History Of Oslo Essay

Oslo is Norway’s capital city. Oslo came from the Old Norse word â€Å"†¦os meaning mountain and lo meaning plain or river â€Å". In other words, Oslo can be described as a place beneath the mountains (â€Å"Oslo† 2006). People of German origin may have settled in the settlements along the Oslo Fjord who moved up to the north from mainland Europe (Zelko 63). The first evident settlement in Oslo was in the 8th century. (â€Å"Oslo† 2006). The first people of who inhabited Oslo lived in â€Å"humble wooden houses with turf roofs† that was surrounded with pens or sheds for goats, sheep and cows (â€Å"Oslo: City† 2006). Like all the other settlers of Norway, the people were grouped together in the form of a tribe and those who were landowners met with his other landed neighbors in a public assembly called Thing. Legislative assemblies were called Lagtings (Zelko 63). During the Viking age, AD800-1000 Oslo settlers grew rapidly as it had become the center for trade and shipbuilding activities and later it earned the name the† Viking Capital† (â€Å"Oslo† 2006). Viking means â€Å"a man from â€Å"Vik†, a huge bay between the Cape Lindesnes in Norway and the mouth of Gota River in Sweden (Britannica 1033). Norwegian Vikings, like other Vikings of Denmark and Sweden, were feared all over Europe as they had â€Å"superior ships and weapons as well developed military organization†. They were basically endowed with extraordinary hunger for adventure (Britannica 1034). Norwegian Vikings were known to be ruthless and brave fighters who killed their victims and greedily loots their conquered settlements and when they were done plundering destroyed the place with fire. They changed the face of Europe as they engaged in raiding and trade and then finally attracted by their conquered lands settled to live there. Their target places were mostly western European countries such as England, Scotland, and Iceland. Their active participation in trading had renewed the neglected European commerce of the middle Ages. Their contact with Western Europe was instrumental for their Christianization and eventually unification of Norway (Britannica 1033). In 885 the first Viking Monarch, Harold the Fair-haired united Norway (Halsey 239). During his reign the settlers of Norway, including Oslo, were commonly engaged in blood feuds, fightings that involve almost, if not all, disagreeing families. Even minor disputes can trigger the killing and maiming of both members of the quarreling families and if not settled can start an endless round of retaliation. The violence can be finally stopped when offending families pay the wronged families which they called â€Å"bot†. Sometimes family feuds were brought to the attention of the Lagtings who will decide the outcome of the disputes and impose penalties. The worst penalty they can give at that time was known as outlawry—a sentence that regarded the offender as if he died already. All his goods were taken away from him and he cannot exercise or claim any legal rights. In fact, anyone can kill him without facing the risk of penalty. These condemned people were left with no choice but to leave their homeland or live in the forest as an outlaw (Tseng 24). In 1050 Harald Hardrade or King Harald III officially founded Oslo and made it the center of southern Norway. This site was located at the eastern side of the harbor on the left bank of the small Akers River (Halsey 239). Harald died in 1066 and his death ended the Viking period as raidings stopped (â€Å"Norway† 2007). Oslo experienced a great era during the reign of Haakon V who was crowned in 1299. He decided to build the Akershus fortress in Olso to serve as his home with his wife Euphemia of Rugens, a Northern German princess (â€Å"Oslo† 2006). He made Oslo the capital of Norway replacing Bergen. This time Oslo and the rest of Norway enjoyed relative peace (â€Å"Norway† 2007). In 1318 Norway was united with the kingdom of Sweden when Duke Erik of Sweden married Princess Ingebjorg, daughter of Queen Euphemia and Hakon V Magnusson. The unification of both countries was officially signed in the Bishop’s castle; now presently know as Oslo Ladergard (â€Å"Oslo: City† 2006). The saddest event that occurred in the early history of Oslo was the Black Death that terrorized the world in 1349. It was estimated that half of Oslo’s population died during the time of the Black Death or â€Å"bubonic† plague. Bubonic plague was carried by fleas in rats from England (â€Å"Oslo† 2006). Because of the loss of its inhabitants and damage to agriculture Norway united together with Denmark and Sweden via the Union of Kalmar 1397(â€Å"Norway† 2007). During this time Copenhagen, instead of Oslo, was selected as the actual capital of Norway. Consequently Oslo lost it political importance and was only regarded as a provincial administrative center while the kings lived in Copenhagen and Stockholm from 1400-1500 (â€Å"Oslo: City† 2006). In 1523, however, Sweden dropped out of the union, and weaker Norway was left in the care of Danish Kings(â€Å"Norway† 2007). Part 2 Modern Era Reformation Period Like the rest of mainland Europe, Oslo was greatly affected by the Lutheran Protestant Reformation of 1537 when the German Monk Martin Luther questioned the laws of Roman Catholic Church and sought to reform the religious beliefs of the Europeans. Oslo citizens were engaged in religious conflicts(Thodock 2003). The catholic bishop of Oslo, Hans Rev was converted to Protestantism despite the reluctance of the citizens( â€Å"Oslo:City† 2006). Since Oslo had slightly lost its political and economic importance as a city at this time as it was being ruled by Denmark most of the buildings constructed there was only made of wood so that the city was easily destroyed by fire in 1624. King Christian IV of Denmark and Norway decided to move the town to the right bank of the Akers River and rebuild it near the Akershus Fortress. The city buildings were constructed in a Renaissance city style with rectangular blocks and renamed it Christiania (Halsey). Scientific Revolution The scientific revolution changed the world’s beliefs entirely, and Norway is in the heart of it Religious beliefs were proven to be wrong and questions were answered. Copernicus first with his opinion on the heliocentric theory, Galileo second with proof of Copernicus’ theory, and Newton third with the laws of gravity to explain how and why the planets revolved around the sun. Enlightenment During the 1700’s the Age of Reason or the Enlightenment flourished in Europe particularly to the Norwegian trading partners of Great Britain and Holland. In these places people were trying to improve their lives with the use of reason instead of following traditional religious or accepted beliefs. Contact with the â€Å"enlightened† British and Dutch affected the daily life of the inhabitants of Christiania. Norwegian traders brought home with them not only the prized cargoes of tobacco, coffee, tea and spices but also enlightened ideas. They constructed luxurious houses with magnificent gardens in accordance with the style western Europe (â€Å"Oslo: City† 2006). Napoleonic wars At first, Denmark and Norway attempted to remain neutral in the Napoleonic wars between France and England and their respective allies in 1805. However, England attacked the entire Danish fleet in 1807 as a result Denmark joined with France against Britain (Britannica 1034). Britain cut-off trading with Norway and set up a continental blockade against Denmark and Norway wherein British navy prevented the goods from both Norway and Denmark in reaching its trading partners . This action greatly affected the economy of Norway. The export of fish and timber from Christiania as well as the import of grain from Denmark were blocked. As a result, citizens of Christiania faced an economic crisis and suffered hunger. To end their trouble, Britain loosened up its blockade against Norway in 1810-13(â€Å"Oslo† 1991). In 1814 the king of Denmark was forced to give up Norway to Sweden in a Treaty of Kiel when Napoleon I was defeated (â€Å"Oslo† 2006). Eager to rebuild their government the Norwegian created its first constitution on May 17 the same year and Christiania became the capital city. In time, Christiania replaced its rival Bergen as Norway’s largest city. The people celebrated with joy as Christiania was expected to reclaim its old glory without giving much thought at first that they were still under the control of a foreigner, Sweden. As a capital city, Christiania once again becomes important politically and economically. For its newly acquired role, new monumental buildings were erected as a venue for important functions. . They were the Royal Palace, Bank of Norway and the stock exchange Oslo Bors. Later, most Christiania citizens joined with the rest of Norway in demanding for a complete control of their own affairs. They did not want to recognize the provisions of the Treaty of Kiel and instead preferred a Danish King to rule them. Because of the political unrest , Sweden was forced to make the Act of Union of 1815,that gave Norway the privilege of having its own army, navy and parliament(Storting) and was permitted to control their own internal affairs in exchange for their strict compliance to the Treaty of Kiel(â€Å"Oslo† 2006). Renaissance Period Because of their internal independence, Christiania’ economic and political power rose. By mid 1800’s, Christiania grew into a major administrative, economic and military center. The economic success brought about by the shipping and agricultural industry made Christiania a dominant economic city of Norway (World Book 1981). The site of rapid industrial revolution in Oslo started at the Aker River around 1840. The development of Industries relied in the electricity provided by this River. Old buildings along the River were demolished and replaced with concrete large textile industrial buildings . Because of the increased jobs offered by industries the population of Christiania increased as peasants and rural populace moved to the cities hoping find work. In the beginning of the Industrial Revolution Christiania’s industrial workers, like most of European industrial cities, lived in poverty since income was low. They mostly lived in crowded houses meant for workers in which sanitation was bad. As a result, sickness was common and spread easily. To augment family income, the children aged below ten were forced to work in the industries, an environment that was not conducive for their well-balanced growth. In fact, industries were noisy and dusty. They caused water and air pollution. Because of this, the health of the children suffered and their resistance to sickness decreased as they lacked the time to play and sleep. In fact, schoolwork was unavoidably neglected (â€Å"Off â€Å"2007). Revolutions of 1848 The political revolutions in Europe in 1848 had increased the desire of Norway to demand for independence from Sweden. In the late 1800’s popular Norwegian playwrights Henrik Ibsen and Bjornstjerne Bjorjornson staged a play in Christiania’s theater with a theme about political hypocrisy, rights of women and social problems. These plays helped Norwegians develop a sense of nationalism. In 1901 the city of Christiania was selected by the notable Swedish inventor, Alfred Nobel to be the site for the awarding of the most prestigious Noble Peace Prize (Lundestad 2001). By 1905 Sweden granted independence to Norway and Christiania at last was freed from foreign interference that began 1300’s (Halsey 240). Industrial Revolution World War One was inevitable due to industrialization and the desire each country had to become supreme. Firstly, relationships between the nations of the world were dramatically altered by the Industrial Revolution of the nineteenth century. Tensions between the industrial powers began to rise. The intensity between the industrial powers grew more and more as each country sought to expand its sphere of influence at the expense of others. Secondly, there was a growing desire by ethnic populations within the larger countries to become independent nations. Norway separated from Sweden and revolts occurred in colonies such as China, Zimbabwe, Namibia, and Ireland. War broke out in the Balkans in 1912 and again in 1913, as Bulgaria, Serbia, Macedonia, and Greece fought first the Ottoman Empire and then Austria-Hungary. Lastly, Colonies around the world were a valuable asset for supporting the host country’s economy. The great European powers needed raw materials and outlets for their goods. They wanted to expand into new colonies while still protecting the ones they already had. World War I The economy of Christiania steadily grew until before World War I. When the First World War broke out in 1914 Norway declared its neutrality. However, Christiania benefited economically from the war by carrying British cargoes inspite the loss of Norwegian lives and ships that were caught in the war (Compton 610). After the war Christiania settled back to its normal life. In 1924, Christiania was renamed back to Oslo (â€Å"Oslo: City† 2006). World War II. On April 9, 1940 Oslo was defeated by the Germans almost with only a slight resistance due the betrayal of Norwegian Officer and Fascist politician Vidkun Quisling who collaborated with the Nazis. As a result, the city was only slightly damaged during the war (Halsey 239). In 1942 Germany installed a puppet government in Norway under National Union leader Vidkun Quisling. However, the Norwegians resisted the Germans and its puppet regime. Oslo became a place of opposition strikes. Other citizens were secretly involved in the large-scale industrial sabotage and espionage on behalf of the allied powers. (â€Å"Oslo† 2006). During their occupation of the city the Nazis used Akershus as a prison and place of execution for those convicted of allied conspiracy and today it’s the site of Norway’s Resistance Museum, which provided a detailed account of German takeover and the Norwegian struggle against it (Thodock 2003). The German forces that overrun Norway surrendered in May 8, 1945 enabling the exiled King Hakon VII to return to Norway from London in June. Oslo then began to rebuild its ruin buildings while at the same time prosecuted â€Å"about 90,000 alleged cases of treason and defection†. Convicted traitors faced execution foremost of which was Vidkun Quisling (â€Å"Oslo† 2006). War had been going on for a very long time when it came to The Cold War, the postwar to World War II. After World War II, as the Cold War began two major alliances were created. Although, in World War I a systems of alliances did not work, the systems of alliances that formed after World War II were bigger and they weren’t buddy-buddy alliances. These two alliances were formed to bring peace throughout the world, to end The Cold War, and to prevent anymore future high scale wars. Toward the end of the war, hostility between Norwegians and the German occupying forces grew considerably stronger. A prime cause was the German withdrawal from all fronts. Retreating German units from the fronts in the north, the USSR and Finland, withdrew to Norwegian territory. In the autumn of 1944, the Red Army followed the Germans into Finnmark, where it liberated Kirkenes and the northeastern areas. As the occupying troops retreated, they ordered an evacuation of the entire Norwegian population in Finnmark and in Troms south to Lyngen. In Lyngen, three German army corps dug in. Then the entire region north of Lyngen was burned and destroyed. The destruction included 10,400 homes, bridges, power stations, factories, fishing vessels, telephone facilities and other types of infrastructure. The scorched earth area was much larger than all of Denmark. After the Soviet Red Army crossed into North Norway, a Norwegian military mission and a small number of Norwegian soldiers from Great Britain and Sweden followed. The Russians withdrew from Norway in September 1945, a few months after the German capitulation.

Big Five Personality Theory Essay

Psychology refers to study of human mind and behavior. The main aim of psychology is to gain an intricate understanding of all and why individuals behave the way they do and what are the causes of their behavior. The ultimate aim is to understand a man in order to benefit society at large. There are many theories that discuss and try to explore different aspects of human behavior. The big five personality theory has been revolutionary and is currently the most accepted model in the scientific community. It consists of five traits – Extraversion, Agreeableness, Conscientiousness, Emotional stability, and openness and can be remembered by acronym – Ocean. One of the best ways to access a trait is to directly ask a person about the trait ( self report ) and then get an observer to confirm the trait ( observer report ). Me and my husband scored me on various traits as detailed above separately. We scored the answers, the scores and details of each trait are as below: Extroversion: My extroversion scores were (41- 41). This suggests I am talkative, outgoing, seek adventure, and excitement. Introverted people are quiet and reserved, though some researchers have shown that introverts can be as gregarious in social situations as extroverts but the key is in the source of energy. Extroverts gain energy from social interactions where as introverts from solitude. This is so true in my case. I have never been comfortable being alone. Openness: I scored (78-65) in openness, which is characterized by imagination, broadmindedness, originality. People low in this trait traditional, stick to familiarity, follow tested paths. It’s true in my case. I love challenges, trying new things adds new dimension and meaning to my life. In fact I would go ahead and say not doing different things disappoints me. It is this trait that got me my boyfriend who is now my husband. I guess this need comes because I lived 22years of ritualistic and traditional life. Thanks to a strict father. Conscientious : I scored (33-36) on conscientious which is characterized by dependability, efficiency and persistence. I love order in anything. Be it my wardrobe, gym routine, doing my laundry on Saturday or cleanliness of the house. Being on time to appointments, keeping order in life, I believe speaks volumes about a person and I intend to have a positive one. Guess, I get that trait from my father. He was always prompt with bills, early for appointments even informal ones. I did not know one could live any other way. Agreeableness: I scored 30(me)-43(husband) in agreeableness. It is characterized by less negative emotions, like jealousy, revenge and more empathy. People low in this trait look to win arguments not people, lean more towards excitement and dominance. I guess my husband sees me as being as agreeable because he himself is a agreeable person and sees positive in others always whereas I am more critical of myself. I am supportive of friends and family and empathize a lot with people to an extent that I feel angry if my close ones are insulted. But at the same time if someone does something wrong even if it is my mother I will not stop myself from confronting her. So, I must say I agree with my score of 30. Emotional stability: I Scored 16(me)-29(husband) in Emotional stability. It is characterized by stability in emotions in various situations in life and they are calm, free from persistent negative feelings. People rating low on this trait show negative emotions like anger, anxiety, depression, low tolerance to stress, mood swings and pessimism, Both me and my husband have scored me low on this scale. The reason is I do get stressed easily. Exams, major decisions in life get me on my nerves. At those times I am a different person – angry, not approachable and irritable. But once I find solution to the problem in my mind, I immediately get back to being myself. I guess, I need to work on being more stable. The big 5 theory helps shed light towards formation of human personalities and why different individuals exhibit different emotions and reactions when dealing with different social situations. Human behavior just like psychology itself is a broad specialty and having all the answers is virtually i mpossible. However having different theories give innumerable details that helps form a bigger picture of causes and variables that shape a human. Anju Priyadarshini

Why California is considered a hazard hotspot and how it copes

A disaster hotspot is somewhere where there is a threat of two or more hazards to the area, ranging from geophysical to hydro-meteorological hazards. This is certainly the case in California, where there are an abundance of hazards which threaten the safety of the population. These hazards include earthquakes, bushfires, landslides, flooding, drought and fog. A major threat to the 40million strong population of California is earthquakes, which are caused by a network of active faults which run under the coastline of the state, including the San Andreas Fault and the Garlock Fault. The San Andreas Fault is a conservative boundary, which can give rise to powerful earthquakes. The 1906 San Francisco earthquake was caused by a rupture on the San Andreas Fault, which is a strike-slip fault meaning it is a crack between two plates sliding past each other. This 7. 7 magnitude earthquake caused a lot of destruction in the San Francisco area, killing an estimated 3000 people and leaving an expensive bill of damage ($9. 5 billion in 2009 dollars). Much of the damage and death toll came as a result of the devastating fires which followed the earthquake, which lasted for four days. The people of California are vulnerable to earthquakes as the faults directly underlie the area and the earthquake events cannot be predicted. As California is part of one of the largest economies in the world, it can afford preventive measures such as an annual earthquake drill and building earthquake proof buildings. Drought is another prevalent threat in California, which also gives rise to wildfires due to dry grounds and air. Droughts are caused by a lack of rainfall, heightened by the onset of La Nina. A particularly bad example of a drought in California was in 1976-77 where they only had half the rainfall compared to a normal year, causing a major crop fail, which in less economically developed countries often leads to a famine disaster. Droughts lead to health problems, particularly for the young and old who are at risk of malnutrition and heatstroke. 2007 was a bad year for wildfires. Prior to these fires the area was experiencing a drought, meaning the land was dry which created good conditions for fires to spread. Across the 19 days of burning, there were 9 deaths, over 500,000 acres of land burned, along with 1500 homes. There had been a build up in bushes in the previous decades of no fires which added to the reason the fires were so destructive as they had a lot of fuel to burn on. California is also at risk of flooding, both coastal and from rivers. These events are largely caused by excessive rainfall. In 1964 the Alaskan earthquake caused a tsunami which devastated parts of California, killing 14 residents. A more recent example of flooding was in December 2010 when hundreds of people were evacuated due to more than 12 inches of torrential rain falling, causing flooding and mudslides. This again caused a lot of economic damage. Other mudslides have occurred across the recent decades, often caused by earthquakes or flooding and erosion. In La Conchita there have been two major mudslides, one in 1995 the other in 2005. The more recent event was far more destructive, burying 15 homes and killing 10 people and was caused by excessive rainfall. In conclusion California is considered a disaster hotspot because its population is vulnerable to a variety of hazards which occur quite frequently and sometimes lead on from one another, for example if there is an earthquake landslides could occur as well as the initial destruction caused by the earthquake itself. As a developed state it has invested money and time to ensure the safety of its residents as much as is possible when the events are unpredictable.

American History Article Example | Topics and Well Written Essays - 250 words

American History - Article Example His influence in the American society, therefore, lies in his activism against Communism and his effort to protect the State against disloyalty, security risks, and Communist infiltrations (â€Å"Senator Joseph McCarthy,† n.d.). During the term of Senator McCarthy, he tried to put into trial those who are Communists and their supporters. The goal of his administration is to prevent the Communists from infiltrating the State and risk military and civilian security, as well as the government’s information and technical system (â€Å"Senator Joe McCarthy,† n.d.). In addition, his committee gathered information on, mostly, government officials, which was later proven to be faulty and had no substantial evidence. As a result, Senator McCarthy faced issues related to civil liberties as he, seemingly, deprived the people of their freedom of belief and expression. However, in the brighter side, his aims are for the good of the government as those develop loyalty and security, as well as ensure that the Democratic stand of the nation is still solid. Therefore, his life and works had made him a prominent figure in American

Competitive and Strategic Analysis Assignment Example | Topics and Well Written Essays - 1500 words

Competitive and Strategic Analysis - Assignment Example Corporate strategy: Corporate strategy on the other hand is the overall and general scope as well as the direction that a corporation takes in relation to its activities in the various departments. It is not specific, but gives a glimpse and idea on how all the operations of the various departments contribute to the general good performance of the corporation. Business strategy: Business strategy refers to the choices and decisions made in a company or corporation to realize a long-term value while at the same time achieving the desired objectives of the company or the corporation in question. It is the means of maximizing the outcome in a companys production system or in realizing the maximum profit from a company. At Best Buy, the functional strategy is vital in the marketing department because it is in this operational department that the customers will be able to familiarize themselves with the company and get to purchase the products. Any strategy put in place in this department is important because it affects the entire business outcome of the company. Marketing thus is the functional division of this company that is useful as the company does not produce its own electronics fully and yet it is a retailer competing with thousands of other retailers. Packaging the marketing team with the right and consistent information will thus affect the entire outcome of the company and affects all other departments. The function essential to the goal of 2014, which is expanding the number of stores, is proper marketing in the new zones of operation. The marketing strategy should be so that it captures the tiny little details and appeals to customers all across the boards as it redefines Best Buy as th e best brand in the market. The marketing team should advertise the company as the best brand available in the market and at the same time gives customers the incentives necessary to have the goods and electrical items from the

Internation Entrepreneurship in Fashion related Industry Thesis Proposal

Internation Entrepreneurship in Fashion related Industry - Thesis Proposal Example The paper "Internation Entrepreneurship in Fashion related Industry" analyzes Internation Entrepreneurship in the fashion industry. Customers spend a lot of time to decide what garment they want to purchase online, to ease their decision almost all websites offer images of the clothes, same clothes in different colors and image enlargement. But these tools are not enough so that customer can buy clothes with complete comfort. Companies that do display their designs online along with different sizes are successful but not meet fully meet the performance expectations. I shall research on a new area in fashion e-commerce which Bill Slawski at SEO proposed. It is a social search engine in which customers will create their profile inclusive of their height and weight measurements, skin color, eye color, hair style , whether you wear glasses or not, preferences (formal/casual/workout clothes) and other personal information regarding the appearance of the customer. The search engine will cr eate a 3-dimensional scan of customer’s body which can be uploaded on a clothing search engine. The clothes recommended for that specific customer’s profile can be used to make a 3D model based upon profile of that customer. A patent filing from Yahoo describes a Fashion Search Engine that can use a 3D model to present garments that can help can help customers find clothes that match their profile. The profile can be updated at any time by the customer for example when the customer loses weight.

Music Publishing Essay Example | Topics and Well Written Essays - 2000 words

Music Publishing - Essay Example Musicians are artists that are mostly hard working and unacknowledged. Making money with music is not an easy road. The way for any business to make money is through volume and this is no different in the music industry. Volume comes when one recording is sold repeatedly so that the money accumulates and makes the people who created and own the music money from its sales. What typically happens, however, is that those with the power ‘buy out’ the rights to what a musician plays so that they do not get paid for every use of the recording that is paid for by one entity or another. Musicians with power will continue to own their rights, but those who are hired for short term of only for the period of time to make a recording are bought out so that the re-sale of the music is not limited by a large body of ‘partners’ who all have rights to be paid (Harrison 2011, p. 232). There was a time when even the artists were not included in the group who was paid on the r eturn of selling the music. Paul McCartney can attest to the pain of that as he saw his entire catalogue of music sold to Michael Jackson after sharing with him that it was going up for sale. As a result of that sale, every time that McCartney wants to play â€Å"Hey Jude† he has to pay a royalty, even though he wrote the song. (Marinucci 2009). In order to create ownership to a piece of music the contract must include that ownership will be retained either in part or as a whole. The statement that is being addressed is whether or not â€Å"All musicians featured on a popular music recording are entitled to an appropriate share and interest in the music publishing copyright of the work performed on that recording†. In addressing the definitions of music, composition, and ownership, the answer is that it is not the case that all musicians would be qualified to gain as an author to a piece of music should they participate in its recording. Contribution is very specifical ly defined and if a contributor does nothing to qualify under the parameters that have been set, they are not eligible for an interest in the exploitation of that piece of music (McLeod and DiCola 2011, p. 78). 2. Defining Music The first thing that must be done in order to support a legal definition of ownership and the right to be paid for music is in defining what is meant by music. The written composition is not what is being discussed. Music is what is heard. Arnold (2009, p. 1) uses the example of a piece of music that is played by Louis Armstrong as it is compared to that of Peter Ecklund. The distinction is clear as the sound that Armstrong creates has a quality that is unique to his own personal nuances in the work. In modern collectives, however, it is not as simple as that. Burnard (2012, p. 68) discusses the creative process for musicians. It is a process that sometimes is led by one or done isolated, that can be done by only select members, or is most often a collective experience in which the philosophy and intentionality of the group is expressed through what is produced musically. This not only includes the musicians, but the producer and sometimes the managers as they all work towards the production of a type of audible expression. Burnard (2012), p. 69) states that this is a â€Å"non-linear, multifactorial, and relational†

HIV1-Infection Drug Resistance Essay Example | Topics and Well Written Essays - 1000 words

HIV1-Infection Drug Resistance - Essay Example Antiretroviral therapy is the only existing response to the HIV/AIDS pandemic. The disease has already and continues to kill so many people in the world. The virus mutates to thrive in antiretroviral conquered environments. This is an obstacle as it will make scientists stop focusing on coming up with a cure and start thinking of fighting this resistance. There is the need, therefore, to understand why the virus mutates and consider the strength of second-line regimens treatments as an alternative. The middle-income countries face the most challenges in trying to solve the virus’ resistance to ART. There is need for independent organizations from developed countries to carry out researches to explain these Assumptions The paper makes the general assumption that, in all low and middle-income countries, the resistance and rate of spread are the same. The opportunistic infections are the same in the people living with the disease in the low and middle-income countries. In additio n to that, the assumption in this paper is that the resistance to antiretroviral therapy is due to mutation of the virus, and no other factors result in the case. Limitations The paper is limited in explaining the factors that contribute to the resistance observed in emerging cases. The reason or reasons as to why the virus mutates once it gets in new environments are not explained. Preview and Methodology The literature review in this paper looks at three different reports analyzing the emergence of the virus and its resistance nature.

The Success of a Business Entity that Depends on an Interplay of Inter Essay

The Success of a Business Entity that Depends on an Interplay of Internal and External Factors - Essay Example One of these companies is DHL. DHL is an express shipping multinational company operating in 220 countries and territories around the globe. It employed more than 22,000 people and delivers more than 1.2 million packages daily (Scott 2007). It is the objective of this essay to discuss the underlying strategies that make DHL a global leader in their field of endeavor using SWOT analysis. The SWOT analysis proffers DHL Company’s strengths, weaknesses, opportunities and threats in both their internal and external environments. The first question that comes to mind when one hears the name of DHL is: where did this company name come from? According to the history of DHL, the name came from the first letters of the last names of the owners or founders of the company: Adrian Dalsey, Larry Hillblom and Robert Lynn (DHL 2008). These founders started the company in September 1969 at San Francisco, USA. It was a milestone when â€Å"the founders began to personally ship papers by airplane from San Francisco to Honolulu, beginning customs clearance of the ship's cargo before the actual arrival of the ship and dramatically reducing waiting time in the harbor† (ibid). Using this concept, delivery of documents was rapidly done through international air express. In a span of fewer than twenty years, DHL expanded its operations to countries such as Hawaii, the Far East, Middle East, Africa and Europe. A major change in ownership occurred in 2002 when DHL was consolidated with Deutsche Post World Net. At present, DHL is already 100% owned by Deutsche Post World Net, but still retained the brand name, DHL. Considering brand association and retention, customers all over the world acknowledge DHL as â€Å"the global market leader in international express, overland transport and air freight. It is also the worlds number 1 in ocean freight and contract logistics. DHL offers a full range of customized solutions - from express document shipping to supply chain management.† (DHL 2008)

Anti Social Personality Disorder Essay Example for Free

Anti Social Personality Disorder Essay Anti-social personality refers to a psychological disorder in which a person lacks the ability to feel emotions such as empathy, remorse, and guilt. These people are often referred to as psychopaths and are dangerous to society because of their violent nature and abilities to overlook what is usually perceived as â€Å"wrong† or â€Å"immoral†. Genetics vs. the Environment. This disorder can come from the conditions of one’s home environment or someone can be genetically predisposed to develop symptoms when crossing with an environmental trigger. Either way, this disorder develops with a combination of physical, genetic, and environmental factors (Mayo Clinic Staff, 2015). Many studies have been done to help determine if children at risk for Anti-social personality disorder are more likely to develop symptoms in an adoptive environment or if that environment would protect them from developing it. Researchers have concluded that the adoptive family environment combined with the biological risks make anti-social personality disorder prevalent in adoptees (Haimowitz, 2011). In other words, it takes a combination of factors to create this particular type of monster. Environment. Criminologist Nathalie Fontaine of Indiana University studies the tendency toward being callous or unemotional- signs of anti-social personality disorder- in children between 7 and 12 years old. Her research showed that these traits aren’t fixed, and can change in children as they grow. So, if psychologists identify children with these risk factors early on, it may not be too late (Moskowitz, 2011). This study supports the idea that, although a person might hold the physical or genetic predisposed factors to develop this disorder, it takes an environmental trigger for the patient to actually begin showing symptoms. Environmental triggers for the disorder could be anything from the death of a loved one during childhood to a violently abusive parent. People diagnosed with Anti-social personality disorder typically have criminal behavior in their lives either from a parent, role model, or having a criminal record themselves. One long-term  study followed 1,795 children from ages 3-23, testing aspects of their growth and development. 137 of these children became criminal offenders by the age of 23. Among the tests that were done on the participants, one measured their responses to fear by associating a stimulus-noise or object- with a punishment such as an electric sh ock or loud sound. After measuring these children’s involuntary reactions through the skin, researchers found a significant lack of fear in the 137 children that became criminals later in life compared to the other 1,568 participants (American Journal of Psychiatry, 2010). Most people are aware of the Little Albert experiment conducted by behaviorist John Watson in 1920. Watson studied a child-Little Albert- by placing him in a room and exposing him to various stimuli including a white rat, white rabbit, and a monkey. The child of course showed joy when being around the cute fluffy animals; the first time. Watson then let the rat back in to the room and this time, when Albert touched he rat, Watson banged a hammer on a metal pipe, making a loud noise and causing the baby to cry. He did this server more times until the child began crying at the sight of the rat, exhibiting fear of the creature itself because he had then associated the loud, scary sound with the rat. This is the way you would expect a child to react, seeing how its human nature. Well, in psychopathic nature, it is more likely that the patient would still relate the noise to the stimuli, but instead would attempt to free themselves of the noise by doing what seems most logical- getting ri d of the rat. This is why children that come from an abusive home are more likely to develop personality disorders than the average child- they relate the abusive behavior to the abuser and instead of exhibiting fear, they seek revenge and closure. Most serial killers have a specific type of victim and this is because their victims are similar to their original abuser and killing them gives temporary satisfaction; but it wears off so they need to seek more, like a drug. The environment in which a child is raised can greatly influence the kind of person the child grows into and what they are able to justify based on what they were exposed to in their childhood. Genetics. In 1998, 8,045 twins were tested using a questionnaire about personality traits common in disorders like antisocial personality. Researchers found that 2/3 of the variations in traits common in personality disorders are explained by genes (Masui, 2011). The character traits and temperament relating to  anti-social personality dis order- violence, narcissism, ignorance, can all be passed down from a parent and the existence of such traits do not imply the development of disorder. The development might begin, however, if the parent acts in these ways toward their child, giving them an environmental trigger. Physical Differences. In one recent study, scientists compares 27 people with severe antisocial personality disorder- psychopaths- with 32 non-psychopaths. In the psychopaths, the researchers observed deformations in another part of the brain called the amygdala- the seat for human emotion- and found that the psychopaths showed a thinning of the outer layer of that region of the brain and an 18 percent reduction in volume compared to that of the average human inability to learn from reward and punishment and also have little response to stress. In Japan, a study was done to support the idea that psychopaths do not respond to reward and punishment, showing a difference in the prefrontal cortex- judgment and panning portion of the brain- in psychopaths compared to the average human brain. In this study, 145 University students in Japan took the 26 question Levenson Self-Report Psychopathy Scale test where they were asked to rate their level of agreement on statements relating to their lives. The 20 students who scored the highest on the test were put in a group labeled as the â€Å"high psychopathy group† (variable) while the 20 who scored the lowest on the test were placed in the â€Å"low psychopathy group† (Control). When presented with various tasks and given reward for one and punishment for another, the researchers found the highly psychopathic showed no change in the proficiency with which the tasks were completed, whether they were offered reward for doing well or threatened with punishment for doing poorly. On the other hand, the control group showed a faster accomplishment rate with the tasks when promised a reward. This study goes to show that people with anti-social personality disorder lack the section of their brain that tells them to respond to incentive. As the aforementioned information supports, I am able to conclude that the three main factors of anti-social personality disorder- Environmental, Genetic, and Physical differences- are all needed for the disorder to develop and grow to its full destructive quality. References Mayo Clinic Staff. Antisocial Personality Disorder. Definition. Mayo Clinic, n.d. Web. 04 Jan. 2015. Haimowitz, Avi G. Heredity versus Environment: Twin, Adoption, and Family Studies. Twin, Adoption, and Family Studies. Rochester Institute of Technology, n.d. Web. 05 Jan. 2015. Moskowitz, By Clara. Criminal Minds Are Different From Yours, Brain Scans Reveal. LiveScience. TechMedia Network, 04 Mar. 2011. Web. 05 Jan. 2015.

Examining Effective Leadership Styles

Examining Effective Leadership Styles Throughout history of health care policy makers they were challenged to develop powerful leadership skills for future nurses leaders. Therefore there was a need to develop different contemporary leadership styles and behaviors, other than those theories known before. Contemporary leadership styles is not just a group of skills or missions, it is rather an attitude that value on the collaboration and effective teamwork. Contemporary leadership is dynamic relationship that will lead the leaders and followers to a higher level of moral and teamwork development. (Lanier Rose, 2008). Effective leaders as reflected in this literature of leadership, is one who is having the ability to create a healthy environment that will affect the motivation, efficiency, and effectiveness of their employees. In addition a good leader needs to have different leadership styles and attitude, and need to know in which situation he/she can evidence a particular approach. Furthermore in order for good leaders to drive their organization forward they need to practice authority, and help their employees to motivate, plan, lead, control, organize and achieve their goals and activities. (Jenkins, 2009). This paper covers briefly seven contemporary leadership styles: quantum leadership, charismatic leadership, transactional leadership, transformational leadership, shared leadership, and servant leadership. Also in this assay I will discusses and examine effective leader from throughout the literature and how leaders can develop effective leadership styles that will impact successfully on the organization. Mainly by exploring and comparing between two famous forms of contemporary leadership approaches, the transactional and transformational leadership styles. Thin I will focus on my writing on one of the nursing leaders that inspired me, what were her leadership styles, and what makes her a good leader in my view, and what I think she was lacking as a leader. Contemporary leadership styles Quantum leadership is based on important strategies, such as building capacity, thinking, planning, and working in collectively. In one of the research study program conducted by Jennifer Milewski, she developed seven drives of effective quantum leadership which are building strong community relationship, open the way for the community initiative, find source of power in society, deal with difficult and complicated tasks, build relationships with other systems, motivate employee for continuous learning, and bring the future to the present. (Milewski, 2006). What makes quantum good is that the leadership is shared activity and skills between the leader and employee in the health care system because all the staff and patient can have access to the information not only the leader. (Sullivan Decker, 2009). Leaders how are having charismatic personality characterizes by being dynamic, with attractive and magnetic personality, and they inspire their followers through their speech. What makes this style strong and powerful is that people follow the leader speech regardless of the content of their message without the need for providing evidence and they usually value religion and politics more than facts, on the other hand charismatic is limited because followers today are more knowledgeable and aware and they will not listen to any leader easily without providing evidence based practice. (Mc Crimmon, 2007). Martin Luther King is good example for this style. Transactional leadership is about exchanging socially whereby the leader and follower are expected to give and receive social, political, physiological, and economical benefit. In this style leaders are expected to motivate, enhance and meet their employee goals, objectives, and loyalty within the scope of their practice and policy, moreover transactional leader work on day to day operation, it is like when you are asked to work overtime hours and on the other hand you expect to receive bonus. (Sullivan Decker, 2009). Transformational leadership as defined by Burns is based on motivating, inspiring and empowering both leader and follower, and to work side by side to achieve and maintain the vision and preferred future. Transformational leader see themselves as a changing agent, lifelong learner, believes in people and able to handle and manage complex task. Transactional leadership has been the basis for the nursing administration curriculum. (Malloch Porter, 2006). Relational leadership or connective leadership as introduced by Klakovich is based on flexible management that will motivate health care team, clients, and families. She also explained that this approach focuses in creating and strengthens interconnection between and among multidisciplinary team. (Klakovich, 1994). The manager usually shows relational leadership element when convening the multidisciplinary team to plan or change the patient care program, and this will break the hierarchical relationship and lead all member to develop leadership at all level in the organization. (Sullivan Decker, 2009). Shared leadership is based on the principle of relationships, partnerships, discussion, and understanding the limit. This approach shares the managing and leading responsibilities between two or more leaders since they donà ¢Ãƒ ¢Ã¢â‚¬Å¡Ã‚ ¬Ãƒ ¢Ã¢â‚¬Å¾Ã‚ ¢t expect that one leader has the ability and knowledge to handle and manage all tasks effectively. (Sullivan Decker, 2009). Servant leadership approach is suggested to support nursing staff in patient care where extra expectation and support are required from the managers, it is also ensure quality nursing care where there is increase the demand on nursing work force. In health care environment ità ¢Ãƒ ¢Ã¢â‚¬Å¡Ã‚ ¬Ãƒ ¢Ã¢â‚¬Å¾Ã‚ ¢s believed that the work will be enhanced and be more effective with more servant- oriented management approach. (Jenkins Stewart, 2010). By the end, each leadership model is attempting to persuade the followers to follow their management strategies for the greater success of the organization. Effective leader and leadership Leadership is defined in many way but all of them agree that it is a process that influence individual, team, or the community to achieve their goal. It can be formal or informal depending on the leader authorities and personal skills. (Sullivan Decker, 2009). Effective leader must be able to influence, empower, and motivate the follower to participate for the effectiveness of the organization. (Chen, Beck, Amos, 2005). Mcshane and Vonglinow in 2005 listed some important characteristic and skills for effective leadership, those include but not limited to intelligent, confidence, motivation, knowledgeable about the business, integrity, command and emotional intelligent, and these skills will enable the leaders to be effective and strong with any leadership style they are following. One reason that might affect the development of effective leader is when a new leader is surprised that people who promoted them are not following, especially in health care system where leadership position is given without strong educational background and experience. Therefore the leader must develop better ways for managing, leading, and convincing their follower. They should be able to negotiate, and satisfy their employees in order to drive the organization forward. (Karlene, 2008). In nursing career leaders who function beyond the classic leadership style are needed, that will provide a direct contact between nurses and their manager in order to create positive work environment specially where retaining nurses are becoming a great challenges. (Amany, Susan, Mary, 2009). Through my reading I realized that effective leader must practice authority, empower and motivate employees to face their fears, and enable them to share in decision making process and by being intelligent in selecting the most effective leadership style that works with different changes in the organization, can have a major impact on the successful of the organization. Moreover maintaining and stabilizing the organization after achieving the success and desired vision is critical for the progression to continue. Transactional and transformational leaderships Many researchers have conducted to examine the most effective model between transactional and transformational leadership theories. The difference between both of them where first recognized by Weber 1998, who said that transactional leadership power is based on controlling the basis of knowledge and leaders usually aim to compromise and negotiate with followers in order to achieve higher efficiency, and they promote subordinates to complete their successful. On the other hand in transformational approach leaders have charismatic character that aim to transform employees and help them to change ways of thinking by using new ideas, and leaders create learning opportunities for their followers and encourage them to solve problems. (Kotlyar, Karakowsky, 2006). Other studies have related transformational and charismatic approaches; both are similar by attracting and enhancing followers. In contrast charismatic inspires followers superficially; however charismatic is certainly a shot of transformational leader. (Bass Bass,2008). what I cant forget and still wander in my mind when she said to me: always follow your intuition and answer the hidden voice inside you, whenever you feel that something wrong is going on with your patient even if you are sure that she is clinically stable, and that is just feeling, dont ignore it and check her continuously till that feeling leave you. Later I realized that sometimes such feeling is harbinger.

Patient with Congestive Heart Failure

Patient with Congestive Heart Failure Patient S.V. is a 54 years old female. She is a postmenopausal housewife and her family history is not being recorded. She is a non-smoker and does not drink alcohol at all. She has no-known drug allergic. The past medical history showed us that Madam S.V. is having, rheumatoid arthritis (RA), hypertension (HPT) for 10 years and diabetes mellitus (DM) for 7 years. She was admitted to the hospital on few weeks ago due to congestive heart failure. Madam S.V.s drugs history include: T. furosemide 40mg od Oedema HF T. perindopril 4mg od HF HPT T. spironolactone 25mg od HF T. Losec (Omeprazole) 20mg bd Duodenal ulceration P. Calcium lactate 1 puff od Calcium supplement T. Rocatriol 0.25mg bd Vitamin D supplement T. Metformin 500mg bd DM T. folate 5mg od Folate deficiency T. Methotrexate 20mg/week RA Clinical data The abnormal result of FBC may due to folate deficiency that caused by side effect of methotrexate. Besides that, patient was having high neutrophil number for his differential count which is 8.7 k/ µL (normal range 1.9-8.7 k/ µL). This may due to the long-term use of corticorsteroid. Patients total carbon dioxide in the blood was two times higher than normal range (23-27 Vol%). Prothrombin time and INR of the patient was low: PT =11.1 sec (normal range = 11.9-14.5 sec), INR = 0.82 (normal range 2-4). However, the reason is unknown. Diagnosis ECG and chest X-ray were carried out and the results showed that patient was having sinus tachycardia and cardiomegaly. Cardiovascular system of patient also had been checked. It found that the patient was having a 3rd heart sound. Hence, the patient was diagnosed with congestive heart failure (CHF). Clinical progress DAY 1 Patient is admitted to the hospital at 10.30am by ambulance. She is weak but conscious and alert. The patient complains that she is shortness of breath (SOB) and her sleep has been interrupted due to SOB. It can also be considered as paroxysmal nocturnal dyspnoea (PND) which is sudden, severe SOB at night that awakes a person from sleep, often coughing and wheezing. At the same time, she also experiences from chest discomfort and swelling leg. Besides that, the patient also shows the symptoms of cushings syndrome such as moonface and hirstuism. The blood pressure (BP) and pulse rate (PR) of Madam S.V. are found to be quite high as well, which is 118/87mm/Hg and 146b/min respectively. Test ordered include FBC, RP, LFT, ABG, Coagulation test, UE, CXR, ECG and random glucose test. Nebulizer is given to patient once she is admitted. She is also on high flow mask oxygen 15L/min at the same time to ease the problem of SOB. Salfasalazine 1g bd is added to patient. The management plan is to carry out lung function test, continue to on the face mask for oxygen supply, revise all test results, restrict fluid and continue with old medications. DAY 2 Patient still complain of minimal SOB and minimal chest pain. Another new complain, headache, has been recorded. Her BP and PR have been slowly decreased but they are still not within the normal range. T. bisoprolol 2.5mg od is added for a better control of HPT and HF. Management plan include restrict fluid DAY 3 Patient is no longer complaining for anything. She has no chest pain and SOB anymore. Her PR has back to normal range. However her BP is still slightly higher than normal range. Management plan is same as day 2. Sulphasalazine since the condition of RA is improved. DAY 4 Patient is feeling well, comfortable and tolerating orally. Her BP and PR are within the normal range. The management plan is to perform a CRX report, patient can be discharged if normal result is obtained and continue old medications. Pharmaceutical care issues There are few things need to be taken care of in this case. Firstly, the patient is having the problem of nausea and vomiting and no action is taken to solve this problem. Antiemetic drug (H1 receptor antagonist, cyclizine; D2 receptor antagonist, halopiridol) should be given. At the same time, underlying cause of nausea and vomiting has to be identified if possible. This may caused by side effect of perindopril. Secondly, patient is having cushings syndrome due to long-term usage of steroids for her rheumatoid arthritis. However, there is no any record about the steroids intake for patient in clinical notes. Hence, we have to ask GP or patient to make sure that whether she has stopped taking steroids or still continue with it. According to CSM, long-term corticosteroids therapy should be withdrew gradually. Abrupt discontinuation of corticosteroids therapy may cause severe symptoms because normal production of steroids by the body has been affected. The dose may be reduced rapidly down to physiological doses (prednisolone 7.5mg daily). Then, the progress of dose reducing can be slowed down. The patient is hirudism which is one of the symptoms of cushings syndrome. This problem can be overcome by local measures such as shaving, or depilation such as using wax or cream (eg: eflornithine). The dose of T.folate for patient which is 5mg once daily is indicated for treatment of megaloblastic anemia. However, the FBC test result does not show any symptoms of megaloblastic anemia. The dose of T.folate should be 5mg once daily if it is indicated for folate deficiency induced by mehtotrexate. Blood film should be carried out to make sure that whether the patient is having megaloblastic anemia or not. FBC, serum folate and serum B12 are reliable indicator of folate status. Real indication of T.folate has to be clarified with doctor before dispense the drug. Oedema problem never been improved since the day patient been admitted into the hospital. Restrict fluid intake and strict I/O charting is carried out. However, patient is not compliance to it. Some simple self-care techniques can be taught to patient to reduce the build up of fluid. Counsel the patient about the importance of following Strict I/O chart. Dose of furosemide can be increased if oedema doesnt improve. The blood pressure of patient is still not stable yet. Patient has to be counseled to improve her diet and lifestyle. It is also necessary to monitor BP of patient regularly. Increasing dose of ÃŽÂ ²-blocker can be considered if BP is not reducing. However, due to its negative inotropic effect, ÃŽÂ ²-blocker should be started in very low dose and increase gradually. Lastly, upon discharge, ensure all appropriate medications are prescribed and patient is counseled appropriately. We have to tell patient that Perindopril is added in and ensure patients compliance with medication. Patient should be told to avoid alcohol and cranberry juice and consult GP if anything goes wrong. Disease overview Incidence Heart failure (HF) affects 0.3-2% of general population. In 2001, officially there are 11500 deaths are recorded in the UK due to HF. The incidence rate increase by double each decade from age 45. It affects 3-5% of those over 65 years and 8-16% of those over 75 years. The Rotterdam study shows that prevalence is higher in men compared to women. Pathophysiology Heart failure can be defined as inability of the heart to supply sufficient blood flow to meet the bodys needs. HF can result from any disorder that reduces ventricular filling (diastolic dysfunction) and myocardial contractility (systolic dysfunction). The leading causes of HF are coronary artery disease and HPT. As cardiac function decreases after myocardiac injury, the heart relies on few compensatory mechanisms. Although those compensatory mechanisms can initially maintain the cardiac function, they are responsible for HF symptoms and contribute to disease progression. An initiating event such as acute MI can cause the HF state becomes a systemic disease whose progression is largely mediated by neurohormones and autocrine/paracrine factors such as agiotensin II, norepinephrine, aldosterone, natriuretic peptides, and so on. Some drugs may exacerbate HF due to their inotropic, cardiotoxic and sodium-/water- retention properties. Diagnosis A complete history, physical examination and appropriate lab testing are essential in initial evaluation of patients suspected from having HF. The signs and symptoms are the key for early detection. Breathlessness, angina, fatigue and wheeze are common signs and symptoms. Patient complains that she is having SOB and PND. Electrocardiogram (ECG) and B-type natriuretic peptides (BNP) are essential tests for every patient with suspected HF. ECG is carried out once the patient is admitted into the hospital. Madam S.V. was detected to have sinus tachycardia by ECG which is one for the common ECG abnormalities in HF. Others common ECG abnormalities include sinus bradycardia, atrial fibrillation, ventricular arrhythmias and so on. Plasma BNP is not measured in this case. Chest X-ray (CXR) is also an essential component of diagnostic work-out in HF. It is very useful for detection of cardiomegaly, pulmonary congestion and pleural fluid accumulation. It also demonstrates the presence of any pulmonary disease or infection that will lead to dyspnoea. Via CXR, patient is detected from having cardiomegaly which is also one of the abnormalities for HF. Echocardiography (ECHO) should be performed shortly if one or both ECG and BNP get an abnormal result. ECHO is widely available and safe and provides essential information on aetiology of HF. However, ECHO is not carried out in this case. Some other tests such as FBC, RP, LFT, ABG, UE and random glucose test have been carried out to exclude others possible conditions. Pharmacology basis of drug therapy Diuretics The most important function of diuretic drug is to act by decreasing Na+ reabsorption. Diuretic drugs can inhibit Na+ reabsorption by actions on different transport mechanism, which are located at different sites in nephron. All diuretics are acting on the luminal surface of the nephron. They are protein bound in blood and reach the tubular fluid by secretion into proximal convoluted tubule utilizing the organic acid transport mechanism. They are mostly used to control symptoms of breathlessness and fluid retention. However, they do not alter disease progression or prolong survival. Thus they are not considered mandatory therapy for patients without fluid retention. Loop diuretics for example furosemide is most widely used if compared to other thiazide. It produces diuresis with NaCl loss. It also has vasodilator action which is partly mediated via prostaglandin. This will increase blood flow in the medulla and hence contributes to their natriuretic effect. Unlike thiazides, loop diuretics maintain their effectiveness in the presence of impaired renal function, although higher doses may be necessary. Thizide diuretics are relatively weak diuretics and used alone infrequently in HF. However, thiazide like metolazone can be used in the combination with loop diuretic to promote effective diuresis. Angiotensin-Converting Enzyme Inhibitors (ACEIs) ACE is binding to the plasma membrane and can also exist as a soluble enzyme. The ACEIs act by substrate competition by binding in the Leu-His binding pocket on ACE. Thus, action of angiotensin-I is inhibited. They also decrease the concentration of angiotensin II and aldosterone and attenuating many of their deleterious effects, including reducing ventricular remodelling, myocardial fibrosis, vasoconstriction and sodium and water retention. In addition, they also very helpful in reducing blood pressure due to arterial vasodilation. However, they will inhibit the breakdown of bradykinin which contributes to strong hypotensive action and cough. There are currently 11 ACEIs available for clinical use with similar structure and properties, including captopril, enalapril, lisinopril and others. ACEIs are indicated in all grades I to IV of heart failure which stated in NYHA. Potassium sparing diuretics should be stopped before starting ACEI. ACEIs may increase the risk of renal failure in patient with high dose diuretics, elderly, those with existing renal dysfunction and patients with grade IV HF. Hence regular renal function monitoring is required once patient has stabilized on drug. ÃŽÂ ²-blockers ÃŽÂ ²-blockers can be either selective for ÃŽÂ ²1-adrenoceptor which is cardioselective such as atenolol, bisoprolol and metoprolol or non-selective which can act on both ÃŽÂ ²1-and ÃŽÂ ²2-adrenocepors such as propranolol and timolol. Blockade of ÃŽÂ ²1-receptors will decrease rate and force of contraction of heart. Meanwhile, ÃŽÂ ²2-adrnoceptor blockade inhibits adrenaline-induced vasodilatation mediated by these receptors. Via these mechanisms, heart rate and cardiac output can be reduced. Beneficial effects of ÃŽÂ ²-blockers may result from antiarrhythmic effects, slowing ventricular remodelling, decrease myocyte death, improving LV systolic function, decreasing heart rate, and ventricular wall stress. The use of ÃŽÂ ²-blockers is not suitable for patients who have unstable HF. Patients should receive a ÃŽÂ ²-blocker even if symptoms are mild or well controlled with ACEI and diuretic therapy. Because of negative inotropic effects of ÃŽÂ ²-blockers, they should be started in very low doses with slow upward dose titration to avoid any symptomatic worsening. ÃŽÂ ²-blockers may worsen HF in the short term, but if use with caution they may be very useful in preventing long-term deterioration. Aldosterone antagonists Aldosterone antagonists such as spironolactone and eplerenone also can be called as potassium sparing diuretics. They act on aldosterone-sensitive portion of nephron (last part of distal convoluted tubule and first part of collecting tubule. They block the mineralcorticoid receptor and inhibit Na+ reabsoption and K+ excretion. Spironolactone can be added to ACEI, diuretic and digoxin to improve morbidity and mortality in patient with severe HF. Eplerenone is more specific compared to spirinolactone as inhibitor of aldosterone receptors and has been shown to reduce morbidity and mortality in patient with left ventricular dysfunction post-MI. However, the diuretic effects of aldosterone antagonists are minimal. Combination of aldosterone antagonist with thiazide or loop diuretics will potentiate the effect of thiazide or loop diuretics. This is a more effective alternative compared to potassium supplement. Angiotensin receptor blockers (ARBs) and Digoxin ARBs may be used as an alternative to ACEIs (eg: losartan) when patient is intolerant to ACEIs or may be used as adjunct therapy (eg: valsartan and cadesartan) in patient who remains symptomatic despite the dose of ACE and ÃŽÂ ²-blockers have been optimised. However, ARB is not given to the patient since she is well tolerated to ACEIs. Digoxin is one of the main drugs for HF treatment. However, digoxin is not recommended in this case. Digoxin can only been given if patients HF is worsening or patient is having atrial fibrillation at the same time. Hence, it is reasonable to exclude digoxin from treatment in this case. Evidence for treatment of the conditions Diuretics Diuretic is a very important drug for heart failure treatment especially for symptoms of fluid retention. A meta-analysis which includes 18 randomised controlled trials (RCT), n=982, had been carried out to study the role of diuretics (loop diuretics and thiazides) in patient with congestive heart failure (CHF). 8 trials were placebo-controlled and another 10 were comparison between diuretics and other drugs such as ACEIs, digoxin and ibopamine. The results had shown that diuretics reduce the risk of deterioration of disease and mortality compared to placebo group. When compared to active controls, diuretics also showed significant improvement in patients exercise capacity. The beneficial effects of diuretics are further supported by Cochrane database which also indicated that diuretics cause significant reduction rate and improvement in patients morbidity. Another study also proved that the withdrawal of furosemide will cause increase in volume load and right ventricular pressure. There will lead to deterioration of CHF which include impaired quality of life, weight gain and walking distance reduced. Higher dose of furosemide will have more desirable effects such as increasing general well-being and reducing symptoms of disease. However, the inappropriate high dose of furosemide will lead to hypotension. The risk of hypotension will be increased if patient on ACEIs or vasodilators at the same time with diuretics. According to NICE guidelines, low dose should be prescribed for the initiation of therapy and titrated up according to patients condition. Furosemide is the most commonly used loop diuretic. However, some patients are more responsive to other loop diuretic such as torasemide. This may due to its longer duration of action and high absorption. Some pharmacoeconomic analyses also proved that torsemide reduces hospitalisation for patient with CHF. Hence, overall treatment costs are reduced although torasemide is more expensive than furosemide. Patients that treated with torasemide have improved their quality of life. The data also suggest torasemide to be used as first-line treatment for patients with CHF and for those who are not response to furosemide. Besides that, according to a double-blind study, n= 1663, additional of aldosterone antagonist, spironolactone with furosemide had significantly reduced mortality and morbidity rate of patients with severe HF Hence from the evidences above, we can conclude that furosemide 40mg od is rationale to be given to patient to treat the symptoms of her CHF. Angiotensin-Converting Enzyme Inhibitors (ACEIs) The patient is taking perindopril 4mg od for her HF. A clinical trial has been carried out to compare the effectiveness between ACEIs and placebo in patients with symptomatic CHF. The overall results showed the significant reduction in total rate of mortality and risk hospitalisation. The benefits of ACEIs are further supported by five long-term randomised trials which had recruited 12763 patients with heart failure or left-ventricular systolic dysfunction (LVSD) to compare the effectiveness between ACEIs and placebo. Results showed that mortality rate has been reduced by 23%, readmission rate of heart failure reduced by 35% and re-infarction rate had been reduced by 26% for the patients who assessed ACEIs compared to placebo group. The benefits of ACEIs were observed at the beginning of therapy and it persisted long term. In SOLVD investigation, n=4228, ACEIs (enalapril) reduced the rate of hospitalisations and also incidence of heart failure in patients with reduced left ventricular ejection fractions compared to placebo group. Some randomised controlled trials proved that ACEIs also improve the exercise capacity and quality of life in majority of the patients. Not all the patients with heart failure due to left-ventricular systolic dysfunction experienced the improvement of exercise capacity. However, ACEIs alone is not enough for the treatment of heart failure with pulmonary oedema. Diuretic is needed to maintain sodium balance and prevent any fluid retention. ACEIs are more often to be prescribed compared to vasodilators and angiotensin receptor blockers due to more evidence supports. ACEIs will cause hyperkalaemia, cough and deterioration of renal function. Hence, renal function and serum potassium level need to be checked before the treatment is initiated. The SOLVD data, a randomised, double-blind and placebo controlled trial with 3379 patients, proved that enalapril caused 33% increased in deterioration of renal function compared to control group (P = 0.03). There is another study (n=191) showed that 44% of patients taking ACEIs suffered from persistent cough compared to controls which is only 11.1% (P The studies above showed that ACEIs are rationale to be used as first-line treatment HF. ÃŽÂ ²-blockers ÃŽÂ ²-blockers should be included in the treatment of HF even though the patient is already well controlled by diuretics and ACEIs. The European Journal of Heart Failure suggested that ÃŽÂ ²-blockers should be prescribed to all patients with stable HF and when left-ventricular ejection fraction à ¢Ã¢â‚¬ °Ã‚ ¤ 40%. A lot of meta-analyses showed that ÃŽÂ ²-blockers play a role in increasing life expectancy in patients with HF due to LVSD. In a meta-analysis which includes 21 trials (n= 5894), ÃŽÂ ²-blockers showed a significantly reduction of overall and cardiovascular mortality by 34-39%in patients with severe HF. Another meta-analysis of 16 clinical studies also showed the reduction of 24% for patients who were taking ÃŽÂ ²-blockers for their HF treatment rather than placebo. An interesting meta-analysis had been carried out to test the efficacy of ÃŽÂ ²-blockers in the patients with diabetes mellitus (DM) and CHF. The result of this meta-analysis showed that ÃŽÂ ²-blockers had reduced the mortality rate of patient with DM and CHF. However, the reduction was not significant (P=0.11) compared to CHF patients without DM. Most of the survival benefits for patient with NYHA class II and III are well documented. There is a meta-analysis had proven that ÃŽÂ ²-blockers are having the same improvement of survival rate among the patients with severe HF compared to patients with NYHA class II and III. However, further studies need to be carried out to evaluate overall benefits versus risks of treatment in NYHA class IV. There are three main studies, nà ¢Ã¢â‚¬ °Ã‹â€ 9000, had been carried out to compare the efficacy between ÃŽÂ ²-blockers (bisoprolol, metoprolol succinate CR, carvedilol) and placebo. Almost 90% of patients involve in there three randomised trials were on ACEIs or ARB. Most of them also took diuretics and digoxin. All trials showed the improvement of mortality rate (RRR= 34%), risk of hospitalisation (RRR= 28-36%) and self-reported well being. So far, there are no significant differences between selective and non-selective ÃŽÂ ²-blockers and those with or without vasodilating propert ies. In one randomised controlled trial (COMET), n=3029, carvedilol was used to compared with the efficacy and clinical outcome of metoprolol tartate. The result has shown that carvedilol reduced the mortality rate significantly among the patients compared to short-acting metoprolol tartate (P=0.0017). However, there is no any clinical trial about comparison between carvedilol and long-acting metoprolol succinate. There is little economic evidence can be found for ÃŽÂ ²-blockers. NICE guidelines suggested that ÃŽÂ ²-blockers are cost effective due to reduction of hospitalisation rate. Bisoprolol 2.5mg od had been added to the patient on second day since patient was admitted. The evidences above do support that the usage of ÃŽÂ ²-blocker should be included in patient with HF. Aldosterone antagonists Spironolactone is the most common aldosterone antagonist used in treatment of HF. In a double-blind study (RALES), 1663 patients with severe HF (NYHA class III and IV), left ventricular ejection fraction à ¢Ã¢â‚¬ °Ã‚ ¤ 35% and being treated with diuretics, ACEIs or digoxin were recruited to test the effectiveness of spironolactone on their morbidity and mortality. The result showed 30% reduction in mortality rate and 35% reduction of frequency of hospitalisation compared to placebo group. Addition of spironolactone to ACEIs, diuretics or digoxin had reduced the mortality rate in patients with severe HF. Additional of spironolactone may lead to hyperkalaemia. However the problem of hyperkalaemia can be solved by closing monitoring the potassium level of patients. Another study also showed that spironolactone reduced 30% mortality rate in patients with HF when it has been added to ÃŽÂ ²-blockers and digoxin. A selective aldosterone antagonist, eplerenone, has fewer side effects compared to spironolactone. A randomised controlled trial (EPHESUS), n=6633, proved that morbidity and mortality rate among patients with left ventricular dysfunction after acute myocardial infarction had been reduced with the addition of eplerenone compared to placebo group. There is no relevant economic evidence of aldosterone antagonist. Eplerenone is mostly used when patients cannot tolerate with spironolactone. Hence, spironolactone 25mg od is appropriate to used as adjunct to diuretics, ACEIs or maybe ÃŽÂ ²-blockers for patient in this case. Since the patient does not suffer any side-effects from spironolactone, it is not necessary to change to eplerenone. Conclusion As a conclusion, patients CHF has been appropriately treated by following the guidelines and also supported by numerous of clinical studies. From the clinical process, we can see that the condition of patient was gradually improved day by day. A ÃŽÂ ²-blocker, bisoprolol was added in the second day in order to achieve a better control of patients HF and also HPT. According to guidelines, the dose of bisoprolol should be initiated with 1.25mg, not 2.5mg. The potassium levels need to be monitored regularly due to the concomitant use of perindopril and spironolactone which may cause hyperkalaemia. ARB and digoxin are not prescribed to the patient because she is well tolerated with ACEIs and she does not have AF. Other treatment for HF such as vasodilators (hydrazine and ISDN) will only be considered when all of the treatment options above have failed to this patient. Non pharmacological treatment such as life-style modification, healthy diet, restrict fluid intake and salt intake als o play a very important in controlling patients HF and HPT for long-term.

Got Milk? Essay -- Advertising Media Advertisements Essays

Got Milk? In the fast paced world of today, advertisers have to keep up with the times. One of the best ways they do this is through the Got Milk ads. Milk is a part of everyday life and the advertisers for Milk show this through modern tactics and popular celebrities. By putting familiar faces on magazine ads and using interesting T.V. commercials, companies sell their products. The ways in which they sell the products is not by just stating that their product is good, they appeal to the human emotions, ethics and most of all what is logical. There are many ad campaigns out there that strongly target one area, such as your emotions, but the Got Milk advertisers campaign has all three of these factors. To begin with, each ad is placed in a certain magazine based on who the reader will be, for instance, a 17-year-old girl is going to be reading Seventeen, not Maxim. When I looked through one of my Seventeen magazines I found a Got Milk ad with Britney Spears in tight clothing standing next to a little girl in a ballet costume. Above the little girl’s head was a statement that said Grow Up. This ad tries to appeal to a person’s logical side. At the bottom of the ad is written, â€Å" 15% of your height is added during your teen years and milk can help make the most of it.† A seventeen year old girl looks at this ad and is tempted to look just like her, so not only is this ad logical it also appeals to a girl’s emotional side. You would not find this ad in a car magazine for older men. Ad companies are not just trying to sell you a product they are trying to sell you the image of their product. It is not just magazine companies that try to get people to buy their product by appealing to emotions, logic and ethics, the pr... ...information posted about the company have a copyright from The National Milk Processor Promotion Board. When we see an ad campaign we know who the company is and exactly what they are selling. We have already seen how different tactics that companies use appeal greatly to ones emotions and ethics but exactly how logical is it? We never consider who is telling us that milk is good. People believe buying milk is right because the ads continuously state that it is good. The campaign for milk appeals to people’s emotions, ethics and their logic, it works because, people continue to buy milk. There are so many ads for milk out there that people just see them and believe that milk is right for them because it says so. People will continue living like this, buying the product without really knowing who sells it because it works, they get money for it and we get milk. Got Milk? Essay -- Advertising Media Advertisements Essays Got Milk? In the fast paced world of today, advertisers have to keep up with the times. One of the best ways they do this is through the Got Milk ads. Milk is a part of everyday life and the advertisers for Milk show this through modern tactics and popular celebrities. By putting familiar faces on magazine ads and using interesting T.V. commercials, companies sell their products. The ways in which they sell the products is not by just stating that their product is good, they appeal to the human emotions, ethics and most of all what is logical. There are many ad campaigns out there that strongly target one area, such as your emotions, but the Got Milk advertisers campaign has all three of these factors. To begin with, each ad is placed in a certain magazine based on who the reader will be, for instance, a 17-year-old girl is going to be reading Seventeen, not Maxim. When I looked through one of my Seventeen magazines I found a Got Milk ad with Britney Spears in tight clothing standing next to a little girl in a ballet costume. Above the little girl’s head was a statement that said Grow Up. This ad tries to appeal to a person’s logical side. At the bottom of the ad is written, â€Å" 15% of your height is added during your teen years and milk can help make the most of it.† A seventeen year old girl looks at this ad and is tempted to look just like her, so not only is this ad logical it also appeals to a girl’s emotional side. You would not find this ad in a car magazine for older men. Ad companies are not just trying to sell you a product they are trying to sell you the image of their product. It is not just magazine companies that try to get people to buy their product by appealing to emotions, logic and ethics, the pr... ...information posted about the company have a copyright from The National Milk Processor Promotion Board. When we see an ad campaign we know who the company is and exactly what they are selling. We have already seen how different tactics that companies use appeal greatly to ones emotions and ethics but exactly how logical is it? We never consider who is telling us that milk is good. People believe buying milk is right because the ads continuously state that it is good. The campaign for milk appeals to people’s emotions, ethics and their logic, it works because, people continue to buy milk. There are so many ads for milk out there that people just see them and believe that milk is right for them because it says so. People will continue living like this, buying the product without really knowing who sells it because it works, they get money for it and we get milk.

The Inklings by Humphrey Carpenter Essay -- Lewis Tolkien Charles Will

The Inklings by Humphrey Carpenter C.S. Lewis heard the bells of one of the colleges strike noon as he hurried purposefully along the narrow cobblestone streets of Oxford. He disliked giving the tutorials required of his position of Tutor in English Language and Literature at Magdalen College and usually kept the sessions to the minimum required time. However, this tutorial had given rise to a particularly enjoyable debate, and he never liked to cut off a good hydebate, although he now wished he had. He was late. Lewis hastily acknowledged the barkeep as he ducked into the Eagle and Child, or Bird and Baby as the pub was better known, and hurried towards the sound of his friends’ laughter coming from the back room and to join in the conversation he had been looking forward to all morning. The group was a usual fixture in the pub on Tuesday mornings, and he was swiftly served his drink as ordering was no longer necessary. As he settled back into his chair, listening to the conversation, he surveyed this group of men, collectively known as the Inklings, which had come to mean so much to him over the years. Present today were Lewis’s brother Warnie Lewis, J.R.R. Tolkien, Charles Williams, and Hugo Dyson. Lewis briefly wondered what the rest of the members (Nevill Coghill, Owen Barfield, R.E. Havard, and Adam Fox) were doing as he began to reminisce. The impact this literary group had on the world, with books like The Screwtape Letters, The Lord of the Rings trilogy, and War in Heaven written by brilliant Inklings as evidence, is tremendous. At the same time, no one was more influenced by the Inklings than Lewis himself. Each of the Inklings might have known one or two others before the formation of the group, thr... ...endship, centered around Lewis, which rose above the diversity. The group rose and began to gather hats and coats to ready themselves for the crisp spring afternoon. It had been a good Inklings and had produced some rather stimulating conversation. It occasionally reached such a fevered pitch that some other patrons of the Bird and Baby, not the regulars who regarded the Inklings as somewhat of a fixture, to raise an eyebrow. Lewis once remarked they â€Å"probably think we’re talking bawdy when in fact we’re very likely talking theology† (185). As this diverse group of friends separated to go back to their jobs at various colleges, Lewis smiled to himself. He was already looking forward to Thursday. Work Cited Carpenter, Humphrey. The Inklings: C.S. Lewis, J.R.R. Tolkien, Charles Williams, and their friends. Eugene, OR: Wipf and Stock Publishers, 1979.

Three Day Road Essay

Elijah and Xavier were always the best of friends. From the day they met at Residential School, they started to bond, and had a connection as strong as two brothers. However, they were eventually split apart, as Xavier had decided to fulfill his role as a bush Indian, and left with his Aunt Niska to live in the wilderness. When years had passed, Xavier got lonely, and the only person he wanted to have by his side was Elijah; thus, their friendship was rekindled. Now, many years later, they still have not left each others side. They consider each other as brothers, and yet, Xavier ends up killing Elijah.In the book Three Day Road, it is clear that Xavier enables Elijah’s actions before and during war that lead to Elijah’s eventual death, causing Xavier to fall ultimately responsible for Elijah’s death. Without Xavier, Elijah would not have succeeded in war. He learned how to shoot, hunt and have killer-instinct from Xavier, turning him into an eventual heartless k illing machine. The first example of Xavier being responsible for the training of Elijah comes from the first scene in the book, when both boys are out together for the first time. After hunting and effectively catching a marten, they suspect it to be dead.As they walk closer to the Marten, it is clear to both characters that it is still quite alive and struggling to break free from the trap that Xavier and Elijah had laid. Panicking, Elijah says: â€Å"What do we do, Xavier? † (2) Xavier quickly responds, without hesitation, by running towards the nearest log he can find, and brutally smashing the marten to death with it. Elijah, in shock, is told that it had to be done by Xavier. He believes him. It is clear that the first example of brutal violence that Elijah was exposed to before the war was both with and produced by Xavier.This one moment is what provoked eventual quotes from Elijah in the novel, such as: â€Å"Killing is in my blood. † (236). Without Xavier, Eli jah wouldn’t have known how to kill an animal, let alone a man, therefore causing the battlefields of Europe to be no place for Elijah Whiskyjack. Xavier is a naturally quiet and passive person, which ultimately resulted in always allowing Elijah to continue on with his inhumane actions during the war. â€Å"He seems to be spending more and more time with Grey Eyes, but I don’t ask much of it† (Xavier, 124). Elijah stating that, â€Å"Scalping Fritz feeds my unger† (312), and sharing that, â€Å"I know you don’t like what happens next, so I won’t give you the details† (Elijah speaking to Xavier about scalping, 286). Each of these quotations are examples in the book of Xavier hearing or witnessing something Elijah saying or doing. Xavier sees Elijah doing things morally wrong all the time, and consistently does nothing about it. He doesn’t even utter a word. When Grey Eyes started spending time with Elijah, Xavier automatically assumed that Elijah wouldn’t try morphine, as it ‘isn’t in his nature’ to do such a thing. He did.When Xavier noticed the scalps piling up in Elijah’s army bag, he feared that something was wrong with Elijah. He feared even more when Elijah stated that scalping Fritz fed his hunger. But surely, thought Xavier, Elijah would not become Windigo; he did. As it is clear to see, Xavier did not voice his opinion at important stages in Elijah’s life. Perhaps if Xavier had simply told Elijah that Grey Eyes was not only a bad influence on him, but a bad person in general due to his heavy morphine use, Elijah would have listened to him and not hung around with Grey Eyes, and never become addicted to the drug.Maybe if Xavier had forced Elijah to stop scalping and take a breath from reality, Elijah would have realized that he was getting out of hand and stop taking Fritz scalps altogether. This way, he never would have turned Windigo. As you can see, ther e are two clear times in the novel where Xavier should have been a true friend and voiced his opinion towards Elijah about his problems, but not once did he do so. This caused Elijah to not see any problems with the things that he was doing or even realize what a terrible person he was becoming. It could have all been prevented.Xavier affected not only the events leading up to Elijah’s death, but literally was the one to kill him. In fact, he attempted to kill him twice. The first time was in an army tent. When Xavier suspected Elijah to be sleeping, he pulled out a needle filled with morphine from Elijah’s army kit. He plunged the needle into one of Elijah’s larger veins, but ended up not going through with the injection, as Elijah woke up confused, asking Xavier what he was doing. Xavier quickly responded, saying that he was giving him morphine, and then â€Å"slowly pulled the needle from Elijah’s arm and placed it back in his kit† (323).This at tempt of killing Elijah went miserably wrong, and caused Elijah to question whether or not he could trust Xavier as a friend anymore. It is clear that Xavier did not have the best track record with Elijah at this point. He trained him for War at a young age and did not speak out about both morphine addiction and scalping enemies. Furthermore, he attempted to kill Elijah with morphine, fearing that he had gone mad. By not going through with killing Elijah in the first place, it lead to him having to deal with him one on one in the middle of a crater on the battlefield (368-372).Elijah, knowing that Xavier would have killed him the first chance they were alone, planned to jump Xavier in the crater. Xavier, at this point, had no choice but to kill Elijah; the war machine that he himself had created. He ended up succeeding in this, only to find himself in a hospital days later. The all-out fight to the death between two best friends could have gone either way, however, it never should h ave occurred in the first place. If only Xavier had made different decisions in respect to Elijah as their friendship progressed, the death of Elijah never would have occurred. Xavier is ultimately responsible for the death of Elijah.

Plan I For Paradise Essay

As we expand our business in Kava, we have to bear in mind that the major obstacle to business in this piece of paradise in the South Pacific is the number of disasters that take place on it. We may lose our business one fine day to a tsunami if nothing else. All the same, our new plan to expand our business in Kava is necessary, seeing that we could be of tremendous assistance to the government of Kava apart from the significant number of people who reside here – all of whom are expecting perfection in this tiny patch of paradise, which is the reason why they do not leave it for good despite the threats faced by Kava. Although there are various models provided by textbooks to understand and measure organizational effectiveness, the basic meaning of organizational effectiveness remains unchanged: It is for the organization to be doing everything that it knows how to do, and to be doing it well. The organization knows how to manage its employees, and to manufacture the products or provide the services that it originally set out to manufacture or provide. However, in order to be effective in its operations, the organization should be managing its employees well, and manufacturing good quality products or providing high quality services to its customers. What is more, in the organizational environment of today, the organization that is effective in its operations must be effectively using information technology. This is, in fact, one of the requirements of organizational effectiveness in our time (Helms). Besides, this is an essential element of clearing the mess for an ‘organization’ to come into existence. With the above definition of organizational effectiveness in view, we shall make the most technologically advanced shopping mall in the center of Kava. Given that our business culture could serve as a model for the rest of the businesses on this land, our organizational culture, which will be the personality of our company, would not only accommodate the latest advances in technology in all respects, but also an emphasis on ethics (McNamara, 1997). We will be supporting the economy of Kava by hiring a great number of people to work on our premises. In our organizational culture, we will value diversity, seeing that it is a highly effective strategy (Whitfield and Landeros, 2006). Diversity in the workplace is expected to facilitate the exchange of new ideas, making the organization more creative in its thinking; improve the problem solving ability of the organization through the invitation of diverse ideas; and establish a respectful as well as tolerant and accepting work environment (Reichenberg, 2001). The workplace that values diversity among its employees would have an organizational culture that stakeholders around the world would admire and respect. An organization that does not value diversity in the workplace, however, will reflect the negative attitude and discrimination toward diverse groups also in its organizational culture. More importantly, the workplace that reflects prejudice and discrimination in its organizational culture would not be able to convince its stakeholders of allowing it to remain in the marketplace, seeing as it is impossible to satisfy the needs of those that the organization despises. Organizational health programs, too, are essential for the survival of companies. Undoubtedly, a healthy workforce would work wonders for any business by reducing absenteeism and turnover, and increasing employee motivation, productivity and revenues. Lowe (2004) writes that hundreds of studies have already documented the direct as well as indirect advantages of â€Å"healthy work environments† to employees in addition to their organizations (p. 7). Indeed, healthy workplaces as well as jobs contribute to the well-being of employees. These benefits may be realized by the whole organization through lower absenteeism, lower turnover, higher job satisfaction, improved performance on the job, lower rates of accident, in addition to â€Å"reduced health benefit and worker compensation costs (Lowe, p. 7). † Moreover, research has revealed that the largest gains in productivity may be realized by the organization that changes the entire work environment to make it healthier for all employees (Lowe). Hence, we will treat the residents of Kava that work with us with utmost respect by not only offering them good salaries, but also by focusing on their health and safety on our premises. Research has revealed that the United States has occupational injury and illness rates that rival those of AIDS, Alzheimer’s Disease, and various kinds of cancers (â€Å"Dying for the Job,† 2002). We will undo the wrongs of the organizational processes in our homeland by making our business environment as safe and healthy as possible. The impact of this aspect of our organizational culture is expected to be great. As a matter of fact, the impact will be experienced even in the United States where businesses might cite our own organization as an example in health and safety management. Because of threats of terrorism, we will employ the most technologically advanced security system in our new shopping mall in the center of paradise. In addition, the environment that we create would reveal itself to be so healthy and safe that all consumers and employees would be able to virtually forget about the disasters in Kava while they remain on our premises. It is necessary to provide such a safe haven for the people of paradise. In point of fact, creating such an environment would yield long term benefits for our company. What is more, by interacting with our customers with their best interests in our view, our company would additionally be able to strengthen its relationships within the community. Finally, it must be clarified that all of our business transactions related to the new business venture would be fair and square. There shall be no dishonesty in any aspect of our business, and all instances of fraud as well as business misunderstandings will be treated with a sense of urgency and justice. By developing a strong and effective organizational culture that incorporates the values outlined above, we would not only be able to nurture our human resources in order to effectively utilize them, but we would also be serving as an exemplar for the rest of the businesses in the community. With good business practices, our company is definitely expected to function in the community for a long time. In order not to lose our focus on ‘best practices,’ as the business community nowadays refers to good business practices, we shall make the following definition of total quality management a part of our mission statement: â€Å"[E]verything in our company has to be done the best that is humanly possible. There’s no room for `good enough (Nelton, 1993). ’† Even in the event of a major disaster, the example we set shall remain as a model for others to follow for a long time to come.