Christians today Coursework Example | Topics and Well Written Essays - 250 words

Christians today - Coursework Example All believers met together at a certain place, and they shared whatever they had. Likewise, Christians today should share what they have with those in need. Another thing that Christians of today can learn from the early church is that there is a need to fellowship with other Christians and worship together. This should be done regularly in churches and other places of worship. Today’s Christians should also learn that they should share generously so that God can add other people to their fellowship. As Christians, there is a need to be in touch with one another and share talents apart from the usual sharing of possessions (Sommer, 2007). Christians of today can also learn from the early church that there is the need to help other people at what they cannot be able to do. In addition, Christians should seek help at what they are not perfect. Just like the bodies of human beings have several parts each playing a certain role, so is the body of Christ. As such, there should be the realization among Christians that they belong to one another as they can be termed as many parts that comprise Christs body (Sommer,

Junot Diaz Bio Essay Example for Free

Junot Diaz Bio Essay Lent DDS was born In the Dominican Republic and raised New Jersey. He Is a creative writing teacher at MIT and fiction editor at the Boston Review. He also serves on the board of advisers for the Freedom university, a Volunteer organization in Georgia that provides post-secondary instruction to undocumented immigrants. From what I have read I have gathered that he really had to rely on himself. Getting him through college working the Jobs where you have to do the dirty work, dishes, and pumping-gas. Supposedly Drown reflects Diazs strained relationship with his own father, with whom he no longer keeps in contact with. Diaz was born in Villa Juana, a neighborhood in Santo Domingo, Dominican Republic. He was the third child in a family of five. Through most of his childhood he lived with his mother and grandparents while his father worked in the united States. Diaz emigrated to Parlin, New Jersey, in December of 1974, where he was able to reunite with his father. He lived close to what he considered one of the largest landfills in New Jersey. His short fiction has appeared In The New Yorker magazine, which listed him as one of the 20 top writers for the 21st He has also been published in Story, The Paris Review, and in the anthologies The Best American Short Stories four times (1996, 1997, 1999, 2000), The PEWO. Henry prize stones (2009), and African voices. He s best known for his two major works: the short story collection Drown (1996) and the novel The Brief Wondrous Life of Oscar Wao (2007). 80th were published to critical acclaim and he won the 2008 Pulitzer Prize for Fiction for the latter. Diaz himself has described his writing style as a disobedient child of New Jersey and the Dominican Republic If that can be possibly Imagined with way too much Diaz has received a Eugene McDermott Award, a fellowship from the John Simon Guggenheim Memorial Foundation, a Lila Acheson Wallace Readers Digest Award, the 2002 PEN/Malamud Award, the 2003 us-Japan Creative Artist Fellowship from the National Endowment for the Arts, a fellowship at the Radcliffe Institute for Advanced Study at Harvard university and the Rome Prize from the American Academy of Arts and Letters. He was selected as one of the 39 most important Latin American writers under the age of 39 by the Bogota World Book Capital and the Hay Festival. [18] In September 2007, Miramax acquired the rights for a film adaptation of The Brief Wondrous Life of Oscar Wao. [19] The stories in Drown ocus on the teenage narrators impoverished, fatherless youth in the Dominican Republic and his struggle adapting to his new life in New Jersey. Reviews were generally strong but not without complaints. 20] Diaz read twice for PRIs This American Life

Steven King Essay -- Biography Biographies

Bio of Steven King Stephen King Stephen Edwin King was born September 21, 1947in Portland, Maine, U.S. He is an American novelist and short-story writer whose many novels and story collections, and the numerous films adapted from this large body of work, have established his reputation as the leading author of horror fictions in contemporary literature, and with reviving the genre of horror fiction in the late 20th century. King graduated from the University of Maine in 1970 with a bachelor's degree in English. Abused by a fanatically religious mother and ridiculed by her classmates, Carrie was the first of many novels in which King blended horror, the macabre, fantasy, and science fiction. Among such works were Salem's Lot (1975), an equally nihilistic novel, which portrays a small Maine village overrun and repopulated by vampires. The Shining (1977; filmed 1980), a writer, his wife, and their young son act as winter caretakers in a ghost-ridden hotel. The Stand (1978), The Dead Zone (1979; filmed 1983), Firestarter (1980), Cujo (1981), Christine (1983), It (1986), Misery (1987), The Tommyknockers (1987), and The Dark Half (1989). In his books King explored almost every terror-producing theme imaginable, from vampires, rabid dogs, deranged killers, and a pyromaniac to ghosts, extrasensory perception and telekinesis, biological warfare, and even a malevolent automobile. Though his work was disparaged as undisciplined and inelegant, King was a talented storyteller...

Analysis of Conan Doyle’s work Essay

English coursework : A comparative essay on 2 Sherlock Holmes stories  The world has chosen to remember Sir Arthur Conan Doyle chiefly for his creation of the fictional master detective, Sherlock Holmes. This prestigious character has been hugely popular for over one hundred years shown in many different ways, whether it be books, television series, magazine articles, and so on.  Conan Doyle himself was born in Edinburgh, rather than the London setting that Sherlock Holmes lives and works. He actually set out to be an oculist, however when no patients came he had plenty of time to write his stories. Around the same time, The Strand magazine was first published, and Sherlock Holmes was printed for the first time in its pages. His stories were not long enough to be books of their own, and thrived as a regular part of their magazine. The Sherlock Holmes stories are written in a very upper class setting. Watson and Holmes take cabs everywhere, and have very high class mannerisms and habits, such as leaving a calling card if the person they have visited is not there. And Holmes himself carries round a cane with him – a rather posh acquirement thought to be that of a gentleman. They also have a resident in the home to look after them both, and take care of the household, which could of course only be afforded by those of the higher class.  The fact that these stories were written in such a way is easily explained. The stories were written for the magazine, ‘The Strand’. In those times, very little people read magazines, and could afford to subscribe. Most people read newspapers, but these magazines were aimed at the higher class, and particularly for the gentleman, because a very small number of women were expected to be able to read, and so they did not benefit from such a publication. â€Å"The Speckled Band† and, â€Å"The Red-Headed League† are both very interesting stories. The structures of both are much the same, but that accounts for all of Conan Doyle’s creations in accordance to the Sherlock Holmes stories.  In accordance to this structure, â€Å"The Speckled Band† begins with a visit to the house from someone needing Holmes’s help. An element included right at the beginning of the story is the deduction Holmes makes of Helen. This is extremely typical of Conan Doyle as it is a feature he nearly always adds as each of his stories unfold. In â€Å"The Speckled Band† Holmes instantly deduces that she travelled early by dog cart on heavy roads to the station before travelling by train to London. The next lines describe Helen giving ‘a violent start’ and staring at Holmes in bewilderment. This is also underlyingly very typical of Conan Doyle to include such a description, as it what he includes in all of his stories at this point. In direct comparison, â€Å"The Red Headed League† features a swift deduction of Jabez Wilson in which he concludes that the man done at some point manual labour, takes snuff, has a freemason, has been in China, and has done a considerable amount of writing recently. The line directly following on from that is set out exactly the same as in â€Å"The Speckled Band† and describes Jabez to â€Å"Start up in his chair, with his forefinger upon the paper, but his eyes upon Holmes† So we can conclude from this that this is an element Conan Doyle likes to include in his stories which also suitably gives a first time reader an idea of the way Holmes’s mind works.  Following on from that, a long monologue is heard which tells every detail of the story. This is unusual in stories written now. We can note that in real life no one tells a story in such detail, uninterrupted, and this reflects tracts of today. But it is actually very typical of writings at the time.

Introduction to Early Childhood Education †Assessment Essay

Identify THREE quality indicators relevant to early childhood education and discuss why they are important for children, parents, and/or society. 300 words. The first quality indicator relevant to early childhood education would be ‘people’. Letting your child learn in an environment where the teachers and assistants are expert, well-trained and the majority of them hold qualifications in the area. They should be able to fully understand your child’s needs, communicate well with them ensuring they make your child feel safe and comfortable being around them. They should also be trusted and respected by staff, parents and children. The ‘place or environment’ would be the second indicator. The learning environment should make all children feel welcome regardless of the cultural, ethnic or language background. They should be able to provide a variety of, materials, equipment and play activity arranged to encourage children to learn. A stimulating outdoor environment that challenges and motivates children to explore, run and play is also important. An environment where they feel safe, and where parents can see their child, and feel comfortable knowing they are there. They should be able to feel secure in the environment they are in and to know their children can only benefit from being there. ‘Programme’ the third indicator. A quality learning programme should provide lots of learning opportunities in a wide range of different areas (reading, water play, sand play, dress-up, science, social play). A variety of activities either working in small groups or individual interactions with teachers. Parents should be able to BEd111: Introduction to Early Childhood Education – Assessment 20120778 Tourmaline Munday- Cooper to understand themselves about what their child is learning, having good communication with the centre employees, knowing what is going on and understanding their ways etc. an eye out being a parent and understanding the centres way. Teachers should always build trusting relationships with parents while always respecting and supporting different families cultures and languages. Reference List Identify TWO early childhood services in your community. Briefly explain their history and then compare and contrast their philosophies, educational goals and the strategies employed to achieve these goals. 450 words. Montessori is a philosophy and method of education pioneered by the Italian educationalist Dr Maria Montessori (The first Montessori school opened in 1909, the first Waldorf school in 1919 and the first Playcentre in the 1930s) Montessori ‘casa dei bambini’ or ‘children’s house’ was first opened in San Lorenzo, Rome, Italy. Dr Maria Montessori recognised that the first six years of a child’s life are the most important. Dr Montessori, trialled many materials and activities, but kept only those to which the children were spontaneously and repeatedly drawn. Playcentre began in 1941 primarily as a support service to women left raising children alone due to partners being away with the Second World War. Lack of transport and low family incomes were the reality for many women. Playcentre’s original aims were â€Å"to provide leisure for mothers and opportunities for the social development of the pre-school child† (Stover, 1998, p. 3). Playcentre is a stimulating environment, they provide a diverse and rich range of experiences, unlimited free play across all 16 areas of play, and a child initiated curriculum. Montessori has a certain structure and is based on their own philosophy unlike playcentre. Playcentre is a parent run co-operative it relies heavily on parental input, participation and support. Montessori aim is to provide an environment with structure and activities that meet the needs of the children and by giving them freedom to move and act within it, it was said that Dr Montessori had revealed the â€Å"true nature† of the child. Their philosophy is aimed for Children to be encouraged to be firmly grounded in reality before being exposed to fantasy. Montessori classrooms are very BEd111: Introduction to Early Childhood Education – Assessment 20120778 Tourmaline Munday- Cooper quiet, as children are deeply absorbed in their work. They input this by managing the classroom materials into six areas (Practical Life Exercises, Sensorial Material, Art, Mathemartics, language, cultural subjects, and also physical is brought into their daily routine). Playcentre however is marked by a stimulating environment, providing a diverse and rich range of experiences, un limited free play across all 16 areas of play, and a child initiated curriculum. Their views and goals are to promote children’s learning through play, Family involvement ( based on the importance of parents as educators of their own children) They like to View children as people who are strong and capable and can make their own choices about how and where to play (childinitiated play). Playcentre teachers are trained parents who take quite a hands on approach and implement learning, using a lot of open ended questions to extend children’s thinking. Montessori and playcentre have different methods. Both focus on the wellbeing of children, and help promote them to learn and grow through many different approaches. The key difference between Playschool and Montessori is that at playschool the whole family joins, rather than it just being a provider of education for the child. Reference List (Pre-schoolers: Preschool Education: Types of Early Childhood Care KYLIE VALENTINE 2010) (Stover, 1998, p. 3). May, H. (2002, Winter). Early childhood care and education in Aotearoa – New Zealand: An overview of history, policy and curriculum. McGill Journal of Education BEd111: Introduction to Early Childhood Education – Assessment 20120778 Tourmaline Munday- Cooper

Cruz Surname Meaning and Origin

Cruz Surname Meaning and Origin The Cruz surname comes from a personal name meaning cross or dweller near a cross, from the Spanish cruz and Latin crux, meaning cross. It may also be a habitational name indicating one who came from any of several places with Cruc, Cruz or La Cruz in their name. Variants of this surname originated in just about every European country, including Cross (English), Groze (French) and Kreuze and Kreuziger (German). Cruz is the 82nd most popular surname in the United States. Cruz is also a popular Spanish name, coming in as the 17th most common Hispanic surname. Surname Origin:  Spanish, Portuguese Alternate Surname Spellings: CRUCES,  DE CRUZ, DE LA CRUZ, DA CRUZ, CRUZADO, CRUSE, CRUISE, CROSS, DCRUZ Famous People with the Surname CRUZ Ted Cruz - Republican senator from Texas; US presidential candidateBobby Cruz - Puerto Rican salsa singerCelia Cruz - Cuban American singerPenelope Cruz - Spanish actressMaria Silva Cruz - Spanish anarchist Where Do People With the CRUZ Surname Live? Surname distribution data at  Forebears  ranks Cruz as the worlds 186th most common surname, found in greatest numbers in Mexico and with the highest density in Guam. The Cruz surname is the most common surname in Guam, where one in forty-five bear the name. It ranks 11th in Honduras and the Northern Mariana Islands, 12th in Palau and Puerto Rico, and 15th in Nicaragua and Mexico. Within Europe, Cruz is most frequently found in Spain, according to  WorldNames PublicProfiler, especially in the southern regions and Canary Islands. It is also very common in northwest Argentina. Coat of Arms Contrary to what you may hear, there is no such thing as a Cruz family crest or coat of arms for the Cruz surname.  Coats of arms are granted to individuals, not families, and may rightfully be used only by the uninterrupted male-line descendants of the person to whom the coat of arms was originally granted. Genealogy Resources for the Surname CRUZ How to Research Hispanic HeritageLearn how to get started researching  your Hispanic ancestors, including the basics of family tree research and country-specific organizations, genealogical records, and resources for Spain, Latin America, Mexico, Brazil, the Caribbean and other Spanish speaking countries. CRUZ Family Genealogy ForumSearch this popular genealogy forum for the Cruz surname to find others who might be researching your ancestors, or post your own Cruz query. FamilySearch - CRUZ GenealogyAccess over 10 million free historical records and lineage-linked family trees posted for the Cruz surname and its variations on this free genealogy website hosted by the Church of Jesus Christ of Latter-day Saints. GeneaNet - Cruz RecordsGeneaNet includes archival records, family trees, and other resources for individuals with the Cruz surname, with a concentration on records and families from France, Spain, and other European countries. CRUZ Surname Family Mailing ListsThis free mailing list for researchers of the Cruz surname and its variations includes subscription details and searchable archives of past messages. The Cruz Genealogy and Family Tree PageBrowse family trees and links to genealogical and historical records for individuals with the last name Cruz from the website of Genealogy Today. References Cottle, Basil.  Penguin Dictionary of Surnames. Baltimore, MD: Penguin Books, 1967.Dorward, David.  Scottish Surnames. Collins Celtic (Pocket edition), 1998.Fucilla, Joseph.  Our Italian Surnames. Genealogical Publishing Company, 2003.Hanks, Patrick and Flavia Hodges.  A Dictionary of Surnames. Oxford University Press, 1989.Hanks, Patrick.  Dictionary of American Family Names. Oxford University Press, 2003.Reaney, P.H.  A Dictionary of English Surnames. Oxford University Press, 1997.Smith, Elsdon C.  American Surnames. Genealogical Publishing Company, 1997.

The Good Times are Killing Me

The Good Times are Killing Me If you are looking for a compelling play for a young mixed-race cast, you may want to take a look at The Good Times are Killing Me by Lynda Barry. This play, published in 1993, offers two strong female roles in which teenagers can play teenagers  and a multiplicity of issues to discuss with cast and crew during rehearsals and with audiences in talkbacks. Format This is a two-act play, but it is unusual in that it is comprised of 36 short scenes or vignettes- 26 in Act One and 10 in Act 2. The story is adolescent Edna Arkins’s story. She is the main character and she appears in every scene; she breaks the fourth wall and speaks to the audience before, during, and after interacting with the other characters. Each vignette has a title like RECORD PLAYER NIGHT CLUB or BEST FRIENDS that communicates the essence of the scene. The scenes- some only a half page long, some three pages long- reveal the story of friendship between two adolescent girls- one white and one black- in mid-1960s America. One vignette flows into the next creating a collection of scenes that reveal the difficulties of coming of age in the midst of family heartaches, personal growing pains, and racial prejudices. Cast Size There are roles for 16 females and 8 males. Broken down by race, the play calls for 10 white females and 6 black females, and 3 white males and 5 black males. Doubling in roles is possible, resulting in an overall minimal cast size of 16. Roles Edna Arkins: A white 12-13 year-old girl who lives with her family in a house on a city street that has slowly become integrated Lucy Arkins: Edna’s younger sister Edna’s Parents and Extended Family: Mom, Dad, Uncle Don, Aunt Margaret, Cousin Steve, and Cousin Ellen Bonna Willis: A black 12-13 year-old girl who recently moved into Edna’s neighborhood Bonna’s Parents and Extended Family: Mom, Dad, younger brother Elvin, and Aunt Martha Recurring Minor Roles: Two black teenagers named Earl and Bonita, and Cousin Ellen’s friend Sharon Ensemble: There are multiple scenes that would be enhanced by friends, neighbors, classmates, and other people. There are also several small roles- a teacher, a mother, a pastor, a Girl Scout leader and her daughter. Set and Costumes Most action occurs on the porches, street, yards, and kitchens of Edna’s and Bonita’s houses. Other settings are Edna’s basement, a campsite, a meeting room, a tough neighborhood, a church, and a school hallway. These can easily be suggested with lighting or a few moveable small set pieces. The time period of this play is critical to the story, so the costumes need to be early 1960s American clothing- mostly casual and inexpensive-looking. Music Songs and singing occur throughout this production, providing mood, underscoring emotions and actions, and contextualizing the story in 1960s urban America. Much of the singing occurs with the records that the characters play; some singing is a capella. The script identifies the precise songs and provides lyrics within the text or in an appendix. Content Issues Much of the content and language of this play seems so innocent given the 20-plus years since its opening night and its setting of 50-plus years ago. Even so, it’s worth noting that the play deals with marital infidelity, racial discrimination (One of Edna’s lines mentions the â€Å"No Negro Kids Can Come in Our House Rule.), and the accidental drowning of Bonna’s brother. The language is relatively tame, but the dialogue does include the words   Ã¢â‚¬Å"ass,† â€Å"boodie,† â€Å"pimp,† â€Å"butt,† and the like. There is, however, no profanity. Lynda Barry also published this story as a 144-page novel with Edna as the narrator. If you would like to hear Lynda Barry talk about her life work, please visit Accessing the Imaginary. Here is a video trailer of a high school production of the play.

Fourth Amendment - the Text, Origins, and Meaning

Fourth Amendment - the Text, Origins, and Meaning The Fourth Amendment to the United States Constitution is a section of the Bill of Rights that protects the people from being subjected to unreasonable searches and seizures of property by law enforcement officers or the federal government. However, the Fourth Amendment does not prohibit all searches and seizures, but only those that are found by a court to be unreasonable under the law. The Fifth Amendment, as part of the original 12 provisions of the Bill of Rights, was submitted to the states by Congress on September 25, 1789, and was ratified on December 15, 1791. The full text of the Fourth Amendment states: The right of the people to be secure in their persons, houses, papers, and effects, against unreasonable searches and seizures, shall not be violated, and no warrants shall issue, but upon probable cause, supported by oath or affirmation, and particularly describing the place to be searched, and the persons or things to be seized. Motivated by British Writs of Assistance Originally created to enforced the doctrine that â€Å"each man’s home is his castle,† The Fourth Amendment was written directly in response to British general warrants, called Writs of Assistance, in which the Crown would grant overarching, non-specific search powers to British law enforcement officials. Through Writs of Assistance, officials were free to search virtually any home they liked, at any time they liked, for any reason they liked or for no reason at all. Since some of the founding fathers had been smugglers in England, this was an especially unpopular concept in the colonies. Clearly, the framers of the Bill of Rights considered such colonial-era searches to be â€Å"unreasonable.† What Are ‘Unreasonable’ Searches Today? In deciding whether a particular search is reasonable, the courts attempt to weigh important interests: The extent to which the search intruded on the individuals Fourth Amendment rights and the extent to which the search was motivated by valid government interests, such as public safety. Warrantless Searches Not Always ‘Unreasonable’ Through several rulings, the U.S. Supreme Court has established that the extent to which an individual is protected by the Fourth Amendment depends, in part, on the location of the search or seizure. It is important to note that according to these rulings, there are several circumstances under which police may lawfully conduct â€Å"warrantless searches.† Searches in the Home:  According to Payton v. New York (1980), Searches and seizures conducted inside a home without a warrant are presumed to be unreasonable. However, such â€Å"warrantless searches† may be lawful under certain circumstances, including: If a responsible person gives the police permission to search the property. (Davis v. United States)If the search is conducted during a lawful arrest. (United States v. Robinson)If there is clear and immediate probable cause to conduct the search. (Payton v. New York)If the items being searched for are in plain view of the officers. (Maryland v. Macon) Searches of the Person:  In what is popularly known as its â€Å"stop and frisk† decision in the 1968 case of Terry v. Ohio, the Court ruled that when police officers see â€Å"unusual conduct† leading them to reasonably conclude that criminal activity may be taking place, the officers may briefly stop the suspicious person and make reasonable inquiries aimed at confirming or dispelling their suspicions. Searches in Schools:  Under most circumstances, school officials do not need to get a warrant before searching students, their lockers, backpacks, or other personal property. (New Jersey v. TLO)  Ã‚   Searches of Vehicles:  When police officers have probable cause to believe that a vehicle contains evidence of criminal activity, they may lawfully search any area of the vehicle in which the evidence might be found without a warrant. (Arizona v. Gant) In addition, police officers may lawfully conduct a traffic stop if they have reasonable suspicion that a traffic violation has occurred or that criminal activity is being carried out, for example, vehicles seen fleeing the scene of a crime. (United States v. Arvizu and Berekmer v. McCarty) Limited Power In practical terms, there is no means by which the government can exercise prior restraint on law enforcement officials. If an officer in Jackson, Mississippi wants to conduct a warrantless search without probable cause, the judiciary is not present at the time and cant prevent the search. This meant that the Fourth Amendment had little power or relevance until 1914. The Exclusionary Rule In Weeks v. United States (1914), the Supreme Court established what has been known as the exclusionary rule. The exclusionary rule states that evidence obtained through unconstitutional means is inadmissible in court and cannot be used as part of the prosecutions case. Before Weeks, law enforcement officials could violate the Fourth Amendment without being punished for it, secure the evidence, and use it at trial. The exclusionary rule establishes consequences for violating a suspects Fourth Amendment rights. Warrantless Searches The Supreme Court has held that searches and arrests can be performed without a warrant under some circumstances. Most notably, arrests and searches can be performed if the officer personally witnesses the suspect committing a misdemeanor, or has reasonable cause to believe that the suspect has committed a specific, documented felony. Warrantless Searches by Immigration Enforcement Officers On January 19, 2018, U.S. Border Patrol agents - without producing a warrant to do so - boarded a Greyhound bus outside the Fort Lauderdale, Florida station and arrested an adult female whose temporary visa had expired. Witnesses on the bus alleged that the Border Patrol agents had also asked everyone on board to show proof of U.S. citizenship. In response to inquiries, the Border Patrol’s Miami section headquarters confirmed that under the long-standing federal law, they can do that. Under Section 1357 of Title 8 of the United States Code, detailing the powers of immigration officers and employees, officers of the Border Patrol and Immigration and Customs Enforcement (ICE) can, without a warrant: interrogate any alien or person believed to be an alien as to his right to be or to remain in the United States;arrest any alien who in his presence or view is entering or attempting to enter the United States in violation of any law or regulation made in pursuance of law regulating the admission, exclusion, expulsion, or removal of aliens, or to arrest any alien in the United States, if he has reason to believe that the alien so arrested is in the United States in violation of any such law or regulation and is likely to escape before a warrant can be obtained for his arrest, but the alien arrested shall be taken without unnecessary delay for examination before an officer of the Service having authority to examine aliens as to their right to enter or remain in the United States; andwithin a reasonable distance from any external boundary of the United States, to board and search for aliens any vessel within the territorial waters of the United States and any railway car, aircraft, con veyance, or vehicle, and within a distance of twenty-five miles from any such external boundary to have access to private lands, but not dwellings, for the purpose of patrolling the border to prevent the illegal entry of aliens into the United States. In addition, The Immigration and Nationality Act 287(a)(3) and CFR 287 (a)(3) states that Immigration Officers, without a warrant, may â€Å"within a reasonable distance from any external boundary of the United States...board and search for aliens in any vessel within the territorial waters of the United States and any railcar, aircraft, conveyance, or vehicle.† The Immigration and Nationality Act defines â€Å"Reasonable distance† as 100 miles.   The Right to Privacy Although the implicit privacy rights established in Griswold v. Connecticut (1965) and Roe v. Wade (1973) are most often associated with the Fourteenth Amendment, the Fourth Amendment contains an explicit right of the people to be secure in their persons that is also strongly indicative of a constitutional right to privacy. Updated by Robert Longley

Causes and Trends of Homophobia in Middle East Essay

Causes and Trends of Homophobia in Middle East - Essay Example It is really an escalating tug of war between the homophobic society, human rights activists, and homosexual oriented persons. Undeniably, the Middle East society has been adamant in supporting lesbians, gay bisexual and transsexual (LGBT) groups since time immemorial. What is the status of homophobia In Middle East? This paper addresses the current issues of homophobia in Middle East by trying to answer the following important questions. What are the current trends of homophobia in Middle East? What are the main causes of homophobia in this region? Current Trends of Homophobia in Middle East Homophobia refers to the outraged fear and expression of anger towards homosexuals or simply to people who express sexuality that differs from the normally accepted heterosexual behavior or identity. Since time immemorial, the general society has always recognized and appreciated the heterosexual type of orientation towards sexual identity. However, few societies have identified and developed their own sexuality identity. Middle East has been in particular very resistant towards any persons or group of people deviating from heterosexuality. For the last few years, increased homophobia has been observed in Middle East. It is claimed â€Å"In parts of Africa, the Middle East, the Caribbean, and elsewhere it is still very dangerous to be gay. People are being executed. Homophobic attacks, rapes, and murders happen all too frequently† (Dehgan, 2011, p. 1). Homophobia has always been suppressed by various societal structures such as the law, traditions, and religion. Most Middle Ea st countries have laws that prohibit marriage between homosexuals or any other form of sexuality besides heterosexuality. For instance, â€Å"More than two dozen men were arrested at what police called a â€Å"mass homosexual wedding† in the United Arab Emirates† (The Advocates, 2006, p. 37). However, as the society becomes more revolutionized more homosexuals come out in the opens and begin fighting for their rights. This is arguably the main cause of homophobia in this region and the rest of the world as well. Many people are coming up in the open to form groups that help them express their concerns on how the society treats them due to sexual orientation. The media plays a very important role in shaping the discourse of issues affecting the society. In the Middle East, media influence is a great force that cannot be ignored. Arguably, it has given the two opposing camps a fair playground in expressing their feelings and opinions. Homosexual groups come out in the me dia and openly express their stand towards sexuality. Internet and television has been one of the most widely used media in which homosexuals use to either express their sexuality or express their outrage against groups fighting them. Middle East countries are mostly Islamic. This implies that there is high degree of homophobia in this region than any other region in the world. Islam religion strictly prohibits homosexuality and has stern disciplinary measures and actions against homosexuals. Koran prohibits this type of sexuality and as such, Muslims in this region use it as a source of authority to discredit homosexuality. Politicians play a role in shaping the societal fabric. Politicians have been known to follow the current trends and demands of the population to achieve their political ambitions. Arguably, the politicians have been instrumental in quenching the homophobia crisis by advocating for equal rights to people of all types of sexual orientation. It has enabled the soc iety to accept the homosexuals and their sexual orientation rather than fighting them. Indeed, there is a slight increase in countries accommodating homosexuality. Habib agrees that â€Å"

Leadership, Teambuilding and Communication Assignment

Leadership, Teambuilding and Communication - Assignment Example In this theory, shows that some people have better leadership traits than others. He concludes that there are those people who are born to lead while others were born to be led. Behavioral approach is one other form of traditional leadership style, in this leadership theory, there are three leadership styles that are distinct from each other. Their styles include; authoritarian leadership whereby, the leader maintains strong control over the group at work. In this form of leadership, motivation is by coercion, and there is no free communication between the leader and the staff. Communication comes from the leader only, and the workers are there to follow. In this kind of leadership, there is high productivity but with low self-motivation and autonomy by the workers. Democratic approach is another form of leadership style that is friendlier to the subordinate staff. In the case here, there is free communication from both the staff and the leadership. Decision-making involves everybody in the organization, and the staff seen as a whole and not as a leader. Therefore, it gives room for constructive criticism and autonomy among the employees in the organization. Lastly, there is laissez-faire leadership style, where there is little or no control from the leader (Murphy, 2005). The kind of leadership is so much of the essence in situations with poorly defined problems that need brainstorming to come over the problems. There are a number of leadership theories that include, transformational, cite suggested that leaders have the abilities to groom their followers into better leaders in the future. The grooming is achieved successfully by letting followers have the freedom to control their behaviors.  

Reading Books Essay Example | Topics and Well Written Essays - 500 words

Reading Books - Essay Example se is recommended because reading books to others has positive effects on children’s academic performance, books are a permanent and ever-lasting source of information, and reading books spurs imagination and creativity in the reader. One of the benefits of reading books is that when they are read to the infants, their communication skills are developed and their concepts of emotions, shapes, and colors are improved. The Organization for Economic Co-operation and Development (OECD) research found out that children whose parents read with the children frequently during their first school year have long-lasting positive effects on their reading abilities (â€Å"Reading to children†). â€Å"What kinds of investments should we be making to help these kids get ahead?...The results of this study indicate that getting some books into their homes is an inexpensive way that we can help these children succeed† (Evans cited in â€Å"Resources, Reports and†). One factor that provides books with an edge over other sources of information is their permanence. Books, once written, become permanent. They are not websites or blogs that keep changing or modifying or even inaccessible with the passage of time. This is why â€Å"selecting books to support readers’ abilities benefits teachers and children alike so long as teachers make decisions within and beyond leveled books based upon their understanding of students’ interests and capabilities† (Szymusiak, Sibberson, and Koch 11). Many people in the present age consider television a more interacting, engaging, and informative source as compared to reading books, though this is not entirely and always true. On one hand, television provides the audience with a colorful motion picture; on the other hand, books make the readers think imaginatively since they have to assume the looks of characters, the background, and the specific details of the story like the characters’ homes and other places. Another very important benefit of

Networkinh Assignment Example | Topics and Well Written Essays - 1500 words

Networkinh - Assignment Example In this scenario, they need to implement a computer network. This report discusses the scenario of Sally and John’s business, as they are running their business without having a proper computer network. This report suggests ways that can be adopted to improve their business capabilities. Introduction A computer network consists of a set of a number of parts which include hardware, software, and computers and all these parts are connected with each other using a wired or wireless medium to help business workers work in cooperation. Additionally, a network is established using particular cabling systems, software, communication medium and devices which deal with data traffic. Hence, a computer network allows its users to share files such as MS Word documents and resource such as scanners and printers, and transmits messages and data files electronically (or email) to each other (TechsChange, 2010; Nash, 2000; Norton, 2001; Turban et al., 2005). This report discusses the concept of networking in the context of Sally and John’s business. They are running their business without having a network support so they are facing several problems in managing their business tasks. This report guides them regarding the establishment of an effective network structure. Problem Analysis and Proposed Solution Up till now John and Sally have been using traditional approaches to run and manage their business process. In view of the fact that their business is growing rapidly and there is a need for an effective communication structure in order to deal with growing business needs hence they need to implement a computer network. A computer network is a set of computers which are connected with each other using wired or wireless medium. In this scenario, networks which are used using wires and cables are known as wired networks. On the other hand, wireless networks use microwaves or radio waves for the communication (Mitchell, 2013; Shelly et al., 2005; Malladi & Agrawal, 2002). Some of the basic requirements and objectives of this network implementation are: John and Silly want to improve communication structure for their business The establishment of an effective data and file sharing environment Implementation of secure data access points of communication Getting a support for remote access to the network Getting the facility of remote data transfer and access mechanism Putting into practice modern data communication framework Implementing an effective data recovery and backup mechanism The implementation of a network structure which allows them to transfer and retrieve data at high speed Suggested Solution Implementation of a VPN (Virtual Private Network) In light of business needs and objectives of John and Sally, I would suggest them to implement a modern and efficient network structure for their business. In this scenario, I would suggest them to implement a virtual private network VPN. A virtual private network extends the range of a private network incorporates connections all the way through public or shared networks such as the Internet. Basically, a VPN allows users to send and receive data and files between two computers across a public or shared internetwork in a way that follows the rules and characteristics of a point-to-point private link. In addition, the

Creation and Development of New Firms Assignment

Creation and Development of New Firms - Assignment Example Side by side, the trouble of poverty also became highlighted in these emerging economies of the entire world. However, in order to recover from such distressful state, most of the countries, especially the emerging or developing countries are reliant on economic liberalization. Due to such economic shift, most of the emerging economies and the firms of recent age are entirely responsible for economic recovery of the world (Yalcin & Kapu, 2008, p. 32). Due to which, most of these firms offered high concentration over the development of the entrepreneurship programs. Therefore, the importance of entrepreneurship program is highlighted in this assignment and it also focuses on five significant areas: Creation and development of new firms Success rates of entrepreneurial activities Global entrepreneurship in developing economies Degree of risks or safety of entrepreneurial programs Present entrepreneurs and innovative technology Creation and Development of New Firms In recent age, the em erging economies of the world are always trying to develop large number of new firms so as to improve their financial condition. Along with this, it also helps in improving the profit margin and revenue of the firms might also be improved. It also helps in enhancement of the employment rates resulting in upliftment of the living standards of the citizens of the economies. As a result, the reputation of the developing economy increases to a certain extent among other neighboring ones in the entire world. For the above reasons, the rate of entrepreneurship is increasing day by day and thereby improving the prospects of the firms and the employees as well. This is mainly because, the entrepreneurs of recent age are extremely talented and intelligent and comprise of excellent management and leadership skills that are extremely essential to control and operate any business firm or organization in this competitive age. As a result, the level of interaction among the employees and the mana gement is extremely high resulting in invention of varied types of new ideas and facts that might result in betterment of the organization (Yalcin & Kapu, 2008, p. 31). So, the prospect of the entrepreneurship has been increasing and it is resulting in amplification of the rate of development of new firms in the emerging economies. Success Rates of Entrepreneurial Activities As the entrepreneurs of recent age always try to develop and introduce new ideas and information for the betterment of the firm. This is done only after analyzing the situation and the strengths and weaknesses of the firm. By doing so, an entrepreneur might attain get a better analysis of the essential requirements of the firm. On the basis of that, the entrepreneur might develop the plans and the strategies that might lead to its betterment. Along with this, after the plans are finalized, the goals and objectives are also developed after consulting with the other employees of the firm. Then, to attain such obje ctives, the innovative skills and talents as well as equipments are introduced within the employees of the organization. Therefore, with the coordinated efforts of the employees, equipments and management, the objectives might be surely achieved resulting in success of the organization. Due to which, the working condition of the organization improved resulting in enhancement of the rate of devotion of the employees towards work. This is the

Economics of Energy and Environment Essay Example | Topics and Well Written Essays - 3750 words

Economics of Energy and Environment - Essay Example The remaining amount of fuel had been utilised for energy motives. It has been observed that the consumption of energy in the UK fell to its lowest level in the years2010 and 2011 compared to the year 1984. This decrease in energy has been conceived due to the reduction of 18% in the utilisation of gas. From the year 1970, there has been a change in the consumption of fuel from solid fuels to fuel mix from 46,120 million tonnes to 2,437 million tonnes of oil in the year 2011. The consumption of fuel has been substituted by gas which increased from 14,408 million tonnes to 42,378 million tonnes of oil equivalent from the year 1970 to 2011. The consumption of electricity is also observed to have increased by a considerable extent i.e. by 65% which is equivalent to 27,334 million tonnes of oil (Crown, â€Å"Energy Consumption in the United Kingdom: 2012†). The industrial sector is responsible for consuming around 40% of energy which amounted to around 62,333 thousand tonnes of oi l equivalent. On the other hand, the domestic sector and transport are perceived to be utilising nearly 24% and 18% respectively. Other users including public administration, agriculture and commerce are observed to be using 12% of energy. Furthermore, 7% of the energy was consumed for non-energy motives (Crown, â€Å"Energy Consumption in the United Kingdom: 2012†). Domestic Energy Consumption From The Year 1970 To 2011 Source: [1] (Crown, â€Å"Energy Consumption in the United Kingdom: 2012†) In the year 1990, it has been perceived that the industrial sector consumed around 24% of energy which signifies that there was fall in energy consumption in the industrial sector as compared to the period of 1970.... This essay stresses that the households are also required to adopt innovative and certified household electrical appliances and products with the intention of better utilisation of energy. Moreover, households are required to adopt latest products which are energy efficient with the motive of ascertaining that energy is consumed at a minimum level. The households are required to acquire technologies which emit carbon in a minimised manner. Furthermore, these innovative and low carbon emitting technologies will facilitate households with better power as well as money saving opportunities. The increased price of energy will initiate households to acquire more innovative technologies for producing renewable sources of energy. This paper makes a conclusion that it can be comprehended that the prices of energy is likely to increase for households, as the current market prices only pay for returns to existing energy production. By raising the regulation and costs of existing energy production, and providing grants and subsidies to encourage the adoption of new technology, the government is rebalancing the costs of energy consumption more in favour of low carbon technologies. In the long run, combined with technological developments making such technologies more affordable, and regulations requiring that they are used, there will be a shift toother non-renewable sources of energy in order to improve energy efficiency, preserve energy for future consumption, as well as reducing carbon emission.

Creation and Development of New Firms Assignment

Creation and Development of New Firms - Assignment Example Side by side, the trouble of poverty also became highlighted in these emerging economies of the entire world. However, in order to recover from such distressful state, most of the countries, especially the emerging or developing countries are reliant on economic liberalization. Due to such economic shift, most of the emerging economies and the firms of recent age are entirely responsible for economic recovery of the world (Yalcin & Kapu, 2008, p. 32). Due to which, most of these firms offered high concentration over the development of the entrepreneurship programs. Therefore, the importance of entrepreneurship program is highlighted in this assignment and it also focuses on five significant areas: Creation and development of new firms Success rates of entrepreneurial activities Global entrepreneurship in developing economies Degree of risks or safety of entrepreneurial programs Present entrepreneurs and innovative technology Creation and Development of New Firms In recent age, the em erging economies of the world are always trying to develop large number of new firms so as to improve their financial condition. Along with this, it also helps in improving the profit margin and revenue of the firms might also be improved. It also helps in enhancement of the employment rates resulting in upliftment of the living standards of the citizens of the economies. As a result, the reputation of the developing economy increases to a certain extent among other neighboring ones in the entire world. For the above reasons, the rate of entrepreneurship is increasing day by day and thereby improving the prospects of the firms and the employees as well. This is mainly because, the entrepreneurs of recent age are extremely talented and intelligent and comprise of excellent management and leadership skills that are extremely essential to control and operate any business firm or organization in this competitive age. As a result, the level of interaction among the employees and the mana gement is extremely high resulting in invention of varied types of new ideas and facts that might result in betterment of the organization (Yalcin & Kapu, 2008, p. 31). So, the prospect of the entrepreneurship has been increasing and it is resulting in amplification of the rate of development of new firms in the emerging economies. Success Rates of Entrepreneurial Activities As the entrepreneurs of recent age always try to develop and introduce new ideas and information for the betterment of the firm. This is done only after analyzing the situation and the strengths and weaknesses of the firm. By doing so, an entrepreneur might attain get a better analysis of the essential requirements of the firm. On the basis of that, the entrepreneur might develop the plans and the strategies that might lead to its betterment. Along with this, after the plans are finalized, the goals and objectives are also developed after consulting with the other employees of the firm. Then, to attain such obje ctives, the innovative skills and talents as well as equipments are introduced within the employees of the organization. Therefore, with the coordinated efforts of the employees, equipments and management, the objectives might be surely achieved resulting in success of the organization. Due to which, the working condition of the organization improved resulting in enhancement of the rate of devotion of the employees towards work. This is the

Netflix Essay Example | Topics and Well Written Essays - 1000 words - 1

Netflix - Essay Example The brand took a bad hit when they increased prices the last time. 2. Netflix has made another positive step towards offering their original productions to the consumers such as â€Å"the house of cards† which has had high viewership rating which should project more segments the company can enter into. 3. The company has so far not been able to penetrate into Latin America because a great deal of the economy works on cash, with a cultural change of high acceptance and usage of debit and credit cards the brand could easily penetrate the market. 4. Netflix collects data from their subscribers, over the years this practice by other companies has received a lot of criticism. Eventually an increased regulation in this regard could result in restricting Netflix’s ability to use technology for data collection and making recommendations. Jacobs, Y. (2011). How I Predicted Netflixs Fall, And Why Its Prospects Are Getting Worse. 2013 Seeking Alpha. Retrieved http://seekingalpha.com/article/294587-how-i-predicted-netflix-s-fall-and-why-its-prospects-are-getting-worse Lawler, A. (2013). As ISPs Like Cablevision Cozy Up To Its Open Source CDN, Netflix Makes 3D And â€Å"Super HD† Video  Available. AOL Inc 2013. Retrieved http://techcrunch.com/2013/01/08/netflix-open-connect-3d-super-hd/ Steltar, B. (2012). A Turnaround at Netflix, as Its Mail Sector Shrink. 2012 The NewYork Times Company. Retrieved

The Importance of Being Earnest Essay Example for Free

The Importance of Being Earnest Essay We live, as I hope you know, Mr Worthing, in an age of ideals what are these ideals in the context of the play in Act One, and how does Wilde present them to the audience?  In The Importance of Being Earnest, ideals are a dominant theme, and to that end are critical in determining the actions of the characters. Wilde is typically subtle in his presentation of these ideals, and consequently many of them come to be used as a means for satirising the society depicted. It is important to establish from the outset that Wildes presentation of ideals utilizes the different characters as bastions for the various ideals, and in doing that subjects them to scrutiny when ridiculing their respective characterizations. One of the most important ideals presented is fittingly one of the first to become apparent; that being the division of the classes and the social status that they entail. On line 1 of the play, Algernon asks Lane, after playing the piano in the adjoining room: Did you hear what I was playing. Lane? Lanes response: I didnt think it polite to listen, sir is indicative of various aspects of his position. Firstly, his butlership requires that he should abstain from partaking in any activity considered to be distracting to his duties, of which listening to the piano would be one. Secondly, his position in society, that of one of the lower classes, demands utter obsequiousness, hence any comment on Algernons playing would be risky in case it appeared to be unflattering. The ideal of social standing being absolute is immediately challenged by Wilde, as it is quite preposterous that Lane should think it not polite to listen, a distinctly ironic and seditious undertone is palpable. In this instance, Algernon represents the foppish dandy without a brain, whereas Lanes quiet obedience, representative of the downtrodden worker, whilst not perhaps admirable is at least sensible. Thus, Wilde establishes certain connections between the tenets of proper society, and its greatest protagonists, and hence weakens the establishment. The fact that this is done through the means of an implicitly comic exchange helps to alleviate any graveness associated with the matter. Connected to the ideal of status and society is the position of women, which is also a prevalent theme in Act 1. During the Victorian Age and before, it was considered proper practice that woman have an inferior position in society to men. This was effected by their disenfranchisement and their inability to ascend to high positions, whether it is in society or in the work place. It is therefore a shock to the system when Gwendolen challenges Jacks natural authority when speaking to him about their marriage. Whereas he is vacillating and circuitous in what he says: I do mean something else Personally, darling, to speak quite candidly, Gwendolen is forceful and direct: I thought so. In fact, I am never wrong I would certainly advise you to do so. By being so controlling, Gwendolen reverses the accepted patriarchy, and in doing so challenges the ideal. In this case in point, Wilde is quite prepared to dispose of any comic vignettes in order to make a point; instead the dialogue itself provides ample means for dismissing the given principle that women should be subordinate. The character of Lady Bracknell is another example of a dominating woman; a slightly more matronly persona gives some precedence for such commands as: Mr Worthing! Rise, sir, from this semi-recumbent posture however her assumption of authority is still contradictory to the established social norms. Her verbose and eloquent manner of speaking is also out of the ordinary, as it challenges the demure image normally associated with women. Lady Bracknell challenges the patriarchal society in a more forceful and deliberate way than does Gwendolen, as seen from her interviewing Jack: You can take a seat, Mr Worthing. Although this matronly caricature is somewhat trite by todays standards, at the time of writing it would have served to provide an original attack on the males dominance of the running of society.

The Debate Over Internet Censorship Essay -- Television Media TV Censo

The Debate Over Internet Censorship Many people believe the Internet has become the World’s Emancipation Proclamation. They believe that this newfound cyber-freedom will free countless generations of people. These people will be of every race, creed and color, whose lives, up until now, have been restrained by the paradigm of governments. Whether it is the United States Government, or the government of a foreign nation, the Internet will be our new Underground Railroad of cyberspace.   Ã‚  Ã‚  Ã‚   Recently, the World Wide Web has come under fire from various forms of censorship. Singapore has been a giant of aggressiveness in regard to censorship and technology. But even with Singapore’s relentless efforts for control of the World Wide Web, the public still seeks to stay informed on every issue that concerns mankind. â€Å"As a new technology the Internet defies censorship because of characteristics such as information explosion, de-massification, convergence, computer culture, and globalization† (Kolko 424).   Ã‚  Ã‚  Ã‚   But is this newfound freedom man’s salvation, or the Plagues of Egypt? â€Å"Almost anything is allowed on the Internet as long as it does not violate the laws of the country in which the originator resides. But even if the law of the land is broken, it is nearly impossible to enforce criminal laws out of that country’s borders† (Kolko 426). As we move from our â€Å"own little world† of existence to a limitless arena of information in cyber space, at what cost does this newfound freedom come?   Ã‚  Ã‚  Ã‚   All countries, like most everything else, have evolved to their ideas, beliefs and laws, primarily based on uncontrollable circumstances. Massive mistakes, holocausts of Biblical proportions, financi... ...ce and above all— warranty (10 years or 100,000 miles—5 years or 60,000 miles, bumper to bumper). Now that is competition!   Ã‚  Ã‚  Ã‚   In conclusion, it is my belief that there is a bright future for Singapore and every other country that allows the freedom of choice for their people. After all it is the people that make a nation, not the governing-few. The governing-few work for us, we do not work for them. And in reality, that is not only true for countries, but states, cities, companies, and industries.   Ã‚  Ã‚  Ã‚   It is my hope that Singapore will continue to prosper (at least until my warranty runs out), and that all of us can learn to agree to disagree about censorship on the Internet. We may not like what we see or hear, but we should hold in highest regard the rights of everyone to be allowed the privilege to decide for their self.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  

Use of the Supernatural in Shakespeares Macbeth Essays -- Macbeth ess

Use of the Supernatural in Macbeth In Shakespeare's play The Tragedy of Macbeth, Shakespeare uses an underlying motif of the supernatural to control the characters and add a new dimension to the play. Shakespeare uses a large motif of light vs. darkness throughout the play to present moral choices and religious ideas. When the play opens, there is thunder rolling around and the witches on stage. The thunder is symbolic of darkness and gives the audience the first impression that the play will not be ordinary. The witches who only appear in darkness, elements of the supernatural, are one of Shakespeare's classic ways of catching the audience's attention and of also setting the mood for the play. Another motif present in Macbeth is appearance vs. reality. In this motif, Shakespeare uses concepts that either hint at the character's delusion or that a supernatural force has taken over and controls what is real and what is not. An example of this is seen when Macbeth sees the dagger before him. The dagger could just be a hallucination or it could be a vision sent from the wi...

New York and Nebraska

In this world no two places can be considered to be same. All the places have a certain amount of distinctness, a certain flavor and a very dominant persona. If we consider two places, New York and Nebraska, there are a lot of similarities and contrasts, as they are the states of a same country, i.e. United States of America. Both the states have discrete histories but have common grounds on the basis of European Settlers. Nebraska became officially part of United States of America only in 1812 after Missouri Treaty bill.   New York on the other hand was dominant by the point of British and it was an important place in terms of the revolution for Independence.Comparisons between New York and NebraskaNew York and Nebraska are both large states of America and have lot of importance to the country. Both the states being large on their own are blessed on natural terms. On the whole the two states have similarities on the basis of its large parks and greenery. Also both the states are b lessed with the amount of voluminous rivers flowing through them. Nebraska and New York have a very good base in agriculture and have large share of their economy dependent on agricultural products. On a religious point of view too, both the states comprising have similarities in terms that both have a maximum population of Christians than any other religions. The states also are very rich in its heritage and culture and the no. of museums both have are outstanding, as both the states have a view of protecting and highlighting their culture.Contrasts between New York and NebraskaFirstly the climate of both the states is very different, and their discreetness is so high that the state of Nebraska has in fact two climates in its region. The state is grossly divided between a humid climate and a steppe climate. Also the effect of Global warming though being everywhere in the world is marginally higher in Nebraska compared to New York. This is assessed by the following:‘Nebraska i s home to an incredible diversity of native wildlife species, including 346 birds, 83 mammals, 87fish, 47 reptiles and 13 amphibians. Rising temperatures in the state will likely change the makeup of entire ecosystems, forcing wildlife to shift their ranges or adapt. Global warming could contribute to a 20-50 percent decline in forested area, particularly in eastern Nebraska, where grasslands and savanna could replace forests and woodlands’.(Courtesy: Myra Wilensky, â€Å"Global warming and Nebraska†. Retrieved on May 4, 2008 from http://www.nwf.org/globalwarming/pdfs/Nebraska.pdf#search=%22%22global%20warming%22%2C%20Nebraska%22)Both the states have a massive difference in the terms of economy as the state of New York is one of the key finance providers of the nation compared to Nebraska. One of the major contrasting feature of the two states politically is Nebraska is a religious Republican follower while the state of New York is avidly a Democratic supporter.Conclus ionBoth the states have their own theories of running the economy and are well blessed with flora and fauna. The comparison between the two states assesses the fact that how much ever two places might be distinct or similar, both of them are unique in their own way.Reference:1)  Ã‚  Ã‚  Ã‚  Ã‚   Myra Wilensky, â€Å"Global warming and Nebraska†. http://www.nwf.org/globalwarming/pdfs/Nebraska.pdf#search=%22%22global%20warming%22%2C%20Nebraska%22 New York and Nebraska In this world no two places can be considered to be same. All the places have a certain amount of distinctness, a certain flavor and a very dominant persona. If we consider two places, New York and Nebraska, there are a lot of similarities and contrasts, as they are the states of a same country, i.e. United States of America. Both the states have discrete histories but have common grounds on the basis of European Settlers. Nebraska became officially part of United States of America only in 1812 after Missouri Treaty bill.   New York on the other hand was dominant by the point of British and it was an important place in terms of the revolution for Independence.Comparisons between New York and NebraskaNew York and Nebraska are both large states of America and have lot of importance to the country. Both the states being large on their own are blessed on natural terms. On the whole the two states have similarities on the basis of its large parks and greenery. Also both the states are b lessed with the amount of voluminous rivers flowing through them. Nebraska and New York have a very good base in agriculture and have large share of their economy dependent on agricultural products. On a religious point of view too, both the states comprising have similarities in terms that both have a maximum population of Christians than any other religions. The states also are very rich in its heritage and culture and the no. of museums both have are outstanding, as both the states have a view of protecting and highlighting their culture.Contrasts between New York and NebraskaFirstly the climate of both the states is very different, and their discreetness is so high that the state of Nebraska has in fact two climates in its region. The state is grossly divided between a humid climate and a steppe climate. Also the effect of Global warming though being everywhere in the world is marginally higher in Nebraska compared to New York. This is assessed by the following:‘Nebraska i s home to an incredible diversity of native wildlife species, including 346 birds, 83 mammals, 87fish, 47 reptiles and 13 amphibians. Rising temperatures in the state will likely change the makeup of entire ecosystems, forcing wildlife to shift their ranges or adapt. Global warming could contribute to a 20-50 percent decline in forested area, particularly in eastern Nebraska, where grasslands and savanna could replace forests and woodlands’.(Courtesy: Myra Wilensky, â€Å"Global warming and Nebraska†. Retrieved on May 4, 2008 from http://www.nwf.org/globalwarming/pdfs/Nebraska.pdf#search=%22%22global%20warming%22%2C%20Nebraska%22)Both the states have a massive difference in the terms of economy as the state of New York is one of the key finance providers of the nation compared to Nebraska. One of the major contrasting feature of the two states politically is Nebraska is a religious Republican follower while the state of New York is avidly a Democratic supporter.Conclus ionBoth the states have their own theories of running the economy and are well blessed with flora and fauna. The comparison between the two states assesses the fact that how much ever two places might be distinct or similar, both of them are unique in their own way.Reference:1)  Ã‚  Ã‚  Ã‚  Ã‚   Myra Wilensky, â€Å"Global warming and Nebraska†. http://www.nwf.org/globalwarming/pdfs/Nebraska.pdf#search=%22%22global%20warming%22%2C%20Nebraska%22

A Study on Various Fruit Juice Companies of Bangladesh

CHAPTER 1: INTRODUCTION 1. 1 Origin of the report: This report was conducted and submitted as a partial requirement for the course Business Communication (BUS 231). The report was authorized by Eng. Mr. Kamrul Hassan, Assistant Professor, Department of Business Administration, East West University. The report was prepared jointly by our group members. 1. 2 Background of the Study: We were assigned as a group to have a study on various fruit juice companies of Bangladesh. We have conducted a study on their organization and also find out the consumer perception about the product.We find out the consumer perception about various fruit Juice. 1. 3 Objective of the study: The main purpose of the project is to show the customer preference to select fruit juice by doing a questionnaire based survey. We were instructed from our business communication course lecturer Eng. Mr. Kamrul Hassan to submit a business communication report on a four generetic products . We choose four fruit juice comp anies that are available in Bangladesh, such as Pran, Acme, Frutika and Shezan mango juice. This project also discusses the frequency table and show graph of different questions about fruit juice.It also helps to know the customer satisfaction level and customer brand loyalty of different brands of fruit juice. We had some objectives behind making the report. These are: †¢ To know about consumer perception for fruit Juice. †¢ To gather practical knowledge on analyzing companies financially. †¢ To be experienced on gathering survey. We believe that we were successful to fulfill most of our objectives. Thanks Allah to bless on us. 1. 4 Scope: The main focus of this report is to discuss the customer preference about the fruit juice and the factors which are the reasons to select their product.It also gives a little description about the history, mission, vision, goal and strategy about the industry. The report discusses the products and service they are giving. It also d iscusses, the target customer and market they are focusing to do business. 1. 5 Methodology: 1. 5. 1 Sources of information: We collect this information from our friends and our relatives. A small proportion of people like 20 from university and 10 from our local friends and uncle’s was selected, as the population of the study. 1. 5. 1. 1 Primary sources:Directly from filling the Questionnaire. 1. 5. 1. 2 Secondary sources: Taken data from various magazines, Newspaper and other prominent source of information collected from different websites and search engines. 1. 5. 2 Data Collection techniques: We have collected our data by questionnaire. 1. 5. 3 Data Analysis techniques: The report was mainly done on the various age of people. These people communicated with us via questionnaires. 1. 5. 3. 1 Statistical tools used: We have used frequency tables and pie chart as our statistical tools. 1. 6 Definitions and Acronyms:The human- relations dimension of communication makes it an activity that involves ethics. But business communication in particular brings ethical considerations into play. The fundamental purpose of a business is to stay in business and, most would say, to maintain or increase stakeholder wealth. When a business is in trouble or the owners are greedy, it can be tempting to try to serve this purpose by using communication in unethical ways. 1. 7 Limitation: The major limitations encountered are: †¢ Lack of enough time: The term paper was prepared within a very short time considering the topics related to it.That’s why; it was not possible to demonstrate all aspects of the report. †¢ Insufficient data: The data required for sufficient analysis for preparing the report could not be collected due to the insufficiency of data. †¢ Inconsistent data: Data from different sources were quite inconsistent which created some problems in making the report & compelled us to verify the data diligently. Some information was withheld t o preserve privacy of the companies. So, we can’t give the exact information always. 1. 8 Report Preview: The first chapter we have talked about the origin & the background of the report.We also have discussed the objectives, scopes, methodologies, definitions & acronyms and finally limitations to wrap up the chapter. Then in second chapter of the term paper we have included the introduction and some brief information on fruit juice companies. It also includes the organ gram of the companies, its missions & visions, its services etc. Then in the third chapter we have analyzed perception of consumers and make a table and graph by using statistical techniques for the fruit juice companies In the final segment, we have drawn our own conclusion regarding the ratio analysis. We also have some recommendations stated at the end.CHAPTER 2: ORGANIZATION 2. 1 History of the organization(PRAN) : PRAN means P- Program for R- Rural A-  Advancement N- Nationality â€Å"PRAN† is cu rrently the most well known household name among the millions of people in Bangladesh and abroad also. Since its inception in 1980, PRAN Group has grown up in stature and became the largest fruit and vegetable processor in Bangladesh. It also has the distinction of achieving prestigious certificate like ISO 9001:2000, and being the largest exporter of processed agro products with compliance of HALAL & HACCP to more than 70 countries from Bangladesh.PRAN is the pioneer in Bangladesh to be involved in contract farming and procures raw material directly from the farmers and processes through state of the art machinery at our several factories into hygienically packed food and drinks products. The brand â€Å"PRAN† has established itself in every category of food and beverage industry and can boost a product range from Juices, Carbonated Drinks, Confectionery, Snacks, and Spices to even Dairy products.Today, our consumers not only value â€Å"PRAN† for its authentic refres hing juice drinks products, but also for its mouth watering quality confectionery products with high visual appeal and exciting texture. We intend to expand our presence to every corner of the world and strive to make â€Å"PRAN† a truly international brand to be recognized globally. 2. 2 Mission: 1. Being respectful towards everyone. 2. Being trustworthy by action. Being passionate and creative in all we do. 3. Keeping things simple in the way we do things. 4. Being ethical and transparent. 5. Demonstrating individual and collective ownership. . Practicing an open culture in communication and interaction. As a uniquely Asian company, our goal is to catalyze progress in Asia by piecing together technology, connectivity and talent – this brand is symbolic of our commitment to the industry, to the region Vision: PRAN is the largest grower and processor of fruits and vegetables in the country. Their contract growers cultivate the choicest fruits and vegetables which are p rocessed in our modern and hygienic factories to highest quality standards. They think the comparative advantage of their country as an economy lies in agriculture.They believe the way to economic prosperity is through agri and agro-business. PRAN is in testimony to their convictions. Strategy: December 2009 — Present (9 months) †¢ To prepare annual, semi-annual and quarterly plan to achieve key commercial targets for the the company. †¢ To identify, analyze and develop the competitor’s price positioning and price points relevant to tariff plans in the industry which meets customer’s needs. †¢ To identify and get well acquainted with pricing model by revising/ implementing new price plan. †¢ To identify threat or potential by tracking entire commercial divisions key performance. To identify and develop product costing and implement quarterly Commercial activities calendar. †¢ To analyze & develop and recommend co-ordination meeting with all stakeholders of pricing & product team to review the activities/stages and going forward. †¢ To identify, prepare pricing concept and develop the commercially feasible report and roll out through approved process. †¢ To achieve targeted KPI of each stages by utilizing pricing tools to meet the Pricing model. †¢ To generate concept and get it approved from management in pursuit of company's business targets. To follow the systems and policy in place to for smooth operation of sales function. 2. 3 Organizational Structure & Size: Pran Company is one of the largest Food & Beverage Company of Bangladesh. They have their network tower all over Bangladesh. They also have much shop within Bangladesh. The basic departments of this organization are- Finance, Marketing, Accounting, HR, Corporate Strategy, Internal Audit, Technology, and Corporate Affairs. There are one head for each of these departments. CEO CSO CHRO CFO CTO CMOAnd other department head officers are also im portant but lesser than these head officers. 2. 4 products, services, customers, markets | | |Company Policy: To market products of consistent quality at home and abroad as per world standards produced hygienically in accordance with | |good manufacturing practices in state of the art plants & process, packed in appropriate packaging and remain committed to these objectives at| |all the times. | | |Corporate Head Office: Property Heights, 12 R K Mission Road, Dhaka – 1203. | |LOCATION OF PRODUCTION | |Location of Production: Ghorashal, Palash, Narshingdi. | |PRODUCT CATAGORIES | |Product Categories: Juice, Drinks, Beverage, Culinary, Snacks, Confectionary, Dairy. | | |Major Exporting Products: Fruit Juices, Fruit Drinks Instant Powdered Drinks, Pickles , Canned Fruits & Vegetables, Extruded & Fried Snacks, | |Tea, Aromatic Rice, Puffed Rice, Flattened Rice, Jam & Jelly, Plain Spices, Blended Spices, Mustard Oil, Mineral Water, Dehydrated fruits, | |Tomato Ketchup / Sauce, Toffees, Candies, Bubble Gum, Biscuits & other confectionery etc. | | |Major Exporting Countries: India, KSA, UAE, Kuwait, Bahrain, Qatar, Djibouti ,Angola, Australia, Austria,, Belgium, Benin, Brunei, Burkina | |Faso, Bhutan, Cameroon, Canada, Capo Verde Islands, Chad, Congo, Eritrea, Equatorial Guinea, Ethiopia, France, Gabon, Gambia, Germany, Ghana, | |Greece, Guinea, India, Italy, Ivory Coast, Japan, Korea, Lebanon, Malaysia, Mali, Mauritania, Mauritius, Myanmar, Mayo tee, Nederland | |Antilles, Nepal, Niger, Oman, Pakistan, Palestine, Qatar, RCA, Reunion Islands, Senegal, Sierra Leone, Singapore, Srilanka, Sudan, Sweden, | |Switzerland, Togo, UK, USA & Yemen. | 2. 5 Future Plan of the Organization: Like every food & beverage company AMCL Pran Company also has a future plan. According to their plan, this company gives strong effort for performing well.This company is performing very competently. They are always tries to ahead of their competitors. This activity indicates that t hey want to grab more market share day by day. So the future plan of AMCL Pran Company is to grab the highest market share within couple of years. 2. 6 History of the organization (FRUTIKA): Akij Group is one of the fastest business conglomerates in Bangladesh. Founded by Late Sheikh Akij uddin, the group started in humble way through trading business in 1940. Under his dynamic and charismatic leadership, the Group rapidly rose to the peak of success and has today 25 large Industrial and Commercial Units. Akij Food and Beverage Ltd is one of them.Akij Group launched in the local market three varieties of fruit juice under the brand name, â€Å" FRUTIKA†. 2. 7 Mission, Vision, Goal Strategy: mission: As a concern sister of Akij Group, the mission of AFBL is to surf the people best quality, social well fare etc. The mission of Akij group is narrow Vision: profit increase, market share and want to be market leader. They also have a vision to create new job opportunities in the m arket. Goal: Akij group has an objective to full fill their mission and also increase the company growth with adequate profit margin and more over want to satisfy their customers. 2. 8 Service, customer, Target Audience and Market:Akij Food and BeverageLimited wants to satisfy their all the customers. But it is very difficult to satisfy the all. . So in order to make sure the customer’s choice they has different flavors of juice named Frutika like mango, Orange and grape. Future Plan: Frutika is now a well known brand. So AFBL has a plan for increase its profitability. They are looking for new plant of new flavor. They are thinking for come in market with 2 liter juice bottle. 2. 9 Future Plan of the Organization: Like every food & beverage company Akij Food and beverage limited also has a future plan. According to their plan, this company gives strong effort for performing well. This company is performing very competently.They are always tries to ahead of their competitors. This activity indicates that they want to grab more market share day by day. 2. 10 History of the organization (ACME) ACME Group is one of the leading and diversified global conglomerates in Bangladesh, with offices in all major cities, employing over 3000+ employees and dedicated to  bringing the highest quality products and services to our customers. The ACME Agrovet & Beverage Ltd. is a FMCG business venture to manufacture fruit juice, mineral water and many more. These are manufactured and bottled in a state-of-the art processing factory using latest machines and Tetra-Pak facility. 2. 11 Mission, Vision, Goal, Strategy: Mission:The mission of ACME group is perpetual quest for excellence. Vision: ACME’s holistic approach is to ensure Health, Vigor and Happiness for all by manufacturing quality products of the highest quality at affordable prices and expanding in the local and global market. 2. 12 Service, customer, Target Audience and Market: ACME, though a pharmaceutic als company, produce juice as a food product. The marketing process of ACME juice is different than the other products that ACME produces. These diversities are found in distribution line, target, promotion strategy, pricing strategy, consumer relation and so on. To identify the potential target market ACME runs survey.For ACME juice the target market is the upper class and middle class people. It includes the people who are health conscious and prefer juice to satisfy thirst rather than cold drinks. 2. 13 Future Plan: ACME’s concern is is that the happy health of consumers. They are buying new plants for innovative-safety pack for their juices. Shezan: Shezan is not our locally made juice. It is imported from Pakistan. In our local market, we get only mango flavor of Shezan. The importer of the Shezan juice in our country is Nature Care. CHAPTER 3: Findings and Analysis Research Approach The respondents for this study are consumers who are using toilet soap at home, lived in Bangladesh.Research is focused mainly on younger consumers. Small amount of elder consumer also present in this survey. A pilot survey was carried out first and then questionnaires were used as a tool to collect required data. Sampling Method There are 10 questions about fruit juice and all brands were very familiar in Bangladesh. The questionnaires were distributed among the male and female consumers who live in Dhaka. Sample size was 30 and which covers all the brands used by different respondents. Data Analysis The statistical data analysis was done mainly thorough descriptive statistics, using Chi-Square method. The SPSS software was used to execute the analysis process.Methods such as pie charts were used to derive and summarize the data. The MS Excel was also used in data summarization process. Questions used in Questionnaires: The survey questions are shown below: 1. Which brand you prefer most as the best fruit juice? i)Pran ii) Frutika iii) Acme iv) Shezan v) Others 2. Whi ch juice you usually take? i) Pran ii) Frutika iii) Acme iv) Shezan v) Others 3. How often do you buy juice? i) Everyday ii) Once in a week iii) After 15 days iv) Once in a month 4. What flavor do you like most? i) Mango ii) Grape iii) Orange iv) Lemon v) Others 5. From where you purchase the juice frequently? ) Super market ii) Grocery shop iii) Fancy shops iv) Premium grocery v) Others 6. The age group who are responding this survey? i) 9-14 ii) 15-20 iii) 21-26 iv) 27-35 v) Others 7. From where do you come to know about this juice you are taking? i)TV adv ii)Radio iii)Bill-board iv)Newspaper v) Others 8. Which size do you prefer most? i)250 mL ii) 500mL iii) 1000 mL iv) 1250 mL v) Others 9. What do you prefer bottle or packet juice? i)bottle ii)packet 10. Thinking of similar products offered by companies, how would you compare your product? i)Much better ii) Some what better iii) About the same iv) Somewhere worse v)much worse SURVEY ANALYSIS Quantity of QuestionnairesThe summary of questionnaires collected is shown below. Question 1: 1. Which brand you prefer most as the best fruit juice? i)Pran ii) Frutika iii) Acme iv) Shezan v) Others ANALYSIS AND INTEPRETATION Table 1: Which brand you prefer most as the best fruit juice? | |Frequency |Percent |Valid Percent |Cumulative Percent | |i |Pran |10 |33. 33 |33. 33 |33. 33 | |ii |Frutika |7 |23. 33 |23. 3 |56. 67 | |iii |Acme |3 |10 |10 |66. 67 | |Iv |Shezan |4 |13. 33 |13. 33 |80. 0 | |v |Others |6 |20 |20 |100. 0 | |Total |30 |100. 0 |100. 0 | | Histogram (Pie chart): [pic] Interpretation:The table is showing that Pran is the best fruit juice on the basis of our survey. Out of 30 respondents 10 respondents go favor of Pran which results for 33. 33% of total and respondents 7 prefers Frutika which result for 23. 33%,Acme 10%,Shezan 13. 33% and Others 20% of total respondents. Question 2: 2. Which juice you usually take? i) Pran ii) Frutika iii) Acme iv) Shezan v) Others ANALYSIS AND INTEPRETATION Table 2: Whi ch juice you usually take? | |Frequency |Percent |Valid Percent |Cumulative Percent | |i |Pran |8 |26. 67 |26. 67 |26. 7 | |ii |Frutika |6 |20 |20 |46. 67 | |iii |Acme |2 | 6. 67 |6. 67 |53. 34 | |Iv |Shezan |6 |20 |20 |73. 34 | |v |Others |8 |26. 67 |26. 67 |100. 0 | |Total |30 |100. 0 |100. | | Histogram (pie chart): [pic] | | | | | | | Interpretation: From the table, we are seeing the juice which usually drink by the respondents. Out of 30 respondents 8 respondents drinks Pran which result for 26. 67% of total and 6 respondents drinks frutika which result for 20%, acme 6. 67%, shezan 20% and Others result for 26. 67% of total respondents. Question 3: 3. How often do you buy juice? i) Everyday ii) Once in a week iii) After 15 days iv) Once in a month v) others ANALYSIS AND INTEPRETATION Table 3: How often do you buy juice? |Frequency |Percent |Valid Percent |Cumulative Percent | |i |Everyday |7 |33. 33 |33. 33 |33. 33 | |ii |Once in a week |9 |23. 33 |23. 33 |53. 33 | |iii |After 15 days |4 |13. 33 |13. 33 |66. 67 | |Iv |Once in a month |4 |13. 3 |13. 33 |80. 0 | |v |Others |6 |20 |20 |100. 0 | |Total |30 |100. 0 |100. 0 | | Histogram (pie chart) : [pic] Interpretation: From the above data it can be concluded without doubt that most people buy fruit juice once in a week. Second highest number of people buys juice every day which results of 33. 33%. Other people buy juice after 15 days and once in a month which results is 13. 33%. | | | | | |Question 4: | | | | | 4. What flavor do you like most? i) Mango ii) Grape iii) Orange iv) Lemon v) Others ANALYSIS AND INTEPRETATION Table 4: What flavor do you like most? | |Frequency |Percent |Valid Percent |Cumulative Percent | |i |Mango |12 |40 |40 |40 | |ii |Grape |4 |13. 33 |13. 3 | 53. 33 | |iii |Orange |5 |16. 67 |16. 67 |70 | |Iv |Lemon |5 |16. 67 |16. 67 |86. 67 | |v |Others |4 |13. 33 |13. 33 |100. 0 | |Total |30 |100. 0 |100. 0 | | Histogram (pie chart) : [pic]Interpretation: From the above table we can see th at from the sample of 30, 40% people like mango flever, 13. 33% people like grape and others and 16. 67% people like orange and lemon. 5. From where you purchase the juice frequently? i) Super market ii) Grocery shop iii) Fancy shops iv) Premium grocery ANALYSIS AND INTEPRETATION Table 5: From where you purchase the juice frequently? | |Frequency |Percent |Valid Percent |Cumulative Percent | |i |Super market |10 |33. 33 |33. 33 |33. 3 | |ii |Grocery shop |2 |6. 67 |6. 67 |40 | |iii |Fancy shops |4 | 13. 33 |13. 33 | 53. 33 | |Iv |Premium grocery |6 |20 |20 |73. 33 | |v |Others |8 |26. 67 |26. 67 |100. 0 | |Total |30 |100. 0 |100. 0 | |Histogram (pie chart) : [pic] Interpretation: From the above table we can see that from the sample of 30, 33. 33% people purchase juice from super market, 6. 67% people purchase from grocery shop, 13. 33% people purchase from fancy shop,20% people purchase from premium shop and 26. 67% people purchase from other market. Question 6: 6. The age group who are responding this survey? i) 9-14 ii) 15-20 iii) 21-26 iv) 27-35 v) Others ANALYSIS AND INTEPRETATION Table 6: The age group who are responding this survey? | |Frequency |Percent |Valid Percent |Cumulative Percent | |i |0-14 9 |30 |30 | 30 | |ii |15-20 |10 |33. 33 |33. 33 |63. 33 | |iii | 21-26 |3 |10 |10 |73. 33 | |Iv |27-35 |6 | 20 |20 |93. 33 | |v |Others |2 |6. 67 |6. 67 |100. 0 | |Total |30 |100. |100. 0 | | Histogram (pie chart) : [pic] Interpretation: From the above table we can see that from the sample of 30, age between 0-14 of customer responds 30%, age between 15-20 of customer responds 33. 33%, age between 21-26 of customer responds 20%, age between 21-26 of customer responds 10%, age between 27-35 responds 20% and above that responds only 6. 67%. Question 7: 7. From where do you come to know about this juice you are taking? i)TV ad ii)Radio iii)Bill-board iv)Newspaper v) Others ANALYSIS AND INTEPRETATION Table 7: From where do you come to know about this juice you ar e taking? |Frequency |Percent |Valid Percent |Cumulative Percent | |i |TV ad |5 |16. 67 |16. 67 |16. 67 | |ii |Radio |6 |20 |20 |36. 67 | |iii |Bill-board |3 |10 |10 |46. 67 | |Iv |Newspaper |8 | 26. 67 |26. 67 |72. 7 | |v |Others |8 |26. 67 |26. 67 |100. 0 | |Total |30 |100. 0 |100. 0 | | Histogram (pie chart) : [pic] Interpretation: from the table we came to know that, 16. 67% came to know about the juice from TV ad, 20% from radio, 10% bill board, 26. 67% from newspapers and others. Question 8: 8. Which size do you prefer most? i)250 mL ii) 500mL iii) 1000 mL iv) 1250 mL v) Others ANALYSIS AND INTEPRETATION Table 8: Which size do you prefer most? |Frequency |Percent |Valid Percent |Cumulative Percent | |i |250 mL |16 |53. 33 |53. 33 |53. 33 | |ii |500mL |4 |13. 33 |13. 33 |66. 67 | |iii |1000 mL |2 |6. 67 | 6. 67 |73. 33 | |Iv |1250 mL |3 |16. 67 |16. 67 |83. 3 | |v |Others |5 |10 |10 |100. 0 | |Total |30 |100. 0 |100. 0 | | Histogram (pie chart) : [pic] Interpretation: From the above table we can see that from the sample of 30, 53. 33% people prefers 250 ml bottle of juice, 13. 33% prefers 500 ml,6. 67% 1000ml,16. 67% people prefers 1250 ml and 10% people prefers others size bottle of juice. Question 9: 9. What do you prefer bottle or packet juice? i)bottle ii)packet ANALYSIS AND INTEPRETATION Table 9. What do you prefer bottle or packet juice? |Frequency |Percent |Valid Percent |Cumulative Percent | |Bottle |16 |53. 33 |53. 33 |53. 33 | |Packet |14 |46. 67 |46. 67 |100. 0 | |Total |30 |100 |100 | | Histogram (pie chart) : [pic] Interpretation: From the table we can see that 53. 33% people prefers bottle juice and 46. 67% people prefers packet juice. Question 10: 10.Thinking of similar products offered by companies, how would you compare your product? i)Much better ii) Some what better iii) About the same iv) Somewhere worse v)much worse ANALYSIS AND INTEPRETATION Table 10. Thinking of similar products offered by companies, how would you compare your produ ct? | |Frequency |Percent |Valid Percent |Cumulative Percent | | i)Much better |11 |36. 67 |36. 67 |36. 67 | | ii)Somewhat better |6 |20 |20 |56. 7 | | iii)About the same |3 |10 |10 |66. 67 | | iv) Somewhere worse |5 |16. 67 |16. 67 |83. 39 | | v)much worse |5 |16. 67 |16. 67 |100. 01 | |Total |30 |100. 0 |100. 0 | | Histogram (pie chart) : [pic] Interpretation: From the data above we can interpret, that most of the customer are brand loyal and they compare product much better. 16. 7%of the sample says that their product is somewhere worse or much worse and 10% customer says that their product is about the same. CHAPTER 4: Conclusions and Recommendations 4. 1 CONCLUSION The fruit juice companies in Bangladesh is consists of a few producers. The demand for this product is very much vulnerable in terms of pricing. All companies are trying to give their product at a price which is affordable to most of the people in the country. Fruit juice is an uprising product in Bangladesh as a gre ater portion of the population, in summer the frui juice demand increases. There are many fruit juice companies (pran,acme,shejan,frutika etc. has been able to penetrate the market with heavy promotional activities. With different flavor, different bottle and packet sizes, different brand, different price, different quality, have been highly successful in their fields. Its distribution process is highly efficient. It has a huge availability around the country. We have found that usually the children love to take it. We found out that mango is a very popular flavor. Though the children love this, the age old people also have interest in it. People find it as a popular medium of drink. As ours is a mainly summer based country, so we see its demand on scotching heat. 4. 2 Recommendation for fruit Juice: fruit Juice should emphasize on taste because most of the buyers prefer the juice which tastes better. ? fruit Juice can have a wide range of flavors as consumer taste varies. ? fruit Juice should launch more attractive advertisements to attract consumers. ? fruit Juice can sponsor various programs to be promoted. ? Rebate or other types of cash offs can be offered to increase sale. ? There should be separate segmentation and targeting for kids as kids motivate their parents to buy fruit Juice ? Explanations of experts can illustrate the purity of fruit Juice which will clear consumer doubts. ? More nutritious factors can be added to fruit Juice to ensure consumer health. Appended Parts: References: 1. www. wikiepidia. org/en 2. ttp://www. AMCL Pran. com 3. Consumer Survey 4. http://www. google. com Blank format of questionnaires: This questionnaire is designed to determine the factors that are most important to you as a customer of juice. Your kind and patient response would enable us to complete the survey. 1. Which brand you prefer most as the best fruit juice? i)Pran ii) Frutika iii) Acme iv) Shezan 2. Which juice you usually take? i) Pran ii) Frutika iii) Ac me iv) Shezan 3. How often do you buy juice? i) Everyday ii) Once in a week iii) After 15 days iv) Once in a month 4. What flavor do you like most? i) Mango ii) Grape iii) Orange iv) Lemon 5.From where you purchase the juice frequently? i) Super market ii) Grocery shop iii) Fancy shops iv) Premium grocery 6. The age group who are responding this survey? i) 9-14 ii) 15-20 iii) 21-26 iv) 27-35 7. From where do you come to know about this juice you are taking? i)TV adv ii)Radio iii)Bill-board iv)Newspaper 8. Which size do you prefer most? i)250 mL ii) 500mL iii) 1000 mL iv) 1250 mL 9. What do you prefer bottle or packet juice? i)bottle ii)packet 10. Thinking of similar products offered by companies, how would you compare your product? i)Much better ii) Some what better iii) About the same iv) Somewhere worse v)much worse

Management Of Transient Ischaemic Attacks Health And Social Care Essay

The NICE guidelines and the National Stroke Strategy ( 2008 ) emphasises the importance of measuring all patients with a suspected TIA within a hebdomad and all high hazard patients within 24 hours. This is to enable originating appropriate direction. This includes life manner steps such as weight decrease, smoking surcease, cutting back on intoxicant etc. in add-on to turn toing hazard factors for shot. Suitable patients are referred for surgical intercession. This systematic reappraisal will look at all these issues and expression at the grounds for medical and surgical intercessions and the timing of the surgery, the type of surgery etc. Around 15,000 people per twelvemonth have a suspected TIA but presently merely 35 % of people are investigated and managed in a timely manner. There is a 20 % hazard of shot within the first 4 hebdomads after shot. Investigating and handling bad patients with TIA within 24 hours could bring forth an 80 % decrease in the figure of people who go on to hold a full shot. The hazard of shot after a TIA is approximately 12 % in the first twelvemonth and so about 7 % per twelvemonth thenceforth. There is a high hazard of shot in the seven yearss after TIA, perchance every bit high as 10 % . The hazard of shot, bosom onslaught or vascular decease is about 10 % a twelvemonth. This is approximately seven times the hazard in the background population. [ From thee Stroke Website ]PurposesThe intent of this reappraisal is to discourse the rapid appraisal and early direction aimed at cut downing ischemic encephalon harm, and in the instance of TIAs, forestalling subsequent shot. This will be achie ved by utilizing the most recent and up-to-date grounds from the literature.IntroductionA transeunt ischemic onslaught ( TIA ) is defined as an acute loss of focal encephalon or monocular map with symptoms enduring less than 24 hours and which is thought to be caused by unequal cerebral or optic blood supply as a consequence of arterial thrombosis, low flow or intercalation associated with arterial, cardiac or hematologic disease. [ Hatano 1976 – Page 1 G.Book ] . More late in 2002, Albers et Als proposed a revised definition for TIA, adding that there is no grounds of acute infarction on encephalon imagination. Infracted tissue is non ever obvious on imagination and so this definition has non yet been widely adopted. Stroke is the 3rd most common cause of mortality in the developed universe and there are a figure of preventable causes. Over the past 30 old ages, the direction of shot has changed at a phenomenal rate. New probes help direct patient choice for specific therapies and may well increase the opportunity of a successful curative result. Specialists have seen a broad scope of therapies introduced for the direction of TIAs and acute ischemic shot. These progresss have led to a theoretical account displacement in intervention, which is apparent in the protective direction of shot victims today.Methods( See ‘Methods ‘ in Appendix 1 ) .Epidemiology of TIAFor us to understand the clinical direction of TIAs and shots, to be after clinical services or to plan randomised controlled tests, and to mensurate the overall impact of interventions, it is of import to understand the epidemiology of TIAs and shots. Each twelvemonth at that place are about one million shots in Europe. [ Sudlow and Warlow – Pg 3 G.Book ] . Approximately 25 % of work forces and 20 % of adult females can anticipate to hold a shot if they live to be 85 old ages old and shot is the 2nd most common cause of decease worldwide. [ Murray and Lopez 1996 – Pg 3 G.Book ] . Mortality information underestimates the true load of shot since in contrast to coronary bosom disease and malignant neoplastic disease, the major load of shot is chronic disablement instead than decease [ Wolfe page 4 g.book ] . Strokes cause 23 % of healthy old ages lost and about 50 % of old ages of life lived with disablement in Europe. Stroke causes many secondary unwellness such as ; dementedness, depression, epilepsy, falls and breaks. In the UK the costs of shot are estimated to be about twice those of coronary bosom disease, accounting for about 6 % of entire NHS outgo. [ Rothwell 2001 – Pg4 G.Book ] . In add-on to shots, TIAs are besides common, and it is estimated that 54,000 TIAs occur yearly in England. Rothwell and Warlow estimate that about 20 % of shots are preceded by a TIA. MRI of patients who have suffered a TIA lasting longer than an hr shows that over 50 % have seeable countries of infarction. Technically they have non suffered a ‘stroke ‘ but a intellectual infarction. This emphasizes that TIA and shot are a continuum. The epidemiology of TIA is a batch more ambitious than that of shots since patients with TIAs are more heterogenous and present to a assortment of different clinical services, if they present to medical attending at all. Furthermore, dependable diagnosing of TIA requires early and adept clinical appraisal, as there is no diagnostic trial for TIA, doing epidemiological surveies really labour intensive and expensive.Aetiology and Clinical PresentationThe causes of TIAs are the same as the causes of shot, with the caution that the huge bulk of TIAs appear to be caused by ischemia instead than haemmorhage. In a TIA it is of import to find the site of the cerebrovascular lesion since this narrows down the likely implicit in aetiology and enables appropriate aiming of probes. The differential diagnosing of TIA differs from that of shot due to the transeunt nature of its symptoms. Hints in the history and on scrutiny can direct the tester to the likely underlying cause, enabling specific intervention to commence and secondary bar. [ Pg 113 G. Book – first parity ] A diagnosing of TIA is supported by a sudden oncoming and definite ‘focal ‘ symptoms, sudden oncoming and definite focal symptoms in the history and grounds of vascular disease on scrutiny [ manus et Al Pg 104 G. book ] . The most common of the symptoms can be seen in Table Ten:SymptomsFrequency ( % )Unilateral failing, weightiness, or awkwardness 50 Unilateral sensory symptoms 35 Dysarthrias 23 Transient Monocular Blindness ( Amaurosis Fugax ) 18 Dysphasia 18 Ataxia 12 Bilateral coincident sightlessness 7 Dizziness 5 Homonymic Hemianopia 5 Diplopia 5 Bilateral Motor Loss 4 Dysphagia 1 Crossed Sensory and Motor Loss 1 The symptoms of a TIA enable classification of onslaught by arterial district affected ; carotid in about 80 % or vertebrobasilar in 20 % . This has of import deductions for farther probe and secondary bar. There are no trials to corroborate a TIA, and the gilded criterion method of diagnosing remains a thorough clinical appraisal every bit shortly as possible after the event by an experient shot doctor, although the coming of new imaging techniques, peculiarly diffusion weighted MRI has allowed the diagnosing to be made or excluded with more certainty in some patients.Probes and Imaging/Diagnosing techniquesThe function of imaging in TIA is to corroborate the diagnosing, confirm the vascular district affected ( where the lesion may be ) , and to place those people who would profit from carotid intercession. [ 1- pg 8 Imaging Guidelines ] . The chief modes for imaging the encephalon parenchyma are CT and MRI. These are progressively being used to measure the intellectual vasculature in TIAs. In TIAs and minor shots neuro-imaging is required to: Exclude stroke mimics Distinguish between haemorrhagic and ischaemic events Determine the Aetiology, eg: carotid stricture with lesions in multiple vascular districts Identify patients at high hazard of early recurrent shot, in order to aim suited intervention. Sensitivity and specificity of different imaging modes varies with the pre-test chance, the nature of the lesion, the hold from event to imagination, whilst expertness in imaging techniques besides varies greatly. Hence when doing determinations about imagination after TIA, the pick of imagination will depend on all these factors, every bit good as patient safety, tolerability and contraindications. For illustration see Table X, for the advantages and disadvantage of CT versus MRI in TIA and minor shot. [ Page 132 – G.Book ] .Imaging ModalityAdvantagesDisadvantagesConnecticutLow Cost and broad handiness Low sensitiveness for little acute ischemic lesions Superior sensing of haemmorhage in early stage Low sensitiveness for mimics, particularly tumors. Radiation exposure IV contrast is nephrotoxic and potentially allergenic.Magnetic resonance imagingSuperior sensitiveness for shot mimics Patient tolerability and contraindications Provides predictive information. Superior sensing of bleeding in the subacute and chronic stage Table – Advantages and Disadvantages of CT and MRI in minor shot and TIA. In cohorts of patients with suspected TIA who were referred straight for scanning by primary attention doctors, prior to expert reappraisal by a shot doctor, rates of alternate diagnosings were high, likely reflecting high rates of misdiagnosis prior to imaging. [ Lemesle et Al 1998 – G.Book Page 132 ]Non-Radiological Probes for TIAFirst-line probes include ; basic blood and urine trials at presentation. Table Ten shows the baseline non-imaging trials for TIAs and shots.ProbeDisorders detectedFull Blood Count Anemia Polycythaemia Leukemia Thrombocythaemia/thrombocytopenia Erythrocyte Sedimentation Rate/ C-Reactive Protein Vasculitis Infective Endocarditis Hyperviscosity Myxoma Electrolytes Hyponatraemia Hypokalaemia Urea Nephritic Damage Plasma Glucose Diabetess Hypoglycemia Plasma Lipids Lipemia Urine Analysis Diabetess Nephritic Disease Vasculitis Second-line probes must be chosen suitably since the likeliness of a relevant consequence depends on the choice of patients and farther probe will incur more cost. [ Page 174 G.Book ] . Cardiac jobs such as AF – echocardiogram may demo atrial thrombus, aneurism of the anterior wall of the left ventricle with mural thrombus, atrial myxoma or left side valve disease. Cardiac monitoring may demo paroxysmal AF. Doppler surveies of the carotid and vertebral arterias may demo contracting. This probe may be followed by Carotid angiography and Carotid endarterectomy if stricture is a least 70 % . It may be argued that full probe for CHD should be initiated, as the most common cause of decease after TIA is MI. Table 1 Secondary probes by the specializer servicesShort-run forecast after TIARecent research has shown that the hazard of shot instantly after TIA is considerable [ Giles and Rothwell 2007, pg 195 G.book ] . However, this poses a challenge to clinical services because it leaves many TIA sick persons at a hazard of a major shot in the short term. Predictive tools have been developed to place patients at high and low hazard in order to inform public instruction, assistance effectual triage to secondary attention and direct secondary preventative intervention. Datas from population-based surveies and tests suggest that 20 % of patients with shots have a preceding TIA. [ Rothwell and Warlow 2005 – Pg 195 G.Book ] . A recent systematic reappraisal identified 18 independent cohorts, all published since 2000, describing shot hazard in 10,126 patients with TIA [ Giles and Rothwell 2007 – Pg 196 G.Book ] . 3.1 % shot hazard at two yearss and 5.2 % shot hazard at seven yearss.ABCD2 score – proof? i? See Document 48395 – Page 9 of 27.A new marking system for two twenty-four hours hazard of shot following TIA, dubed ABCD2. The Hazard factors employed in the ABCD2 marking system for 2 twenty-four hours hazard of post-TIA can be seen in table Ten:Hazard FactorValuessPointsAge a†°? 60 old ages1Blood Pressure lift ( either/or ) Systolic a†°? 140 millimeter Hg Diastolic a†°? 90 millimeter Hg1Clinical Features ( either/or ) Unilateral failing Speech damage without failing21Duration of TIA a†°? 60 min 10-59 min21Diabetess Yes/ No1( Reference = Johnston SC et al – Lancet 2007 369 ( 9558 ) :283-292. )Recognition of Symptoms and delays to directionPressing direction of patients with TIA depends upon the right acknowledgment of symptoms and appropriate action by patients and their fleet triage to specialist attention where probe and intervention are quickly initiated. Public consciousness and behavioral surveies are missing, nevertheless, one survey of cognition among the general populace indicated that 2.3 % of a indiscriminately selected sample of people in the USA have been told by a doctor that they had a TIA, based on self-report in a telephone study conducted in 2003 [ Johnston et al – Pg 239 G.Book ] . However an extra 3.2 % of respondents recalled symptoms consistent with TIA but had non sought medical attending at all and accordingly had non been diagnosed by a physician. Of those with ‘diagnosed ‘ TIA, merely 64 % had seen a physician within 24 hours of the event. Merely 8.2 % right related the definition of TIA, and 8.6 % were able to place a typical symptom. This suggests that frequent public instruction is required non merely on the nature of a TIA but besides what to make in the event of one.Recognition ToolsSeveral tools have been devised to help the right acknowledgment of shot and TIA symptoms. In the pre-hospit al scene, FAST, LAPPS and CPSS have been designed for usage by exigency services to guarantee rapid conveyance of patients to specialist attention. In the exigency puting ROSIER mark has been designed to help exigency doctors in diagnosing. The chief purpose of these tools has been to increase the Numberss of patients showing to hospital within three hours and, therefore, addition eligibility interventions. However due to the increasing accent on rapid direction for minor shot and TIA, their usage in informing public instruction and right diagnosing of minor shot and TIA is likely to go more widespread. The ABCD system was so developed to foretell the early hazard of shot following a TIA, and one of its chief utilizations has been in triage between primary and secondary attention. [ Rothwell et all 2005 – pg 241 G. book ] .Discussion of the Management of TIAs – Critical Reviewing( Use Diagrams and Tables ) Although the acute intervention of major shot, TIA and minor shot have many common elements, there are of import differences. In the acute intervention of TIA, the purpose is secondary bar of a disenabling shot, which might follow in the immediate hours and yearss after the initial event, as opposed to reversal of any neurological shortage caused by the shot itself. To cut down the hold in intervention, improved public instruction and improved triage to secondary attention and coordinated patient direction in specialist units are critical facets of intervention in TIAs. However there is a greater focal point on pressing, effectual secondary bar for TIA and minor shot. Although the construct of TIA arose in the 1950s and interventions for it were proven effectual, it was non until 2007 that the first studies were published on the feasibleness and effectivity of pressing appraisal and intervention of TIA in specialist units [ Rothwell 2007 – Pg 239 G.Book ] .Lifestyle AlterationAll tobacco users, including those with a history of shot or TIA, should be advised to halt, and intercessions such as guidance, nicotine replacing should be used if needed to assist them accomplish this. [ 257-263 ] . Avoiding extra intoxicant is reasonable and everyone including those who have suffered from a TIA or shot, should avoid heavy imbibing. Although a twosome of units of intoxicant per twenty-four hours may protect against future vascular events. [ 274-276 ] Reducing dietetic salt intake reduces BP, peculiarly in the aged with high BP, possibly ensuing in long term decrease in vascular events. It may besides assist those on antihypertensive medicine to halt their intervention without a rise in BP. It is advisable for old TIA or stroke sick persons to cut down consumption of concentrated fat, since it produces moderate decrease in cholesterin degrees, which are associated with little decreases in vascular events. [ 279-281 ] . Corpulent persons should be encouraged to lose weight utilizing dietetic or if necessary pharmacoligcal or surgical intercessions. All patients should have general advice about a healthy diet, low in concentrated fats, with plentifulness of fish, fruit, fiber and veggies. These intercessions have good effects on vascular hazard factors and seem likely to bring forth little decreases in vascular results despite there being no clear grounds that they do. [ 286-289 ]The Medical Management – Secondary PreventionNumerous interventions have been shown to forestall shot in the long term after a TIA, including antiplatelet agents such as acetylsalicylic acid, clopidogrel, and the combination of low-dose acetylsalicylic acid and extended release dipyridamole [ CAPRIE 1996 – pg241 GB ] ; blood force per unit area take downing drugs [ PROGRESS 2001 ] ; statins [ Amarence et Al 2006 ] ; anticoagulation for atrial fibrillation [ European atrial sibrillation test survey group 1993 ] ; and endarterectomy for diagnostic carotid arteria stricture & gt ; or equal to 50 % [ Rothwell 2003-04 ] . If the effects of all these interventions are independent, combined usage of all these intercessions in the appropriate patients would be predicted to cut down hazard of recurrent shot by 80-90 % [ Hackam and Spence 2007 Pg241 GB ] . However tests of intervention in acute shot suggest that the benefits of several of these intercessions are even greater in the acute stage, until late there has merely been few dependable informations on the benefits of ague intervention after TIA. NICE guidelines suggest that appraisal and probe should be completed within one hebdomad of a TIA. [ Wolfe 1999, Johnston 2006, NICE 2008 – pg 242 GB ] . Rapid intervention of TIA can forestall up to 80 % of recurrent shots. [ Rothewell Pg 285 GB ] . There is considerable grounds associating to the effectivity of assorted interventions to cut down the hazards of vascular events after TIA and shot. See Table 1:DrugTestTreatmentAspirinCastAspirin versus placebo within 48 hours of major ischemic shotISTAspirin versus placebo ( and SC heparin versus placebo ) acutely after major ischemic shot.Anti-thrombotic Trialists ‘ CollaborationMeta-analysis of tests analyzing antiplatelet agents in patients at high hazard of occlusive vascular disease. DipyridamoleClairvoyances 2Aspirin and Modified Release Dipyridamole versus placebo in a 2Ãâ€"2 factorial design started within 3 months of TIA or ischemic shot.EspritAspirin versus acetylsalicylic acid plus dipyridamole started within 6 months of TIA or minor shot. ClopidogrelMatchClopidogrel versus acetylsalicylic acid plus clopidogrel within 6 months of ischemic shot or TIA.CharismaAspirin versus acetylsalicylic acid plus clopidogrel in patients with cardiovascular disease or multiple hazard factors ( including ischemic shot )FASTERAspirin versus acetylsalicylic acid plus clopidogrel in the ague stage after TIA or minor ischemic shot. Antihypertensive DrugsAdvancementPerindopril plus or minus Indapamide versus placebo after TIA or ischemic shot in patients with or without high blood pressure. Cholesterol-lowering drugsHorsepowerSimvastatin versus placebo in patients with coronary disease or other occlusive vascular disease including TIA or shot.SPARCLAtorvastatin versus placebo started within 1 to 6 months of TIA or ischemic shot. Table: Major tests and meta-analyses lending to the grounds base for medical intervention in secondary bar after TIA and ischemic shotVariation in intervention worldwide:Unsurprisingly there is considerable international fluctuation in how patients with suspected TIA are treated in the acute stage, possibly due to the historical deficiency of grounds. For case, Gallic and German health care systems provide immediate exigency inmate attention and the average infirmary stay is about seven yearss [ albucher ] , whilst other systems ( such as Canada ) provide non-emergency outpatient clinic appraisal [ Johnston and Smith 1999, Goldstein 2000 – pg 242 ] . For illustration a Canadian survey showed that in more than one tierce of the patients, antithrombotic therapy was non prescribed on discharge. In the UK, the standard agencies of appraisal and direction is a neurovascular outpatient clinic ( â€Å" TIA Clinic † ) [ Intercollegiate working party for Stroke 2004 – Pag e 242 ] .Antiplatelet AgentsSeveral big controlled tests have now compared antithrombotic therapy ( antiplatelet or anticoagulant agents ) versus control in acute ischemic shot these have been big and have provided dependable grounds on safety or efficaciousness. Antiplatelet drugs such as acetylsalicylic acids can be effectual in the secondary bar of ‘serious vascular events ‘ ( Stroke, MI, and Vascular decease ) [ 12 from the IST survey ] . If taken for a few old ages after a myocardial infarction, ischemic shot, or transeunt ischemic onslaught ( TIA ) , antiplatelet therapy typically avoids about 40 serious vascular events per 1000 patients treated. In acute ischemic shot there is significant thrombocyte activation, which can be inhibited by acetylsalicylic acid. [ 2,14,15,16 from IST ] . Aspirin was by far the most widely studied antiplatelet drug in the ATT ( antithrombotics triallists coaction ) reappraisal. Among about 60,000 high hazard patients, excepting those with acute ischemic shot, aspirin entirely reduced the odds of a serious vascular event by one one-fourth. Almost 10,000 of these patients had a anterior TIA or ischemic shot. Aspirin significantly reduced the comparative odds of a serious vascular event by 17 % , matching to an absolute hazard decrease of 30 per 1000 over 3 old ages. Controversy has surrounded the most appropriate dosage of acetylsalicylic acid, clinicians have argued about doses runing from 30 milligrams to 1500 mg. [ 158-160 Big book chapter 16 ] . Theoretical grounds suggest lower doses might in fact be more good than higher doses. After sing all the available grounds from direct and indirect comparings in bad patients, it seems sensible to reason that acetylsalicylic acid at a dosage of 75-150 mg day-to-day is every bit effectual as higher doses and is most appropriate for long-run secondary bar of serious vascular events to maximise benefits and to minimise inauspicious effects. Doses below 75 milligrams day-to-day may be as effectual, but this still remains rather unsure. Patients with TIA or acute shot, should be treated with acetylsalicylic acid every bit shortly as operable after encephalon imagination has excluded bleeding. Sandercock et al 2003 reviewed two really big randomised controlled test ( International Stroke Collaborative Group 1997 ( IST ) and Chinese Acute Stroke Trial Collaborative Group ( CAST ) which together randomised over 40,000 patients. Sandercock clearly established that get downing aspirin therapy within the first 48 hours of acute ischemic shot avoids decease or disablement at six months for about 10 patients per 1000 patients treated. A farther 10 patients per 1,000 treated will retrieve wholly. intracranial and extracranial bleeding are reported with aspirin therapy but this has low rates, and it is offset by the benefit of excess lives saved. In the IST, patients were allocated, in an unfastened factorial design, to intervention policies of: 300 milligrams aspirin daily, Lipo-Hepin, the combination, or to ‘avoid both acetylsalicylic acids and Lipo-Hepin ‘ for 14 yearss. In the CAST, patients were allocated, in a double-blind design, to 1 month of 160mg aspirin day-to-day or fiting placebo [ Get references 156 and 157 from Chapter 12 -Big Book ] . There is no clear consensus about whether acetylsalicylic acid should be given before encephalon imagination. This is applicable in state of affairss where entree to imagination is delayed or where drugs could be administered by ambulance staff. [ IST 1997 ] There is besides no clear grounds that any peculiar dosage of acetylsalicylic acid is more effectual that others. However symptoms of aspirin toxicity are dose-related, so the smallest effectual dosage should be used. Initial dosage of 150-300mg per twenty-four hours is advised for the acute stage, followed by long-run intervention with 75-150mg per twenty-four hours. Patients intolerant to aspirin should be treated with clopidogrel or with dipryidamole, these newer agents are well more dearly-won than acetylsalicylic acids.Alternate Antiplatelet therapies/regimensAspirin acts on merely one of a figure of tracts taking to platelet activation and so thrombosis. Antiplatelet drugs moving through different tracts might hence be more effectual than aspirin if given as options to, or combined with, acetylsalicylic acid. Several recent big tests have provided information about alternate antiplatelet regimens. Clopidogrel V acetylsalicylic acid: A systematic reappraisal of RCTs of a thienopyridine V acetylsalicylic acid in bad patients identified 10 relevant tests in 26,865 patients. Aspirin was compared with clopidogrel in one test of 19,185 patients with ischemic shot and with ticlopidine in the staying nine tests in a sum of 7,633 patients, most of whom had a recent TIA or minor shot. Thienopyridines modestly and significantly reduced the odds of a serious vascular event compared with acetylsalicylic acid. [ 174 from chapter 16 BB ] . No important inauspicious effects were found in footings of bleeding. On the other manus the thienopyridines were associated with lower hazard of GI shed blooding. [ 174 ] . Few tests that have compared clopdogrel and ticlopidine have straight suggested better safety and tolerability with clopidogrel, doing it the theienopyridine of pick on safety evidences [ 183-185 BB ch 16 ] . In drumhead, clopidogrel is every bit effectual as acetylsalicylic acid and slightly perchance more so. The high cost of clopidogrel and the uncertainness of any extra benefit compared to aspirin do it unreasonable to propose that it should replace aspirin as the first pick antiplatelet drug for all patients at high vascular hazard. It is a sensible alternate antiplatelet drug for patients with a history of TIA or minor shot, who are truly allergic to aspirin. There is presently no grounds from RCTs to back up the usage of combination of clopidogrel plus acetylsalicylic acid to forestall vascular events in patients with TIAs. Antiplatelet therapy reduces the hazard of perennial vascular events after TIA. Most test informations concerns aspirin nevertheless, clopidogrel { CAPRIE Steering commission 1996 ) and drawn-out release dipyridamole ( Sivenius 1991 ) have besides been shown to be effectual in their ain mechanisms of action.Combination Antiplatelet therapy:The combination of acetylsalicylic acid and dipyridamole is more effectual than aspirin alone [ Diener et Al 1996, Halkes et al 2006 ) . This combination shows a comparative decrease in the hazard of perennial shot of around 30 % compared with aspirin entirely. On the contrary, the combination of clopidogrel and acetylsalicylic acid was non superior to clopidogrel entirely in secondary bar after shot, TIA or other vascular disease in the MATCH and CHARISMA tests. [ Diener et al 2004, Bhatt et al 2007 ] . However there was no important tendency towards benefit from combination antiplatelet intervention in the MATCH test, there was besides a higher hazard of bleeding after 18 months in the combination therapy, which was non evident until 4 months into the test. Consequently, it is possible that draw a bead oning along with a short class of clopidogrel may be effectual in the ague stage after a TIA and minor shot. Antiplatelet agents: – prevent extension of arterial thrombus, prevent thrombocyte collection in microcirculation, prevent re-embolisation from embolic beginning, cut down release of eicosanoids and other neurotoxic agents. Aspirin: – inhibits COX-1, cut downing dislocation of arachadonic acid to thromboxane A2 and thrombocyte granule release. Clopidogrel and other thienopyridines: – encirclement of thrombocyte membrane ADP receptors, suppressing ADP-dependent thrombocyte activation and granule release. Dipyridamole: – Inhibition of phosphodiesterase, doing lift of intracellular thrombocyte cyclicAMP and a attendant decrease in Ca suppressions ; this thrombocyte activation and granule releases. [ TABLE 24.2 – Page 287 G.B ]Anticoagulation and patients with AF:Immediate therapy with decoagulants such as LMWH, unfractionated Lipo-Hepin, and heparinoids in patients with acute ischemic shot is non associated with net short- or long-run benefit [ IST 2007 – Berge 2007, Wong et Al 2007 – Pg 258 GB. ] . These agents cut down the hazard of DVT and PE, but are associated with important hazard of intracranial bleeding, which is dose dependent. Patients in AF after a presumed TIA benefit from anticoagulation in the long-run to forestall a farther shot. However, the best clip to get down therapy after an ischemic shot is ill-defined as the hazard of bleeding is hard to foretell. [ IST – Donnell 2006 – pg 258 GB ] . Patients in AF who have a TIA should be given anticoagulation therapy if there are no contraindications [ European Atrial Fibrillation Trial Study Group 1993,1995 ] . Recent surveies have shown that Coumadin is every bit safe as acetylsalicylic acid in aged patients with AF [ Rash et Al 2007, Mant et al 2007 ] . Patients with presumed cardioembolic TIA or stroke secondary to other causes should surely have antithrombotic therapy. Besides they may profit from anticoagulation in other cardiac fortunes, but at that place have been no randomised controlled tests in state of affairss other than non-valvular AF. Anticoagulation is non effectual in secondary bar of shot for patients in sinus beat. Warfarin intervention to a mark INR of 3-4.5 was associated with important injury due to a big addition in major hemorrhage complications, particularly intracerebral bleeding, in patients with old TIA – in the Stroke Prevention in Reversible Ischaemia Trial ( SPIRIT ) [ Algra et al 1997 ] The subsequent Warfarin versus Aspirin in the Secondary Prevention of Stroke ( WARSS ) test of aspirin versus Coumadin for patient in fistula beat and without cardioembolic beginning or with more than 50 % CAS ( carotid artery stricture ) showed no extra benefit for Coumadin at a mark INR of 1.4-2.8 [ Redman and Allen 2002 ] . There has been uncertainness as to whether anticoagulation is preferred to antiplatelet intervention for the secondary bar of ischemia relate to intracranial coronary artery disease. A robust randomised dual unsighted test ( WASID – Warfarin-Aspirin Diagnostic Intracranial Disease ) test of Coumadin, to a mark INR of 2-3, versus acetylsalicylic acid to 1300 milligrams per twenty-four hours in patients with 50-99 % stricture of a major intracranial arteria showed no important benefit for Coumadin over aspirin [ Chimowitz et Al 2005 – pg 287 G.B ] . In fact, Coumadin was associated with increased rate of bleeding and other inauspicious events ; as a consequence the survey was stopped early. However patients having Coumadin were in the curative scope for merely 63 % of the clip. Curative INR appeared to be associated with a much reduced incidence of ischemic shot and cardiac events, proposing that anticoagulation may supply increased benefit over acetylsalicylic acid if curative INR can be maintained much more systematically.FASTER: [ Kennedy FASTER et Al 2007 – pg 246 ]The FASTER randomised controlled pilot test, studied the benefit of clopidogrel versus placebo and Zocor versus placebo initiated within 24 hours of symptom onset in patients with TIA or minor shot, all were treated with aspirin [ Kennedy et Al 2007 – pg246 GB ] . The survey was stopped early owing to failure to recruit patients, likely due to the increased usage of lipid-lowering medicines during the survey period.Blood Pressure and Lipid take downi ng agents:There is some robust grounds from randomised tests to demo that blood force per unit area and cholesterin lowering are effectual for secondary bar of shot. The PROGRESS survey of perindopril and Lozal showed that BP decrease with an ACEi and diuretic get downing several hebdomads or months after TIA reduces the hazard of subsequent shot by about a 3rd. There is a positive correlativity between cholesterin and hazard of ischemic shot. Cholesterol take downing with lipid-lowering medicines reduces the hazard of shot in patients with old shot, coronary or peripheral vascular disease or diabetes. The Heart Protection Study 2002 did non demo a decrease in hazard of perennial shot on lipid-lowering medicines [ Collins et Al 2004 – pg 288 ] , perchance because patients were at low hazard of shot return since the incident shots occurred on mean 4.6 old ages before the survey oncoming. However the subsequent SPARCL test of Lipitor in patients who had had a shot or TIA within one to six months before survey entry showed a reduced overall shot hazard [ Amarenco et Al 2006 – page 288 ] . However there was a important parallel addition in hazard of hemorrhagic shot had been found in the HPS in the 3280 patients with old shot or TIA [ Collins et Al 2004 pg 288 ] . Lipid-lowering medicines should non, hence, be used in patients with old intracerebral bleeding unless there is a strong indicant related to the hazard of ischemic events.Cholesterol-lowering drugs:Meta-analyses found that larger decreases in LDL Cholesterol led to larger decreases in hazard of major vascular events and its constituent results, proposing that attachment to a statin regimen bring forthing a 1.5mmol/L decrease in LDL cholesterin would take to a decrease of about one tierce in the comparative hazard of major vascular events. The full benefits of cholesterin take downing with a lipid-lowering medicine emerged over the 2-3 old ages of intervention and continued for each twelvemonth that intervention was continued thenceforth. HPS was the largest of the RCTs in this meta-analysis. It included over 20,000 people. In a subsequent RCT, the SPARCL test, non included in the meta-anlysis, patients with a recent shot ( about all ischemic ) or TIA and no known coronary bosom disease were indiscriminately assigned to either atorvastatin 80 mg day-to-day or placebo for 5 old ages. The difference between HPS and SPARCL in the effects of of shot or TIA could be explained by opportunity, different intervention regimens, enlisting of patients earlier after their event in SPARCL, or a different balance between ischemic and hemorrhagic shot results. Both tests found similar comparative decreases of approximately 20 % in ischemic shot, and a 70 % or more increased relation hazard of hemorrhagic shot. Both tests found comparative decreases with a lipid-lowering medicine of approximately 20 % in major vascular events. [ See 119-120 ref from BB page 811 ] . There is really good grounds for routinely sing the usage of drawn-out lipid-lowering medicine intervention to take down cholesterl degrees in allpateints at high hazard of any type of major vascular event, including those with a anterior ischemic shot or TIA, and irrespective of the baseline cholesterin concentration. Treating 1000 people with a anterior ischemic shot or TIA for 5 old ages with a lipid-lowering medicine will take to the turning away of over 50 major vascular events. The grounds clearly suggests that cholesterin take downing with a lipid-lowering medicine should be considered in everybody with a history of an ischemic cerebrovascualr event. Lipid-lowering medicines are non recommended for those patients whose untreated cholesterin or LDL choleserol degrees are below 3.5 mmol/L in cholesterin and below 2.6 mmol/L in LDL choleseterol. It is besides non recommended to order a lipid-lowering medicine for patients with a history of intra intellectual bleeding ( ICH ) but no ischemic vascular events, since really few of these patients were included in the two chief RCTs. For those patients with a history of ICH who are besides considered to be at peculiar high hazard of future ischemic shot or coronary events, it is likely sensible to order a lipid-lowering medicine [ Page 814 Big Book ] . Evidence besides suggests that it may be good to get down the lipid-lowering medicine therapy in the first few yearss after the TIA. [ 134 Large book page 815 ] . To reason on lipid-lowering medicines ; intervention tends to get down with a lipid-lowering medicine every bit shortly as the diagnoss is made of a TIA with a baseline entire cholesterin of & gt ; 3.5 mmol/L or LDL cholesterin & gt ; 2.6 mmol/L. Both simvastatin 40mg day-to-day and atorvastatin 80mg daily have been shown to be good in these patients.SURGICAL INTERVENTION120,000 people have a TIA or shot every twelvemonth in the UKat least 10,000 might be suited for CEA yet merely 4500 are being performed each twelvemonth. Recently published NICE guidelines suggest that CEA should be done on appropriate patients in 2 hebdomads of presentation. There have been unacceptable holds between symptom and surgery in the UK. Merely a fifth of diagnostic patients have surgery within two hebdomads, which is the recommended NICE guidelines. Diagnostic CEA is pressing and should hold precedence over elected surgery. The recent GALA test shows that the first 1001 UK patients had a average hold between symptoms and surgery of 82 yearss [ 7 from BLUE BMJ Research article )Carotid Endarterectomy – Evidence of its benefitSurgical remotion of the atheromatic plaque from within the carotid arteria – the carotid endarterectomy ( CEA ) . Tests have proven that it is an effectual intervention for the secondary bar of shot in selected patients. CEA is associated with a assortment of possible complications such as shot and decease [ Naylor Ruckley, Bond et al – GB Ch 25 ] . It is apparent that surgery clearly prevents stroke in patients with diagnostic terrible CAS, but at a monetary value: hazard of shot as a effect of surgery, cost of surgery, hazard of other complications of surgery, cost of probes for choosing suited patients. Nowadays there is concern in the UK as to which patients should be offered surgery. [ 374 375 – BB- Ch 16 ] . As a consequence of big RCTs, it is now clear that CEA of late diagnostic terrible CAS about wholly abolishes the high hazard of ischemic shot over a period of 2-3 old ages. [ 369-371,445-447- Ch 16 BB ] . A clear advantage to surgery is shown when the diagnostic stricture exceeds 80 % diameter decrease of the arterial lms utilizing the ECST method ( European Carotid Surgery Trial ) , which is different to 70 % utilizing the NASCET method. In the NASCET test, CEA reduced the comparative hazard of shot by 65 % compared to medical intervention. The hazard of shot in patients with less than 60 % ( ECST ) stricture is so low, the hazard of surgery is non worthwhile for them. For patients with between 60 % and 80 % ( ECST ) stricture there is still some uncertainness as some of these may be at immense hazard of shot who gain from surgery. Whether the benefits of CEA or stenting in patients with symptomless stricture warrant the hazards and cost is still ill-defined, peculiarly in an epoch of improved medical interventions. ACST and ACAS, had absolute decreases in five-year hazard of shot with surgery were similar: 5.3 % and 5.1 % , severally.Carotid Stenting:Carotid stenting is less unpleasant and less invasive than carotid endarterectomy, and is more convenient and quicker. It is carried out under LA. Some little tests have compare stenting with CEA, and suggested that the procedural shot complication rate of stenting was similar to that of CEA and that there are fewer shots in the long-run. They besides showed that stenting might hold a higher hazard of shot and decease than CEA, and a higher rate of restenosis. The SPACE test is the largest survey comparing CEA with carotid stenting.Timing of SurgeryOptimum timing of surgery has been a extremely controversial subject [ 473-474 – ch 16 BB ] . Surgery should be performed every bit shortly as it is moderately safe to make so, given the really high early hazard of shot during the first few yearss and hebdomads after the TIA in patients with diagnostic CAS. [ 16-475 – ch 16 ] . In stable patients there is no difference between early and subsequently surgery. Thus for stable patients with TIA, benefit from endarterectomy is greatest if performed within 1 hebdomad of the event. [ 390 ch 16 ] However in exigency carotid enarterectomy patients with germinating symptoms ( sucha s stoke in development, crescendo TIA ) had a high operative hazard of shot and decease of 19.2 % which was much greater than that for stable patients 9390 – 477 ch 16 ] . Therefore there is still uncertainness about the balance of hazard and benefit of surgery within 24-72 hours of the presenting event. [ 475 478 479 – hc 16 ] . Merely a minority of patients with TIA are possible campaigners for carotid endarterectomy ( CEA ) or stenting, make up one's minding on surgical intercession instead than medical intervention entirely can be hard. In the ECST 30 % of patients with 90-99 % stricture had a shot in three old ages, 70 % did non. Both ECST and NASCET have two values for the stricture and this difference has been down to the manner the two tests underwent at that place angiographic techniques and to what extent the techniques used to mensurate stricture were accurate. ECST i? 70 % NASCET i? 50 % – WHY THE Difference? ? THE BIG AUDIT The DoH stroke scheme recommends that CEA should be carried out within 48 hours of symptoms, when the hazard of shot is highest, in patients with TIA who are neurologically stable. [ 17 BMJ ARTICLE ] . To accomplish this, utilizing FAST will assist public to recognize TIA and early shot [ 17 BMJ article ] . And the ABCD2 mark helps primary and secondary services to place those patients with TIA who are at highest hazard of shot. [ 18 BMJ Art. ] .Future Directions – How Potential Future Research may be designed to get the better of spreads and challengesMentionsAppendix 1:MethodsLiterature Search StrategyA controlled hunt scheme was employed to obtain informations from medical databases such as PubMed, EMBASE, MEDLINE ( Via PubMed ) , Web of Science, Science Direct ( Elsevier ) , and The Cochrane Library. I besides used the University MetaLib system. I used the capable hunt subdivision and selected ‘Health and Medicine ‘ as the chosen subject of research. It helped further my hunt for e-journals and articles. The systematic hunts were performed in September 2010 to place suited surveies and reappraisals that were published from 2000 until the present twenty-four hours ( i.e from the past ten old ages ) . Although some robust randomised controlled surveies were included which were necessarily dated back beyond this day of the month scope. Drawn-out hunts were made via cyberspace web sites and manual searching of diaries. Recently published, well-conducted systematic reappraisals and primary surveies were selected for inclusion in this systematic reappraisal. Interlending and Document Supply was besides used as a service provided by the Lancaster University Library, to recover some diary articles.Key WordssTranseunt Ischaemic Attack, TIA, TIA Management, Treatment, Current therapy, Anti-coagulation, antiplatelet drugs, acetylsalicylic acid, clopidogrel, dipyridamole, combination therapy, cerebrovascular accident, secondary bar.Using MeSH and seeking different Fieldss by using bounds enabled me to polish my consequences from databases. Any articles found within this hunt were so critically appraised ; their relevancy to this systematic reappraisal was besides so decided.Relevant diaries that were non found on the library MetaLib system, were searched for on Google Scholar and the page was taken straight to the database beginning site and so searched within the peculiar database archives. These include: Stroke, The Lancet, New England Journal of Medicine, European Journal of Vascular and Endovascular Surgery, Journal of Vascular surgery, An nals of Vascular surgery.