Participation in higher education and women empowerment

Cooperation in advanced education and ladies strengthening In the exploration led by Samina Malik and Kathy Courtney the finding from Maliks 2005 examination was summed up. It was from his examination that the needed to research that how much does ladies strengthening was dependant on the picking up of advanced education by ladies. In the exploration the significance of the common culture and standards on ladies strengthening was likewise featured as they assume a key job in keeping ladies from asserting the rights that they have been given by law which incorporates having equivalent rights to training. As Pakistan is a creating nation it has been evaluated s the country with the most stretched out sex hole and victimization ladies (UNICEF 2006). The unified countries populace data arrange gave the understanding that ladies strengthening has five significant segments, which incorporate ladies feeling of self-esteem, their entitlement to have and to decide decisions, their entitlement to approach openings and assets, their entitlement to have capacity to control their own lives, both inside and outside the home, their capacity to impact the course of social changes to make a progressively social and financial request, broadly and internationally,(POPIN n.d) Anyway it has come to see that generally speaking the young ladies and ladies are at disservice and the development to realize any adjustment in their position or their way of life has fizzled. Framing an end from the exploration it has been demonstrated that the achievement of advanced education specifically is acknowledged as a methods for social change. The interest in instruction has numerous focal points for the ladies one of the most significant one being financial autonomy. As settled upon by Iram, samiullah, tanveer, bedi-uz-zaman, shujaat and Ali ladies strengthening is a social marvel. Ladies in Pakistan are dependent upon next to no support in the financial circle of life. Generally they are either come up short on or unpaid specialists in the rural foundation. I their exploration the creators additionally subject that ladies strengthening can be estimated dependent on their investment in governmental issues. Anyway the most significant angle being taken into account in their investigation is the effect of male young people sees on ladies strengthening. Since Pakistan is obviously a male overwhelmed society and the perspectives on the male portion plays either a steady or contradicting job towards ladies strengthening. It was finished up after the investigation that the overarching perspective on ladies strengthening from the eyes of the male youth has various parts of acknowledgment. With respect to of property, vote throwing and enlistment the rea ction was genuinely positive. It was additionally positive towards equivalent openings for work, preparing system and enrollment of association and association however political support and interest out in the open fights and political battles was a negative. Generally speaking anyway the demeanor of youth towards ladies strengthening was viewed as a positive yet the family practice of the uplifting mentality was restricted which might be because of the guardians foundation and nature of instruction. As per Malik hassaan the purpose behind ladies being dismissed and lookdown upon may lie in some regular variables which originate from the historical backdrop of the nation. The normal practices and societies and the hazard of neediness have been put down on the shoulders of the ladies of this nation since its introduction to the world. The thought recommended that monetary improvement to real happen in a country requires the support of the whole residents of the country by Malik is urgent to this nation. The idea featured is the significance of destitution and government mediation in the creating scenes. The history hairy by the creating countries has a significant influence additionally in another investigation pertinent to this is by Ndrit. Assie-Lumumba with respect to the ladies and strengthening in Africa. The thought being examined by both the creators lie in the way that the countries having taken part in numerous global advancement and improvement projects and associations the execution of laws star ladies have been poor because of the historical backdrop of neediness and culture winning in these countries. The immaterial intercession of the legislature and the absence of positive will towards this thought thwart the social prosperity as well as the e monetary prosperity of these creating countries. As Assie-lumumba clarifies the investment of ladies I advanced education and colleges are very low because of which any examination led from these establishments dont show the real picture. In spite of the fact that the instructive framework has been taken from the wests model, the enduring absence of support by the female division can't be overlooked. The explanation behind the absence of association doesnt anyway lie exclusively with the notable practices yet in addition by the ongoing practices which have stemmed out from the notable practices basically reinforcing them. The issue being that without access to essential and optional training the female masses can't have the chance to progress into advanced education. The act of not permitting equivalent open door at the underlying degrees of instruction is a significant prevention for the ladies of Africa. The other principle issue talked about in the investigation identifies with the absence of capacity to have time, hardware and accounts being dispensed to ladies in the African culture. This additionally raises the sexual orientation hole and generally diminishes the capacity of ladies to take an interest in training. The nonattendance of legitimate approaches and execution of these arrangements along these lines bring about the unfair strategies with respect to training and ladies in the African mainland. The possibility that the greater part of the decisive exploration done in the creating nations result from the examination led in the college setting, the nonappearance of ladies structure these establishments bring about an absence of data and real examination. The arrangement of approaches likewise lay on the data gathered consequently the absence of data in this way bring about ill-advised and deficient endeavors being directed in the manner to ladies strengthening. Lumumba likewise appropriately finishes up dependent on appraisal that the job of the specialists are profoundly urgent in the forward perspective on the mainland and it is their obligation to investigate all break down all the social parts to at last concoct ends. In this manner teaching the female masses of the country is fundamental to monetary prosperity and destruction of neediness as well as a more advantageous social remaining of the country. A similar standing is advanced by Malik Hassan in his examination that destitution and financial supportability of Pakistan lays on the shoulders of strategy producers and scientists. There is a urgent requirement for legitimate exploration and information accessibility and a desperate need of the arrangement creators, the administration to take care of business changes and execute them in the most productive and viable way as without this the country won't have the option to move from the creating class to the created. The annoyance of neediness and the financial shakiness is legitimately identified with the no investment of the whole country towards there removal. In his decision Malik likewise clarifies the significance of mindfulness among the residents, limit working of ladies, exploration and documentation on the accomplishments of ladies and support for strategy in ideological groups as fundamental and generous prerequisites to defeat the basic impediments and absence of mindfulness in the nation. The significance of ladies support in strategy plan and their portrayal at all degrees of the administration is fundamental for the prosperity and progress of Pakistan. Ladies strengthening is characterized as a change I the setting of a womens life that will empower her to lead a satisfying human life, it being reflected both in outside characteristics and inner characteristics (human improvement in south Asia (2000) as cited by Mathew (2003). In the exploration by purusottam nayak and bidisha mahanta it is discovered that ladies of India, another creating country, are moderately impaired and given a lower status than their male partners. The current of this sexual orientation hole exists essentially with respect to training and business. Various parts of the investigation concentrated on various variables that were taken a gander at by the analyst. These incorporate ladies reserving the option to instruction and business; abusive behavior at home and state on spending their profit; womens introduction to media and beneficiary inclusion in governmental issues. After an unmistakable view it was inferred that ladies were dependent upon inconsistent t reatment b the male commanding society. Dr suvarna sen and ishita mukherjee additionally in their investigation take a gander at the predominant patterns of job of ladies in India and they likewise inspect the business levels, wages, proficiency and school enrolment; their cooperation in legislative issues and individual medical problems. They likewise propose from their examination that ladies are being liable to financial predispositions which everything considered influence their status in the public arena. The most disturbing find from both these examinations show the acknowledgment of this inconsistent and inclination treatment by the ladies all in all. Every one of these variables are either the consequence of governments move from raising genuine mindfulness as well as usage of approaches organized for ladies strengthening. The significant job of advanced education and work is the convincing component in both the examinations. It has been seen in Dr surarna sen and ishita mukherjees finding that ascending of mindfulness and training are the main discussions which may bring about capacity to battle these practices. The whole thought of is additionally upheld by purusottam nayak and bidisha mahanta in their discoveries that entrance to training and work are the main empowering components to strengthening. Anyway in closeness the investigations additionally presume that the deterrent towards this objective is chiefly because of the absence of government support. The possibility that le gislature doesn't bolster reassuringly the foundations set to detail arrangements with respect to the advancement of the female populace and furthermore doesnt make strides

Anthopologist Term Paper Example | Topics and Well Written Essays - 1000 words

Anthopologist - Term Paper Example Relocation is the development of individuals starting with one nation then onto the next for causes that are either for greener field or openings; want to appreciate majority rule opportunity from struggle circumstances or for instruction, retirement or delight for new atmosphere; and for a sample of better political authority. In United States, the example of movement created anent with geopolitical development of United States of America in other significant areas of the world. This is reflected to the sort of nationals US have nowadays who originated from various shafts of the world with particular social structures, verifiable roots, political affiliations, financial characters and social settings. A typology of foreigners demonstrated that they originated from Europe, Asia, Latin America and different territories of the world. They all leave their families, properties and the way of life which formed them to meander into bigger networks that require significant alterations in wa ys of life notwithstanding vulnerabilities, of new laws, standards and social structures that could either acclimatize them or underestimate them. Movement in this manner represents a test on how social relationship and collaborations are obliged in the standard of American culture with consoling feeling of belongingness. Numerous accounts delineate tragic and incredible stories about issues on racial and personality that may identify with white’s pilgrim extension and financial misuse or to racial segregation of African blacks which took a Hegelian accomplishment toward inborn unification and battle for autonomy. This demonstrated vagrants passed notable biased procedures which isolated them from the white in an ideation that their skin and personalities are stepped with mediocrity. This partiality is a position made by prevailing race with an impressive inclination and thought of detesting someone else due too their local social characters. In the event that such is really showed in practices by precluding or abusing others based on participation, this becomes separation. The last develops into an institutional separation if bias and underestimation are done efficiently as a state approach. A great case of this case is the ironclad detachment of high contrast because of Apartheid policyâ€a law that socially isolate individuals by custom and laws and from high contrast. This made issues on reconciliation, authoritative association, access to the utilization of social offices, and therefor cause abberations, disparities or imbalances in economy, governmental issues or choice makings, height of very lives, doubt in social relations and, hence, causing ethnocentrism and interracial clashes in different structures. The circumstance propelled on US managers to discourse about relocation, race and ethnicity in scan for shared opinion and to perceive basic qualities, for example, opportunity, rights, reasonableness, security and equity in light of developi ng requests of settlers for the state to look earnestly into. The arrangement of national discoursed likewise arrange viewpoints whether race is a critical issue in America and about the profound effect of ethnicity during the time spent incorporating and mainstreaming new individuals into American overlay. Such implied a verbose conversation about getting to and giving equivalent chance and equivalent assurance, training, occupations, medicinal services and in benefiting for equity under the law. It likewise inspired America to upgrade their comprehension of migrant’s history by featuring in discoursed the encounters of Natives, Afro-Americans, Latinos,

Taking AP European History Essay Samples

Taking AP European History Essay SamplesTaking AP European history essay samples can be helpful in preparing for the exam. Many students do not take the time to prepare for this portion of the exam. The test will cover a wide range of material, but students need to know what is on it before they even begin studying. The AP European history essay sample provides some of the best material that students should have on hand when they are taking the exam.The essay samples cover a wide range of topics, including the eras of ancient Greece and Rome, the Middle Ages, and the Renaissance, to modern times in Europe and North America. The aim of the test is to compare and contrast different cultures. Students should pay particular attention to these types of eras. It is important to be familiar with the materials used and the time period during which they were written.AP European history requires a thorough knowledge of the cultural customs and traditions of the period in question. Students mus t be able to identify the major civilizations in Europe and the different languages they spoke. Students will need to apply their knowledge of ancient Rome and Greece to the countries that they will study in detail.Students who plan to take the AP European history exam may want to begin their preparation with a review of the materials in the course. The various types of assignments in each section can be found online and in the AP European history literature guide. This can make reviewing easier.The AP tests will consist of multiple-choice questions. These allow the test taker to check all of the relevant information needed for the assignment. The essay sections in the test will not be as difficult but will require students to be well-prepared for both content and composition.The student should make sure that they are prepared for every type of question on the test. They should also write their essays in the manner that they will answer the questions. Most students will need to edit the essay so that it closely mirrors the way that they will answer the questions.Exam preparation can help prepare students for the AP European history exam. They should be familiar with the materials and understand what the questions mean. In addition, they should be able to demonstrate an understanding of the various periods in which the questions are used and the events that the writers will be examining.AP European history writing samples are perfect for students who want to improve their writing skills. Students will benefit from studying and writing about each period they will cover. By paying close attention to the material used and the time period covered, students will be able to prepare themselves for the AP European history exam.

The Benefits of Recycling Plastics

Plastics are used to manufacture an incredible number of products we use every day, such as food and beverage containers, trash and grocery bags, cups and utensils, childrens toys and diapers, and bottles for everything from mouthwash and shampoo to glass cleaner and laundry detergent. And thats not even counting all the plastic that goes into furniture, appliances, computers,  and automobiles. Suffice it to say, one good reason to recycle plastic is that there is just so much of it. Why You Should Recycle Plastics Plastic Use Is Growing As the use of plastics has increased over the years, they have become a larger part of our nations municipal solid waste (MSW)—growing from less than 1% in 1960 to more than 13% in 2013, according to a report by the Environmental Protection Agency. According to Statista, bottled water sales have been steadily increasing for the past decade: The U.S. saw 8.45 billion gallons of water sold in 2009, and that number reached 13.7 billion gallons in 2017. America is the worlds leading consumer of bottled water, and, clearly, that trend continues to grow. It Conserves Natural Resources and Energy Recycling plastics reduces the amount of energy and resources (such as water, petroleum, natural gas, and coal) needed to create plastic. According to a 2009 study by researchers Peter Gleick and Heather Cooley  from the Pacific Institute of California, a pint-sized bottle of water requires about 2,000 times as much energy to produce as the same amount of tap water. Recycling Plastics Saves Landfill Space Recycling plastic products also keeps them out of landfills. Recycling one ton of plastic saves 7.4 cubic yards of landfill space. Thats not to mention the discarded plastic that ends up directly in the environment, breaking down into tiny pieces to pollute our soil and water and contribute to the oceans Great Garbage Patches. It's Relatively Easy Recycling plastics has never been easier. Today, 80% of Americans have easy access to a plastics recycling program, whether they participate in a municipal curbside program or live near a drop-off site. A universal numbering system for plastic types makes it even easier. According to the American Plastics Council, more than 1,800 U.S. businesses handle or reclaim post-consumer plastics. In addition, many grocery stores now serve as recycling collection sites for plastic bags and plastic wrap. Room for Improvement Overall, the level of plastics recycling is still relatively low. In 2012, only 6.7% of plastics in the municipal solid waste stream were recycled, according to the EPA. Alternatives to Plastic While recycling is important, one of the best ways to reduce the amount of plastic in our nations MSW is to find alternatives. For example, reusable grocery bags have seen a growth in popularity in recent years, and they are a great way to limit the amount of plastic that needs to be generated in the first place.

Giovannis Room - 1365 Words

Giovannis Room In James Baldwins second novel published, we meet a young American called David. He has left his home country to live in Paris. In the first meeting with this man, he stares out a window and thinks about his life. Even this early in the book we get an impression of everything not being in its right place. This is where emptiness lives. As Davis starts to tell about his life as a young boy in America, he lets us know about his mother dying far too young, and him being raised by his father and aunt. Davids dad is stereotype of a man and their emotions. He and his son never have a close relationship. Even when David gets hurt in an accident, his father doesnt want him to cry. He wants him to be a man, a manly man and†¦show more content†¦Baldwin, him self, was a gay man, and probably knew what he was talking about. He meant that the worst crime in the world was being inauthentic, in other words not being true to your self. After his weeks with Giovanni, David gets a letter from Hella, the girl who left him to find her self in Spain. She is now returning to Paris to accept his proposal. This forces the young American to choose; the convenience of choosing a girl or the happiness he has with Giovanni. . He wants to be an ordinary husband to Hella, a good and descent son to his father and deep down, all he wants is to be with Giovanni. He is torn in different directions, but decides to take what he thinks is the easiest way, to marry a woman. Of course, this decision is bound to end in a failure. Once again David defies his feelings by doing what he thinks is right. When David came to see Giovanni for the last time, the young Italian said some very honest and true words; ‘You want to be clean. You think you came here covered with soap and you think will go out covered with soap- and you do not want to stink (Â…) You want to leave Giovanni because he makes you stink. You want to despise Giovanni because he is not afraid of the stink of love Its not before he finds himself in the south of France with his wife to be, that he realize what a big mistake he has done. Then its too late. Giovanni is committed for murder and is facing the guillotine. All this could have beenShow MoreRelatedGiovannis Room643 Words   |  3 PagesENGL-154 Paper #2 Aarthi Ramesh ‘David’s Un-Happy Ending’ Loneliness is a central theme governing the interactions of the characters pertaining to the novel, Giovanni’s Room. David’s words are a source of wisdom for why loneliness so frequently follows the actualization of love. He says, â€Å"With this fearful intimation there opened in me a hatred for Giovanni which was as powerful as my love and which was nourished by the same roots† (p 84). BaldwinRead MoreJames Baldwins Giovannis Room Essay843 Words   |  4 PagesJames Baldwins Giovannis Room James Baldwins Giovannis Room: Function of Parents in the Identity Struggle James Baldwins novel, Giovannis Room presents the struggle of accepting homosexuality as one young mans true identity. One way in which Baldwin presents this issue is through the character David and the forces of his father and dead mother. Davids father has an idealized vision of his son as rough and masculine which leads DavidRead MoreEssay on Analysis of Baldwins Giovannis Room1878 Words   |  8 PagesBaldwin portrays sexual oppression in his novel entitled, Giovannis Room. Sexual oppression is exemplified through individual homosexual white men who are unable to find happiness or contentment in themselves or in everyday relationships. In Baldwins Everybodys Protest Novel he writes, but our humanity is our burden, our life; we need not battle for it; we need only to do what is infinitely more difficult-that is, accept it. Giovannis Room is about each individuals need to accept their ownRead More Comparing Love in Go Tell It on the Mountain, Giovannis Room, and Another Country2405 Words   |  10 Pages     Ã‚  Ã‚  Ã‚   Baldwin’s first three novels -Go Tell It on the Mountain, Giovannis Room, and Another Country-boil over with anger, prejudice, and hatred, yet the primary force his characters must contend with is love.   Not meek or mawkish but ...something active, more like fire, like the wind (qtd. in ONeale 126), Baldwins notion of love can conquer the horrors of society and pave the way to emotional security (Kinnamon 5).   His recipe calls for a determined identity, a confrontation with and acceptanceRead MoreGiovannis Room Essay1336 Words   |  6 PagesGiovannis Room In James Baldwins second novel published, we meet a young American called David. He has left his home country to live in Paris. In the first meeting with this man, he stares out a window and thinks about his life. Even this early in the book we get an impression of everything not being in its right place. This is where emptiness lives. As Davis starts to tell about his life as a young boy in America, he lets us know about his mother dying far too young, and him being raisedRead MoreJames Baldwins Giovannis Room1445 Words   |  6 Pagesabstract concept, one that seems to go unnoticed until it is violated. When observed using Western culture, the entire nature of the concept of privacy relates to it being particularly special or sensitive to an individual. In James Baldwin’s novel Giovanni’s Room, the reader encounters tension between the main character, David’s, perception of privacy and the reality he encounters while living in France. David is a young American who has recently become engaged to his girlfriend, Hella. However, David’sRead MoreGiovanni s Room Essay : What Makes You More Of A Many?1258 Words   |  6 PagesBenno Batali 9/22/14 Paul Barron Giovanni’s room essay What Makes You More of A Many? James Baldwin’s novel â€Å"Giovanni’s Room† deals with the principal character David, and his struggle to affiliate him self with who he really is as a homosexual. Specifically the book focuses on David’s denial of his relationship with another man, Giovanni, as well as the ideas of male dominance and masculine identity. First we need a little background of Baldwin. A native New Yorker, Baldwin was born in HarlemRead MoreMain Theme Of Giovannis Room1219 Words   |  5 PagesHigh School. He wrote his first book in 1953, and published his second novel three years later in 1956. Giovanni’s Room was the tip of the controversial iceberg, but for the author it was his way of letting out his civil rights politics and opinions. In Giovanni’s Room, the material sheds light on social adversity and alienation regarding homosexuality and race. The primary theme of Giovanni’s Room is homosexuality and the psychology behind the protagonist’s experience, the perception of society, andRead MoreGiovanni s Room By James Baldwin1723 Words   |  7 PagesThe two novels Giovanni’s Room by James Baldwin published in 1956 and Price of Salt by Patricia Highsmith published in 1956 share the interest of both the main characters having trouble publicizing their sexual orientation due to the way society would view them. There location of living have a big impact on their actions of expressing their sexuality towards other people or themselves. During the 1950’s, homosexual activity was prohibited. People who were found having an affair with the same sexRead MoreDiscrimination Against Homosexualsandafrican- Americans1319 Words   |  6 Pagesrecognition. The salient themes discussed in a larger framework throughout the literature were not socially acceptable at the time. In his works Giovanni’s room and A Fire Next time, Baldwin exposes the similar feelings and circumstances that both homosexual and African American individuals experienced during the greater part of the 20th century. Giovanni’s room was one of James Baldwin’s extraordinary fictional stories. The main character David is a white man who discovered and explored his true sexuality

The Impact Of Media On Women s Perceptions Of Image,...

Media plays a huge role in people’s perceptions of image, gender roles, and overall self worth. The media is constantly reinforcing limiting stereotypes through television, advertisements, films, and more. These stereotypes are especially geared towards women, suggesting that they have to look and act in an overtly feminine manner in order to be accepted by society. Though there are stereotypical qualities of men illustrated in media as well, they are mostly suggesting that men are dominant and hold more power than women. Therefore, women are more negatively affected by the media than men through stereotypes and gender roles implying they aren’t capable of doing what men can. Women in the media are underrepresented, hypersexualized, and shown in very traditional roles that undermine their abilities. Women are significantly underrepresented in today’s media. The media inaccurately displays proportions of males and females in the population, which erroneously suggests that men are the cultural standard, therefore suggesting that women are imperceptible or not as important. There are trends of women being less apparent than men present in news coverage, film, and even children’s television programs. Women’s Media Center, a nonprofit organization working to ensure that women’s voices in media are heard, conducted a study that found that â€Å"Men were 69.2 percent of all TV news directors in 2014. Women were 30.8 percent, up from 28.7 percent in 2013†¦Ã¢â‚¬  (Gray). Though the numbersShow MoreRelatedAdvertising Advertisements And Body Image1645 Words   |  7 Pagesindustry and SROs in ensuring that women and men continue to be portrayed positively and responsibly in advertising. History - WOMEN IN ADVERTISEMENTS AND BODY IMAGE Authors have also attempted to correlate various demographic variables such as age and education, as well as geographic variables with preferences for role portrayals in advertising. Through the ages men have been considered to be financial providers, career-focused, assertive and independent, whereas women have been shown as low-positionRead MoreThe Impact Of Social Status On Sports And Physical Activity1362 Words   |  6 Pageswithin society on a much larger scale. It evaluates the impact of social status on the types and levels of participation in sport and physical activity. The impact of power and relationships within society and the distribution of sporting resources and rewards on participation in sport and physical activity are also covered within the structural level of the framework. The interpersonal level is the relationship that affects an individual s participation and access to sport. The interpersonal levelRead MoreSelf Esteem And Body Image1263 Words   |  6 Pag es Self-Esteem Body Image â€Å"When you accept yourself the whole world accepts you.†Self-esteem is used to describe a person s sense of self-worth. Self-esteem can involve different of beliefs about themselves, such as belittling their own beliefs, appearance and behaviors. Body image is your own attitude towards your body. It’s how you see yourself, how you think and feel about the way you look. Self-esteem and body image can also be influenced by age, your ownRead MoreSocietal Expectations And Media Influences Of Body Image Essay1769 Words   |  8 PagesExpectations and Media Influences of Body Image Numerous studies have been conducted on the various aspects of the impact and societal expectations held by north America and the impacts that it has on today’s youth. Body Image is a picture or mental image of your own body and how you view it.However, during my research process, there were very few sources that supported the media’s projection of body image. As we explore all the aspects of what body image really is and what impact may the media play inRead MoreWomen and Body Image3391 Words   |  14 PagesEleven million women in the United States suffer from eating disorders- either self-induced semi-starvation (anorexia nervosa) or a cycle of bingeing and purging with laxatives, self-induced vomiting, or excessive exercise (bulimia nervosa) (Dunn, 1992). Many eating disorder specialists agree that chronic dieting is a direct consequence of the social pressure on American females to achieve a nearly impossible thinness. The media has been denounced for upholding and perhaps even creating the emaciatedRead More The Medias Influence on Body Image Essay4394 Words   |  18 Pages Eleven million women in the United States suffer from eating disorders- either self-induced semistarvation (anorexia nervosa) or a cycle of bingeing and purging with laxatives, self-induced vomiting, or excessive exercise (bulimia nervosa) (Dunn, 1992). Many eating disorder specialists agree that chronic dieting is a direct consequence of the social pressure on American females to achieve a nearly impossible thinness. The media has been denounced for upholding and perhaps even creating the emaciatedRead MoreBarbie the Teenage Fashion Doll Essay examples1212 Words   |  5 PagesThe idea of Barbie came about when a woman named Ruth Handler was watching her daughter play with dolls. In the 1950’s, girls of all ages only had paper or cardboard dolls to play with and preferred to play with cut outs of teenagers and adult dolls. So, Ruth Handler thought to ma ke The Teenage Fashion Doll for older girls, as a three dimensional doll, called Barbie, named after her daughter Barbara (Heppermann 2010). However, Mrs. Handler met resistance when she went to her husband with the ideaRead MoreWomen s Objectification Of Women3147 Words   |  13 PagesObjectification of Women in Media An Assignment Submitted by Name of Student Name of Establishment Objectification of Women in Media Introduction The mass media, in all the diversity, prevail in the contemporary society. Indeed, media technologies, as a means for mass communication, are, virtually, unavoidable, especially with the introduction of new mobile devices that enable constant access to Internet. On the one hand, the ubiquity of media enhances their attributed role as a major informationRead MoreEffective Communication And Interpersonal Communication Essay1995 Words   |  8 Pagesdistractions, or irrelevance to the receiver: If the person is not interested or cannot relate, noise is making it difficult to hear one another or making it too difficult to concentrate or give undivided attention †¢ Cultural differences and differences in perception and viewpoint: If you cannot relate or see eye to eye, way of life and beliefs, values, and morals are not mutually understood. †¢ Physical disabilities such as hearing problems or speech difficulties: Inability to comprehend or understand. DifficultyRead MoreA Black Girl s Sexual Journey1953 Words   |  8 PagesNovember 14, 2016 A Black Girl s’ Sexual Journey Multidisciplinary Paper Jocelyn Bishop Word Count: 1,744 Within the history of representation of the Black Woman on network television, content creators have reinforced images and ideals that a dark-skinned sister is no more than a deviant sexual object used for men’s pleasure. She is represented as a woman with an innate fire within her, but rarely ever the object of unbiased love and affection. Many scholars and media critics blame the lack of

Stress Taken by Leaders

Question: What is the lesson here? What is the take-home message here? Answer: This study mainly deals with explanation on the reason behind stress taken by leaders as well as managers (Johnson et al., 2013). Leading team is a stressful job and excessive tension on their part leads to burnout on an adverse form. It is advisable to remain patient at work and prepare commotion list of all the daily activities that needs should be performed. Leaders have lot of responsibilities in alignment with serious stress and tension. It is recommended to manage with stress as far as possible. Managing stress with regular exercise and engaging in social activities for building strong relationships (Girdano et al., 2012). Reference List Girdano, D., Dusek, D. E., Everly Jr, G. S. (2012). Controlling stress and tension. Pearson Higher Ed. Johnson, S. J., Holdsworth, L., Hoel, H., Zapf, D. (2013). Customer stressors in service organizations: The impact of age on stress management and burnout. European Journal of Work and Organizational Psychology, 22(3), 318-330.

Analysing The Parable Of The Sower Religion Essays

Analysing The Parable Of The Sower Religion Essays Analysing The Parable Of The Sower Religion Essay Analysing The Parable Of The Sower Religion Essay Essay Topic: Parable Of the Sower The Parable of the Sower is found in each of the synoptic Gospels, every bit good in the Book of Thomas. But why? Each of the authors must hold seen fit to include it for some ground or another. Luke saw the manner in which the fable could be used to turn to the hapless people of his clip. His concerns for the financially impaired and castaway were some of the most outstanding facets of his Gospel. He was besides really concerned with the predicament of adult females during his clip. Although it is found in the New Testament, many Church Fathers have written commentaries on this parable, analyzing different facets of the narrative and explicating their symbolism. The Parable of the Sower is non a actual narrative of a husbandman ; it is a manner in which Jesus conveys the message of God s Kingdom to the people who were listening by comparing himself and the message of God to a sower and a seed. Luke does non bespeak where Jesus is when he is giving this parable. However, it is known that Jesus is going with his apostles and with a group of Galilean adult females. This same group of adult females will besides go with Jesus to Jerusalem and be informants to his decease. But for now, they are prolonging their gypsy teacher out of their ain agencies ( Just 130-137 ) . It is besides of import to observe that going with adult females in this manner is counter-intuitive when looking back on the civilization of the clip. Womans were practically second-class citizens and the fact that Jesus was conveying them with him fits really nicely into Luke s positions of adult females s rights and demands during the clip he was composing. The crowd that Jesus is prophesying to is a slightly random mixture of people. The transition states a great crowd gathered and people from town after town came to him ( Luke 8: 4 ) . This suggests that there is a consolidative subject behind Jesus narratives. His ability to learn is impressive, but the fact that he can make out to so many people, including Greeks, Romans, Jews and Gentiles, is intriguing. There are adult females in the crowd every bit good, which comes as another surprise. The normal Semite tradition would non let adult females in an country or session such as this. Besides, it is noted that Jesus household is in the crowd, waiting to see him. He responds, stating that My female parent and my brothers are those who hear the word of God and make it ( Luke 8: 21 ) . This implies that Jesus has cut some of his secular ties and that the 1s who act in conformity to God s will is his household. This subdivision of the book consists of two chief parts: the parable and Jesus account of the parable. Jesus helps his adherents to understand his words, yet still uses a big sum of symbolism when he talks. For illustration, he spoke often about ears. Ears, in a scriptural context, frequently represent the credence or rejection God s word ( Macmillan Dictionary ) . Harmonizing to Cyril of Alexandria, Jesus clearly divides people into two classs: those who have been given by God cognition of the enigmas of the land, and the remainder, who do non cognize the enigmas ( Just 130-137 ) . Cyril is in understanding with the symbolic impression of ears because both transitions seem to split the audience into two cantonments: those who have heard or accepted God s word and those who have non. Both of these thoughts are utile in explicating this transition because Jesus subsequently says Let anyone with ears to hear listen, ( Luke 8: 8 ) proposing that anyone who has the capacity to hear and that is willing to understand and accept God s message should listen to his words. Basil the Great says that the ear gives entree to the bosom and the interior individual ( Just 130-137 ) . In this sense, the ears are an effectual manner of making a individual. By sharing the message of God, Jesus is efficaciously seeding the seeds of a fledgeling faith. Another word that is often used in the transition is seed. The seed, though it is chiefly used for agricultural intents, is described to exemplify forms of growing in the land of God ( Macmillan Dictionary ) in scriptural texts. In this instance, the seed is supposed to stand for the word of God and how it is received among the assorted peoples of the clip. Cyril of Alexandria says, in add-on to placing the seed as the Word of God, Jesus besides implies that the birds are the Satan, who snatches the good seed on the way ( Just 130-137 ) . The Satan is snaping the good seed by taking from the memory the words of the catechetical talks, says Symeon the New Theologian. Even the objects that impede the seeds growing on the way, such as the dry land and the irritants have implicit in significances. Ephrem says that the thankless psyche is like a tract for immorality and that the Word of God finds difficult dirt during times of persecution ( Just 130-137 ) . In this subdivision, Ephrem is indicating out that it is hard for the Word of God to distribute during times of utmost persecution. Peoples will be less likely to hear the Word if there is a solid menace of decease attach toing it. If the seed is the word of God, so the sower, the one distributing the seed, must be Jesus. Many Church Fathers wrote commentaries refering this portion of Luke s Gospel. They all tend to hold that Jesus was the sower in this fable. Harmonizing to Clement of Alexandria, he ( Jesus ) is the lone agriculturist of the dirt from the foundation of the existence. Cyril of Alexandria says Jesus is the sower who sows the seeds ( Just 130-137 ) . Even Origen seemed to hold, composing that Seed should non be sown beside the manner but in the manner itself, which is Jesus, who is the Way ( Just 130-137 ) . These three interpreted the parable to intend that Jesus is the chief figure of the parable. The sower is responsible for the future growing of the works and is supposed to works the seed where he thinks it will outdo flourish. If Jesus is the sower, it is his duty to make his best to give the seed a proper topographic point to get down and to assist the word of God spread every bit rap idly as possible. The Parable of the Sower is an of import message. However, it is known that Luke was non an eyewitness to most of Jesus ministries. Therefore, many of his histories must hold been taken from others. Because he is a secondary beginning, there are many differences in entering between his Gospel and the others. The disagreements normally concern what Jesus really said. For illustration, the Gospel of Matthew provinces that the individual who is like the seed sown along the way does non understand the word of God and is hence susceptible to the evil 1. However, Luke suggests that the word of God is stolen and that the people are non given the chance to understand it ( Hultgren 180-202 ) . The difference is that Matthew writes that a individual ( remarkable ) does non understand the word of God, where Luke suggests that the people ( plural ) are non given the word so hence they are robbed of the chance to understand God s message. Luke writes so that the people who are hapless or friendl ess can associate more readily to Christian beliefs. If they think that they are downtrodden because they have non been exposed to the message, they are more likely to accept the message in hopes of a better hereafter. Another facet that should be examined is the differences between the relations of the parable. The narrative appears in all three of the Synoptic Gospels, every bit good as the Coptic Gospel of Thomas. There are non any serious textual and translational jobs between the texts, aside from the aforesaid disagreements refering what Christ really said. However, the order in which the fables were written is evident. After analyzing verbal similarities between the Gospels, it can be concluded that both Matthew and Luke based their relation of the parable on Mark s version. Matthew writes in a really similar manner, which would bespeak that he drew his stuff from Mark. Luke s version is much shorter than Mark s ( Hultgren 180-202 ) . This shows that he borrowed stuff from Mark because it would be hard for him to compose a longer version of a narrative that he did non informant. The Parable of the Sower is one of the narratives that is used in each of the Synoptic Gospels. It has values that each of the authors can pull strings to suit their docket. Luke used the parable as a manner to turn to the demands of the hapless, the downtrodden, the castaway and the adult females. By using what Jesus said and somewhat altering the diction, he was able to link the message of God to the people with which he was concerned. He was a talented author with much more literary pattern than most of the people during his clip. However, the narrative that he relays about Jesus interactions with the hapless people have been the topic of examination by tonss of scriptural bookmans. Church Fathers look into fables like this one in order to understand the deeper significance behind the Word of God. It is this examination that displays the writers single concerns with the people of the clip. Luke s feelings toward the hapless and oppressed are highlighted by authors such as Origen and Cyril of Alexandria as they dig deep into the symbolism of Luke s authorship. However, this parable sheds another visible radiation on Jesus, demoing him as a instructor who accepts those who follow God s will as his household. The narrative that Luke portions is non about a husbandman and a seed ; it is about Jesus and his message. What we choose to make with that message now is all that affairs.

Cancer management The WritePass Journal

Cancer management Introduction Cancer management IntroductionLiterature review criteria:Primary search terms:Secondary search terms:Exclusion criteria:Patient case presentationScreening and HPV testingFertility preservationPsychological SupportChemotherapy and TrialsConclusionReferencesRelated Introduction The aim of this case report is to provide a source of information regarding patients with Bulky stage 1B cervical cancer by focusing on optimum care and treatment pathway of a patient.   The author aims to describe important scientific observations from clinical trials, and therefore provide insightful information to expand knowledge and new research already present. Despite a ‘well established’ UK screening programme for detecting cervical pre-invasive disease there are still approximately 2,800 cases of cervical cancer per annum and 1,000 women still die from cervical cancer each year (Cancer research UK, 2003). The case study focuses on a patient with squamous cell carcinoma of the cervix uteri (exocervix and endocervix), poorly differentiated and staged by FIGO staging system at IB2 N1 (appendix A). The FIGO staging system (Appendix 1), is based on clinical evaluation (inspection, palpation, colposcopy), radiological examination of chest, kidneys, and skeleton, and endocervical curettage and biopsies.   The FIGO staging recommendations were last revised in 1995.   Stage IB (T1b) includes all invasive tumours limited to cervix larger than stage 1A2 lesions.   Stage T1b occult is no longer used.   Stage IB lesions (confined to cervix) were subdivided into stage IB1 clinical lesions (≠¤4cm in size) and stage IB2 lesions (4cm in size).   There were no changes in other stages, including the 1987 definitions of stages IA, IA1, and IA2 (FIGO, 1995). Brady et al (1999) acknowledge squamous cell carcinoma of the uterine cervix originating at the squamous columnar junction (transformation zone) of the endocervical canal and portio of the cervix.   This lesion is frequently associated with severe dysplasia and carcinoma in situ, which has the possibility of progressing to an invasive carcinoma in 10 to 20 years. The malignant process breaks through the basement membrane of epithelium and invades the cervical stroma.   If invasion was less than 3mm, the lesion was classified as microinvasive or superficially invasive (stage IA1) the probability of lymph node metastasis is about 1% (Bohm et al, 1976). Perez et al (1998) suggested incidence of pelvic node metastases to be approximately 15% in stage IB, 25% to 30% in stage IIB, and 50% in stage IIIB disease.  Ã‚   Incidence of para-aortic node metastases was found to be approximately 5% in stage IB, 19% in stage IIB, and 30% in stage IIIB disease. Fagundes et al (1992) submitted the tumour may spread to adjacent vaginal fornices or to paracervical and parametrial tissues, with eventual direct invasion of bladder, rectum, or both.   They advocated the most common metastatic sites as lungs (21%), para-aortic nodes (11%), mediastinal and supraclavicular lymph nodes, bones, and liver. Literature review criteria: The most recent form of literature available was published scientific articles in form of electronic journals. Literature found included, reviews on the subject of Cervical cancer and published clinical trials which demonstrated clinical benefits and subsequent evaluation.   Journals were accessed via internet using PubMed and Science Direct databases.   Papers were selected based on merit of abstract and relevant articles were extracted from reference lists. Primary search terms: ‘Cervical cancer’ ‘Squamous cell carcinoma of cervix’ ‘Cancer of the cervix’ Secondary search terms: ‘Poorly differentiated IB2 N1 Cervical cancer’ ‘IB2 N1 Cervical Cancer’ ‘Ovarian Transposition + Cervical Cancer’ ‘Phase 1 trials +Cervical Cancer’ ‘Treatment pathway + Cervical Cancer’ ‘Supportive care + Cervical Cancer’ ‘HPV + Cervical Cancer’ Exclusion criteria: Most of the references used were less than eight years old, although older articles were reviewed to note development of treatment. Patient case presentation The patient case is of a twenty two year old women (gravida 0, para 0).   She had no familial history of Cervical cancer or any other type.   She consumes two units of alcohol per week and is an occasional smoker with a one pack per year history.   She is currently employed and works thirty-six hour per week. In November 2008, patient presented with an abnormal cytologic (Papanicolaou) smear test and some postcoital spotting.   She denied any forms of vaginal discharge but remarked a feeling of heavy fatigue and pelvic pain. A general physical examination of the patient was carried out with special attention to supraclavicular (nodal) areas, abdomen, and liver.   A careful pelvic examination which included a bimanual palpation of the pelvis took place. Following an abnormal smear test the patient was referred for a colposcopic examination, where high grade cervical dysplasia was discovered.   The patient was consequently referred in October to her local hospital for a LLETZ (large loop excision of transformation zone of cervix) biopsy of cervix.   Specimens obtained during this procedure identified an invasive, moderately differentiated squamous cell carcinoma of large cell keratinising type.   Vascular invasion was not identified.   The tumour was staged as IB+. November 2008, contrast MRI of abdomen and pelvis completed, which concluded a large homogenous mass being seen arising from lower end of cervix extending slightly more to the right.   Cervical canal was noted to appear preserved and the endometrium and rest of uterus appeared normal.   There was suspicion of extension of tumour into the upper vaginal wall.   A right sided simple ovarian cyst was noted, with a normal left ovary observed.   A large lymph node was seen in the right pelvic sidewall highly suspicious of being metastatic.   No Para- aortic lymphadenopathy noted.   Concluding staging on MRI grounds was recorded as a Stage T2b, N2 cervical cancer. Based on MRI findings, patient was referred for EUA (examination under anaesthesia) for consideration of trachelectomy, in November.   Trachelectomy is a surgical removal of the uterine cervix.   EUA recorded a large 5cm exophytic tumour and on looking around it on 360⠁ ° no macroscopic infiltration into vagina was seen.  Ã‚   In order to give better definition an endo-cervical coil MRI was performed in December 2008, which further confirmed a definitive 6cm exophytic cervical cancer and enlarged right pelvic lymph node.   Due to this the patient was not an ideal candidate for a trachelectomy. The patient was next referred for a EUA, cystoscopy, colonoscopy, sigmoidoscopy and biopsies.   Procedure was uneventful. No vaginal or parametrial involvement were identified.   Cystoscopy, sigmoidoscopy and colonoscopy were normal.   This gave a concluding staging of Ib/2a. The patient’s case was discussed within a MDT (multi-disciplinary team) meeting.   Here it was decided that chemo-radiotherapy would be preferred treatment. The patient’s main concern was preservation of fertility due to her young age.   Due to the progression of disease and quick follow through from diagnosis to treatment, the patients family, patient and partner all became very distressed, and a referral was made to a specialist gynae – nurse, where information regarding treatment, prognosis and side effects could be explained and discussed again. The oncologist referred patient to a fertility specialist in December 2008, to discuss possible options for fertility sparing prior to patient commencing radiotherapy and chemotherapy.   From this meeting it was decided that the patient was to undergo ovarian transposition to exclude them from the radiation scatter effect from the proposed adjuvant radiotherapy. Within the same procedure in December, patient underwent a laparoscopic para-aortic node assessment, which subsequently defined the radiotherapy field.   The results of the assessment were discussed within a MDT meeting whereby it was found that the frozen section of the suspicious right obturator node confirmed malignancy, although, the para-aortic lymphadenectomy was negative.   Patients consent, height and weight were taken in order to calculate Cisplatin chemotherapy dosage needed for concomitant chemotherapy. December 2008, patient proceeded to commencing radiotherapy prescribed at 50.4Gy in 28 fractions with a four field technique at 10MV.   In addition to this she commenced her first concomitant chemotherapy of Cisplatin 40MG/M2 60MG, first of four cycles. The patient was reviewed throughout her radiotherapy and chemotherapy and tolerated both well with minimum side effects.   Subsequently the patient was consented for intrauterine and intravaginal high dose rate brachytherapy for February 2009. The patient was noted to be down and depressed and very tearful and expressed concerns of not coping.   The patient was referred to a CLIC/Sargent social worker for support and advice in January 2009. Prior to first fraction of brachytherapy, patient underwent EUA.   It showed a good regression of tumour, but was still bulky.   A smit sleeve was inserted as well as intrauterine tube and ovoids.   Patient was admitted for brachytherapy (16.5Gy to point A in three fractions) which proceeded without complication, patient was subsequently discharged.   Following brachytherapy, an external beam pelvic side wall boost was performed at 5.4Gy in three fractions. The patient was reviewed five weeks post treatment in March 2009.   She noted slight bowel changes and noticed that she was leaking small amounts of urine.   This was dismissed as radiotherapy related.   The patient was given vaginal dilators and provided with instructions as well as an explanatory DVD.   Patient relayed her fears of being re-infected by HPV.   Patient was encouraged to talk with long partner regarding HPV testing.   The patient also mentioned experiencing a few night sweats and hot flushes, actioning referral for an estradiol level, FSH and LH check. April 2009, patient was given news that hormonal tests taken showed signs of menopause.   Patient devastated as ovarian transposition was not successful.   Patient referred for hormone replacement therapy.   Three month follow up MRI scan and clinical examination revealed no sign of disease. July 2009, three months post follow up, patient seen in clinic complaining of recurrent pain in right upper quadrant.   Patient was on regular analgesics, but denied any per vagina bleeding or discharge.   Bowels and micturation not working properly, denied it being associated with pain.   Patient sent for CT scan of thorax, abdomen and pelvis in conjunction with FBC and U and E’s. Results of patient scans discussed within an MDT in August 2009, where it showed recurrent disease in the transposed side ovary.   The plan decided within MDT is to perform a diagnostic laparoscopy and removal of said ovary.   Patient and family were extremely distressed and emotional on hearing this news. Final pathology of biopsies taken laparoscopicaly in September 2009 confirmed malignancy in the right ovary.   Following discussion at MDM, decision made to give the patient three cycles of Carboplatin and Taxol and reassess to see if surgical excision were possible.   It was noted that peritoneal washings taken at time of biopsy were positive, which implies that peritoneal disease is elsewhere.   Patient was consented for further chemotherapy and was distressed about possibility of hair loss due to chemotherapy.   Patient was referred to MacMillan team for assessment of grant for financial assistance. An interval CT scan was taken post 3rd cycle of chemotherapy in November 2009.   This showed a response in disease with the mass having reduced slightly in size.   Patient proceeded with a further two cycles of chemotherapy with G-CSF support (granulocyte-colony stimulating factor) a growth factor that stimulates the bone marrow to produce more white blood cells. After the patient had finished five cycles of Carboplatin and Taxol, patient was consented and referred for a laparotomy and exploration of lesser sac and paracolic gutter in December 2009.   This showed evidence of metastatic disease in form of omentum nodules, which subsequently tested positive for metastases on frozen section.   The tumour was found in right hepatic flexure and was fixed to the right para-colic gutter involving head of pancreas and infiltrating liver.   From this discovery of metastatic disease, it was considered inappropriate to proceed with the proposed right hemicolectomy, cholecystectomy, resection of part of liver and excision of the Gerota’s fascia. Patient and family were understandably very distressed about intra-operative findings.   They were given a psychological support referral.   Family were seen by a clinical psychologist, although the patient declined the appointment, but opted to speak to a CLIC Sargent social worker.   Community palliative care team were to liaise and follow up with patient and family.   The patient and family were additionally put in contact with a local hospice within their catchment Based on findings the clinical oncologist felt that the Carboplatin and Taxol regime was ineffective in controlling disease progression and spread and was therefore stopped.   In December 2009, next chemotherapy line suggested was Topotecan, although a request was made to consider the patient for a Phase 1 agent. Due to patients increasing pain and problems with control the patient was not a suitable candidate for Phase 1 chemotherapy.   Therefore patient was commenced on fives cycles of standard palliative chemotherapy Topotecan in January 2010. Patient had extensive meetings and liaisons with social worker for young people.   Macmillan nurse, from hospice arranged for home visits to assess pain medication.   The patients ECOG performance was ranked as 1 (Appendix 2).   Re-staging CT was performed which showed an increase in size of tumour with further encroachment onto liver, new malignant lesions were identified as well as more dilated bowel loops. Patient completed intended cycles of Topotecan but was admitted for treatment of Sepsis with IV antibiotics in March 2010. Subsequent CT scans in April 2010 displayed disease progression despite Topotecan.   Patient commenced on Tamoxifen therapy due to her disease having some ER positivity. Patient’s family were seen separately from patient, advised of patient’s prognosis to be less than 6 months.   Patient’s mother raised concerns of patient expressing suicidal ideation.   Macmillan nurse visited patient’s home. May 2010, patients pain became difficult to control, home visit made by consultant in palliative medicine as patient became increasingly drowsy.   Patient deteriorated rapidly and was commenced on the Liverpool Care Pathway.  Ã‚   Marie curie nurse, present most evenings with patient at familial home. June 2010, patient passed away with family around her. Screening and HPV testing Since first being introduced as a screening test for cervical cancer by Papanicolaou in 1927 (Papanicolaou, 1928), the cervico-vaginal smear test has proved to be one of the most cost effective test within medicine.  Ã‚   The American Cancer society (1997) states that according to the National Cancer Institute, mortality rate from cervical cancer has dropped   70% over the last 70 years. Currently only 30% of cervical cancers are screen detected, the majority of these cases occur in women who have never had a smear (PAP- Papanicolaou) test or regularly attend a screening programme.   The patient discussed (patient A), was part of this statistic as she had never had a smear test due to the UK cervical screening age being 25.   Patient A presented with symptoms aged 22.   Standard practice within the UK is for women aged between 25 and 60 to be contacted every 3 to 5 years and asked to go for a cervical screening test.   In patients A case, a smear test was only done due to other symptoms such as post coital bleeding. An article in ‘The Times’ (2009) confirmed that new guidance will be issued to all GP’s and practice nurses to increase awareness and management of cervical cancer, but age at which women are screened will not be lowered to 20, announced by the department   of health.   This decision was finalised after a review by the Independent Advisory Committee on Cervical Screening (ACCS) which found that risks for women under 25 of false positive results and premature births outweighed benefit of identifying a â€Å"few extra cases†. The ACCS found that treating women for abnormal cervical cell changes has been linked to an increased risk of premature birth.   While women of all ages who are treated are more likely to give birth prematurely, benefits of screening older women outweigh this risk, the panel said. One in three women under the age of 25 will have an abnormal result compared with one in fourteen for older women, the ACCS said, meaning that there are many false positives identifying abnormal changes in cells that often return to normal without treatment. A study by Sasieni et al (2009) further confirmed the ACCS’s findings that cervical screening in women aged 20-34 is less effective than in older women.   By studying the effect of screening in smaller age groups, Sasieni et al showed that efficacy of screening decreases with decreasing age, even within the age 20-34.   On average, participation in the UK cervical screening   programme by a woman aged 35-64 reduces her risk of cervical cancer over the next five years by 60-80% and her risk of advanced cervical cancer by about 90%.   The benefit of screening for women aged 25-34 is more modest.   Screening in women aged 20-24 has little or no impact on incidence of cervical cancer under the age of 30. HPV is a factor being recognized as a major risk factor in pathogenesis of squamous cell carcinoma of   cervix.   Any woman who is sexually active is at risk of infection from human papillomavirus (HPV).   Patient A was sexually active from aged 16. De Villiers et al (2004) identified Over 100 subtypes of HPV. A significant proportion of HPV disease is attributed to four subtypes; 6, 11, 16 and 18. HPV subtypes 16 and 18 cause approximately 70% of cervical cancer cases worldwide. HPV subtypes 6 and 11 infections are responsible for genital warts (Wiley et al, 2002). Arbyn et al (2007) acknowledge that HPV is the major cause of nearly 100% of all cervix cancers.   This finding rapidly led to the development of vaccines against common and aggressive virus strains causing cervix cancer, the HPV genotypes 16 and 18 (Harper et al, 2006). According to Tornesello et al (2011), the role of HPVs in the etiology of cervical cancer precursor lesions and invasive carcinoma development has been well established.   Bouvard et al (2009) found that at least 12 viral genotypes of alpha genus (HPV types 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58 and 59) have been found associated with a high relative risk of cervical cancer and labelled carcinogenic to humans.   Although holding different prevalence rates, HPV types 16 and 18 were the most common viral types in invasive carcinoma of the uterine cervix worldwide (Li et al 2008). Cheryl et al (2000) explain the HPV as replicating primarily within the proliferating basal cells of squamous epithelium.   In order for the virus to infiltrate these cells, disturbance of the overlying epithelium must occur.   Once present in the basal squamous cell, HPV early genes are expressed, which lead to viral replication and host cell duplication. Previously no specific antiviral treatments existed for HPV-associated diseases, including genital warts, cervical, vaginal and vulval dysplasia as well as cervical cancer.   The development of vaccines against HPV is an attractive strategy for both prevention and therapeutic intervention against genital tract HPV infections (Sherman et al, 1998). Two HPV vaccines have been developed: Cervarix ® (GlaxoSmithKline, London, UK) a bivalent HPV (types 16, 18) vaccine and Gardasil ® (Merck Co., Whitehouse Station, NJ), a quadrivalent HPV (types 6, 11, 16, 18) vaccine. Both are prophylactic vaccines that have been shown to be effective in young women prior to HPV exposure.   Following advice of the Joint Committee on Vaccination and Immunisation (JCV I) the Government and Department of Health (DOH, 2007) have introduced HPV vaccines for girls aged 12 to 13 years of age, starting from September 2008 (Garland et al, 2007).   This was implemented three months after Patient A’s diagnosis. Cricca et al 2006 recognised an increased interest being focused on HPV detection in cervical lesions.   They subsequently reported that detections of HPV DNA in the absence of cytological abnormalities may indicate persistent high-grade squamous lesions which may have been missed by PAP screening within the follow up of CIN3 – cervical intraepithelial neoplasia (severe dysplasia, carcinoma in situ- Dysplastic cells extend into the upper third and may occupy the full thickness of the epithelium) treated patients. A study carried out by Silvana et al (2007) found HPV testing significantly predicts disease clearance or persistence, in comparison to PAP smear whose results did not register any statistical significance.   The study further suggested that after treatment women should be followed up at 6-month intervals, for a minimum of 2 years with both PAP and HPV testing being carried out. Patient A only received HPV testing after her abnormal smear test was analysed.   Introducing routine HPV testing as part of screening process every three years could have had a marked impact on her prognosis. Fertility preservation Patient A’s initial main concern was preservation of fertility and a referral was made by the clinical oncologist for her to see a fertility specialist to seek advice.   In women who preservation of fertility is anticipated, an alternative to simple/radical hysterectomy is a radical trachelectomy. This process requires vaginal resection of cervix, upper 1 to2 cm of vaginal cuff and medial portions of cardinal and uterosacral ligaments. The cervix is transected at lower uterine segment and a prophylactic cerclage is placed at time of surgery . Landoni et al (1997) argue that for early stage disease, surgery conserves ovarian function and avoids effects of early menopause. They further propose that less shortening and fibrosis of vagina occurs compared to radical radiotherapy which gives better results in terms of residual sexual function.   Surgery was thought to be the preferred treatment option in young women excluding the presence of any contraindications.   Patient A fell into the young woman classification and initially had no contraindications to surgery.   Relative risks and benefits of different surgical management approaches should be thoroughly discussed with the patient on an individual basis (Shepherd, 2009).   Patient A had a thorough consent process prior to each surgical procedure and was put in contact with a specialist gynaecological nurse to answer any further questions. Patient A presented with a 5cm exophytic tumour.   She undertook a radical trachelectomy, although research suggests that it does not appear to increase rate of recurrence, provided tumour diameter is no greater than 2cm (Landoni et al, 2005).   Safety of radical trachelectomy in women with lesions that are greater than 2cm in diameter is not known as the majority of reported cases of radical trachelectomy have been in women with tumours less than 2cm in diameter.   A recent prospective multicentre study by Renaud et al (2004) of radical trachelectomy combined with laparoscopic pelvic lymphadenectomy reported three recurrences in 100 treated patients (FIGO IA1, IA2, and IB1). NICE (national institute for clinical excellence) guidelines (2010) state, that women requesting fertility conservation should be offered radical trachelectomy and pelvic lymph node dissection, providing   tumour diameter is less than 2cm and no lymphatic-vascular space invasion is present.   As established within the case notes, Patients A tumour presented at 5cms, which means guidelines were not properly followed. In addition to trachelectomy patient A underwent ovarian transposition.   Preservation of ovarian function is an important concern in premenopausal cancer patients whose treatments include external beam radiation to pelvic structures that incorporate ovaries applicable to patient A.   Ovarian transposition was developed to displace ovaries from their normal anatomic position and away from direct radiation, with goal of maintaining long-term ovarian function.   Ovarian transposition is seen as 40-50% successful (Shepherd, 2009). Techniques for ovarian transposition using a laparoscopic approach depend on radiation field size and location.   Tinga et al (1999) have described transposition of ovaries in a fixed position behind uterus (to lie beneath an external midline block) as well as a superior transposition to level of iliac crest. They contend that the disadvantage of midline oophoropexy (surgical fixation or suspension of an ovary) is a higher level of internal radiation scatter, as the area is generally surrounded by in-field radiation.   Morice et al (1998) reported a series of 24 patients who underwent ovarian transposition to paracolic gutters, before radiation for gynecologic malignancies.   Authors concluded that this procedure was a safe and effective method of preserving ovarian function. Complications in both of these reports were rare.   The fact of Patients A recurrence being at sight of transposition was noted as extremely rare and was the first case experienced by the clinical oncolo gist.   No literature was found outlining risks of recurrence of cervical cancer with ovarian transposition.   It could be noted that perhaps Patient A’s size of tumour was too large for radical fertility sparing surgery. Psychological Support Patient A and her family experienced a great deal of distress during the care pathway.   In 1983 Derogatis et al acknowledged cervical cancer as having a significant psychological and psychosocial impact on the individual and felt it was important to develop strategies to deal with this. Fallowfield et al (2001) recognise psychological distress as being common in patients with all forms of cancer and advocate it as remaining undetected.   Regardless of socio-demographic characteristics or clinical characteristics, the well-being of patients with cervical cancer changes during the course of their disease (Greimel et al, 2000).   A study by Greimel et al (2000) of 119 patients’ newly diagnosed gynaecological cancer evaluated psychological well-being and functions of daily living before surgery, three months after surgery and one year after surgery. Greimel et al (2000) noted a decline in psychological well-being and functions of daily living scores at three months after surgery.   After one year there was a significant improvement in psychological well-being and no significant difference in functions of daily living compared to before surgery.   Greimel (2000) recognised that in patients treated with surgery, level of psychological distress may be related to extent of surgery. The multidisciplinary team (MDT) should routinely screen for presence of psychological distress and be aware of risk factors for very high levels of psychological distress from point of diagnosis onwards (including during follow-up review phases) (Fallowfield et al, 2001).   The MDT team involved with patient A routinely screened her psychological well-being and monitored it closely due to the young age of the patient.   Patient A had regular contact with a support group and social worker for young patients in a similar circumstance.   She was able to discuss matters which she was unable to share with her family and partner, such as body image and sexuality issues. As illustrated by Fallowfield et al (2001), many of psychological, physical and practical challenges facing women with cervical cancer are common to all cancer patients. These include, coping with shock of diagnosis, pain, nausea, fatigue and disfigurement from surgery as well as treatment worries over practical issues such as travel costs and loss of income.   These above challenges were all experienced by Patient A.   MDT supported the patient through these challenges.   There is evidence that providing psychological and practical support may have a positive effect on patients’ well-being (Slevin et al, 1996). Evidence identified in relation to support needs of cancer patients was from small heterogeneous studies such as Walker et al (1999) and types of help offered are very varied.   No studies found were specific to patients with cervical cancer but were comparable to cervical cancer population.   Interventions included structured psychological support, relaxatio n techniques, orientation programmes and general psychological support. The interventions reduced anxiety levels and improved quality of life.There are many national and local support services, for example, voluntary agencies, clinical nurse specialists, liaison psychiatry, clinical psychologists, local support groups, drop-in centres and day centres.   These support services may offer complementary therapy services, such as yoga, aromatherapy and reiki.   Reflexology was undertaken by patient A which, was offered by one of these support services. NICE guidelines (2010) state that â€Å"Patients with cervical cancer should be offered psychological support at time of diagnosis and at intervals throughout their management.   Information about local support services should be made available to patients.   Carers, families and dependants should be made aware of support available including local and national organisations. Multidisciplinary teams across healthcare settings should have agreed protocols for offering support for carers, families and dependants of patients with cervical cancer.†Ã‚   These guidelines were adhered to in the treatment of patient A. Near the end of Patients’ A life, a MDT decision was made to commence the Liverpool Care Pathway.   Over past few years a major drive has been underway to ensure that all dying patients, and their relatives and carers receive a high standard of care in the last hours and days of their life.   The Liverpool Care Pathway for the Dying Patient (LCP) is a key programme within the palliative care pathway for a patient. LCP was recognised as a model of best practice in the NHS Beacon Programme (2001).   It was recommended in NICE guidance on supportive and palliative care for patients with cancer (2004) as a mechanism for identifying and addressing the needs of dying patients.   It was recommended in the Our Health, Our Care, Our Say white paper 2006 as a tool that should be rolled out across the country.   It is recommended in the End of Life Care Strategy DH 2008. Optimal management of cervical cancer involves a multidisciplinary team as demonstrated in Patients A case.   The challenge for the team is to individualise treatment.   As cervical cancer commonly occurs between ages of 30 and 45, this includes offering women with early disease the option of having fertility conserving surgery, where appropriate.   Patient A did not fall into common age group for occurrence of cervical cancer. Patient A presented aged 22.   For those such as Patient A, with intermediate or advanced disease, aim is to minimise treatment side effects without compromising outcome. Chemotherapy and Trials Within the last ten years concomitant chemoradiation has been the standard of care for advanced cervical cancer.   Patient A received Cisplatin with radiotherapy followed by Adjuvant Topotecan.   Varying proposals have been made that to control occult metastatic disease adjuvant chemotherapy after chemoradiation will improve outcome. In 2009 Duenas-Gonzalez et al described results of a phase III randomized trial which compared chemoradiation with gemcitabine and cisplatin followed by adjuvant gemcitabine and cisplatin for two additional cycles VS chemoradiation with cisplatin in women with stage IIA to IVA cervical cancer.   Results showed a significant survival benefit for patients receiving chemoradiation plus adjuvant chemotherapy, the results concluded a 3 year survival of 74% in the chemoradiation plus chemotherapy arm against 65% in the chemoradiation arm.   In order to confirm these results future trials are imperative, Kitchener et al (2010) aim to randomise women receiving chemoradiaiton after radical hysterectomy to four additional cycles of carboplatin and paclitaxel or no additional therapy. Chemotherapy is recognised as a standard treatment for women with late stage disease and those with recurrence not eligible for chemoradiation or surgery applicable to patient A.   Monk et al (2009) published results of a phase III trial which compared 4 platinum containing doublets.   Patients were randomised to receive cisplatin combined with either paclitaxel (the reference arm), vinorelbine, gemcitabine or topotecan.   The results showed that progression free survival and response rates were similar in all four arms.   Cisplatin with paclitaxel was found to have the best toxicity profile with quality of life similar across the four arms Angiogenisis is the formation of new blood vessels that grow into the tumour, giving it nutrients and oxygen to assist its growth.   As with other cancers the role of anti-angiogenic targeted agents are of interest and importance in the treatment of cervical cancer.   A phase II trial of bevacizumab in women with persistent or recurrent cervical cancer concluded a median progression free and an average overall survival range 3.4 – 7.3 months thus showing favoribilty within cervical cancer (Monk et al, 2009).   Leading from the results of this trial Kitchener et al (2010) constructed a phase III trial where women are randomised to one of four arms using bevacizumab with cisplatin/paclitaxel or topotecan/paclitaxel. Monk et al (2010) identified Pazopanib as a second anti-angiogenic agent usuable within the cervical cancer patient population.   This agent is known as an oral tyrosine kinase inhibitor which targets the vascular endothelial growth factor receptor.   It was found that patients treated with pazopanib had a median overall survival of 50.7 weeks. Patient A received topotecan as a single adjuvant agent, if combined with an anti-angiogenic agent such as bevacizumab or pazopanib she may have had a prolonged life expectancy.   Funding, costing and PCT approval may have been a barrier to access. Conclusion Patients A case is a sad case.   The patient underwent ovarian transposition in order to preserve fertility but unfortunately the disease recurred at this site.   Perhaps if the transposition was not undertaken then she may have still been alive.   Ultimately it was the patient’s choice and due to the patients young age fertility preservation was very much applicable and supported by the clinician. There is a lot of controversy surrounding the topic of lowering the age of PAP smear testing and the standardisation of HPV testing as routine.   If patient A had had regular smear tests and HPV testing as research has proved beneficial her disease may have been identified earlier and put through radical treatment. The availability of anti angiogenic has not yet been standardised by some PCTs, patients A access to chemo drugs such as pazopanib may have prolonged her life further. Throughout the past years there have been many advances and discoveries in the prevention and treatment of cervical cancer,   Within the next five years there are many other advcances and technologies that will possibly impact the management of this common indiscriminatory disease.   Active areas of research that can change the management and practice include the use of PET/CT imaging to guide therapy and PET or high-field MRI to monitor response to treatment, combined use of hyperthermia and radiation therapy to treat locally advanced disease and the role of intensity modulated radiotherapy. Appendix 1 FIGO staging of cervical carcinomas Stage I: Stage I is carcinoma strictly confined to the cervix; extension to the uterine corpus should be disregarded. The diagnosis of both Stages IA1 and IA2 should be based on microscopic examination of removed tissue, preferably a cone, which must include the entire lesion. Stage IA: Invasive cancer identified only microscopically. Invasion is limited to measured stromal invasion with a maximum depth of 5 mm and no wider than 7 mm. Stage IA1:   Measured invasion of the stroma no greater than 3 mm in depth and no wider than 7 mm diameter. Stage IA2:   Measured invasion of stroma greater than 3 mm but no greater than 5 mm in depth and no wider than 7 mm in diameter. Stage IB: Clinical lesions confined to the cervix or preclinical lesions greater than Stage IA. All gross lesions even with superficial invasion are Stage IB cancers. Stage IB1: Clinical lesions no greater than 4 cm in size. Stage IB2: Clinical lesions greater than 4 cm in size.    Stage II Stage II is carcinoma that extends beyond the cervix, but does not extend into the pelvic wall. The carcinoma involves the vagina, but not as far as the lower third. Stage IIA: No obvious parametrial involvement.   Involvement of up to, upper two thirds of the vagina. Stage IIB: Obvious parametrial involvement, but not into the pelvic sidewall. Stage III Stage III is carcinoma that has extended into the pelvic sidewall. On rectal examination, there is no cancer-free space between the tumour and the pelvic sidewall. The tumour involves the lower third of the vagina. All cases with hydronephrosis or a non-functioning kidney are Stage III cancers. Stage IIIA: No extension into the pelvic sidewall but involvement of the lower third of the vagina. Stage IIIB: Extension into the pelvic sidewall or hydronephrosis or non-functioning kidney. Stage IV Stage IV is carcinoma that has extended beyond the true pelvis or has clinically involved the mucosa of the bladder and/or rectum. Stage IVA: Spread of the tumour into adjacent pelvic organs. Stage IVB: Spread to distant organs. Source: TNM Classification of malignant tumours. L. Sobin and Ch. Wittekind (eds.), UICC Internation Union against Cancer, Geneva, Switzerland, pp155-157; 6th ed. 2002 Appendix 2 ECOG Performance Status These scales and criteria are used by doctors and researchers to assess how a patients disease is progressing, assess how the disease affects the daily living abilities of the patient, and determine appropriate treatment and prognosis. ECOG PERFORMANCE STATUS Grade ECOG 0 Fully active, able to carry on all pre-disease performance without restriction 1 Restricted in physically strenuous activity but ambulatory and able to carry out work of a light or sedentary nature, e.g., light house work, office work 2 Ambulatory and capable of all self-care but unable to carry out any work activities. Up and about more than 50% of waking hours 3 Capable of only limited self-care, confined to bed or chair more than 50% of waking hours 4 Completely disabled. Cannot carry on any self-care. Totally confined to bed or chair 5 Dead As published in Am. J. Clin. Oncol. :Oken, M.M., Creech, R.H., Tormey, D.C., Horton, J., Davis, T.E., McFadden, E.T., Carbone, P.P.: Toxicity And Response Criteria Of The Eastern Cooperative Oncology Group. Am J Clin Oncol 5:649-655, 1982 References Cancer Research UK. (2003) UK Cervical Cancer incidence statistics [online]. Available from http://info.cancerresearchuk.org/cancerstats/types/cervix/incidence/Information Services Division. Cervix Uteri (ICD-9 180; ICD-10 C53). (Accessed 16th February 2011) Bohm, J.W., Krupp, P.J. and Lee, F.Y.L., (1976) ‘Lymph Node Metastases in Microinvasive Epidermoid Cancer of the Cervix’. Obstet Gynecol. 48(1) pp 65-67. Perez, C.A. (1998) Principles and Practice of Radiation Oncology, 3rd Ed. Lippincott-Raven Publishers. Fagundes, H., Perez, C.A. and Grigsby, P.W. (1992) ‘Distant Metastases after Irradiation alone in Carcinoma of the Uuterine Cervix’. International Journal Radiation Oncology, Biology, Physics. 24 pp 195-204. Sasieni, P., Castanon, A., Snow, J. and Cuzick, J. (2009) ‘Effectiveness of Cervical screening with age: population based case-control study of prospectively recorded data’. British Medical Journal. 339 pp 2968. Available from bmj.com/content/339/bmj.b2968.full.pdf.   Accessed 20th February 2011) Wiley, D. J., Douglas, J., Beutner, K., Cox, T., Fife, K. and Moscicki, A. B. (2002) ‘External Genital Warts: Diagnosis, Treatment, and Prevention’. Clinical Infectious Diseases. 35(Supplement 2) pp 210-24. Renaud, M. C., Plante, M., Francois, H. and Roy, M. (2004) ‘Vaginal Radical Trachelectomy: an oncologically safe fertility-preserving surgery. An updated series of 72 cases and review of the literature’. . Gynecologic Oncology, 94(3) pp 614-23. Landoni, F., Maneo, A., Colombo, A., Placa, F., Milani, R. and Perego, P. (1997) ‘Randomised Study of Radical Surgery versus Radiotherapy for Stage Ib-IIa Cervical Cancer’. Lancet. 350 (9077) pp 535-40. National Institute for Health and Clinical Excellence. (1999) Topotecan for the treatment of recurrent and stage IVB cervical cancer. Available from http://guidance.nice.org.uk/TA183/Guidance/pdf/English. (Accessed 20th February 2011) Tinga, D.J, Dolsma, W. V. and Tamminga, R. Y. (1999) ‘Preservation of Ovarian Function in 2 young Women with Hodgkin Disease by Laparoscopic Transposition of the Ovaries prior to Abdominal Irradiation’. Nederland Tijdschrift voor Geneeskunde. 143 pp 308–312. Morice, P., Castaigne, D. and Haie-Meder, C. (1998) ‘Laparoscopic Ovarian Transposition for Pelvic Malignancies: indications and functional outcomes’. Fertility and Sterility. 70 pp 956–960. Derogatis, L., Morrow, G. R., Fetting, J., Penman, D., Piasetsky, S. and Schmale, A. M. (1983) The Prevalence of Psychiatric Disorders among Cancer Patients. Journal of the American Medical Association. 249 pp 751-7. Fallowfield, L., Ratcliffe, V., Jenkins, V. and Saul, J. (2001) ‘Psychiatric Morbidity and its Recognition by Doctors in Patients with Cancer’. British Journal Cancer. 84 pp 1011-5. Greimel, E. R. and Freidl, W. (2000) ‘Functioning in DailyLliving and Psychological Well-being of Female Cancer Patients’. Journal of Psychosomatic Obstetrics Gynecology. 21(1) pp 25-30. Shepherd, J. H. (2009) ‘Challenging dogma: radical conservation surgery for early stage cervical cancer in order to retain fertility’. The Royal College of Surgeons of England – Hunterian Lecture. 91 pp 181- 187. Bouvard, V., Baan, R., Straif, K., Grosse, Y., Secretan, B. and EL, G.F. (2009) ‘A review of human carcinogens – Part B: biological agents’ . Lancet Oncology. 10(4) pp 321-322 Li, N., Franceschi, S., Howell-Jones, R., Snijders, P.J. and Clifford, G.M. (2010) ‘Human papillomavirus type distribution in 30,848 invasive cervical cancers worldwide: variation by geographical region, histological type and year of publication’. International Journal of Cancer. Tornesello, M.L., Losito, S., Benincasa, G., Fulciniti, F., Botti, G., Greggi, S., Buonaguro, L. and Buonaguro, F.M. (2011) ‘Human papillomavirus (HPV) genotypes and HPV16 variants and risk of adenocarcinoma and squamous cell carcinoma of the cervix’. Gynecologic Oncology. 121 pp 32-42. Arbyn, M. and Dillner, J. (2007) ‘Review of current knowledge on HPV vaccination: an appendix to the European guidelines for quality assurance in cervical cancer screening’. Journal of Clinical Virology. 38 pp 189-197. Harper, D.M., Franco, E.L. and Wheeler, C.M. (2006) ‘Sustained efficacy up to 4.5 years of a bivalent L1 virus-like particle vaccine against human papillomavirus types 16 and 18: follow-up from a randomised control trial’. Lancet. 367 pp 1247-1255. Rock, C.L., Michael, C.W., Reynolds, K.R. and Ruffin, M.T. (2000) ‘Prevention of cervix cancer’. Critical Reviews in Oncology/Hematology. 33 pp 169 – 185. Papanicolaou, G.N. (1928) ‘ New cancer diagnosis. Proceedings of the Third Race Betterment Conference’. P 528. American Cancer Society. Cancer Facts and Figures. Atlanta, GA: American Cancer Society, 1997:1997. Costa, S., Negri, G., Sideri, M., Santini, D., Martinelli, G., Venturoli, S., Pelusi, C., Syrjanen, S., Syrjanen, K. and Pelusi, G. (2007) ‘ Human papillomavirus (HPV) test and PAP smear as predictors of outcome in conservatively treated adenocarcinoma in situ (AIS) of the uterine cervix’. Gynecologic Oncology. 106 (2007) pp 170-176. Cricca, M., Venturoli, S., Morselli-Labate, A.M., Costa, S., Santini, D. and Ambretti, M. (2006) ‘HPV DNA patterns and disease implications in the follow-up of patients treated for HPV16 high-grade carcinoma in situ’. Journal of Medical Virology. 78 pp 494-500. Garland, S.M., Hernandez-Avilla, M. and Wheeler, C.M. (2007) ‘Quadrivalent vaccine against human papillomavirus to prevent anogenital diseases’. New England Journal of Medicine. 356 pp 1928-1943. 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Amusement Park Case Study Example | Topics and Well Written Essays - 2750 words

Amusement Park - Case Study Example The change that would take place in the company after the proposed information system has been implemented successfully is summarized. The resources and involvement needed for the change is also described in the latter part. A self reflection at the end gives light to the expertise and foresightedness needed for an administrator in implementing an information system to change a key processing with its experience. In the diagnosis and the latter part of the work are based on theory and academic notion. "Veega Land, India's first water theme park, has since its inception been an irresistible attraction for hundreds of thousands of fun loving people of all ages from all over India. Spread over 30 acres of landscaped space, built to international standards and impeccably maintained, Veega Land has a mind boggling array of sophisticated rides to thrill anyone till one can't take any more" (Veega Land) Veega Land Amusement Park is situated in the outskirts of Bangalore City in the South Western part of India. It is about a 30 km west to the heart of the city. It is a well established company located in the capital city of the state. The park offers verity of Caravans and motor homes. There is a water theme park with quiet a number of rides for both children and adults. A visit to the park in fact can be an experience of the life time.Park also has a small shop which can be utilised to increase the revenue. Since the shop is with in the premises the products are sold at a high price. There are a number of games rooms for the children and adults who would be staying over night. The park could almost be filled to the brim during the peak season.The theme park as with all the companies of the same kind has lot of rides made for both children and adult. Especially the Veega maintains another park for the small kids alone. Thus the peak season of the year is being the summer holidays. I n spite of all the changes the company had down the years the company still remains to be a family business. It is owned and managed y the same person. 2. A System Based Diagnosis of the SituationThe issue is to improve the promotion process to stabilise the customers flow to a certain extend during the peak season and off season. A diagnosis of the current promotion process is needed in a unique knowledge based approach called INSPIRE which has been designed to help drive and implement change, to help managers to simultaneously harness innovation, and to control the organizational change process (Kawalek, 2009). The promotion proce

Social Media in Brand Management and Brand Research Paper

Social Media in Brand Management and Brand - Research Paper Example However, the organization has commonly embraced the use of, facebook, Google and mobile applications as its major marketing channels (Evans, & McKee, 2010). Weinberg (2009) argues that H & M netted a huge number of followers on face-book through its publication, which states that customers can easily get a quick response on their inquiries posted on the fan page. Moreover, the organization has gone a notch higher by integrating their face-book onto other international languages. For instance, the H & M organizations face-book is intercepted by the local Chinese social platforms; Youku and Sina-Weibo hence making it easier to market the organizational products through different languages internationally. Besides, H & M has drawn a pool of over ten million fans on its face-book fan page though promotional post by encouraging customers to earn more rewards from the purchases. The above tactic enables H & M to improve on its sales volume that later translates to higher organizational turnouts. Besides, the organization runs a promotion that requests customers to post images on H & M’s fan page to win a variety of festive prices. The above consideration is a great deal that aims at drawing more attention of customers towards the organizational products. A good example is â€Å"the hashtag #HMBikeStyle." Looking at the social perspective of popularizing H &M through facebook, the organization has made much fairness by allowing people across different classes, age and cultural backgrounds within the society to have equal position towards the realization of the organizational brands. Despite the fact that facebook plays recommendable role in H & M’s marketing, its service provision is never maintained all the time thus making it difficult to give instant answers to the customers. Besides, the sales person is not in a position to meet customers directly thus making it harder to determine customer’s

Black Elk Speaks Essay Example for Free

Black Elk Speaks Essay Black Elk Speaks is about a Native American boy that has visions and these visions help him with the religious aspects of live. He has these visions that tell him what to do and shows him the path to righteousness. These visions can also be seen as myths, which are stories that try to explain something. Every culture has their own collection of myths. Black Elk Speaks is also a very symbolic book, because it has the use of many objects or people that represent other things. In the American culture, as well as other cultures around the world, are also very symbolic. The American culture is very diverse in that there are many different cultures that have mixed and created the American culture. The American culture is not something that is easily explained, because it is so mixed with many other cultures from around the world. At first there were American Indians and they brought along their tribes and myths and rituals. Then came the British and over time the Chinese because of the California gold rush. In time America was in habited with many different nationalities and ideas. These ideas were slowly but surely blended together. As for example, when the British shared their meal with the Indians they were also sharing their culture and food. The exchange of food and other ideas brought the two distant worlds closer. The more important ideas are what does all this exchanging of food and ideas symbolize? â€Å"A symbol is something such as an object, picture, written word, sound, or particular mark that represents something else by association, resemblance, or convention†(Wikipedia, 1). The object used in Black Elk Speaks is a pipe, given to them by a â€Å"young and very beautiful† woman, which symbolizes trust and companionship. Now, my friend, let us smoke together so that there may be only good between us† (Black Elk Speaks, 5). Black Elk and Neihardt have a smoke together to share their friendship and trust between the two. The pipe can also symbolize peace amongst people and/or tribes. Another act, such as the killing of a bison, might be seen as bravery, integrity, courage, pride. The American culture changed drastically when more cultures were included, such as the Chinese and African Americans. Slaves brought in from Africa, which meant that they brought along their culture and tendencies to America. Even though slavery was not the right thing to do, it brought a new culture into America and made it more diverse and â€Å"developed. † For example, superstitions are something that has shaped the culture as well. Spilled salt, walking under a ladder, a broken mirror, etc. are all superstitions that are said to lead to bad luck. When someone does one of these things they believe that bad luck is upon them. This causes them to act in a different way. Something bad in the future happens they may turn and blame it on the bad luck. Maybe some of the things that happen are just coincidences but culture has taught us to believe that it was the bad luck caused by the spilled salt, broken mirror, or walking under a ladder. Another big symbol in Black Elk Speaks is the four ribbons tied to the pipe that Black Elk and Neihardt smoke. It represents the powers of the four quarters of the universe. There are four ribbons tired to the pipe and each ribbon is a different color, which symbolizes a different power. Black is for the west, the source of the rain; red is for the east, the place of the morning star that gives wisdom; white is for the north, source of cleansing wind; and yellow is for the south, the places of summer and growth. Myths are another big thing that shapes a culture. Black Elk’s visions are like the myths in this story. In his vision, a bay horse greets Black Elk. He then tells Black Elk that he will tell him a story of the life history of himself. The horse walks in a circular motion â€Å"‘Behold me! ’ he said, ‘My life-history you shall see. ’†¦ ‘Behold them! Their history you shall know’† (Black Elk Speaks, 19). Each side that the horse goes to there are twelve horses that are each in a group of different colors. The horses to the north are white, those to the east are sorrel, those to the south are buckskin, and the ones to the west are black. The horses will take Black Elk to his Grandfathers. The sky fills with dancing horses that change into diverse creators and lead a formation of the horses from the four directions. They arrive at a cloud those changes into a tepee with a rainbow door, which inside the six Grandfathers are waiting. A myth is like a traditional story which usually contains some sort of hero or event. In this myth, the vision that Black Elk is having, is an event that is occurring. A bay horse appears in front of him and shows him the way to meet the six Grandfathers. Sometimes myths may sound like a fairy tale. For example, in ancient China, there was once this monkey that was very troublesome and cause destruction to the heavens. He was punished and put under a mountain. After about several hundred to a thousand years a monk comes along to save the monkey and there starts a journey of adventures and evil to obtain immortality. This is a myth because it is a legend of a hero that is punished for his crimes and therefore pays his debt by serving under his master. There are many aspects of a culture. The American culture is very diverse and tough to explain in one short answer. There is no true American culture because it is just a mixture of different cultures from around the world. Black Elk Speaks shows the forms of myths and symbols and how they contribute to American culture. Black Elk’s myths and symbols are very similar to those of the American culture.