there are hidden costs as well; as Kotler (1965, p. 109) observed: ‘No financial accounting can adequately convey all the hidden costs.’ At some point, with declining sales and rising costs, a harvesting strategy becomes unprofitable and a divesting strategy necessary† (49). Early marketing strategy concepts were: Borden’s â€Å"marketing mix†Ã‚  Ã¢â‚¬Å"In his classic Harvard Business Review (HBR) article of the marketing mix, Borden (1964) credits James Culliton in 1948 with describing the marketing executive as a ‘decider’ and a ‘mixer of ingredients.’ This led Borden, in the early 1950s, to the insight that what this mixer of ingredients was deciding upon was a ‘marketing mix'† (34). Smith’s â€Å"differentiation and segmentation strategies† â€Å"In product differentiation, according to Smith (1956, p. 5), a firm tries ‘bending the will of demand to the will of supply.’ That is, distinguishing or differentiating some aspect(s) of its marketing mix from those of competitors, in a mass market or large segment, where customer preferences are relatively homogeneous (or heterogeneity is ignored, Hunt, 2011, p. 80), in an attempt to shift its aggregate demand curve to the left (greater quantity sold for a given price) and make it more inelastic (less amenable to substitutes). With segmentation, a firm recognizes that it faces multiple demand curves, because customer preferences are heterogeneous, and focuses on serving one or more specific target segments within the overall market† (35). Dean’s â€Å"skimming and penetration strategies† â€Å"With skimming, a firm introduces a product with a high price and after milking the least price sensitive segment, gradually reduces price, in a stepwise fashion, tapping effective demand at each price level. With penetration pricing a firm continues its initial low price from introduction  to rapidly capture sales and market share, but with lower profit margins than skimming† (37). Forrester’s â€Å"product life cycle (PLC)† â€Å"The PLC does not offer marketing strategies, per se; rather it provides an overarching framework from which to choose among various strategic alternatives† (38). There are also corporate strategy concepts like: Andrews’ â€Å"SWOT analysis† â€Å"Although widely used in marketing strategy, SWOT (also known as TOWS) Analysis originated in corporate strategy. The SWOT concept, if not the acronym, is the work of Kenneth R. Andrews who is credited with writing the text portion of the classic: Business Policy: Text and Cases (Learned et al., 1965)† (41). Ansoff’s â€Å"growth strategies† â€Å"The most well-known, and least often attributed, aspect of Igor Ansoff’s Growth Strategies in the marketing literature is the term ‘product-market.’ The product-market concept results from Ansoff juxtaposing new and existing products with new and existing markets in a two by two matrix† (41-42). Porter’s â€Å"generic strategies† Porter generic strategies – strategy on the dimensions of strategic scope and strategic strength. Strategic scope refers to the market penetration while strategic strength refers to the firm’s sustainable competitive advantage. The generic strategy framework (porter 1984) comprises two alternatives each with two alternative scopes. These are Differentiation and low-cost leadership each with a dimension of Focus-broad or narrow. ** Product differentiation ** Cost leadership ** Market segmentation * Innovation strategies — This deals with the firm’s rate of the new product development and business model innovation. It asks whether the company is on the cutting edge of technology and business innovation. There are three types: ** Pioneers ** Close followers ** Late followers * Growth strategies — In this scheme we ask the question, â€Å"How should the firm grow?†. There are a number of different ways of answering that question, but the most common gives four answers: Horizontal integration Vertical integration Diversification Intensification These ways of growth are termed as organic growth. Horizontal growth is whereby a firm grows towards acquiring other businesses that are in the same line of business for example a clothing retail outlet acquiring a food outlet. The two are in the retail establishments and their integration lead to expansion. Vertical integration can be forward or backward. Forward integration is whereby a firm grows towards its customers for example a food manufacturing firm acquiring a food outlet. Backward integration is whereby a firm grows towards its source of supply for example a food outlet acquiring a food manufacturing outlet. A more detailed scheme uses the categoriesMiles, Raymond (2003). Organizational Strategy, Structure, and Process. Stanford: Stanford University Press. ISBN 0-8047-4840-3.: Prospector Analyzer Defender Reactor Marketing warfare strategies – This scheme draws parallels between marketing strategies and military strategies. BCG’s â€Å"growth-share portfolio matrix† â€Å"Based on his work with experience curves (that also provides the rationale for Porter’s low cost leadership strategy), the growth-share matrix was originally created by Bruce D. Henderson, CEO of the Boston Consulting Group (BCG) in 1968 (according to BCG history). Throughout the 1970s, Henderson expanded upon the concept in a series of short (one to three page) articles in the BCG newsletter titled Perspectives (Henderson, 1970, 1972, 1973, 1976a, b). Tremendously popular among large multi-product firms, the BCG portfolio matrix was popularized in the marketing literature by Day (1977)† (45).

Hemodialysis In Esrd Diabetics Health And Social Care Essay

Chronic kidney disease ( CKD ) is defined as the irreversible loss of kidney map and can be categorized as symptomless kidney harm with mild nephritic disfunction or end-stage nephritic disease ( ESRD ) . ESRD finally consequences in decease without nephritic replacing therapy, which can be either nephritic organ transplant or dialysis. Nephritic replacing therapy as a intervention protocol identifies that, at end-stage nephritic disease, the optimum intervention is kidney organ transplant, as dialysis can non retroflex the biosynthetic and metabolic activities of the normal kidney ( Haller, Gutjahr, Kramar, Harnoncourt, & A ; Oberbauer, 2011 ) . End-stage nephritic diseases and its precursor CKD are globally emerging as a important public wellness job, with increasing morbidity and mortality every bit good as economic deductions for health care, ( Szucsa, Sandoza, & A ; Keuschb, 2004 ) . The World Health Organization 2002 estimation indicated that globally CKD contributes to over 850 000 deceases and over 15 million disability-adjusted life old ages, with epidemic rise of ESRD in multiple parts in the universe. The study notes that by 2010 more than 2 million people will necessitate care dialysis worldwide, ( WHO, 2003 ) . In St. Lucia, chronic nephritic inadequacy as a consequence of diabetes, high blood pressure, autosomal dominant polycystic kidney disease, and reaping hook cell disease are the chief grounds for get downing dialysis intervention in patients with kidney map failure. This is similar to the findings of PeroviA†¡ and JankoviA†¡ ( 2009 ) . Zelmer ( 2007 ) postulates that non merely is ESRD a chronic disease with important morbidity impact, but it besides involves high-cost intervention options. These options are frequently limited in developing states such as St. Lucia, where available options include haemodialysis or the aggressive direction of hazard factors to detain patterned advance of ESRD. Global estimations indicate that about 30 % of patients with ESRD are as a effect of diabetic nephropathy [ commendation ] . In St. Lucia, the figure is significantly higher, stand foring 41 % of the ESRD patients who have received haemodialysis for the period 2002-2009. At the terminal of that 8 twelvemonth period ( 2002-2009 ) mortality rate among that population was every bit high as 53 % with mean age at decease being 57 old ages. These statistical figures indicate that ESRD among diabetics is a serious wellness concern with inauspicious clinical results that straight impact quality of life while bring forthing significant medical costs. The economic force per unit areas of ESRD intervention on the corporate wellness system are good documented. Haller et Al. ( 2011 ) identifies it as resource intensifier, necessitating significant sums of finite health care financess to handle a little per centum of the population. In 2005 entirely, attention for ESRD patients in Canada represented 1.2 % of all healthcare outgo, despite an incidence of 0.092 % , ( Zelmer, 2007 ) . Less than 0.06 % of St. Lucians have ESRD, yet the disease generated direct health care cost is important compared to other diseases. In 2008, the direct health care cost of ESRD was $ 2.2 million EC, about 5 % of the health care outgo, the economic weight of which was borne chiefly by the authorities. These findings indicate that the economic sciences of ESRD therapies are a little but instead expensive section within the overall health care proviso in any state. Yet cost-effectiveness surveies of the modes of intervention are few ( Haller, 2011 ) . Cost-effectiveness is the fastest turning field in wellness research and it embodies a signifier of full economic rating that looks at cost and effect of wellness programmes or intervention ( Muennig, 2008 ) . Using the definition by Palmer ( 2005 ) that states â€Å" cost-effectiveness surveies compare costs with clinical results measured in natural units, like life anticipation or old ages of diseases avoided † , Glassock ( 2010 ) noted that the entirety of costs may non needfully be captured. However, it is a utile tool with pertinence for the enconomic anlaysis of issues within the wellness system. Cost-effectiveness analysis ( CEA ) of intercession programmes as a valuable tool employed by decision-makers can be used to measure every bit Wellss as perchance better how the wellness system operates. Its application allows policy shapers to place which intercessions provide the highest â€Å" value for money † and help in assisting to choose intercessions and programmes that maximize wellness for the available resources. Health economic experts are able to buy the most wellness under a fixed budget, prioritising services within the wellness sector. CEA hence requires information on the extent to which current and possible intercessions improve population wellness, i.e. , effectivity and the resources required to implement the intercessions, i.e. , costs, ( Muennig, 2008 ) . The inclusion of cost agencies that the design of the survey will integrate cost-unit analysis as a tool to analyze the economic impact of the proviso of the service of dialysis for terminal phase nephritic patients with diabetes and cost effectivity to find the quality adjusted life twelvemonth ( QALYs ) or wellness related quality of life ( HRQoL ) for that population. The chief result step will concentrate on costs per quality-adjusted life old ages ( QALYs ) , similar to a survey conducted in Austria ( Haller et al. , 2011 ) . QALYs were estimated utilizing the 15D, a generic standardised instrument to mensurate wellness related quality of life, ( Sintonen, 2001 ) . Cost will be viewed from the position of direct disbursement on wellness attention for dialysis, coupled with the indirect costs of productiveness losingss due to premature decease and short- and long-run disablement. The impact of mortality costs as the amount of the discounted present value of current and future productiveness losingss from premature deceases will be measured from an incident-based human capital attack, pulling from a similar survey conducted in Canada in 2000 ( Zelmer, 2007 ) . Muennig ( 2008 ) posits that because it is frequently hard to account for all cost, and the clip and resource restraints associated with micro-costing, certain premises as relates to costs are frequently made during cost-effectiveness analysis. This survey employs the usage of a authorities position to analyse the cost effectivity of dialysis for terminal phase nephritic patients with diabetes in St. Lucia. This requires that cost analysis be conducted to mensurate the repeating direct and indirect cost of supplying the service. In the part, specifically in the state under survey, wellness attention organisations seldom know the cost of the service provided and seldom employ the tools needed to measure that cost on a regular footing. In a globally runing economic society, economic tendencies have made it imperative for both net income and non-profit organisations that provide services, including authorities bureaus, to measure the cost of clinical services provided. Finance for wellness is non infinite and with significant budget cuts in the wellness service industry, there is increasing force per unit area for wellness attention installations to go more accountable and be more efficient with the financess allocated to well ness attention ( Basch, 1999 ) . Health economic sciences recognises the demand for wellness services to be provided in a mode that is non merely efficient but sustainable. Measuring, understanding and documenting the cost of services makes it easier to better cost-efficiency of these services, while foregrounding the support demands of the sector and by extension the authorities. It besides provides an chance to set up fees for clients that are based on realistic site costs. Previous surveies on cost-effectiveness of intervention options for ESRD have compared different modes of dialysis or organ transplant, [ commendation ] . The analysis of haemodialysis versus pharmaceutical direction to detain ESRD patterned advance flexible joints on the fact that the current capacity of the Renal Unit in St. Lucia can non supply dialysis for all ESRD patients. But it is rather clear that haemodialysis like pharmaceutical direction is non the optimum intervention option for ESRD as the optimum protocol is organ transplant. The wellness system in St. Lucia is mandated by its aims to better the wellness of the population and accordingly needs to guarantee that its limited resources are non devoted to expensive intercessions with little effects on population wellness, while at the same clip low cost intercessions with potentially greater benefits are non to the full implemented. While old research has been conducted to place the economic impact of the estimated health-care costs for ESRD, every bit good as the cost-effectiveness of assorted options for nephritic replacing therapies, similar surveies have non been replicated in the resource strapped Eastern Caribbean. This survey wishes to concentrate on the cost-effectiveness of haemodialysis among type 2 diabetics in St. Lucia over an 8 twelvemonth period ( 2002-2008 ) . Using the usage of CEA, it aims at comparing the cost and effects or results ( cost-effectiveness ) of haemodialysis for diabetic nephropathy utilizing the comparator of making nil, which in this instance is the pharmaceutical direction of patients with diabetic kidney diseases to detain patterned advance of ESRD. This is particularly relevant to the wellness system in St. Lucia, as concerns on the prevalence of diabetes mellitus and its rate of addition, and the determination to spread out the service to two new installations in the absenc e of research requires that a better apprehension of the range and magnitude of the entire economic load of ESRD and the cost effectivity of dialysis intervention for diabetics with ESRD. The findings will assist to inform those doing policy determinations, and may be utile in set uping a set of precedences for farther research, bar plans, and in the planning of alternate interventions to assist relieve that load.MethodologyThis survey uses a retrospective attack to data aggregation. The survey population was selected from the lone public Renal Unit which forms portion of the general infirmary, Victoria infirmary. While there is another Nephritic Unit of measurement in St. Lucia that offers dialysis, it is a portion of the private infirmary which did non wish to take part in this survey. The survey population comprised ESRD patients with diabetic kidney diseases. Patients were considered depending on whether they received haemodialysis or whose diabetes was being pharmaceutically ma naged to detain ESRD patterned advance. Of the 111 patients on dialysis, 45 were due to diabetic kidney disease and 21 were actively having organ transplant at the clip the survey was being conducted. The nephrologists identified 12 ESRD patients who were non having dialysis but were being managed pharmaceutically. All diabetics who are or have been on dialysis with end-stage nephritic disease for the period 2002-2009 and were having dialysis due to diabetic kidney diseases were included in the survey. Persons were excluded from this survey if they were on dialysis prior to being diagnosed with diabetes. The comparator group differs from the haemodialysis group merely in the signifier of intervention that they are having, dwelling of all patients with ESRD due to diabetic kidney diseases who are non having dialysis but whose diabetes is sharply managed with medicine to detain ESRD patterned advance. Chronic conditions such as ESRD require uninterrupted intervention and as a effect a cost-effectiveness of intervention options over a period of clip for a cohort of patients, employs the usage of the Markov theoretical account to look into long term costs and results. The Markov theoretical account developed for this survey describes the procedure of attention observing that patients were assigned or began their patterned advance through the theoretical account in either of two provinces, hospital haemodialysis or pharmaceutical direction of type 2 diabetes to detain ESRD patterned advance, and decease signifies the terminal of the rhythm. A systematic literature reappraisal was conducted of peer-reviewed economic ratings of dialysis intervention modes among diabetic patients. Ebscohost and PubMed were searched utilizing the keywords cost-effectiveness, dialysis, end-stage nephritic disease and diabetic kidney disease and was limited to articles published in the last 12 old ages ( 2000-2011 ) , some articles, if they fell out of the selected old ages of publication were accepted based on the strength of their findings. The inclusion standards identified articles that included the keywords in the capable headers every bit good as the usage of Renal Replacement Therapy/economics, Renal Dialysis/economics, Hemodialysis Units, or Kidney Failure. If they included the term peritoneal dialysis or haemodialysis they were besides included. Exclusion standards of articles were identified as non-English articles and those that did non compare intervention options. More than 500 articles were identified but 31 were selected for ma nual reappraisal. Data on wellness attention costs, passage to other wellness provinces and quality of life were imputed into the Markov theoretical account. Data was obtained from the Renal Unit at the Victoria Hospital, the public wellness installation. Data on quality of life was obtained utilizing the 15D, a multidimensional, standardised generic instrument to mensurate quality or health-related quality of life ( Sintonen, 2001 ) . The 15D was used since it combines the advantages of a profile and individual index mark step that describes the wellness position by measuring 15 dimensions. The mean mark value for each dimension was used to find the wellness related quality of life in the survey population. The usage of the 15D used to mensurate quality of life result was reported in QALYs, a step of the load of disease that included the quality and measure of life lived against a pecuniary value, medical intervention or intercession. The mean mark value for each dimension measured by the 15D was used to find the wellness related quality of life of the survey population utilizing the graduated table provided by Sintonen ( 2001 ) . The findings were standardized against the load of disease markers identified by the WHO ( Ref ) . Other variables were considered in the survey and a standard questionnaire was administered to the survey population to obtain informations on the socio-economic position of individuals within the survey population. The socio-demographic questionnaire was tested against a pool of eight individuals from those who are on dialysis for grounds other than diabetic nephropathy and who were as similar to the survey population in footings of gender, instruction, socio-economic position and geographic location. Contented analysis was used to measure the information obtained from the socio-demographic questionnaire. All survey participants were provided with a missive refering namelessness and confidentiality and informed consent was obtained prior to engagement. Ethical blessing was obtained from the IRB at St. George ‘s University and the moralss commission of the Ministry of Health in St. Lucia.CostssCost-effectiveness was examined from a governmental position utilizing the clinical records of the Division of Nephrology patient enrollment and charge systems at the Victoria Hospital coupled with information from published surveies on endurance and quality of life among diabetic nephropathy patients. The theoretical account used included the direct wellness service costs associated with the intervention options, and an one-year cost per patient was calculated for each wellness province in the theoretical account. Direct health care costs associated with dialysis usage included bing regular dialysis Sessionss, complications of the dialysis, such as curdling of the fistulous withers or hypo tension episodes, research lab trials and services required as a effect of dialysis and medicine usage as a consequence of intervention. Premises were made on the regularity of direct health care cost associated with dialysis, such as regularity of research lab testing and blood transfusions. Micro-costing, roll uping informations on staffing, consumables, capital, and operating expenses were used to find the cost of one session of haemodialysis ( Table 1 ) . Structured interviews were used to obtain inside informations sing staff clip allocated to dialysis activities, every bit good as the regularity of other services used as a consequence of the intervention options. The survey identified capital points as the edifice infinite allotted to the Unit for intervention, and equipment such as the dialysis machines and air conditioner unit. Costss have been reported in Eastern Caribbean Dollars ( EC ) presented at the 2008 degree and an tantamount one-year cost calculated utilizing a 3 p er centum price reduction rate over the predicted life span. Muennig ( 2008 ) argues that a governmental position can include some facets of transportantion costs. Evidence from the Minstry of Communication and Works and the conveyance board imply that there is no nationally agreed policy for conveyance costs. There are fluctuations across St. Lucia in footings of milage, hence for the intents of our analysis, conveyance costs are excluded. The survey reviewed costs over an 8 twelvemonth period ( 2002-2009 ) . This clip frame was partially determined by the handiness of the informations two old ages after the programme was initiated and the premises made with mention to the analysis were tabulated ( Table 2 ) . Incremental costs per QALY gained were calculated by utilizing the estimations of costs and QALYs for each of the two modes obtained from the theoretical account, and the findings were presented as incremental costs per QALY. A one-way sensitiveness analysis was used to look into variableness in the information, changing the price reduction rate from 3 % to 5 % the age weights and disablement weights. A concluding sensitiveness analysis of mortality rates was besides conducted since the premise was that the mortality rates for haemodialysis were the same as those of pharmaceutical direction of ESRD diabetics.Consequences[ Presentation of Results†¦ ]Discussion[ Discussion of Results and deductions†¦ ] Locke ( 1987 ) is a advocate of the position that all surveies have built-in restrictions and boundary line. Primary and secondary information was used in this survey. Jankowich ( 2005 ) warns of the restrictions of the usage of secondary informations, as the methodological analysis used in garnering secondary informations has come into inquiry. The survey was limited by the truth and quality of the informations, which Basch ( 1999 ) argues is a repeating job in developing states. The questionnaire as a tool for garnering information airss some disadvantages, as it does non supply an chance for inquiries to be clarified or to verify that replies are understood or that all inquiries are answered. In add-on it means that the individuals being surveyed must hold the pre-requisite literacy accomplishments. This restriction was minimized by pre-testing the socio-demographic questionnaire was tested against a pool of eight individuals from those who were on dialysis for grounds other than diabetic nephropathy and who were as similar to the survey population in footings of gender, instruction, socio-economic position and geographic location, ( Table 2 ) . Another restriction to the survey was the inability to prove the 15D questionnaire as it could non be altered to be more specific. Low response rate every bit good as non-response prejudice for the questionnaire may significantly skew the information as the survey population is so little. Jankowicz ( 2005 ) argues that coaction is maximized when respondents are in some sense rewarded for cooperation and that these wagess outweigh the cost in footings of money and attempt. To accomplish this, respondents were shown that their information was valued and the construction of the questionnaire would necessitate really small in footings of clip and attempt. The absence of other surveies that compared the intervention modes used in this survey serves as a restriction of this paper, but it remains the lone feasible comparator that was available to the research worker. There are restrictions and troubles in any effort to cipher the average cost of a dialysis session, particularly in public installations where cost is subsidized ( commendation? ) , as every aspect of attention and cost associated with the session must be taken into consideration. Consequently premises were made on cost for direct and indirect services related to intervention options compared in this survey, ( Muennig, 2008 ) . Premises are justified as this is a non-funded research with clip restraints and a demand to cut down cost drivers. The survey was besides limited in its position as it could non show on national costs from a social position such as the patient ‘s ability to work or the chance costs. The strength of the survey lies in the usage of triangulation to garner and analyze informations to determine their common decision, effectivity based on costs and QALYs. Decrop ( 1999 ) concurs that one of the chief ways to avoid the combative issue of cogency and dependability is the usage of triangulation. He defines triangulation as â€Å" looking at the same phenomenon, or research inquiry from more than one information beginning † ( p158 ) . Information coming from different angles can be utilised to confirm, lucubrate or clear up the research inquiry. Denzin ( 1978 ) besides claims that triangulation bounds personal and methodological prejudice every bit good as enhances the survey ‘s generalizability. The usage of the Markov theoretical account is an built-in strength of the survey. Gonzalez-Perez, Vale, Stearns, and Wordsworth ( 2005 ) argue that the theoretical account ‘s ability to predict comparative effectivity and cost overtime makes it appropriate for patterning chronic intervention options such as RRT. The usage of cost-effectiveness to find QALYs is advantage and the usage of a standardised instrument to mensurate QALY besides strengthens the survey. The 15D is recognised as by and large being a little measuring load to both respondents and research workers. As an rating tool it is extremely dependable due to its repeatability of measurings with minimized random mistake. The consequences generated are valid because of the grade of assurance that research workers can put on the illations that are drawn from the tonss. Sintonen ( 2001 ) posits that as an instrument to mensurate cost-effectiveness, it is peculiarly suited for ciphering quality-adjusted life old ages ( QALY ) . Choice prejudice is limited in this survey due to recruiting of the full mark population. This is the first survey of its sort in the part and it does non hold any concern associations, an built-in strength to this survey. It is able to function as a precursor to farther research and therefore is poised to assist steer policies on how cost-effectiveness surveies are done in the part and their application to decision-making in health care. The enlargement of haemodialysis to run into the turning ESRD population, and an increased incidence of diabetic kidney disease in St. Lucia has deductions for the findings of this survey. It is of import that focal point is directed at primary, secondary and third intercessions aimed at cut downing cost of diabetic attention and accordingly complications from diabetes, such as diabetic kidney disease. Primary intercessions are the most cost-efficient. Health publicities to cut down hazard of developing diabetes, which is a hazard factor for ESRD, needs to go portion of the authorization of the Ministry of wellness. A policy on Chronic Diseases developed within the primary health care program that presently exist, would assist steer that focal point. Mann et Al. ( 2010 ) argue cautiousness against population based testing for CKD, and recommend that testing, as a secondary intercession, should concentrate on at hazard populations. Their survey concluded that ‘targeted showing of people with diabetes is associated with an acceptable cost per QALY in publically funded health care systems ‘ . Such an attack can be adopted in the wellness system in St. Lucia. While the bulk of cost-effectiveness analysis of intervention modes for diabetic nephropathy focal points on the disease at its latent or progressed phase, Glassock ( 2010 ) noted that a survey by Gearde et Al. ( 2008 ) identified that early sensing of diabetic kidney disease and intensive pharmaceutical intercessions are non merely cost effectual but significantly reduces the hazard of ESRD among type 2 diabetics. These findings are replicated in a survey by Keane and Lyle ( 2003 ) and Szucs et Al. ( 2004 ) who found that Losartan reduced the incidence of ESRD among diabetics. They went on to reason that albuminuria which is the ‘single most powerful forecaster ‘ of in type 2 diabetes is a simple and cheap showing trial, and early sensing can take to the early disposal of drugs that have been proven to cut down ESRD incidence. Cost-effectiveness analysis is able to supply valuable penetration to prioritising within health care and so the findings of this survey is able to supply grounds to back up efficiency in the usage of limited resources. Policy-makers should utilize these findings to reexamine the determination to spread out the figure of haemodialysis centres in St. Lucia. Further research to place more cost-efficient intervention options would be the first measure to bettering efficiency of resource allotment. The domination of haemodialysis as a intervention mode for ESRD, despite the overplus of surveies that have identified it as the least cost-efficient of RRTs, ( Haller et al. , 2011 ; Just et al. , 2008, Kontodimopoulos & A ; Niakas, 2008 ) , provides the wellness sector, with the grounds needed to revise intervention protocols and an chance to improved cost-effectiveness of ESRD intervention. This can be achieved by significantly cut downing the usage of haemodialysis and introducing as an option, peritoneal dialysis which have been cited as being the most effectual of dialysis options. Just et al. cautiousness that the economic sciences of dialysis in the underdeveloped universe, where labor may be cheaper than the importing of equipment and solutions, may take to the perceptual experience that peritoneal dialysis is more expensive than haemodialysis. They go on to observe that this is non conclusive as there is a famine in economic ratings in developing states to confirm that posi tion. A good developed CKD Care Program is able to significantly cut down the chance of developing ESRD among at hazard populations, every bit good as significantly lower health care costs among ESRD patients, ( Wei et al. , 2010 ) . There is a demand to spread out the services offered by the Renal Unit every bit good as its coverage to assist accomplish that terminal.Decision[ Conclusion based on findings ]