The Birth of 8th Grade Essay Samples

The Birth of 8th Grade Essay Samples Pets should be permitted in school. Students learn how to write effectively when they write more frequently. Most students have the ability to finish this task without help. Drunk drivers ought to be imprisoned on the very first offense. Therefore, many students and employees decide to acquire affordable essay rather than writing it themselves. Company and industry failure. The New Fuss About 8th Grade Essay Samples Nowadays it includes broad array of media and internet sources also. You could also get in touch with your writer to supply some additional recommendations or request information regarding the order's progress. Citations and extracts from assorted sources have to be formatted properly. If you are fortunate enough to land the ideal site, you will surely find several topics that are worth note. Key Pieces of 8th Grade Essay Samples It is vital to pay exclusive attention to the opening sentence. As soon as it is great in the event the topic gestates out of your own head, it's always alright to have a peek at a number of the sample thoughts and topics. From its name, you might guess you should have a crystal clear picture of a specific thing so as to offer your reader with a very clear and concise explanation. And this isn't the close of the story yet. The Do's and Don'ts of 8th Grade Essay Samples Your conclusion is easily the most significant part your writing piece. It's known that each terrific thing starts with small measures. You've got zero idea where you're. Likewise, it has to be logically complete and express a particular idea. The cost of an essay is dependent upon the quantity of effort the writer has to exert. Your reader will observe all details throughout the prism of your ideology. If you discover that the writer did not provide precisely what you expected, request a revision, and we'll make the corrections. Writing a narrative essay is all about telling a story using your initial voice. I appreciate all comments or feedback. If you don't feel you have sufficient ideas about how to proceed with the essay, it's prudent to drop the topic straight out. This report should be written in the 3rd individual. To begin with, you should secure the significance of the expository essay definition and select the topic you understand well or at least find it interesting to find out more about. Ideally, there shouldn't be any limits concerning the topics you may want to cover in your eight grade essays, on account of the freedom of speech in this nation. Our life is about words. Islam is the and increasing religion, and the 2nd biggest religion on the planet. Assume which you're dwelling in a society which has no law. State standards do change somewhat, but you can be certain that writing will be prominent. Farmers who may no longer afford their prior lives would be discovered in western California. Writing is among the most effective modes of self-expression, and additi onally it is a remarkably effective means to help your students sort out all their ideas and feelings. Students are requested to indicate how a specific sentence may be corrected or improved or the way the organization or development of a paragraph may be strengthened. In this manner, it supplies the students a reason behind learning, for they are related to their lives. In conclusion, at the present moment school is a significant stage of my life. Generally, whenever someone is educated, they haven't only a feeling of self, but in addition a strong character. Every student demands help with homework from time to time. Even though you will face new tasks, a number of them will actually be quite familiar with you, and you'll have the ability to complete them successfully using knowledge and skills you currently have. Anyway, the shortage of suitable grammar makes the listeners drop respect to the speaker. In eighth grade, students utilize every phase of the writing procedur e and continue to construct their understanding of writing conventions. Hence, the majority of the moment, feedback can be regarded as a reinforcement, and plays an important role in reinforcing the superior learning habits of students.

Phineas Gage and the Role of the Brain in Cognitive...

Phineas Gage and the Role of the Brain in Cognitive Functioning BreAnne Warden PSY/360 December 5, 2011 Devlin Crose Phineas Gage and the Role of the Brain in Cognitive Functioning The brain plays a key role in cognitive functioning. Of the many areas in the brain, only certain areas have an impact on cognitive functioning. The case of a man named Phineas Gage showed key elements of specific areas in the brain that support certain cognitive functions. The traumatic brain injury that Phineas Gage suffered in 1848 has aided cognitive and neuropsychologists in making large strides in understanding the human mind. In the following work, the role of the brain in cognitive functioning will be examined and better explained. Examples†¦show more content†¦Phineas Gage worked as a blaster for the Rutland and Burlington Railroad project in 1848 (Grieve, 2010). While working for the railroad, one of Gage’s duties was using gunpowder and long iron rods to blast a hole into the rock so as to continue building the tracks (Grieve, 2010). In a seemingly careless action, a three foot tamping i ron was blown from the ground through Gage’s skull (Grieve, 2010). Instead of killing him, the tamping iron left a large hole all the way through the skull and brain of Phineas Gage (Grieve, 2010). It is clear that the injury sustained by Phineas Gage is no ordinary injury. According to the National Institute of Neurological Disorders and Stroke (NINDS), the injury that was sustained by Phineas Gage can be classified as a traumatic brain injury or a TBI. A traumatic brain injury can be defined as â€Å"an injury that occurs when a sudden trauma causes damage to the brain† (NINDS, 2011). Depending on the severity of the injury to the brain, the symptoms of a traumatic brain injury can include headaches, confusion, vomiting, dizziness, instability of mood, fatigue, changes in behavior, and blurred vision amongst many other symptoms (NINDS, 2011). The traumatic brain injury that Phineas Gage suffered as a result of the tamping iron exploding from the ground caused obv ious immense damage to Gage’s brain (Grieve, 2010). A large portion of Gage’s brain was damaged when the tampingShow MoreRelatedPsy 360 Cognitive Functions and Phineas Gage994 Words   |  4 PagesCognitive Functions and Phineas Gage Sherrie Y. Saunders PSY 360 Evi Pover March 18, 2013 Cognitive Functions and Phineas Gage The discussion of this paper is the role of cognitive brain functions and Phineas Gage. The amazing story of Phineas Gage will be analyzed and the explanation of cognitive functioning in regard to his situation is very interesting and is also a major topic in this paper. Cognitive brain functions will be thoroughly examined in this paper as well. Read MoreThe Role of the Brain in Cognitive Functions: A Case Study1040 Words   |  4 Pages Introduction Neurosciences study of Cognitive Function is a relatively late phenomenon. As late as 1848, the accident and resulting injuries of Phineas Gage amazed the medical community. Furthermore, retrospective study of Gages injuries continues to yield new information about brain injury, personality and rehabilitation. Body: The Role of the Brain in Cognitive Functions Cognitive function is a series of intellectual processes whereby a person becomes aware of or comprehends ideasRead MoreRole of the Brain in Determining Cognitive Functioning1163 Words   |  5 PagesIntroduction The brain and its parts play a significant role in determining cognitive functioning. Cognitive functions may be defined as the abilities of a person to process information and thoughts. The brain consists of different areas, but only specific areas have an impact on cognitive functioning. The tragic case of a rail-road construction foreman known as Phineas Gage in 1848 showed the relation between certain areas of the brain and their support for specific cognitive functions. Phineas traumaticRead More An Evaluation of Case Studies and Their Contribution to Cognitive Neuropsychology as a Discipline2085 Words   |  9 PagesCognitive psychology is the study of the brains internal processes that guide behaviour; to study cognition, psychologists examine case studies of patients with damaged brains that can infer areas, and functions involved in particular processes. Patient studies have provided insights into the processes that take place within our minds, and have enabled psychologis ts to create models, which can be tested and fractionated. Cognitive neuropsychology has developed from cognitive psychology to becomeRead MoreThe Prehistory Of The Mind833 Words   |  4 Pageshumans from other primates and animals is our rationale, our ability to regulate emotions, and also the cognitive computational processes we have to understand complex social situations. In the book The Prehistory of the Mind, the author proposes that the evolution of the prefrontal cortex over the course of history is responsible for these executive processes that result in modern humanity’s cognitive fluidity -- the ability to combine and use intellectual information across specific domains (MithenRead More The Role of the Lesion Method in the Understanding of Healthy Brain Functions1578 Words   |  7 PagesUnderstanding the relationship between brain and behaviour has been of great phenomenon in the field of neuropsychology yet a compound one. Studying the effects of brain funct ions on human behaviour requires us to operate with methods that allow us to dissect different aspects of mental functions. This paper therefore addresses one of the ways of assessing brain functions in human and non-human animals; the lesion method (in Banich, 2004). The basic concept of the lesion method is to determine aRead MoreUnderstanding the Brain: The Case of Phineas Cage Essay examples1956 Words   |  8 Pageswith lesions affecting the dorsolateral prefontal cortex. In 1948 Phineas Gage, an American railroad construction foreman, was involved in a terrible accident during which a tamping iron was explosively forced upwards through his left cheek and exiting the top of his head (Harlow, 1948). He stunned his colleagues by not only surviving the event and swiftly regaining consciousness but by also by walking to a nearby cart. Gage regained many of his physical and mental abilities but remained alteredRead MorePsychological Perspectives: Abnormal Psychology2146 Words   |  9 PagesThis assignment is going to outline four approaches to psychology. The approaches are: psychodynamic, biological, cognitive and behavioural approaches. Psychodynamic approach studies unconscious activities in the mind to elaborate on human thoughts, feelings and behaviour (Bernistein, 2013). Freud was able to treat clients by making them recall negative aspects of their past through psychoanalytic techniques such as free association, dream interpretation and transference (Wollheim, 2008). AccordingRead MoreThe Biological Theory Of Psychology936 Words   |  4 Pagesat the functioning of the brain, nervous system (CNS), genetics or chemical processes. As an example, a person has aggressive issue and decide to seek help. The psychodynamic approach will assume the root cause of the aggression is from childhood experiences and unconsciousness urges. However, the biological approach will look at the biological roots that lie behind aggressive behaviours, they might consider genetic factors that contribute to such displays of behaviour, damages to the brain or nervousRead MoreEmotions, Emotion, Grief, Sadness, Anger, Outrage, Surprise, Happiness And Sadness1480 Words   |  6 PagesEmotions play a fundamental role in our everyday lives. As human beings we can experience many emotions throughout the day, for example, we may experience sadness when given bad news, but experience happiness when given good news. Like most psychological phenomena’s, emotions are recognised fairly easily but are difficult to define. How can we define happiness, sadness or fear in a way that everyone can agree? According to Hockenbury et al (2007) emo tions are â€Å"complex psychological states that involve

Tony Fernandes free essay sample

Introduction Tan Sri Anthony Franicis Fernandes or knows as Tony Fernandes is a Malaysian entrepreneur in airline business. He is the founder of Tune Air Sdn. Bhd. who introduced the first budget no-frills airline, AirAsia, to Malaysian with the motto of â€Å"Now everyone can fly†. With his innovation, he is successful to turn a failing government-linked, DRB-Hicom commercial airline into a highly successful budget airline public listed company. (Air Asia, 2005) 1. 1 Background Tony was born in Kuala Lumpur, Malaysia in 1964 to an Indian Goan father and Malacca Portuguese mother. His father was a communist doctor while his mother is a business women. When he was young he used to follow his mother a business women in selling Tupperware around Malaysia. He was educated at Epsom College from 1997-1983 and graduated from London School of Economics in 1987. (Sen Z. amp; Ng, J. , 2008) Although Tony grew up in a middle-class Malaysian family, Tony’s early thinking was shaped by the British education system. We will write a custom essay sample on Tony Fernandes or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page He was about 12 when his parents sent him to boarding school in England, where he lived and worked well into early adulthood. Boarding school had brought a huge culture shock for him, but he has always been adjustable, so he managed to survive it. Moreover Tony is very good at sports, therefore it makes things easier for him to solve since everyone there was a foreigner and he managed to break the ice between them. He also said that he can be put anywhere in the world, and he will be able to get on with people around. (Sen Z. amp; Ng, J. , 2008) Tony studied accounting but he became an auditor in Virgin Atlantic after graduating from the London School of Economics (LSE) in 1987. However the job was seems to boring for his adventurous spirit and he gave it up after six months working there. Then he started to looked for something more exciting, and set his sights on the music industry since he love music. He is an amateur guitarist and enjoys playing the keyboard and the drums. (Sen Z. amp; Ng, J. , 2008) After resignation of auditing job, he sent his resume to record companies. And finally he got employed as the financial controller for Richard Brandson’s Virgin Records in London from 1987 to 1989. After that, he moved to Warner Music International London and become the senior financial analyst till 1992. Tony transferred to Malaysia as General Manager of Warner Malaysia. Within six months, he was appointed managing director, becoming the youngest candidate in the company’s history to hold the post. In August 1996, he became Regional Managing Director Tony Fernandes free essay sample When Time Warner Inc. merged with America Online Inc. , he quitted andstarts his journey to fulfill his childhood dream. This idea is generated when he was studyingin England and wanted to go home during term break but was rejected by his father becausethe flights tickets are expensive. Later, he started a company under the name of TuneAir Sdn. Bhd to take over AirAsia, Malaysia’s second national carrier with the tagline â€Å"now everyonecan fly†. I like his idea that everyone can fly because not much people afford to go overseaswhen the flight ticket are expensive, especially it happens when only one company dominatethe market. He was awarded a lot of honour such as Commander of the Order of the British Empire (CBE) honour, Forbes Asia Businessman 2010, Officer of the Legion d’ Honneur andso on as recognition to his contributions to the community in each country. I think Tony Fernandes possessed good leadership because he is able to react tochallenges and does not give up easily. We will write a custom essay sample on Tony Fernandes or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page From the material I got in the internet, it was a bigchallenge for him to start up because situation at that time was terrible and was widelyassumed that the low-cost model will fail. However, Tony Fernandes predicted that Asiawould face economy downturn and he could take this opportunity. The biggest challenge inhis pathway to succeed in turning AirAsia from a fledging government-link commercialairline to a highly successful public-listed international company is the proposing of the ideaof openskies agreements with Thailand, Indonesia and Singapore in 2003, which our country didn’t have before . He tried to reduce the cost, waste and unnecessary expenses to enable hiscompany to promote more low-cost flights for everyone, with the tagline â€Å"now everyone canfly† which I think it is not easy for any company. He keeps the costs low by utilizing onlineservice to sell tickets, not offering meals for short distance flights, shorten the time betweenlanding and takeoff to have maximum flights per day and last but not least increasing the lifespan of the parts of airplane by good maintenance and pilot’s flying techniques (i. e. tires thatcan last for 180 landings compare to 70 landings previously). As a leader in a company, he isopen-minded and ready to listen to employee’s opinion because staffs are nearer and able todiscover the problems easier. He said: â€Å"My staffs are my greatest asset. I know every one of them by name and we all share the same passion. I pay them well and we are transparent. † The personality on Tony Fernandes that I admire is ambitious. We have the similarsituation that people thought that our dreams are unrealistic but he dares to realize his dreamscompare to me which only dare to dream of my dreams. He dreamt to own an airport when hewas young and everyone thinks that it is stupid and unrealistic. He decided to pursue hisdream when he is in 36 years old when he saw an advertisement of Easy Jet on Television. His motto is â€Å"believe the unbelievable, dream the impossible and never take no for an answer†. With this believe, he bought AirAsia by paying RM1 each for 51. 68 million sharesand the assumption of fifty percents of the net liabilities of AirAsia. In other words, AirAsia is indebt before he bought it and he had spent only one year to clear all the debt and had led AirAsia to become th e world’s best low cost airline and largest in Asia in eight years which isonly $3. 21 per seat kilometre. Besides, I saw Tony Fernandes thinks, look and do things different from others thatmade his life different. Three days after he signed the deal with DBR-Hicom for AirAsia, the world’s airline industry was severely affected by the tragedy happened on 11 th September2001. Everyone thinks that Tony Fernandes will fail miserably because nobody would fly butTony Fernandes think that aircraft leasing cost reduces 40% and layoffs meant that qualified staffs were readily available. He believes by promoting cut-rate flight that save money and time during tight economy can attract Malaysian instead of having luxury services in flights. Tony Fernandes are able to shift his thinking quickly to find and react to opportunities. He isable to look at the world beyond and view something new as it is shown in second half year2008, where he decided to take the advantage of unwind fuel hedges before his competitorsdo so and now AirAsia is getting the full benefit of oil at $40 a barrel which is cheaper thanhis competitors. It can be seen that Tony Fernandes always wear a baseball cap, open neck shirt and jeans because he thinks that everyone is equal and hierarchy should be eliminated,which is seldom seen in Asia. AirAsia employs pilots that started as a baggage handlers andstewards, as well as Tony Fernandes, he spends a day as a baggage handler every months,cabin crew every two months, check-in clerk every three months. I think this will help him to generate more ideas in enhancing the airline services because he is able to observe more problems instead of hiding in the office without approaching the real service line. Whensomeone asked him for the secret of his success, he said: â€Å"I decided that I would run theairline my way, not as others might†. Another characteristic that I wish to learn from Tony Fernandes is being a risk-taker. In his 37, Tony Fernandes drove a company Jaguar, had a $10000 stereo system in the officeand opportunities to fly around the world with artist and entertainment executives but he haddecided to quit his job, mortgaged his home, and used up his savings and brought investorsfrom outside to develop the AirAsia to fulfil his childhood dream. Even before September11 th , the world’s airlines were already in trouble; his move to revived Malaysia’s loss -makingsecond airline is seen to be impossible as the previous owners have failed to save thecompany after spending two years.

Pesticide Using Essay Example

Pesticide Using Essay A pesticide is like a double-edged blade. If it s used, it cause jobs, and if its usage is discontinued, it still causes jobs! A pesticide is something that kills an unwanted being. In the agricultural sector, about $ 11 billion dollars are used on pesticides. The husbandman loves pesticides since they help maintain the husbandman s harvests integral, nevertheless it s been shown that the toxic effects the pesticides have on an being are get downing to impact worlds every bit good. A authoritative illustration is organophosphates, a 3rd coevals pesticide. A survey conducted by Gbaruko illustrated that in worlds, frequent exposure to organophosphates could damage enzymes in the nervous system. Companies tried to acquire around this by fabricating adult male made pesticides, called man-made pesticides. Synthetic pesticides, such as pyrethroids, are less toxic compared to their former opposite numbers, and therefore are used widely. However, recent surveies demonstrate that even these n ewer, less toxic pesticides are non every bit safe as companies proclaim. Bifenthrin is a authoritative illustration of such pesticide. Bifenthrin, a man-made 3rd coevals pesticide, is derived from pyrethrins which are extracted from chrysanthemums. Since it s deemed as a safe pesticide, it has been used in many families for old ages. The pyrethroid bifenthrin plants by maintaining sodium channels unfastened, altering the membrane potency of nervus membranes. Active Na channels leads to depolarisation and do nervousnesss fire action potencies quickly. Nervousnesss discharge continuously, doing hyper-excitability, and finally, palsy of the cardinal and peripheral nervous system by restricting neurotransmission ( Fecko ) . Below is a construction of bifenthrin. Bifenthrin affects the nervous system by interrupting down indoors an being s organic structure. Bifenthrin degrades into a biphenyl acid, intoxicant, aldehyde, and other acids, by spliting an ester bond, oxidization, or hydroxylation. These debasement merchandises lead to palsy of the nervous system. Bifenthrin is besides an ATPase enzyme inhibitor. For some aquatic beings, this is rather a job. Aquatic animate beings must keep ideal ionic concentrations in their systems to last. ATPase enzymes enable these beings to maintain their ion count at normal degrees. By forestalling the activity of ATPase enzymes, these animate beings are unable to keep their osmotic balance and finally decease ( Fecko ) . We will write a custom essay sample on Pesticide Using specifically for you for only $16.38 $13.9/page Order now We will write a custom essay sample on Pesticide Using specifically for you FOR ONLY $16.38 $13.9/page Hire Writer We will write a custom essay sample on Pesticide Using specifically for you FOR ONLY $16.38 $13.9/page Hire Writer What makes bifenthrin a less toxic and widely used pesticide is its unsolvability in H2O ( it s solubility is merely 0.1mg/l ) and low vapour force per unit area ( 1.8110-7 mm/Hg ) . As shown in the molecular construction above, bifenthrin is largely a hydrophobic molecule. Since bifenthrin is non that soluble and has a low vapour force per unit area, it wo nt zap into air when it s applied to dirt. Besides, because of its low solubility, a batch of bifenthrin can be found absorbed in dirts where its half life is between 7 yearss to 8 months. Bifenthrin binds to the dirt strongly, and tends non to travel. Therefore there is barely any taint of land H2O from this pesticide, which is a immense advantage compared to many other pesticides that leak into groundwater. Another asset to bifenthrin is that even in direct sunshine, this pesticide is pretty stable. Fecko stated that the aqueous photolysis half life of 276 yearss for 14-C- cyclopropyl and 416 yearss for C-14-phenyl labeled bifen thrin indicates photo-stability. Another benefit to utilizing bifenthrin is that it is comparatively non-toxic to mammals, but is really effectual against insects. So far, this seems like good intelligence, holding a pesticide that is nt every bit toxic as its relations, does nt pollute the H2O, and barely affects worlds. Right? Wrong. There have been a turning figure of surveies demoing the contrary. New research has been indicating to the same decision for the past twosome of old ages, that bifenthrin is less toxic, but being persistently exposed to it causes neurodegenerative disease in worlds. What led this great pesticide, which possessed a small injury to worlds, into something wholly the antonym? Chronic, gradual exposure to bifenthrin, and the fact that no affair how safe we can do a pesticide, someway, one manner or another, it still has the possible to ache worlds. Pesticides are non good things. They are made to kill insects, which affects us as good. In worlds, bifenthrin has been found to lend to neurodegenerative diseases and makes it so that worlds are at a higher hazard to other toxicants. Dr. Benjamin Weeks, a professor at Adelphi University, has conducted two experiments which demonstrate that bifenthrin may so be a hazard factor for neurodegenerative disease. Dr. Weeks studied the consequence of bifenthrin on PC12 cells obtained from rats. He found that bifenthrin inhibits neurite formation and causes neurite abjuration, which have besides been found in other similar surveies to Weeks s. Neurites are developing nerve cells, which procedure and send messages to the encephalon. Neurons transmit information to the encephalon, which so elicits a response. By forestalling neurite formation, we are forestalling nerve cell formation, which leaves the encephalon unable to react to harmful stimulations. In his first paper, Dr. Weeks illustrates after handling rat nervus cells with bifenthrin, in 12 hours, there was 80 % neurite abjuration, and after 48 hours, about all the neurites had retracted. In his 2nd paper titled, PolicosanolPlus and NeuroprevinTM ameliorate pesticide-mediated suppression of neurite branch and neurite devolution, Weeks launches into a farther treatment of what happens when PC12 cells are treated with bifenthrin, and he discusses two nutraceutical addendums ( PolicosanolPlus and Neuroprevin ) which really promotes neurite endurance in the presence of bifenthrin. This is a great effort, for we genuinely can non extinguish pesticides. If pesticide usage were wholly eradicated, nutrient production would diminish by about 30 % . The cost of nutrient would increase by at least 50 % and the population would be exposed to many insect-borne diseases. Pesticides are a necessity. If we can happen a harmonious balance between both, where we can hold pesticides, yet non be exposed to their toxic effects, so we can hold both good harvests and increased human endurance due to a lessening in diseases from pesticides. PolicosanolPlus is a nutraceutical addendum that is a combination of aliphatic intoxicants, saturated fatty acids, and polyunsaturated fatty acids. All these parts can be found in nature and are derived from waxes. Dr. Weeks has conducted farther surveies where he has found that PolicosanolPlus has shown to hold significant neurotrophic and neuroprotective properties.and protects nerve cells from excitotoxicity and from age related neurite abjuration in PC12 cell civilizations. Even if nerve cells experience high irritability due to the presence of invariably unfastened Na channels, they will be protected and prevent nerve cells from deceasing. Neuroprevin is a mixture of vitamins, aminic acids, and metabolites, and besides protects against neural decease. Chronic exposure to pesticides may take to neurodegenerative diseases such as Alzheimer s disease. The makers of PolicosanolPlus and Neuroprevin province that possibly by forestalling neural decease, which leads to Alzheimer s dis ease, the addendums may in fact aid battle Alzheimer s disease ( Innovation Labs ) . Dr. Weeks believes the same. In rat PC12 cells, bifenthrin prevents the growing of neurites, and causes neurites to abjure. Weeks began his experiment by turning PC12 cells in civilization. He treated all the cells with 100 ng/ml of nervus growing factor ( NGF ) , except the control. In one civilization, his cells were exposed to nil ( control ) , in another civilization, the cells were merely exposed to growing factor. In the 3rd civilization, he had cells exposed to growing factor and bifenthrin, and in the last civilization, he had cells exposed to growing factor, bifenthrin, and to 2ug/ml PolicosanolPlus and Neuroprevin. During this portion of the experiment, note that he added all the constituents to the civilization at the same clip, right when the cells were seeding. Weeks found that cells with NGF did turn and widen neurites ( B ) . Cells with NGF and bifenthrin ( BiF ) did non bring forth as many neurites ( C ) , and cells with NGF, bifenthrin, PolicosanolPlus ( P ) and Neuroprevin ( NT ) , really did bring forth neurites ( D ) ! Adding PolicosanolPlus and Neuroprevin at the same clip as bifenthrin to the cells, masked bifenthrin s inhibiting ability, and in bend led to the growing of neurites. The below is a image, which illustrates this. A is the control civilization. Over a 72 hr period, Weeks found the same decision. 55 % of the cells with NGF extended neurites. Merely 3 % of the cells treated with bifenthrin and NGF had neurites. Cells with either PolicosanolPlus or Neuroprevin or a combination of the two exhibited the same consequences, that there were 46-51 % of cells that had neurite formation and extension. two demonstrates this below. It can be seen that the bulk of neurites formed when there was NGF, and the nutraceutical addendums present. The undermentioned tendency can be seen: NGF, along with PolicosanolPlus and Neuroprevin, prevent the inhibiting effects of bifenthrin. Note that during this full experiment, the cells were still feasible, it s merely the neurites that were affected by the pesticide and addendums. Dr. Weeks did another experiment, where he changed the manner he added the variables. At cell seeding, he merely added NGF and PolicosanolPlus and Neuroprevin, intending in all the civilizations he added the growing factor. He left one civilization with merely growing factor as the control, another civilization with growing factor and PolicosanolPlus, another with Neuroprevin and NGF, in the 4th one another there was both PolicosanolPlus and Neuroprevin and NGF, and in the last one, there was merely growing factor which was traveling to be used subsequently on. 24 hours after the cells seeded, Dr. Weeks added bifenthrin to all the civilizations except the control. In the last civilization, he found that NGF did non dissemble the effects of bifenthrin, and alternatively bifenthrin caused a lessening in neurite formation and extension, which was besides shown in two, when the NGF and bifenthrin were added together. After 72 hours, he saw that merely 5 % of the cells had neurites in thi s civilization. With the PolicosanolPlus + NGF, Neuroprevin + NGF, PolicosanolPlus and Neuroprevin + NGF civilizations, he found that the addendums one time once more prevented neurite devolution and abjuration. 63-67 % of the cells contained neurites after 72 hours. four exemplifies these tendencies. Many scientists now think that exposure to pesticides may really be doing many neurodegenerative diseases in worlds. Dr. Weeks paper is merely one that supports this point. Industrial exposure to pesticides has ever been a concern, but what about family exposure? There are pesticides at place that we are exposed to mundane. Yes, companies have tried to do man-made pesticides, which seem to be less toxic. However, these man-made pesticides have shown that they truly are nt less toxic, and can do neurodegenerative disease merely as the extremely toxic one, possibly at a slower gait, but that s about it. At the same item, pesticides can non be disposed of. They do hold their advantages, such as eliminating insect-borne disease. Again, here comes in the double-edged blade. What do we make? A promising solution seems to be nutraceutical addendums, which allow pesticides to be without damaging nerve cells. These addendums help protect neurites and let them to organize even if when the pesticides try to suppress their formation. In footings of the environment, bifenthrin, compared to other pesticides is non so much of a job. It stays in the dirt and does nt fade out in H2O. It does bioaccumulate in birds, which lead to many birds deceasing, but overall, there has nt been another Silent Spring yet so as of now we are ok. How long that is traveling to last? No 1 knows. It s best to get down taking action right off. Additionally bifenthrin is stable, is nt every bit toxic as other pesticides, and does nt truly ache worlds if they are exposed to it a small. That does nt intend bifenthrin should ever be used. There should be alternate agencies to pesticides, or at least addendums that counter their effects. Plants Cited Fecko, Andrew. Environmental Fate of Bifenthrin. Publication. Web. lt ; www.pw.ucr.edu/textfiles/bifentn.pdf gt ; . Gbaruko, Benedict C. Organophosphate induced chronic neurotoxicity: Health, environmental and risk exposure issues in developing states of the universe. Frican Journal of Biotechnology 8 ( 2009 ) : 5137-141. Web. lt ; www.atlas.iviji.com/AJB/PDF/pdf2009/19Oct/Gbaruko % 20et % 20al.pdf gt ; Hougard, J. M. Bifenthrin: A Useful Pyrethroid Insecticide for Treatment of Mosquito Nets. Publication. Web. lt ; www.emerald.qld.gov.au/Temp_Documents/Hougard.pdf gt ; . Neuroprevin. Advanced Labs. Web. lt ; hypertext transfer protocol: //www.innlabs.com/neuroprevin.html gt ; . Pesticide User s Guide. Web. lt ; hypertext transfer protocol: //ohioline.osu.edu/b745/b745_4.html gt ; . Pyrethroids/ Pyrethrins. Safety Source for Pest Management. Web. lt ; hypertext transfer protocol: //www.beyondpesticides.org/infoservices/pesticidefactsheets/toxic/pyrethroid.htm gt ; . Web. lt ; hypertext transfer protocol: //en.wikipedia.org/wiki/Bifenthrin gt ; . Weeks, Benjamin, and A. Nandi. Bifenthrin causes neurite abjuration in the absence of cell decease: a theoretical account for pesticide associated neurodegeneration. 2006. Web. lt ; hypertext transfer protocol: //www.ncbi.nlm.nih.gov/pubmed/16641870 gt ; . Weeks, Benjamin. PolicosanolPlus and NeuroprevinTM ameliorate pesticide-mediated suppression of neurite branch and neurite devolution. Med Sci Monit ( 2006 ) : 379-84. Hypertext transfer protocol: //cat.inist.fr/ ? aModele=afficheN A ; cpsidt=18443851. Web.

Superlative Forms of Modifiers - Definition and Examples

Superlative Forms of Modifiers s The superlative is the form or degree of an adjective or adverb that indicates the most or the least of something. Superlatives are either marked by the suffix -est  (as in the fastest bike) or identified by the word most or least (the most difficult job). Almost all  one-syllable  adjectives, along with some two-syllable adjectives, add -est  to the base to form the superlative.  In most adjectives of two or more  syllables, the superlative is identified by the word  most or least.  Not all adjectives and adverbs have superlative forms. After a superlative, in or of a noun phrase can be used to indicate what is being compared (as in the tallest building in the world and the best time of my life). Exercises and Quizzes Exercise in Using the Comparative and Superlative Forms of AdjectivesPractice in Forming the Comparative and Superlative Degrees of Adverbs Examples and Observations This is the saddest story I have ever heard.(Ford Maddox Ford, The Good Soldier, 1915)The [New York City] subway is a gift to any connoisseur of superlatives. It has the longest rides of any subway in the world, the biggest stations, the fastest trains, the most track, the most passengers, the most police officers. It also has the filthiest trains, the most bizarre graffiti, the noisiest wheels, the craziest passengers, the wildest crimes.(Paul Theroux, Subterranean Gothic. Granta, 1984)[O]f all forms of tyranny, the least attractive and most vulgar is the tyranny of mere wealth.(Theodore Roosevelt,  Theodore Roosevelt: An Autobiography, 1913)Bart Simpson: This is the worst day of my life.Homer Simpson: The worst day of your life so far.(The Simpsons Movie, 2007)In one second, without any previous training or upbringing, he had become the wettest man in Worcestershire.​​  (P.G. Wodehouse, Very Good, Jeeves, 1930)I responded in what I thought was the most truthfulor least untruthfulmanner, by saying no.(James R. Clapper, Director of National Intelligence, explaining why he told Congress in March 2013 that the National Security Agency doesnt intentionally collect data on millions of Americans) To the man who loves art for its own sake, it is frequently in its least important and lowliest manifestations that the keenest pleasure is to be derived.(Arthur Conan Doyle)[T]he newspaper business, despite its many flaws, managed to do a lot of good. And it employed, in its newsrooms, the smartest, hardest-working, funniest, quirkiest, most cynical and at the same time idealistic group of borderline insane people Ive ever known.(Dave Barry, Ill Mature When Im Dead. Berkley, 2010)It is turning out to be the most beautiful, most quiet, largest, most generous, sky-vaulted summer Ive ever seen or knowninordinately blue, with greener leaves and taller trees than I can remember, and the sound of the lawnmowers all over this valley is a sound I could hum to forever. (Nicholson Baker, The Anthologist. Simon Schuster, 2009)The greatest discovery of my generation is that a human being can alter his life by altering his attitudes of mind.  (William James) Double Comparatives and Superlatives Speakers of vernacular dialects often use double comparatives and superlatives such as more higher and most fastest. Although such constructions may seem redundant or even illogical, in reality both standard and nonstandard varieties of all languages are replete with such constructions. In English the redundant comparative dates back to the 1500s. Prior to this, in Old and Middle English, suffixes, rather than a preceding more or most, almost always marked the comparative and superlative forms of adjectives and adverbs, regardless of word length. In the Early Modern English period . . . [double markings were commonly used to indicate special emphasis, and they do not appear to have been socially disfavored.​  (comparative, The American Heritage Dictionary of the English Language, 4th ed., 2000) Unusual Superlatives Make sure your gathering is the meatiest, cheesiest, feastiest ever with our platters, cold subs, salads, snacks, and desserts.  (Firehouse Subs, Savannah, Georgia)- Another of Springfield’s belovedest citizens has been murdered.  (Kent Brockman in The Simpsons) Pronunciation: soo-PUR-luh-tiv

How Donald Trump Won - The 2016 Presidential Race

How Donald Trump Won - The 2016 Presidential Race Voters and political scientists will debate how Donald Trump won the presidential election in 2016. The businessman and political novice stunned the world by winning a presidential election most analysts and voters believed had firmly been in the hands of Hillary Clinton, who had far more experience in government and had run a more orthodox campaign.   Trump ran his campaign in the most unconventional of ways, insulting large swaths of potential  voters and shunning  the traditional support from his own political party. Trump won at least 290 electoral votes, 20 more than the 270 needed to become president, but got more than 1 million fewer actual votes than Clinton did,  reigniting the  debate over whether the U.S. should scrap the Electoral College. Trump became only the fifth president to be elected without winning the popular vote. The others were Republicans  George W. Bush in 2000,  Benjamin Harrison in 1888 and Rutherford B. Hayes in 1876, and Federalist John Quincy Adams in 1824. So how did Donald Trump win the presidential election by insulting voters, women, minorities, and without raising money or relying on support from the Republican Party? Here are 10 explanations for how Trump won the 2016 election. Celebrity and Success Trump portrayed himself through the 2016 campaign as a successful real-estate developer who created tens of thousands of jobs.  I’ve created tens of thousands of jobs and a great company, said during one debate. In a separate speech, Trump proclaimed his presidency would create job growth like you’ve never seen. I’m very good for jobs .In fact, I will be the greatest president for jobs that God ever created. Trump  runs dozens of companies and serves of numerous corporate boards, according to a personal financial disclosure he filed with the U.S. Office of Government Ethics when he ran for president.  He has said he is worth as much as $10 billion, and though critics suggested he is worth much less Trump projected an image of success and was one of the most well known brands in the county. It also didnt hurt that he was host and producer of NBC’s hit reality series  The Apprentice. High Turnout Among Working-Class White Voters This is the big story of the 2016 election. Working class white voters- men and women alike- fled the Democratic Party and sided with Trump because of his promise to renegotiate trade deals with countries including China and levy stiff tariffs on goods imported from these countries. Trumps position on trade was seen as a way to stop companies from shipping jobs overseas, though many economists pointed out taxing imports would drive up costs to American consumers first. His message resonated with white working-class voters, especially those who live in former steel and manufacturing towns. Skilled craftsmen and tradespeople and factory workers have seen the jobs they loved shipped thousands of miles away, Trump said at a rally near Pittsburgh, Pennsylvania. Immigration Trump promised to essentially lock down the borders to prevent terrorists coming in, an appeal to white voters who were not necessarily worried about crimes being committed by undocumented immigrants by jobs being filled by them. What we are going to do is get the people that are criminal and have criminal records, gang members, drug dealers. We have a lot of these people, probably two million, it could be even three million, we are getting them out of our country or we are going to incarcerate, Trump said. Trumps position contrasted starkly with Clintons position on illegal immigration. James Comey and the FBIs October Surprise A scandal over Clintons  use of a personal email server  as secretary of State had dogged her through early parts of the campaign. But the controversy appeared to be behind her in the waning days of the 2016 election. Most national polls in October and the first days of November showed Clinton leading Trump in the popular vote count; battleground-state polls showed her ahead, too. But 11 days before the election, FBI director James Comey sent a letter to Congress stating he would review emails found on a laptop computer belonging to a Clinton confidant to determined whether they were relevant to the  then-closed investigation of  her use of the personal email server. The letter cast Clintons election prospects into doubt. Then, two days before Election Day, Comey issued a new statement that both confirmed Clinton did nothing illegal but also brought renewed attention to the case. Clinton directly blamed Comey for her loss after the election. Our analysis is that Comey’s letter raising doubts that were groundless, baseless, proven to be, stopped our momentum,† Clinton told donors in a post-election telephone call, according to published reports. Free Media Trump didnt spend a whole lot of money trying to win the election. He didnt have to. His campaign was treated by many major media outlets as a spectacle, as entertainment instead of politics. So Trump got lots and lots of free airtime on cable news and major networks. Analysts estimated Trump had been given $3 billion of free media by the end of the primaries and a total of $5 billion by the end of the presidential election. While free media has long played an important role in our democracy by fostering political discourse and disseminating electoral information, the sheer enormity of coverage on Trump puts a spotlight on how the media may have influenced the course of the election, analysts at mediaQuant wrote in November of 2016.  Free of earned media is the widespread coverage he received by major television networks. He also spent tens of millions of dollars of his own money, mostly fulfilling a vow to finance his own campaign so he could portray himself as being free from ties to special interests.  I dont need anybodys money. Its nice. Im using my own money. Im not using the lobbyists. Im not using donors. I dont care. Im really rich. he said in announcing his campaign in June 2015. Hillary Clintons Condescension  Toward Voters Clinton never did connect to working class voters. Maybe it was her own personal wealth. Maybe it was her status as a political elite. But it most likely had to do with her controversial portrayal of Trump supporters as deplorable. To just be grossly generalistic, you can put half of Trump supporters into what I call the basket of deplorables. Right? Racist, sexist, homophobic, xenophobic, Islamaphobic, you name it,  Clinton said just two months before the election. Clinton apologized for the remark, but the damage was done. Voters who were supporting Donald Trump because they were fearful over their status in the middle class turned solidly against Clinton. Trump running-mate Mike Pence capitalized on Clintons mistake by crystallizing the condescending nature of her remarks.  The truth of the matter is that the men and women who support Donald Trumps campaign are hard-working Americans, farmers, coal miners, teachers, veterans, members of our law enforcement community, members of every class of this country, who know that we can make America great again, Pence said. Voters Didnt Want a Third Term for Obama Regardless of how popular Obama was, its incredibly rare for presidents from the same party to win back-to-back terms in the White House, partly because voters become fatigued by a president and his party by the end of eight years.  In our  two-party system, the last time voters elected a Democrat to the White House after a president from the same party had just served a full term was in 1856, before the Civil War. That was James Buchanan. Bernie Sanders and the Enthusiasm Gap Many- not all, but many- supporters of Vermont Sen. Bernie Sanders did not come around to Clinton after she won the brutal, and what many thought ,  rigged, Democratic primary. In a scathing criticism of liberals Sanders supporters who didnt support Clinton in the general election, Newsweek magazines Kurt Eichenwald wrote:   Awash in false conspiracy theories and petulant immaturity, liberals put Trump in the White House. Trump won slightly fewer votes than Romney did in 2012- 60.5 million compared with  60.9 million. On the other hand, almost 5 million Obama voters either stayed home or cast their votes for someone else. More than twice as many millennials- a group heavily invested in the â€Å"Sanders was cheated out of the nomination† fantasy- voted third-party. The laughably unqualified Jill Stein of the Green Party got 1.3 million votes; those voters almost certainly opposed Trump; if just the Stein voters in Michigan had cast their ballot for Clinton, she probably would have won the state. And there is no telling how many disaffected Sanders voters cast their ballot for Trump. Obamacare and Health Care Premiums Elections are always held in November. And November is open-enrollment time. In 2016, as in previous years, Americans were just getting notice that their health insurance premiums were rising dramatically, including those who were purchasing plans on the marketplace set up under President Barack Obamas Affordable Care Act, also known as Obamacare. Clinton supported most aspects of the health care overhaul, and voters blamed her for it. Trump, on the other hand, promised to repeal the program.

A thematic analysis of 4 interviews with lesbian prostitutes Essay

A thematic analysis of 4 interviews with lesbian prostitutes - Essay Example All of the women I spoke to were between the ages of 22 and 26; Margaret had been in the business the longest and was 26. Katie was 22, Lenore 23 and Irene was 24. I am not sure whether these were their real names or the names they go by when they go on a job. All for ladies were dressed well and no one would have noticed that they were prostitutes necessarily. They were very clean and well kept and they took their jobs seriously. All four had a clientele of men as well as women saying that it was better to have both "because you wont get paid enough just with women". Each woman had a different idea of this but essentially it was because of the money. My questions consisted of 20 questions that I asked each woman and then there were other questions for clarification (Ive listed questions at the end of this paper). As I went through the transcripts of these women I was struck by how casual and nonchalant they were about the business. I can see that because it is legal in the UK these women may not feel the constraints or the fears that some women would feel in other countries. None of them seemed to be upset with the questions I asked nor did they seem worried that someone would find out about them as we talked. I spent time getting to know each woman so she would feel comfortable talking with me. Each interview was unique and one of the women identified herself as bisexual, though she saw many more women clients than she saw men. Katie was 22 years old and started her career as a prostitute when she was eighteen. She started because she needed to pay for university and had to earn her rent. She was one of the most outspoken in the group. She saw her work as a normal job and she felt that people who understand this are better able to understand her. She had a great sense of humour about it all. Katie identifies her self as a lesbian and she is in a romantic relationship with a woman

London underground as a customer role for equipment report Essay

London underground as a customer role for equipment report - Essay Example The tube services a record 270 number of stations which is the largest underground network in the world and also covers around 402 kilometres. Acting as a pioneer in its design, the design of LU has been adopted by several underground networks across the world. Almost 86% of the passenger fares are covered by the tube which makes it stand out as the main traffic tool in the nation (Urbaneye, 2002, p.7). London underground’s customer role for equipments London underground having a relatively old infrastructure should consider prospects of up gradation of its equipments mainly required for comfort, safety and security of their passengers. This raises the role of London underground as a customer for its equipments and subsequent consideration of its equipment reports. The major equipments of London underground are the CCTV camera, ticket machines, support systems for ventilation, emergency alarms, availability of reservations or wheel chairs for senior citizens, handicapped, etc (Kelly, 1999, p.4). As a customer to its equipment report, London underground needs to at its suppliers, competition for the contract of supply of equipments, whether the equipments are customized for the tube and the payment amount for equipments installed. Major suppliers of CCTV for installation in London Underground include market leaders like Panasonic, Sony, Eneo, British Security Industry association, etc. The suppliers need to bid for the contract on London Underground’s decision of installation of new CCTV cameras or up-gradation of the existing system (Source Security, 2013, p.1). The supplier offering the best competitive price and quality of information is awarded with the contract. For example, For example, Sony has installed around 5000 CCTV cameras by 1996. In 2002, a 500 camera system has been installed with a three-room capacity for controlling activity in order to enable LU with monitoring capacity of health and safety of passengers, detection and prevention of crime and closed circuit surveillance. The CCTV surveillance system used in London underground as installed and supplied by Sony are the one’s used for general business surveillance (Glanz and Nacerodien, 1996, P.1). Thus the CCTV system has not been much effective in large underground station in tracking activities like pick-pocketing, bag-snapping, etc. However, the CCTV has been able to detect crime in small underground stations. The effect of CCTV old system wears out with time as offenders learn about their position of tracking. Looking at upgrading the infrastructure, London underground announced a one-billion pound sterling program for station regeneration of which 40 billion pound sterling was spent on CCTV installation in 1997-98. Apart from CCTV, the London underground also installs ticket machines which passengers can use through top up oyster cards. The major supplier of all ticketing machine in London Underground is Cubic Transportations System Inc. The emerg ency alarms are supplied by manufacturers like Vesda and Wagner. In order to upgrade its old transportation system in the face of increasing passengers, London Underground has upgraded its WaterLoo and City line in 2006 with five trains instead of existing four, Victoria line now includes a fleet of 47 higher capacity with better ventilation capacity than before (Fire Systems Ltd, 2013, p.1).

Marketing Nike Essay Example for Free

Marketing Nike Essay Growing up there was one brand that all professional athletes used in my eyes, Nike. The Swoosh, was the icon that all kids had to have, and why not? All the big time players not only had it, but endorsed it. Ads, which had Michael â€Å"Air† Jordan, Bo Jackson, or Wayne Gretsky â€Å"The Great One† doing amazing physical feats, always, motivated the crowds. The Nike company new this, and blasted it marketing campaign through all sorts of media. In this essay I will break down this multi-billion dollar company’s marketing techniques in the areas of: customer value, promotional items, marketing’s four p’s of the marketing mix, the segmentation, targeting, and positioning (STP) approach to market the product, Customer Relationship Management (CRM), environmental trends, the largest customer base, its competitors, and ethical marketing for this corporation both stateside and overseas. Putting these athletes in the ads is just one way to build value for a company. From Ashford universities â€Å"Principle of Marketing† by â€Å"Sara White† We are introduced to marketing with the definition of marketing as â€Å"an activity designed to stimulate exchanges that have value for customers, partners, and society at large†. With this definition of marketing intact the question that still is out pondering is what is value? â€Å"Value was defined as the perceived trade-off between benefits and the sacrifice required to take possession of those benefits†. To break it down further we will look at customer value. Customer value is a title for the cost of a particular trade for the purchaser (buyer) instead of the company (seller). Looking into a selling Nike abroad, whatever a customer may pay in the United States may not be the same overseas. The first thing is to look at is how the current client group influences the market in the states. Nike had a humble start with creators Bill Bowerman and Phil Knight trying to improve on the track shoe of the day. The former â€Å"Blue Ribbon Sports Company† now known as Nike wanted to increase value into their product by having athletes endorses it. So they found the person that they thought would be the best at building future customer value, Steve Prefontaine. During his college time he never lost a race on his home track, and was exposed to national notoriety with is fourth place finish in Munich. This was one of their first successes in marketing. As popularity for their product rose the selected new sports models to display the shoes on the track. This really kicked of the sale of the shoes. Seeing how this success worked at their home setting, taking it to other countries should be no problem. Paving the way with athletes that had above average ability in their field was how Nike struck the marketing campaigned. Finding someone in another country that could spark the same influence over the masses would keep thing on track for Customer value overseas. This would all depend on what country we planned on taken our product to. The last thing that we are going to look at with customer value is the four utilities of customer value. The four utilities are: Form, Time, Place, and Ease of Possession. The form in the four utilities shows what effort Nike puts into their product that makes it desirable. Part of this desire is the quality and showmanship they place in every item. The other part is who they put in their invention. This was very clear in the mid-80 when Nike was the company that took on NBA rookie Michael Jordan, to represent their company’s goals. Being one of the leaders of in business, time is important. Nike put their product out when they need to. They also change it enough to keep things fresh. Time also goes along with place. Not only does the timing of releasing product play a huge role, the place does as well. Lastly, ease of possession is just that, how easy will it be to get the product. Included in this is can I get my item fixed or replaced easily also. With internet available in almost everyone’s pocket from smartphones to tablets getting Nike’s items have become very accessible. With ease of possession we have to look at what trends are working or not, so that we may fix them. Understanding these four utilities just scratches the surface of what we need to know. To be more in-depth with a strategy we must look at the targeting and market mix portion of promoting. In order to utilize the four utilities properly we must look at the STP approach of marketing. This Approach involves segmentation, targeting, and positioning looks at what a byer values. â€Å"Segmentation can be defined as the process of splitting a market into smaller groups with similar product needs or identifiable characteristics, for the purpose of selecting appropriate target markets. Targeting (or target market selection) refers to: An organization’s proactive selection of a suitable market segment (or segments) with the intention of heavily focusing the firm’s marketing offers and activities towards this group of related consumers. And positioning (which is sometimes referred to as product positioning) is: Positioning is the target market’s perception of the product’s key benefits and features, relative to the offerings of competitive products. † With the number of competitors only the rise it is important for an organization to forecast what the consumers buying trends are. Nike, although one of the largest establishments in their field, they still are not untouchable. They have to stay a success by continually improving on the products. Nike leads the way with new technology that innovate all sports. In the late 80’s the introduction of Nike air did this well. Again they launched a promotional campaign that introduced a series of ads by Bo Jackson one of the top athletes at the time. They saw the future of what their clients wanted, Air. It was the first shoe out on the market with air in the sole. Following the marketing targeting set at this point propelled them ahead of their competitors. To stay ahead of the game the implementation of the four P’s is the next tool to evolve business plan. The four P’s that come from the widely used â€Å"marketing mix† developed in the 60’s includes production, price, place and promotion. â€Å"Product: The combination of tangible goods, services, and beliefs offered at a specific price. † To stay on the breaking edge of athletic gear with rivals on your heels they have to produce a â€Å"product† that reaches the masses. The creations did just that, they made it tangible for all with a specific price. â€Å"Price: The amount of money or other consideration a customer must exchange for the offering. † Nikes merchandise because it was ahead of others cost a little more. At the same time they could justify their cost due to the fact the merchandise operated better than anyone else’s. â€Å"Place: The strategy by which a company gets the right goods in the right quantity to the right place. † Because Phil and Bill both had roots on the west coast mainly Oregon, this is where the perfect place to offer the product out of was. Now, a global sensation you can get it from any corner of the world. â€Å"Promotion: The advertising and selling activity a company undertakes to create demand for the offering . † The only real way to endorse this type of product is to show the benefits in different people that use it. This not only sums up the four P’s but gives examples of how it applies to this enterprise. While putting all of these aspects together there has to be a way to track certain trends to be more productive. This can be done by customer relationship management or CRM system. CRM is a good tool to utilize once your product has hit the market. This system tracks the companies’ relationship with the purchaser. The data collected will be from sale and overall marketing . Some items that might be pulled from this information are demographics of the individual buying an item. This is so important to direct and promote ads to those that will actually be utilizing them. When I got my first pair of Nike shoes I was stoked. They were everything that I wanted and more. I was fast to show them to my friends. At that point I would have done anything that Nike asked me to (I was a typical kid). Inside the box was a card and at the time I did not understand what it for. It had questions on it like race, age, sports that I played in at school level†¦etc. This was there way of finding out who is buying their goods. Some places will add in rewards or freebies to get their customer feedback. This information can also give feedback on when to promote certain items so that there will be a larger return. Now that all the information is being tracked and fixed, we can now see how it does abroad. In the 90’s Nike wanted to figure out how to reach an even larger fan base. Soccer was the ticket to gain that popularity not only in one country but almost every country in the world. At the point of taking production to another country the process of building customer value and marketing kind of starts over. Knowing this Nike took players from the World Cup-winning Brazilian National team. They redesigned the uniforms and pulled in some US teams as well . This organization could go a little farther by endorsing other sports as well. One of the most important things about going into other countries with this appeal line is to see what effects it has on the area. From â€Å"Principles of Marketing† by â€Å"White† there are a couple of things that affect the marketing environment. The acts that affect the environment are actors and forces . They both exist in two different categories Micro environment and Macro environment. In Micro-environment actors are individuals like: stockholders, board members, competitors, public, and customers . In this category there are also forces which include: Strategic moves by, competitors, Channel partners, Changes in consumer behavior . Macro- environment deals actors with leaders in Culture/society, Politic, Economics, Technology development, Finance and Law . Forces in Macro-environment are; globalization, Technology and media . Let’s see how this looks with Nike. If Nike is to be a success in other countries they have to know how they are going to affect the environment where they go. They also need to know how other countries can affect them. An example of this would be in the Middle East females are not treated as equals. Therefore it would not be a good idea to start up only female sporting lines there. Another example of how they could be affected by the environment is the culture is different that the US, some countries that would use their product cannot afford American prices. This would cause a new marketing scheme. A good place to start is checking the CRM to see what trends these cultures prefer. So currently who is Nike’s biggest byer? Nike hits such a wide range of sports, from their start in track, to sponsoring golfer Eldrick â€Å"Tiger† Woods. Almost every sport today has some kind of influence from Nike. The largest in today’s market is probably the NFL. The National football league has just signed up Nike to create some new gear for this 2012 – 2013 season. The great thing about Nike is it now has sister labels that produce more than just athletic products. â€Å"A significant event in Cole Haan’s timelines happened in 1988 when Nike acquired Cole Haan . Thence, international flagship stores and more outlets opened making the reach to influence the use of quality and fashionable footwear become broader and wider . † â€Å"Then the technology of Nike Air was incorporated in the design of women’s shoes which made a mark on Cole Haan’s emphasis on providing comfort and protection not only for men but also for women. This was the first at that time and the demand for Cole Haan shoes continued to rise . † Nike seems to be unstoppable but they are only a small percentage of the market. There are so many different shoe companies out there today. If an individual can get it in the States they can get overseas via the internet. A few brands that compete with Nike are: Reebok, Adidas, Asics, and New balance. But they are not close to the company that distributes to over 170 countries. Unfortunately although Nike from the stand point of business is a great company they have a dark side also. Ethics is gaining power in the business world. People are tired of seeing cooperation’s destroy morale of the world and marketing is no different. There is a responsibility to the public to give honest communications and things that are not going further corrupt children mind. A lot of marketers will play to children’s weaknesses. Rebecca Clay wrote an article on advertising to children. The article goes on to explain that children’s psyches are not to the level to decipher fact from fiction. This weakness is exploded and ads well over load kids with ideas of toys and games that they do not need nor should they have. One case of unethical marketing goes deeper than what we can see. It was what was going on behind the curtains. According to† Mail Online† that put out an article on Nike, about the treatment in the converse factory . They continue on to say that the employees are under paid, making around 50 cents an hour. Terminology such as; dog or pig from supervisors are thrown around in a derogatory way. This is a decade after Nike came under fire for their child labor seat shops in Indonesia. Should something be done to this marketing tycoon? Some kind of apology should come to the public not only in America but to the world. This is part of their obligation to the society has a whole. As kids we can be drawn into many different that catch our attention. Mine, like many juveniles was following the dream of growing up to become a professional athlete. It was the lifestyle at the time that seemed effort less. Nike open my eyes to this more than probably any other brand. The slogan† Just do It† was what I needed to pursue my goals. For a while it felt as though they were not just talking about sports but life who knows maybe they are. Whatever it may be there marketing plan from the start of the back of a trunk; to multibillion dollar cooperation is one of the best. Going through the marketing world with Nike we covered the following: customer value, promotional items, marketing’s four p’s of the marketing mix, the segmentation, targeting, and positioning (STP) approach to market the product, Customer Relationship Management (CRM), environmental trends, the largest customer base, its competitors, and ethical marketing for this corporation both stateside and overseas. References: (n. d. ). Clay, R. A. (2000, September). Advertising to children is it ehtical. Retrieved Jan 11, 2013, from American Phychological Association: http://www. apa. org/monitor/sep00/advertising. aspx Fripp, G. (2012). .segmentationstudyguide. Retrieved Jan 14, 2013, from www. segmentationstudyguide. com Reporter, D. M. (2011, July 13). Mail Online. Retrieved Jan 13, 2013, from daily mail: http://www. dailymail. co. uk/news/article-2014325/Nike-workers-kicked-slapped-verbally-abused-factories-making-Converse-line-Indonesia. html uknown. (2011). History Heritage . Retrieved 01 10, 2013, from Nike, inc : http://nikeinc. com/pages/history-heritage unknown. (2013). A History of Cole Haan. Retrieved jan 13, 2013, from Shoe metro delivering sole satisfaction: http://www. shoemetro. com/t-history-of-cole-haan. aspx unknown. (2013, jan 13). Forbes: profile and News. Retrieved Jan 2013, 2013, from Forbes. com: http://www. forbes. com/companies/nike/ White, S. (2012). Principles of Marketing. San Diego: Bridgepoint Education,inc.

The Matrix Revolutions :: essays research papers

Neo was last found unconscious in the Real World, where his mind has been, in the Matrix World, captured by the Merovingian and taken to a Limbo state-of-mind, between the Real World and the Matrix World. He confronts a program that speaks only of love and religion, something that Neo realizes has never been the case before with a program. He stated that he went back to the Matrix to rescue his daughter, Sati (the last exile before the war between Man and Machine was going to start and end). Based on his karma, he was supposed to return to his world and leave Sati with the Oracle. Trinity and Morpheus were last seen left on the Hammer, one of the ships that were escorted from Zion in search of the Nebuchadneezer (Morpheus' ship), which had just recently exploded. They receive a call from Seraph, and they must meet the Oracle at once. The Oracle is now a different person (Mary Alice has taken the role of the Oracle since the great Gloria Foster had passed away during the production of this movie), yet her link as the Oracle in the Matrix is still very well the same. The movie explains that because of her choice to help Neo and the others, there was a consequence. The Oracle let them know where to find Neo, and he's been held as a prisoner in the Limbo state by the Merovingian. After a brutal attack at a rave party, Neo is rescued, and asked to see the Oracle before all time ran out. The rest of the movie concerns on Neo's quest to the Machine City (because he beleives that's where he needs to go to end this war), and the rest is basically the war; Zion vs Sentinals. It is a brutal battle, where the Sentinals basically slaughter most of Zion's bottleneck warhouse before a final dig into Zion's mainframe, when Neo confronts the Deus

Cause Marketing Essay

As the world progresses towards globalization and markets integrate to enhance global trading, there is a constant increase in the competition among businesses. Marketing is tool that is used by every business in order to create a name for it and promote its brand among the consumers. The non-profit goals to promote the well being of the society and its people are often foregone by businesses during their quest for a larger market share. This paper would be focusing upon cause marketing. This marketing essay would be analyzing two businesses that implement cause marketing. Moreover, it would elaborate the benefits that this scheme provides to a ‘for profit’ business and a non-profit organization. Discussion Cause marketing is basically the mutual effort of two types of organizations with two contradicting objectives. Cause marketing combines the motives of the non profit organizations with the resources of a business. The motive is generally a social or charitable cause that requires large scale marketing. Cause marketing is a distinction from the normal profit oriented market and it is a positive steps towards working for a good cause, benefiting the society and at the same time benefiting the organization. One of the oldest examples of cause marketing would be the relationship that the Boston Red Sox baseball team and the jimmy fund share. Jimmy fund is a charity that supports cancer care and research at the Dana-Farber cancer institute. The jimmy fund and the Red sox have been collaborating for charity events since almost 6 decades and have worked on numerous projects. The jimmy fund/red sox license plates help to raise funds to fight cancer. The money earned from the sale of these license plates adds the amount to charity. This collaboration is one of the most successful and long lasting examples of cause marketing. The jimmy fund has been gathering charity to work on cancer patients with the help of the promotion made through the Red sox team. Conversely, the team has gained a encouraging and heartfelt support from the people and have managed to maintain their self image in a more compassionate and empathetic fashion. Another company that can be taken as an example for cause marketing can be fisher-price. Fisher-price is a company that produces toys for children and infants. It is a well-known and attractive retailer of children toys, baby gear and parenting guides and aims on projecting a friendly and kindhearted image. Since children have an affinity for animals and are naturally fascinated by them, fisher-price has seized this opportunity to collaborate with an organization that protects the wild life and wild places through conducting educational programs and conservation across the globe, the wild life conservation society. Fisher-price carries out this partnership by creating a new line of ‘precious planet’ toys and baby gear. The sale of these items would set aside amount for donation to sustain the wildlife conservation society. With the help of the financial resources from fisher-price, the wildlife conservation society gains the benefit of having an increased capacity to promote their organization and also, to create greater awareness with the support of fisher-price customer-base. On the other hand, fisher-price gains a positive public image and relations. It would provide the company to improve its customer relations and also help it gain perspective on other marketing prospects. Conclusion Cause marketing is a friendly collaboration of the wellbeing of the society and the achievement of business goals. Non-profit organizations often face the problem of creating awareness and promoting their cause but with the help of large scale well established businesses a larger number of people can be reached. Works Cited Adkins, S. Cause related marketing. Butterworth-Heinemann, 1999. Daw , J. Cause marketing for Nonprofits. Wiley-interscience, 2006.

Memorial Health System Essay

In going through the case study of the Memorial Health System CPOE Implementation it is apparent that the direction of the implementation was developing trouble from the onset of the proposal and the evaluation (Wager, Glaser, 2009). The first problem that is apparent is the lack of belief in the project. When the board approved the CPOE initiative and appointed the champions of the project the CEO Fred Dryer and CIO Joe Roberts there was already opposition from some of the stakeholders about this project. The physician believed the CPOE system would create more workload for them as well as this system reducing the physician to secretaries. To minimize the effect of this indicator a physician would have been appointed as a champion of this project to serve as an advocate of the system (Wager, Glaser, 2009). To gain buy-in from other physicians and user of the new system to ensure they have adequate input into the decision- making process (Wager, Glaser, 2009). The lack of clarity of purpose is apparent in this implementation. The project does not determine the scope and expectations clearly the board approved a multimillion dollar initiative to install an enterprise-wide clinician provider order entry system to reduce medical errors. To minimize this indicator the implementation team must determine the scope of the project and what the organization hopes the project will achieve (Wager, Glaser, 2009). A senior health care executive should meet with the implementation team to set the tone and communicate how the project relates to the organization’s strategic goals (Wager, Glaser, 2009). The team will determine the scope, establish expectations, and institute a project plan to minimize this indicator (Wager, Glaser, 2009). Insufficient leadership support is another indicator that played a part in the failure of this implementation. When leadership wants to hear positive communication about a project and not the negatives the project will fail. To minimize this  indicator clear and concise communication on the progress of the project is necessary the leader involve in the project should make time for reports on the progress of the implementation to handle any issues that may occur that could hinder the progress of the project (Wager, Glaser, 2009). Appointing people who believe and committed to the project into leadership position to lead the team and make time for communication from team and other leadership (Wager, Glaser, 2009). Another issue that was an indicator of failure to this project was the requirements analysis was rushed several key workflow and system integration issues were missed. To minimize this indicator a thorough requirement analysis is done to ensure that all workflow analysis to support the change in workflow and the system requirements analysis to ensure the requirements needed for the system to work are aligned with the strategic goals of the organization (Wager, Glaser, 2009). Budget cut to the project was a big indicator the would lead to failure of this project because in the status review meeting it was presented that the project was on scope, on schedule, and on budget led to leadership taking resources from the CPOE project. It is important the present a true picture of how the project is going not just what someone wants to hear (Wager, Glaser, 2009). Present a clear picture of how the budget is spent and what the project will continue to spend as the implementation goes to completion, such as training, or a newer version of the software (Wager, Glaser, 2009). Showing an account of the budget can help to minimize this indicator (Wager, Glaser, 2009). This project was doom from the beginning there was not a clear scope or the expectation of the project. Analysis were not done there was not a detail project plan plus and unrealistic time line for the project to be implemented. Leadership did not communicate enough to persuade the stakeholders who were against the project to change their thoughts and so on. However, for the project to work the objectives of the initiatives are clear and communicating these objectives and initiative, and test the degree to which the organizational members have brought into them. Dividing the project into manageable pieces address the complexity and test the evidence that the project may be at risk from trying to do too much all at once. Reference Wager, K. A., Lee, F. W., & Glaser, J. P. (2009). Health Care Information System: A practical approach for health care management (2nd ed.). San Frncisco, CA: Jossey-Bas.

Abc Apparel Case Essays

Abc Apparel Case Essays Abc Apparel Case Essay Abc Apparel Case Essay ABC Apparel Case | | | | |Questions | | | | | | | |1 |What are the respective amounts and percentages of Materials, Labor, Overhead and Other in total COGS for ABC? | |* Illustrate on an Excel pie chart showing amounts and percentages for each slice. | | | | |[pic] | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |2 |What percentage of total COGS is represented by what Mr. Price called full package (purchased finished goods)? | | | | | |â€Å"Finished Garments† represent $647 Million. This assumes the purchased finished goods are supplied freight and duty paid; otherwise, applicable freight and duty| | |costs would have to be added. Note that not all freight and duty can be added to this category, since freight and duty must also support the owned supply chain | | |operations. | | |$647 / $2528 = 25. 6% | | | | |3 |Where do you see the largest opportunities for cost reduction? List your Top 3, with strategies to pursue each one. | | |* Explain your selections. | | |Purchase price or cost of supply (TCO) reductions in purchased finished goods. At 38% of COGS, these represent the largest single opportunity for cost | | |management / reduction. | |Material price reductions (30% of COGS) through supply chain procurement practices. | | |Other Costs. Freight and Duty represent almost 10% of COGS, which is probably ripe for improvement. Evaluate reducing carriers from 4-5 to fewer. | | |Labor – At 20%, Labor is a substantial percentage of cost but has probably already given up the â€Å"low hanging cost fruit† in the relocation to offshore | | |geography, and would probably be difficult to further reduce. | | | | |4 |Which functional areas would you prioritize in your cost reduction efforts? Why? | | | | |Following the same priorities in Question 3: | | |Purchase price or cost of supply (TCO) reductions in purchased finished goods. Apply supply chain procurement practices such as negotiated price reductions, | | |reverse auctions, global sourcing, target costing, centralizing procurement, spend analysis or supplier rationalization. | | |Material price reductions. Apply supply chain procurement practices such as negotiated price reductions, reverse auctions, global sourcing, target costing, | | |centralizing procurement, spend analysis or supplier rationalization. | | |Other Costs Reduction. Freight and Duty represent almost 10% of COGS, which is probably ripe for improvement. | | |Labor Cost Reduction. At 20%, Labor is a substantial percentage of cost but has probably already given up the â€Å"low hanging cost fruit† in the relocation to | | |offshore geography, and would probably be difficult to further reduce. | | | | |5 |Which internal manufacturing processes would you prioritize for improvement? Why? | | |Evaluate moving the textile manufacturing processes (yarn through Fabric Finishing) from US to offshore, preferably close to the cutting operations. If the key | | |materials could be sourced in-region, this would eliminate the cost, risk and lead time of shipping these products from the US to Central America / Caribbean, | | |reducing the high freight costs. | | |Evaluate Supplier Relationship Management programs with Asia garment suppliers. Objective would be to fully identify and reduce â€Å"hidden† costs of supply from | | |this region through collaborative problem-solving and joint incentives (â€Å"gainsharing†) for improved performance. | | |Pursue lead time reductions and reduced lead time variability through improved logistics practices. Seek use of technologies to identify logistics wait times | | |and unplanned delays. Consider use of a 3PL to become accountable for coordinating all Western Hemisphere logistics, negotiating with the major carriers to | | |reduce costs, pre-clearing all shipments through customs, etc. | | | | |6 |What is the ratio of internal manufacturing cost to purchased garment cost? | | | | | |Ratio, internal to external costs | | |275% | | | | | Internal $1,881 | | |External | | |$647 | | | | | | | | | | | | | |7 |Assuming a SGA rate of 24% and a gross margin of 35%, what annual revenue would you estimate for ABC? Show your calculations. | | | | | |[pic] | | | | |8 |What is ABCs net profit margin, in dollars and percent? | | | | |11% | | |$428 | | | | | | | | | | | | | |9 |What is ABCs profit leverage effect of reducing purchased item costs? How much additional revenue would be required to equal a 5% reduction in purchased | | |prices paid? | [pic] | | | | | | | | | | | | | 5% of 1404 = $70 Million. So, reducing purchased costs by 5% reduces COGS and increases profit by $70M. To yield an equivalent increase through sales, sales must increase by ($70/. 35) = $200 Million (6%).

Top 10 Ways to Waste Time in College

Top 10 Ways to Waste Time in College College life is hard. As a student, you most likely balance your classes, homework, finances, a job, friends, a social life, a relationship, cocurricular involvement, and ten million other things all at the same time. Its no wonder, then, that you may need to just spend time, well, wasting time now and then. But how can you tell if youre wasting time in a productive or nonproductive way? 1. Social Media Productive uses: Catching up with friends, socializing, connecting with family and friends, connecting with classmates, relaxing in a fun way.Nonproductive uses: Gossiping, snooping out of boredom, obsessing over old friends or partners, getting information out of jealousy, trying to start drama. 2. People Productive uses: Relaxing, hanging out with friends, socializing, getting to meet new people, engaging in interesting conversations, experiencing new things with good folks.Nonproductive uses: Malicious gossip, looking for people to hang out with because youre avoiding a task, feeling like you have to be part of the crowd when you know you have other things to do. 3. The Internet Productive uses: Doing research for homework, learning about topics that are interesting, catching up on current events, looking into academic opportunities, looking for employment opportunities, booking travel to visit home.Nonproductive uses: Stumbling around just to keep boredom at bay, looking at sites you werent interested in in the first place, reading about people and/or news that have no connection or impact on your time in school (or your homework!). 4. The Party Scene Productive uses: Having fun with friends, letting yourself relax during the evening, celebrating a special event or occasion, socializing, meeting new people, building friendships and community at your school.Nonproductive uses: Engaging in unhealthy behaviors that impede your ability to do things like homework and going to work on time. 5. Drama Productive uses: Getting help for your friend or yourself during a time of need, connecting a friend or yourself to other support systems, building and learning empathy for others.Nonproductive uses: Making or being involved with drama that is unnecessary, feeling the need to fix problems that arent yours to fix and that cant be fixed by you anyway, getting sucked into drama simply because you were at the wrong place at the wrong time. 6. Email Productive uses: Communicating with friends, catching up with family, contacting professors, exploring job or research opportunities, dealing with administrative offices (like financial aid) on campus.Nonproductive uses: Checking email every 2 minutes, interrupting work every time an email comes in, emailing back and forth when a phone call might better suffice, letting emails take priority over other things you need to do at your computer. 7. Cell Phone Productive uses: Communicating with friends and family, dealing with timely matters (like financial aid deadlines), calling to solve problems (like bank errors).Nonproductive uses: Texting every 10 seconds with a friend while trying to do another task, using your phone as a camera/video camera all the time, checking Instagram at bad times (in class, in conversation with others), always feeling like its the priority instead of your task at hand. 8. Movies and YouTube Productive uses: Using to relax, using to get into a mood (before a Halloween party, for example), just hanging out with friends, socializing, watching for class, watching a clip or two for fun, watching videos of friends or family, watching impressive feats or performances, watching snippets on a topic for a paper or project.Nonproductive uses: Getting sucked into a movie you didnt have time to watch in the first place, watching something simply because it was on TV, watching for just a minute that turns into 2 hours, watching videos that add nothing to your own life, using as an avoidance from the real work you need to do. 9. Video Games Productive uses: Letting your brain relax, playing with friends (near or far), socializing, learning about new games while meeting new people.Nonproductive uses: Losing sleep because youre playing too late at night, playing for too long when you have homework and other work to do, using video games as a way of avoiding the realities of your college life, not meeting new people because youre alone in your room playing video games too much. 10. Not Getting Enough Sleep Productive uses (are there really any?): Finishing a paper or project that took longer than expected, engaging with other students about something so exciting its worth missing a little sleep over, meeting a scholarship deadline, doing an activity instead of sleeping that truly enriches your college life.Nonproductive uses: Staying up too late on a regular basis, missing so much sleep that you arent functional during the time you are awake, having your academic work suffer, having your physical, mental, and emotional health suffer from lack of sleep.

Changing Gender roles,expectations, attitudes Essay

Changing Gender roles,expectations, attitudes - Essay Example And this choice is what marks itself as progressive in how gender roles are looked upon in modern times. A friend who was a recent divorcee prompted Judy Brady to attempt to answer the question why would anyone want a wife. â€Å"I want a wife who will work and send me to school. And while I am going to school, I want a wife to take care of my children,† (Brady, p.380). The wife is necessary for the man to ensure that harmony in accordance to how he perceives it is attained as he returns to the normal routine he is accustomed to. This accounts for the necessity and the convenience of having a wife in the pursuit of consensus within a traditional household before. Brady’s characterization of the wife as exemplified in her essay â€Å"Why I want a Wife† is quite point blank and resounding of the reality of the role of women in the family as the one who nurtures and oversees the overall welfare of the family. It is still widely read today, decades after its publication because it still contains a vast degree of reality even in today’s evolved modern life. There is the paradox of the woman who becomes a wife and evidently becomes a mother, who in the process loses her independence and consequent financial stability. The career of the woman is then compromised as she is delineated to the caring of the home and in ensuring the satisfaction of her husband. That a majority of women are classified as wives and as mothers (Brady, p.380). But years after this, as showcased in Glenn Sacks article, there is now a new category wherein the fathers take over what is usually a relative female role in the home. From the commonly accepted ‘setup’ where the wife cooks as the husband goes to work, the old definition of gender roles has now become loose. More and more women are now opting to have a career simultaneous with raising a family. There is though truth to what Sacks is saying regarding the real status of

Parenting Today Essay Example | Topics and Well Written Essays - 750 words

Parenting Today - Essay Example These parents know the best way of disciplining their children. This is so because they can watch the activities of the children and thus know them better. Punishment methods such as time outs enable the children to reflect on their behavior. Disciplined children are more likely to do well in academics especially when their parents are available at home to assist them. In addition, their availability helps their children deal effectively with any stressful issue that they may have (Brooks, 2011). There is a variety of factors that influence spillover. Work-family spillover occurs when the activities that take place at work affect an individual at home. On the other side, family-work spillover occurs when activities at home affects an individual at work. Job satisfaction results in to positive spillover and thus an individual go to his family with energy and satisfaction (Brooks, 2011). The sections of the population who experience positive spillover are mostly individuals who are satisfied with their positions at work. In addition, parents who spend time with their children experience positive spillover. Many studies have indicated that families enhance positive spillover. The sections of the population that have families thus experience positive spillover. A family composed of a father, a mother and two children can enhance the performance of the parents at work. One child can be very young and in kindergarten. The other child can be approaching adolescent. This family is likely to have a delightful time together, and activities that members can engage in are numerous. The parents will have to teach the young child how to read and write, and this can be satisfying and enjoyable to the parents. They have to advice the older child too on various issues such as changes occurring in his or her body. Such a family is small and thus easy for each of the parents to manage. The parents can also have spare time to discuss their

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

Summarizing - Essay Example Religious constitutions are important to these leaders because they act as their guidance. They view themselves as leaders chosen by God. Monarchy could relate its way of leadership to the supreme authority. The leadership is hereditary and remains within the family. The family members are the top organ of the country. These two types of monarchy still exist but differ in their structure. The Arabs drew a common definition to balance this Monarchies. A situation like this could use the word ‘Malik’ to balance. People say; king and Malik is both equal, and they are both important (Gause 96). Arabs have evidence on their royal titles. A person could trace the background of the title by studying the evidence, example, studying the coins (Gause 95). In ancient Arab, people did not like the Kings. Arabs did not want any form of central government. Liqah is the word used to describe people who abide by every rule of the king. Islam draws their hate of kings from the bible. They give the example of the monarchy of Israel, in the book of Hebrews. The case is not the same for all Kings. The Quran depicts David and Solomon as good kings. The only difference of determining which kingdom is good is when one contrasts kingdoms with caliph and caliphate (Gause 79). Malik depicted military leaders. Their authority was secular, where religion had no place (Gause 90). The rule had no laws from the ruler, but rather use of personal thoughts. King, as a title, was improved in terms of imperialism. After improvements, the name king improves and becomes sultan or Persian. Pedishabs self-declare themselves as emperors. They make their own rights and rules. Examples of padishans are the sultan of Turkey and Shah of Persia. The considers them great (Gause 95). Kings were coordinators of the Padishans. The title of king became so small and less influential in Muslim countries. Foreign leaders in the country were kings. Harun al-Rashid was a

Long Bone Fractures in Children: IN Fentanyl Treatment

Long Bone Fractures in Children: IN Fentanyl Treatment Introduction The clichà © that states children are just small adults is certainly not true in the case of long bone fractures. A childs experience of long bone fractures is dramatically different from that of an adult on account of their rapidly developing physiology (Wood et al 2003). This rapid development results in biochemical and physiological differences between a childs and an adults skeleton, the mechanisms of fracture and healing, are an important component of their treatment needs and consequently crucial part of emergency care management (Bonadio et al 2001). In addition, children, from infancy through to adolescence, have common fracture patterns related to their stage of development. The structural differences between the bones of a child and an adult enable childrens bones to endure greater forces and to heal quicker a childs remodeling potential supports full recovery with limited or no long term side effects from long bone fractures (Lane et al 1998). Injuries of all types are the second leading cause of hospitalization among children younger than 15 years (Landin 1997). Musculoskeletal trauma, although rarely fatal, accounts for 10% to 25% of all childhood injuries (McDonnell 1997, Landin 1997, Lane et al 1998). Boys have a 40% risk and girls a 25% risk of incurring a fracture before the age of 16 years (Landin 1997, Ritsema et al 2007). The most common site of fracture is the distal forearm which accounts for 50% of paediatric fractures. The rates of fracture increases with age as children grow; peaking in early adolescence. Fortunately, most fractures in children are minor greenstick and torus fractures constitute approximately 50% of all fractures in children (Landin 1997, Lane et al 1998, Gasc Depalokos1999, Richards et al 2006) and only 20% require reduction. Thus, the management of paediatric fractures is often straightforward. Without exception children will experience pain at the time of injury, attending the accident and emergency department and during recovery. The most common pain management strategies involve a multi-modal approach that includes both pharmacological and non-pharmacological components delivered via the least invasive technique (Worlock et al 2000). In practice this includes oral medication, such as oramorph, paracetamol, and NSAIDs, inhaled entonox, intranasal diamorphine (IND) or intravenous opioid where necessary and distraction with age appropriate devices, such as interactive books, bubbles, music and computer games in older children. Notably, IND is currently embraced as the key route of opioid delivery for children attending AED with fracture pain in the UK British Association for Accident and Emergency Medicine (BAAM E 2002). Parents and guardians of children frequently seek care in AED for the relief of pain from traumatic injuries and as a result the field of emergency medicine has assumed a leadership role in paediatric pain management. However, despite this the literature suggests the provision of pain relief for children attending AED remains suboptimal when compared to adults with the same injuries. Further discrepancies are reported between paediatric accident and emergency departments (PAED) and district general accident and emergency departments (DGAED) (Emergency Triage 2004). One reason suggested for these differences is the geographic distribution of specialised services, which are predominantly located in large cities where they are affiliated with universities. However, a recent audit by the British Association for Emergency Medicine (BAAEM 2005) of their guideline for the management of pain in children shows inconsistencies in provision of analgesia particularly for fracture pain throughout the country with no measurable difference between PAED and DGAED. A key feature of this guideline is the algorithm which advocates the use of IN diamorphine for acute moderate to severe pain in children over the age of one year (see appendix 1). The whole topic of analgesia in the paediatric population is complex and still imperfect especially in acute moderate to severe pain requiring urgent treatment in the emergency department (Schechter et al 2002). The road to pain free suffering is still paved with impediments such as failure of pain recognition and methods of delivery of analgesia (Murat et al 2003). Oral administration can be inadequate in an emergency situation with particular limitations in potential choice of drug and delay in gastric absorption and gastric emptying. Intramuscular (IM) and intravenous (IV) administration can be distressing to children and have been shown to influence future response to painful procedures (Gidron et al 1995, McGrath et al 2000, Fitzgerald et al 2005, Walker et al 2007). Rectal administration has limited acceptability given unpredictability of onset together with occasional problems of consent (Mitchell et al. 1995). By contrast, the efficacy and safety of the IN route has been well documented for desmopression acetate (DDAVP), insulin, antihistamines, midazolam and calcitonin (Jewkes et al 2004, Loryman et al 2006). In contrast, intranasal administration has a number of advantages. It is technically straightforward, socially acceptable and demonstrably effective. The nasal mucosa is richly vascular and administration by this route avoids the first-pass metabolism phenomenon Summary Studies in the 1990s such as Yearly Ellis (1992) have also demonstrated the efficacy of administration of intranasal medication via a nasal spray rather than drops in adults, although the efficacy of this application in the paediatric population remains to be proven. Intranasal administration is possibly the ideal route of analgesic administration in children. Currently, within the accident and emergency department (AED) of Bristol Royal Hospital for Children (BRHC) intranasal diamorphine is used as the first rescue analgesia in the paediatric population presenting with acute moderate to severe pain, most frequently in patients with long bone fractures who do not require intravenous access for resuscitation. Diamorphine is a semi synthetic derivative of morphine with a number of properties that render it a desirable analgesic agent for administration via the nasal route. It is a weak base with a pKa of 7.83 and is water soluble allowing high concentration to be administered in small volume (Rook et al 2006). Unfortunately the legal use of diamorphine is limited to two European countries i.e. United Kingdom (UK) and Sweden. Furthermore periodic problems with its availability during the past few years (with further shortfalls in availability predicted by the NHS purchasing and supply agency) have resulted in an alternative efficacious analgesia being sought for this population. Fentanyl, however, is a short rapidly acting opiate has several qualities that render it useful as an IN analgesia and a potential candidate to replace IN diamorphine in the AED for acute facture pain management in children. It has a very high lipid solubility, potency and diffusion fraction, and unlike diamorphine it is not a prodrug and does not cause histamine release (Reynolds et al 1999). Assessment of a patients pain experience is not directly accessible to others, collecting and analyzing information about the processes of pain relief and pain prevention is not straightforward and presents significant challenges to health care professionals. In children, this task is further complicated by their varied stages of physical and cognitive development. Recent research by Bruce Frank (2004) however, has shown that the ability to measure pain in the paediatric population has improved dramatically and that today there now exists a plethora of age appropriate pain assessment tools for acute pain in children ranging from pre-term infants to adolescents, the majority claiming validity (strength and robustness) and reliability (consistency). However, most clinical research into pain management strategies continue to rely on the gold standard self report and visual analogy score tools (mostly 0-10) (Chalkiadis 2001, Walker et al 2007). Although these tools are reliable they are not always adapted appropriately for a childs stage of development. Childrens understanding of pain and their ability to describe pain change with increasing age in a developmental pattern consistent with the characteristics of Piagets preoperational, concrete operational and formal operational stages in cognitive development (Smith et al 2003). The quality or int ensity of the pain can be difficult to determine in children, as most tools rely upon a patients relative judgment between the intensity of present pain versus a patients worst pain experience (Murray et al 1996). These tools can therefore be unreliable where a childs age of development means they have limited or no memory of pain experience. Stevens et al (2002) recently described a conflict of understanding that resulted in a study bias and an insignificant reported power of (p=0.6). In the study an 8 year old boy had chosen the VAS (0-10) but frequently reported his score as 10, although he understood the increasing value of the scoring system further questioning identified he perceived 10 of 10 to be a good score and 0 of 10 to be poor. The boy was at a stage of development that limited his understanding of less is more. This case highlights the importance of utilizing a pain assessment technique that reliably accounts for a childs age of development. A preliminary search of literature suggests there is currently exists limited research to support for the use of intranasal diamorphine or intranasal fentanyl for the management of acute pain in long bone fracture in children as evidenced based medicine. Despite this lack of evidence it remains a key strategy within paediatric AED for the pain management of long bone fractures and is anecdotally reported as a gold standard for paediatric pain management. Therefore; its lack of availability could profoundly compromise pain management for this population. Thus, this extended literature review will examine the efficacy of intranasal fentanyl as an alternative to intranasal diamorphine for traumatic fracture pain in children attending accident and emergency departments. However, in these days of evidence based medicine, it clearly needs to be established beyond all reasonable doubt. In view of that only research into paediatrics will be included increasing the credibility of its applicat ion to practice. SEARCH STRATEGY A range of complimentary search techniques were used to capture key research including a systematic electronic literature search of the Cochrane library, Embase, CINAHL, Proquest, Medline, PubMed since 1990 up to 2009 (this has to be to year of submission). The scope of the search was extended beyond the recognised five years of current research so as to include the empirical work into the development of IN analgesia in children. Key words used included the following: pain, acute pain management, intranasal diamorphine, intranasal fentanyl, procedural, accident and emergency, emergency department, child, pediatric, paediatric, child and fracture pain, as well as various combinations. In addition, in order to ensure the completeness of the search, an internet search was completed using the Google search engine, IASP, Pain Journal, Paediatric Nursing, BAAEM, NICE, Medline, EBM; the RCN was also utilised. Backward chaining of references found was also performed to ensure all relevant papers were identified. Although this review identified twenty seven citations it should be noted that historically there are fewer Randomised Controlled Trials (RCT) in children compared to adults possibly due to problems gaining ethical approval and consent. Additionally even experienced researchers will be unable to find all relevant papers and much research is not submitted for publication. The studies identified were divided into the three modalities of IN route, IN diamorphine and IN fentanyl with the majority presenting evidence for the IN route. All papers were critiqued using a tool published by the Learning and Development Department within the Public Health Resource Unit of the NHS (www.phru.nhs.uk/casp). The tool facilitated critiquing different forms of quantitative research and is based on work by Sackett (1986), Sackett et al (1996) and Phillips et al (2008) (see appendix 2). The results of the critique process for each paper and level of evidence applied in line with the modalities they address informed understanding of current practice and development of a research proposal. STRUCTURE OF THE LITERATURE REVIEW This literature review will focus on determining whether IN fentanyl is an effective alternative to IN diamorphine for the management of long bone fracture pain in children attending an AED. The scope of the literature review considers literature from 1990 onwards although occasionally earlier research has been referenced. Given the limited available evidence on the topic the following review structure has been selected. Chapters 1, 2 3 will present the evidence sourced on each theme intranasal route, intranasal diamorphine and intranasal fentanyl with a short summary to conclude each chapter. Chapter 4 will present an in-depth discussion and conclusion on the utility of the evidence, its application to practice and the requirement for a multi-centred comparative randomised control trial to improve the credibility of the evidence base for this field of treatment. Finally chapter 5 will present a research proposal for a comparative study of these modalities. Intranasal (IN) route of medication delivery in children. Nasal administration of drugs has been reported as having several significant advantages over current practice which are predominately oral, IM, IV and rectal (Williams Rowbotham 1998). It is emerging as a low-tech, inexpensive and non-invasive first line method for managing either pain or other medical problems (Wolf et al 2006). Nasal medication delivery takes a middle path between slow onset oral medications and invasive, highly skilled delivery of intravenous medications. The nose has a very rich vascular supply, IN facilitates direct absorption to the systemic blood supply due to increased bio-availability of the drug by missing first pass metabolism, It avoids the potentially technically difficult of sterile intravenous access, is essentially painless and is considered acceptable to children when compared to other routes of administration (Shelly Paech 2006) (see table 1). a theory which will be considered when reviewing the studies within this chapter Therefore suggesting th e IN route will result in therapeutic drug levels, effective treatment of seizures and pain without the need to give an injection or a pill, furthermore; it is quite inexpensive, an advantage in this era of increasingly expensive medical technology (Shelly Paech 2006). Additionally given the complexity of the developing child and the known consequence of poorly managed pain on the future responses to pain the IN route does, if it is as efficacious and as safe as suggested offer one of the most acceptable, definitive forms of analgesia delivery in children. The degree of accuracy of the previous statements will be established within this chapter by critically reviewing the 16 studies identified on IN medications other than intranasal diamorphine or intranasal fentanyl in the paediatric population (see table 2) as these agents are considered individually in later chapters. The rigour of the studies will be addressed within this chapter and reflect the level of evidence applied according to Sackett (1986) criteria (see appendix 3). Most studies reviewed were randomised clinical trials and in some cases compared against a placebo Conversely, this does not concur with the trials discussed earlier (Lahat et al 1998, Al-rakaf et al 2001, Fisgin et al 2002, Mahmoudian and Zadeh 2004 and Holsti et al 2007) where significant dosing was applied or in Wilson et al (2004) who retrospectively studied 30 children age 2-16 years receiving 0.3mg/kg at 5mg/1ml INM and 13 patients receiving rectal 0.2mg/kg diazepam for seizures. The authors report equal efficacy for both routes. Success of these agents was considered on cessation of seizures, no reported complication and not needing to attend A+E. A total of 27/30 families who had used INM found it effective and easy to use. Although 20/24 (83%) who had previously used rectal diazepam still preferred it mostly due to the coughing and the volume of liquid administered via the IN route. Given it is generally considered that the optimum IN dose as stated above is 0.1- 0.2 ml per nostril, all but the studies discussed so far were using drug concentration and dosing regimes whic h resulted in large volumes of liquid being dripped in to the nasal cavity. This is particularly poignant in Wilson et al (2003) who compared buccal to IN midazolam in 53 children aged 3-12 years experiencing seizures lasting > 5 minutes attending AED. A key feature of this study is the mean age of the children (age 9 years), mean weight (24kg) the study drug concentration as with previous studies was of 5mg /ml. IN dosing was at a dose of 0.3mg/kg. Given these figure the average dose would have been 7.2mg = a volume of 1.4ml being administered. Since the comparative route of administration for this study was buccal there is a possibility that part of the IN dose was buccally absorbed therefore creating a flaw in this study methodology, raising questions over why this comparative route was chosen and suggesting the only real conclusion to be taken from this particular study is buccal midazolam is effective and safe in children. Furthermore although this is described as a blind RCT and the authors claim the time to cessation of seizure was quicker for the INM group 2.43 (SD 1.67) to 3.52 (SD 2.14) for buccal route there is little detail on the blinding process or data collection procedure suggesting the rigour of the study maybe flawed therefore the efficacy and safety claimed for the IN route should not be embraced without further study. On the other hand Fisgin et al (2002) and Hardord et al (2004) compared the INM with rectal diazepam. In Fisgin et al (2002) in an unblinded RCT equivalence study the authors compared INM with rectal Diazepam to ascertain the safety and efficacy of INM for the development of a clinical protocol in the management of prolonged seizure in children attending the AED. Forty five infants and children age 1 month -13years experiencing prolonged seizures > 10 minutes were either given INM 0.2mg/kg or rectal diazepam 0.3mg/kg. The authors report proven efficacy (p Intranasal Diamorphine (IND) The delivery of opioids via the IN route is perhaps one of the most valuable indications for IN medication delivery. Acute pain is a frequent experience for children whether attending an AED, hospital and hospice setting (Hamer et al 1997). Furthermore it is not unusual for them to experience frequent episodes of breakthrough pain which requires additional support from fast acting analgesic agents. Owing to the developmental and physiological difference in the paediatric population there is a need for a variety of effective treatment option from which to select and individualise the patients therapy to meet their needs. IN opioid is simply one such option available which may be useful in children. It has been suggested that the delivery of medications via the IN route results in rapid absorption with medication levels within the cerebral spinal fluid (CSF) being comparable with (IV) administration (Chien and Chang 1997). Diamorphine hydrochloride is a semi-synthetic derivative of morphine. It is extremely hydrophilic, which makes it ideal to use when preparing in high concentrations in solution, thus allowing high doses to be administered in smaller volumes via the intranasal route (Kendall Latter 2003). However, this route of administration can be a painful process as reported by adults (Henry et al 1998). Despite this the intranasal route is considered more acceptable to children and their parents and is thought to lessen the opioid side effect profile seen in IV administration (Stoker et al 2008). This concept has been well recognised throughout the UK and many centres already use intranasal diamorphine for acute pain in children, following the guidelines by the British Association for Accident and Emergency Medicine Clinical Effectiveness Committee (2002) (BAAEM). Although the administration of intranasal diamorphine is now a first line choice for moderate to severe acute pain for children atten ding AED, as is the case within our institution, there is very limited research to substantiate this practice although as noted above it has been readily accepted by the BAAEM for acute pain management in children and very successfully used within our institution A recent shortage of diamorphine evoked the search for an equally effective and acceptable alternative. Early research in animals and adults reported pharmacokinetics of nebulised inhalation and intranasal administration of diamorphine as detected morphine in plasma at six minutes (Masters et al 1988, Kendall 2001). Despite the age of this research and the fact that the later study was in adults, it is still quoted as creditable evidence to support this practice in paediatrics. However the legitimacy of this should be questioned, due to children not being just small adults but have physiological differences intrinsic to their age and stage of development which may affect the bodys absorption and level of toxicity in different ways to adults. The extensive literature search highlighted four randomized controlled trials (RCT) that demonstrate IND to be clinically superior to intramuscular morphine and inferior to IV morphine particularly in the management of acute pain in children, a case study of an 8 year old boy and clinical audit of IND for pain relief in children attending AED (see table 3). The key methodology in the RCTs by Wilson et al (1997), Kendall et al (2001), Brennan et al (2004) and Brennan et al (2005) suggest these are superiority studies where the authors hypothesised improved pain management with the IND when compared to a variety of routes. The rigour of the studies will be discussed later in the chapter. Although while the critiquing process takes place it is fundamentally accepted that RCT are considered level 1 or 2 evidence as opposed to case study or audits at Level 3b and therefore generally sourced to Latest published clinical evidence to support the use IND in the paediatric population is presented in an audit by Gahir Ranson (2006) of 54 children whose care was managed by the use of an integrated care pathway for acute pain management while attending the local AED. This integrated care pathway focused strongly on the use of IND. Data collection was on a one page performa and included consent, date, patient demographic, pain score and side effect profile. Data collection was retrospective and data analysis illustrated limited recording of side effect profile but improved pain scores. However only 60% of patients have this information documented so data collection was difficult. Despite this lack of hard evidence no clinical incident, including the side effect profiles, were reported. Thus suggesting the practice of IND for acute fracture pain management in children could be safe, effective and more acceptable to children than the more painful alternative of IM or IV administration. However there is limited strength in an audit, other than a review of practice (Bowling Ebrahim 2005) and in this case a key feature for review should be the documentation process in the department as there were facets in the care pathway administration documentation missing. Therefore this audit suggests that IND is safe and effective pain management for children, but this conclusion can not be categorically drawn from the limited data available. The potential outcome of this audit could be education on documentation, to do a more rigours prospective audit of practice. Unfortunately at this point it only offers an insight to their clinical practice which is favourable for this agent and route. Albeit as noted before IND has improved childrens pain management and over all experience of acute care in our PAED additionally as with the results of the audit we have experienced no side effects or complications, further highlighting the importance of seeking an alternative to IND which offers equally efficacy. Intranasal Fentanyl (INF) Monitoring of the usual observations and pain scoring in the child was recorded prior to the administration of fentanyl (20 micrograms for 3-7 year olds and 40 micrograms for 8-16 yrs) and continued at 5 minute intervals for the 30 minute period. Additional doses of fentanyl (20  µg) were available if required at 5 minute intervals. Pain assessment was achieved with two validated pain assessment tools, the visual analogue scale (VAS) in older children and the Wong-Baker Faces (WBF) for younger children. Both are reliable and known to support consistency in pain assessment. Though there was no mention of training for those assessing this primary end point using these tools in the paper therefore this should be considered in the overview of the standard of evidence produced by this study. Additionally although forty five patients were randomized following consent unfortunately no details on the randomization process was disclosed in the paper either. This may not be significant, but when reviewing the credibility of the authors claims these obvious omissions could be responsible for a flaw in this study and remains to be established. On the other hand, the methodology that has been disclosed in the paper appears sound as it addresses key areas of sample calculation (power of the study) as a superiority study with the sub groups size adequate to detect a significant difference (Greenhalgh 2004); demographics, blinding of the drugs, assessors and appropriate statistical analysis of the data therefore supporting the validity of the results claimed and the application of the results to the age of patient targeted that this literature review is aiming to find an analgesic alternative to IND for. The results concluded by Borland et al (2002), are a reduction in pain score at 10 minutes to 44.6 mm (95% confidence interval) 36.2-53.1 mm from 62.3 mm 53.2-69.4 mm (95% confidence interval) at assessment using the VAS and 2.2 (95% confidence interval 1.3-3.1) at 10 minutes from 4.0 (95% confidence interval 3.3-4.7) at assessment in 16 children using WBS. Visual analogue pain scores demonstrated clinically significant reductions in pain scores by 5 minutes that persisted throughout the entire study (up to 30 minutes) for both INF and IV morphine. The second primary end point of this study (side effect profile) showed no significant change in physiological parameter of the childrens pulse or respiratory rate, blood pressure or oxygen saturations, interestingly the side affect profile chosen for monitoring such as pulse and blood pressure are not considered to be one of the primary side affects of morphine, however nausea and vomiting which are was not assessed. Ultimately, there wer e no negative side-effects and the sizeable reduction in pain scores (compared to baseline assessments) was accomplished in children using INF by 10 minutes and maintained throughout the 30 minute period with the mean INF dose at 1.5 µg/kg and ranging from 0.5-3.4  µg/kg. Interestingly 35.5% of children in the INF group only required one dose. Given the clinical equivalency of these two agents and routes the authors conclusion that INF offers the benefits of a simple painless technique for treating acute pain is substantiated. These benefits suggest that the IN route could be a valuable technique not only in an AED but also for breakthrough pain by offering a fast onset of pain control in moderate to severe painful conditions. It could also provide pain relief and allow topical anaesthetics to take effect on the skin prior to IV establishment. Therefore this may be a suitable alternative to IND. A similar and more recent double blinded RCT trial by Saunders et al (2007) claimed efficacy of a larger dosing regimen with a mean dose of 2 µg/kg INF (50 µg/ml) for pain reductions in paediatric orthopaedic trauma compared with IVM at 0.1mg/kg in 60 3-12 year old children. This study reports positive outcome for INF following both patients and carers reporting very effective pain management and satisfaction using this treatment method. However there is little information in the paper of methodology and results are given in percentages rather than a P value or NTT which should be expected in a rigorous creditable RCT of two agents (Bowling Ebrahim 2005) reducing the level of evidence applied to the paper to L3. Even supposing the results are an accurate reflection of the efficacy and safety of INF, particularly the fact that no significant difference in pain score or side effect profile and INF is a way forward, the lack of detail the randomisation process and analysis of data in the study methodology merely implies that these results maybe flawed. Interestingly given the concentration of fentanyl 50 µg/ ml a dosing volume for a 25kg child would have required one ml = 0.5ml per-nostril therefore suggesting some of the administration may have been oral rather than IN and present the issues of bad taste which is put forward as a possible study limitation by the authors. Then again there are no complications or reports on taste presented in the results and the authors conclusion on the efficacy of INF for acute pain management in children may be founded. However, without sourcing more details from the authors it cannot be considered evidence to inform this dissertations aims but merely an ex ample of poor research or appropriate omission by publishers. Further suggesting there remains a requirement for more research on the topic within double blind, equivalence, RCT focused on INF efficacy and dosing with sound methodology that is transparent in publication to answer the dissertation question. Conversely an older and more rigorous study which also looked at dose related analgesic effect between routes of administration is by Manjushree et al (2002). The authors demonstrated the clinical efficacy of INF in a cohort of 32 children (aged 4-8 yrs) in a postoperative situation and with a double blind level 1 RCT. The study design gives the impression of sound methodology as blinding, assessment and analysis of data was appropriate and available for scrutiny in the paper, particularly the analysis of both nonparametric and nominal data. The only weakness is possibly the sample size of 32 patients. Although the authors performed a power calculation which identified 40 patients to show a significant affect, they only recruited 32 patients, furthermore, this appears to be an equivalency study where the authors hypothesised INF would be equal to and not inferior to IVF therefore would have needed a larger sample to de