Fear Essay Example | Topics and Well Written Essays - 750 words - 1

Dread - Essay Example It is the comprehension of this understudy the distinguishing proof by Phil Barker of the primary explanations behind the foundation and practice of dread inside the current model is completely right. One need look no farther than the fundamental explanations behind the upsurge in radical Islamic psychological warfare, the ethnocentric and bigot activities of gatherings that accept their lifestyle is tested, or the manners by which social or potentially strictly underestimated networks incorporate the comprehension of dread inside their positions to comprehend and welcome the manners by which this assists with characterizing practically every single part of human cooperation and personality. Similarly, Jim Buren, the hero of Cather’s My Antonia, speaks to a reiteration of fears that serve to give a significant and order impact in transit that the character incorporates with his general surroundings. Normally, the story itself is for the most part worked around Jim’s fas cination in Antonia; in any case, the sub plot that infests the story is concerning the way where Jim Buren battles between the portrayal of what others see that he ought to be and what he himself wishes to be. This brings out a lot of fears in Jim concerning how others see him and it is one of the principle reasons why he decides to get hitched rashly and to a lady that he isn't really infatuated with. Believing that the riches and status that the lady gives will be more valuable than genuine affection, Jim races into a wedding of comfort that will at last make him a more disenchanted and less fulfilled person. Eventually, the decisions that Jim makes, up to and including until the finish of the novel are intelligent of the dread of reprimand and analysis that others may load upon him. This is expected in huge part to the way that Jim is an outcast of the network and has put a high accentuation on the significance of consideration as a methods for accomplishing what he set out to. At last, likewise with numerous choices and inquiries of right or wrong, the decisions that Jim made in life assisted with moving him to a moderately high and significant position and enhance him substantially. This status was the immediate and unchallenged aftereffect of the way that his unavoidable dread of rebuke and judgment made him place a very elevated level of significance upon acknowledgment that an extravagant activity and an all around regarded vocation and lucrative compensation could manage the cost of him. In any case, the final product was that he was profoundly bankrupt when contrasted with Antonia. As an element of the twisted personality that Jim had worked for himself, the degree of joy that he had the option to appreciate and acknowledge in this life was perpetually decided dependent on the feelings of trepidation of acknowledgment and judgment that he conveyed inside him from quite a while ago. As a methods for incongruity, a similar differential that kept Anton ia and Jim separated in their childhood, their various standpoints and perspectives, keep on giving an extremely wide inlet between the two in mature age. The story itself assists with embodying the manner by which fears can rapidly work their way into a person’s life and try to completely rethink the manner by which they recognize themselves and the truth that characterizes life. As a component of

Economic Growth Rate of Malaysia

Financial Growth Rate of Malaysia After world downturn the paces of development were changed from a years ago equivalent to Malaysia (charts cry). Malaysia has been feeling the consequence of worldwide financial decay, primarily in the last quarter of 2008. Fares and venture had centered during the time that thusly made genuine GDP development decelerate pointedly to a minimal 0.1%.In the substance of expanding worldwide financial complexities, the Government had revealed the subsequent Stimulus bundle of RM60 billion in March 2009 so as to keep the local economy from decreasing and fall into a profound downturn. More than 2009 and 2010, the bundle executed that additionally help work, private division venture and utilization just as giving social security net. In November 2008, the Government had declared the principal improvement bundle adding up to RM7.0 billion. The financial upgrade bundles are to praise expansionary money related approach to help bolster residential spending and in general monetary development. The Government as of late modified descending the countrys GDP anticipate for 2009 to between short 5.0% and less 4.0% from its previous projection of less 1.0% to 1.0%. The update was made after first quarter 2009 GDP shrank a more terrible than anticipated 6.2%. This is the principal decrease since second from last quarter of 2001 (- 0.4%). Entire the world was discovered a terrible conditions in downturn and swelling, and this information showed the duties of Malaysia government for forestall its nation in against of expansion and its warmth on lifes quality. To put it plainly, The Malaysian economy recorded a balance in 2008 influenced by the sharp decay in worldwide economy as the US sub-prime home loan issues developed into an out and out worldwide budgetary emergency. The decay in outer interest had unfavorably influenced the countrys fare and venture execution, while hindering spending on utilization. As an open economy, Malaysia is encountering the more grounded effect of worldwide monetary emergency this year and the countrys genuine GDP could likewise slip into downturn in the wake of posting a moderate 4.6% development a year ago. Various money related and financial arrangement measures have additionally been declared by the Government to help bolster the economy. While the financial boost includes high budgetary expense to the Government, and the monetary shortfall will essentially grow, the expansionary strategy reactions are important to help keep the economy from sliding into a more profound downturn. Nonetheless, the constructive outcomes of these approach measures must be accomplished after their fast and viable usage. Financial development take places at whatever point individuals take assets and rearrange them in manners that are increasingly important. A helpful illustration for creation in an economy originates from the kitchen. To make significant last items, we combine ease fixings as indicated by a formula. The cooking one can do is restricted by the gracefully of fixings, and most cooking in the economy produces bothersome symptoms. On the off chance that monetary development could be accomplished distinctly by accomplishing increasingly more of a similar sort of cooking, we would in the long run come up short on crude materials and experience the ill effects of unsuitable degrees of contamination and aggravation. We gain from mankind's history that, in any case, financial development springs from better plans, not simply from all the more cooking. New plans for the most part produce less horrendous symptoms and produce increasingly monetary worth per unit of crude material. Each age has seen the cutoff points to development that constrained assets and unwanted symptoms would present if no new plans or thoughts were found. Additionally, every age has thought little of the potential for finding new plans and thoughts. We continually neglect to get a handle on what number of thoughts stay to be found. The trouble is a similar one we have with intensifying: potential outcomes don't simply include. In 1997, Malaysia experienced a brutal pass up the Southeast Asian monetary emergency, the swapping scale of Malaysian cash ringgit against the U.S. dollar has diminished 46%, the composite list of securities exchange fell the greater part. In 1998, Malaysias economy first, began the negative development (- 7.5%) since most recent 13 years, after that joblessness and swelling rates expanded. In September 1998, Malaysian Government received the expansionary financial approach, at that point the presentation of particular capital and cash control computes came out. The significant substance focused on the guideline of transient outside speculation, the Ringgit Malaysia against the U.S. dollar conversion scale will be fixed at the degree of 1:3.8, and afterward government reported the preclusion of seaward ringgit exchanges. From that point forward, Malaysia budgetary circumstance was being settled, the securities exchange had additionally been step by step recouped, and a yearly financ ial normal development rate has stayed above 8% since that year. Lately, Malaysian saw the steady swapping scale of money, rebuilding of bank corporate obligation, extending request of local and new fare approaches, the economy of Malaysia has kept up a fast development. Government had focused on some significant executions to financial shortage, for instance, the annulment of various exorbitant picture ventures, particularly concentrating on the development and other fundamental businesses, for example, farming. Government suggests the expending and contributing practices, so now the private parts are as the countrys new monetary development columns. Simultaneously, government energizes the advancement of the travel industry, instruction and accomplishes monetary expansion. To build the monetary development rate, first, must limit the expenses and assimilate greater speculation. Presently we can see there are numerous nations are contending with one another, they battle since they need greater speculation, however this conduct may bring down the norm, just as decreasing the assortment of prerequisites. Along these lines, these are misfortunes to us. Malaysia can plan something for keep away from this circumstance. For instance, help Malaysian the travel industry to be renewed. Furthermore, Malaysia government likewise wouldn't like to bring down the measures. Else, they should additionally keep up an exclusive expectations and own image. Malaysia government needs to have their very own portion strategies and measures, not simply to state that they reject all the suggestions from west, yet actually, they simply need to accomplish an equalization. We may feel that the west measures rely upon the straightforwardness and responsibility. Notwithstanding, the reality in Asian nations, this has been a shortcoming, they generally state that there would be numerous upgrade bundles, and the unnoticed part isn't completely used or the piece of measures we need from west for concentrating on the responsibility, which was referenced above, while fortifying inspecting the gauges. By thusly, Malaysia government can support the individuals, not by various outer undertakings of the mischief and effect, these things are as of now not mindful by them, and not, at this point their duty. In the event that Malaysia endeavors to accomplish a quicker financial development rate as indicated by the current worldwide circumstance, I think, contrast and the focal points got as of now, Malaysia residents will trouble more disservices once government settles on this choice. For instance, joblessness and financial development are negative relationship, that is, monetary development rate rises, joblessness rate decreases; despite what might be expected, financial development rate decays, joblessness rate increases. Then again, swelling and financial development is connected so intently, it implies that the high monetary development rate has commonly been joined by a high pace of expansion. Initially, the quick monetary development, will additionally animate the development of speculation, yet in addition increment a considerable interest in total, along these lines adding to an expansion in costs which prompts the swelling; if Malaysia government bring down the speed excessivel y quick, despite the fact that the costs might be settled for some time, yet in addition will bring problemssupplies are decreased, and numerous organizations will be in cut-off, semi cut-off state, even a few specialists will lose their work security which likewise causes the social instability(this is as of now occurred on Malaysia send out businesses a couple of years back). All things considered, if the economy is becoming excessively quick, clearly surpassed the extent of assets, which will cause a genuine swelling. About the rising costs, particularly the sharp ascent in costs will influence the economy keeps on developing quickly. Since costs rise forcefully is so destructive, the state will embrace gravity measures to check swelling. The constriction speed will lead a sharp declining in monetary development rate or in any event, supporting a moderate financial development rate. Subsequently, during the monetary rebuilding procedure of Malaysia, in spite of the fact that her economy runs its own multifaceted nature and vulnerability, the applicable divisions in government must execute the undertakings, which are appointed by the residents to keep up the financial security of Malaysia.

What Do You DO All Day

What Do You DO All Day [by Joan Horvath 81] What do you DO all day? Theres a certain furtiveness when someone asks a scientist or engineer this question: perhaps it is nervousness about how thorough and multi-syllabic the response is likely to be, or perhaps a sense that maybe its best not to know. As for me, Im trying to get everyone so familiar with what scientists and engineers do that they wont have to ask! I graduated from MIT in aeronautics and astronautics a thousand internet years ago, when those of us who lived over on the Boston side had to hike over the Harvard Bridge to this place called a library to get information. It was, of course, uphill both ways in the snow to get to the Institute back then. After a stint in grad school someplace with palm trees, I spent 16 years at the Jet Propulsion Lab (JPL) in Pasadena, California. JPL is the place that sends out robots to explore other planets. The high point for me was when I was on the flight team for the Magellan spacecraft, which orbited Venus and sent back radar images of the surface. We got to see the images shortly after they came down, and I remember looking at Venus surface and saying to myself, No one else in history has seen this before. It was like being along with Roald Amundsen at the South Pole, but warmer and with better food. In 2000 I left JPL to try out consulting, teaching and writing a rather different style of exploring the world. At JPL I was usually surrounded by other techies, as I was when I was an undergrad at MIT. When I started consulting, though, I discovered that there was a little pause at business social events when I cheerily described myself as a rocket scientist. She really is, too, friends of mine would helpfully add, which made it even worse. You could see the wheels turning desperately to generate rocket scientist small talk: So, what is it like to meet an alien? They imagined a lab in my basement that involved arcing electricity and some creature that would call me Miiiissstresss. (This would have its points if Critter-Boy could vacuum, but we digress.) Then there were the people who asked, conversationally and expecting a short response, whether I really believed in evolution. I had been complaining about this for years to friends of mine Doug Adrianson and Hope Frazier, both former newspaper editors. A point came finally when we convinced ourselves that I should write a book telling stories about real scientists and engineers and that they should edit it. It would not be a book about the science itself but about what it was like to live a techie life, about why people became scientists or engineers in the first place and then stayed that way. It had to be written in a style that wouldnt scare people off, and be short enough to be read in a night. Writing a book isnt like engineering: there are right and wrong grammar choices (and even arguments there), but there are no standard answers about the best way to tell a story. I think of myself as a pretty good communicator. Imagine my surprise when the first installment came back from the editors in shreds. Says who? They asked after reading (obvious, to me) descriptions of why science worked a certain way. I was being boring, they said: who are you trying to impress? Tell stories like you would over lunch. Get out there and tell us about these people! Let it rip! It was like being at MIT all over again, complete with late-night rewriting. More goes into a book than just the writing and editing. I wanted the book to have some illustrations, too, to make it more approachable. Brainstorming with artist Nichole Wong about visual ways to get across the energy and fun of doing science gave me yet a different perspective. For example, characters in the illustrations wear lab coats in a nod to the visual shorthand of what a scientist is, but are shown in settings beyond benches and glassware. Science fiction author Greg Bear wrote a foreword for us. Stargazer Publishing Company agreed to publish it and orchestrated the myriad of things that need to happen for a book to make it out the door. So now its out there, standing on its own. Its cool to think about someone Ive never met reading what Ive written and maybe thinking about science and scientists differently. Maybe a third-grade teacher will read it and understand why she needs to show her students how to do experiments. Maybe a parent who is uncertain whether a science career is a good idea will get more comfortable with his childs tendency to take things apart. And maybe someone will vote for a candidate for office who understands science better than the opposition, all else being equal. (Hey, we can dream.) But life gets in the way, too. Around the time we were finishing up writing the book, my friend and editor Hope was diagnosed with cancer. We lost her after what she called her nine month dance with the disease, a month before the release. I like to think that a bit of her carries on between those covers. Youll learn a lot if you to come to MIT. But the greatest thing youll learn is confidence to try something really different when the opportunity comes along. Make sure you grab every one of those you can! Book details: What Scientists Actually Do. By Joan Horvath; illustrations by Nichole S. Wong with a Foreword by Greg Bear. 2008, ISBN 978-1-933277-08-0 Stargazer Publishing Company

Essay on Cosmetic Surgery and the Mask of Aging in Western...

Cosmetic Surgery and the Mask of Aging in Western Society Grogan, Sarah (1999) Body Image: understanding body dissatisdaction in men, women and children. London and New York: Routledge 2 4 25 41 48 49-52 57 68 151 152 191 Body Image: The picture of our own body which we form in our mind, that is to say, the way in which our body appears to ourselves. (Schilder, 1950: 11) * (25) Slimness is seen as a desirable attribute for women in prosperous western cultures, and is associated with self-control, elegance, social attractiveness and youthà ¢Ã¢â€š ¬Ã‚ ¦women have always been encouraged to change their shape and weight to conform to current trends. Through the ages women have†¦show more content†¦* Why? The question of why women undergo unnecessary surgery to make their bodies more pleasing may help us to understand the nature of body dissatisfaction in women. * Feminist viewpointà ¢Ã¢â€š ¬Ã‚ ¦ * Women as active and knowledgeable agents who make decisions based on limited range of available options. Women see through the conditions of oppression even as they comply with them. Women making free choices, although thses choices are limited by cultural definitions of beauty and by the availability of particular surgical techniques. The choices need to placed within a framework which sees womens bodies as commodities. * A way to re-negotiate identity through changing the appearance of the body. * Kathryn Morgan (1991) ÃÆ' more mainstream feminist view. She argues that although women may feel that they are making a free and informed choice, they are not really free to make a genuine choice because of patriarchal cultural pressures on them; that, although women may say that they are creating a new identity for themselves, they are really conforming to traditional (male dominated) ideologies of how womens bodies should look. She argues that women who believe they are somehow taking control over their bodies by opting for plastic surgery have really been coerced byShow MoreRelatedCosmetic Surgery and the Mask of Aging in Western Societies Essay705 Words   |  3 PagesCosmetic Surgery and the Mask of Aging in Western Societies Nature isnt always the best. I have the money to improve on nature and I dont see why I shouldnt (Cher, as cited in Glasgow Evening Times: 24 April 1992) We hadnt seen or heard from each other for 28 yearsà ¢Ã¢â€š ¬Ã‚ ¦Then he suggested it would be nice if we could meet. I was very nervous about it. 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As the US fell into a deep financial crisis in 2008, consumers who felt wealthy from the housing boom and treating themselves to indulgences such as designer handbags and luxury cosmetics had started looked for lower-priced mass brands and private label products as to close their wallets. Besides, consumers have also begun to buy less products and wait until their cosmetics bottle empty to buy another. Many middle classRead MoreOne Significant Change That Has Occurred in the World Between 1900 and 2005. 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At the organizational level, marketing is a vital business function that is necessary in nearly all industries whether the organization operates as a forprofit or as a not-for-profit. For the for-profit organization, marketing is responsible forRead MoreStephen P. Robbins Timothy A. Judge (2011) Organizational Behaviour 15th Edition New Jersey: Prentice Hall393164 Words   |  1573 Pagesand Organizational Psychology. Fellowship: Dr. Judge is a fellow of the American Psychological Association, the Academy of Management, the Society for Industrial and Organizational Psychology, and the American Psychological Society. Awards: In 1995 , Dr. Judge received the Ernest J. McCormick Award for Distinguished Early Career Contributions from the Society for Industrial and Organizational Psychology. In 2001, he received the Larry L. Cummings Award for mid-career contributions from the OrganizationalRead MoreFundamentals of Hrm263904 Words   |  1056 Pagesbook will provide that strong foundation upon which additional coursework in HRM can be built. The objectives and content in this text have been created to be compatible with the content areas and curriculum templates developed and suggested by the Society of Human Resource Management (SHRM). The minimum HR content areas as identified by SHRM include: ââ€"   ââ€"   ââ€"   ââ€"   ââ€"   ââ€"   ââ€"   ââ€"   ââ€"   ââ€"   ââ€"   Compensation, benefits, and total rewards Employee and labor relations Employment law History of HR and its role HR and globalization

Heart Disease And Health Outcomes - 2279 Words

Kyle Andrade Tatiana Perrino June 2, 2015 Health Disparites Heart Disease and Health Outcomes 1. Epidemiology In the documentary, â€Å"Unatural Causes: is Inequality, making us sick?†, we are exposed to a number of different health outcomes that are ascertained due to various socioeconomic conditions. One such outcome is heart disease, which is a grave public health concern, due to its chronic effects and the sheer numbers of people living with the disease. Every year about 610,000 Americans die from heart disease, approximately 1 in every 4 deaths. Coronary heart disease is the most prevalent type of heart disease, resulting in more than 370,000 deaths annually. It tolls the United States approximately $108.9 billion each year. This massive amount includes the cost of health care services, medications, and lost productivity. HEART DISEASE FACT SHEET It is the No. 1 killer in the United States, resulting in nearly 787,000 deaths in 2011. It is also the major cause of death for most racial/ethnic groups in the United States, including African Americans, Hispanics and W hites. In respect to Asian Americans or Pacific Islanders and American Indians or Alaska Natives, heart disease is second only to cancer. Cardiovascular diseases claim more lives than all forms of cancer combined. Every 34 seconds a person in the United States has a heart attack. While every 60 seconds someone in the U.S. dies from a heart disease related event. Approximately 720,000 people in the U.S.Show MoreRelatedFactors That Influence Health Status958 Words   |  4 Pagesthat influence health status are known as determinants of health. Social determinants of health reflect the social factors and physical conditions of the environment in which people are born, live, learn, play, work, and age. According to Florida Public Health, Heart disease was the second leading cause of death in 2012, accounting for41, 643 deaths. The heart disease age-adjusted death rate per 100,000 populations decreased between 1990 and 2012 from 286.5 to 155.3. Heart disease was the leadingRead MoreTh e Death Of St Lucie County796 Words   |  4 Pages(2014) in the United State heart disease is the leading cause of death and stroke is the third leading cause of death. These diseases are very evident in this health care provider community of St. Lucie County. The County of St Lucie ranks 22 out of 67 in health outcome. Health outcome represents how healthy a County is (County Health Ranking, 2013). This poor health ranking in St. Lucie County is evident in the disease category of heart disease and stroke. Heart disease was the second leading causeRead MoreAuthor Lives In Mississauga City, Canada. And Her Background1736 Words   |  7 Pagespopulation. In Canada heart disease is the second leading cause of death accounting for 20% all death. 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CoronaryRead MoreRegulating Hypertension Through And Exercise Intervention1265 Words   |  6 Pageshistory. The risk for a disease is found using a genogram. Hypertension was determined to be the most prevalent disease based on the assessment of each family member and through her strengths and risks. Through the steps of the nursing process, the author will assess the disease entity obtained from the family genogram to plan a desired outcome, to then implement a thorough evidence-based intervention, and finally, to then evaluate the intervention to determine if the desired outcomes were met. The overallRead MoreSocial And Behavioral Theories Of Behavior Change889 Words   |  4 PagesIntroduction According to the World Health Organization (W.H.O), Cardiovascular disease is the number one killer disease in the world, killing about 17.5 million people and responsible for about thirty-one (31%) of global death in 2012. It is a major challenge for both the developed and the low and middle income countries (W.H.O. 2016). In the United States, heart disease is also the foremost killer disease. It killed 614,398 people in 2014 which is about twenty-three percent (23%) of the total deathRead MoreHow Is The Hrrp Reducing Chf Readmissions?1700 Words   |  7 PagesHow is the HRRP reducing CHF Readmissions? Congestive heart failure is a growing chronic condition in the United States that accounts for over one million hospitalizations and is responsible for 27% of patients with heart failure on Medicare are readmitted with 30 days of discharge (Hines, Yu Randall, 2010). The intensity of the disease process poses a financial strain on both the patient and the payers, especially Medicare, as 10 per 1000 population are 65 years or older and therefore a MedicareRead MoreHypertension Is The Leading Risk Factor For Cardiovascular Disease In Germany1096 Words   |  5 Pagesis the leading risk factor for cardiovascular disease in Germany. It is estimated that 33% of the total population is affected by high blood pressure (RKI, 2015). The healthcare infrastructure and access to basic needs also contribute to the health profile in Germany. Health care insurance remains a universal system that features a multi-payer system combining statutory health insurance (SHI) that account for 85% of the population and private health insurance (PHI) accounting for 11%. ApproximatelyRead MoreWellness Programs: Disease Management Essay1564 Words   |  7 PagesDefinitions Disease Management Disease management, as defined by the Care Continuum Alliance (CCA), 2011, is a multi-disciplinary, comprehensive, continuous, and coordinated method to achieving desired outcomes by utilizing preventive measures and evidence-based practice guidelines to alter the natural course of the disease; therefore, improving the overall health for a population. These outcomes include processes of reducing healthcare costs while improving the quality of life for individualsRead MoreAnalysis Of The Movie Fire Escape 911 Words   |  4 Pages75% of the 2.7 trillion dollars we spend on healthcare in this country is spent on treating diseases that are largely preventable, such as heart disease and diabetes. Why do you think this is happening? What can be done to change this statistic? The movie fire escape emphasizes that America has the most expensive health care system in the world but is not one of the best in regards to healthcare outcomes and life expectancy. It spends more than what the whole world all together spends on pharmaceutical

Fashion Film Free Essays

Rules and Regulations As fashion film is a new addition to the fashion installment, there aren’t any specific rules and regulations that the filmmakers have to follow because fashion is all about expressing opinions, feelings etc. However there are a few ethics that they should be aware of, with any film such as violence, drug abuse, discrimination etc. The filmmakers need to be aware of these ethics because the last thing you want the film to do is offend anyone because then the company, or in this case designer, could get a bad reputation and not become successful. We will write a custom essay sample on Fashion Film or any similar topic only for you Order Now Other things that should be considered when putting together a fashion show is the location because you want the show to be memorable to the audience and a unique location will help make it more memorable. The set is another important thing to think about because if there is a theme such as ‘nature’ being carried out though the fashion then you’ll want to back that up with a nature themed set; this will also make it more memorable to the audience. Seating should be considered because you want the audience to have a perfect view of the fashion and the film hat they will be seeing though out the show so that they can fully take in what they will be seeing. Lights are an important part of a fashion show because you want the catwalk to be lit up perfectly so the audience can see the clothes perfectly especially if there is any fine detail in the clothes. Music is something to consider because this can really add on to the theme of the show and create the sense of escapism that some audiences crave for; for example if there is a nature theme in your show then it could be a good idea to add some slow classic music with some wildlife sounds. The air and make up of the models is key to a fashion show because this can complete the look of the whole fashion show and really enhance the theme of the fashion show. One fashion show that really has been thought out to every detail is the Alexander Macaque show Homeowners SIS 10 in Paris. The title of the show was ‘Plat’s Atlantis’ and was inspired by concepts of environmental destruction, stem-cell technology, ‘mutation of the fittest’ and the underwater kingdom of Atlantis. The location of this fashion show is unknown but it was performed in Paris during Fashion Week at the end of October 2010. I would hold my fashion show in Paris because it is considered the fashion capital of the world. Paris is a great place to hold a fashion show because the fashion history is so strong compared to other cities like London or Tokyo. The set of the fashion show consists of a very long, white, wide catwalk to represent a laboratory to expand the theme of Stem Cell Technology; there was also a 60 foot LED screen at the back to display the fashion film and two twenty foot robotic cameras along side of the catwalk where one of the cameras displayed the footage it was getting onto the giant screen. I really liked this set because it enhanced the theme of a laboratory really well from the Petri dish like catwalk, the fashion on the models making them appear to be the experiments in the lab and the cameras acting like the scientists observing what was going on. The lighting used for this show was simple and even, this allowed the audience in the fashion show to see each outfit perfectly. This is a great way to install lights and I would defiantly use it in a fashion show because it doesn’t take the attention of the viewers away from the fashion. The music for this fashion show sounds like it would e played in an opening scene for a blockbuster movie set underwater; it contains a lot of heavy synchs and long slow drums. I like this music and would use it in a fashion show because it adds to the theme of the show ‘Atlantis’ and gives the audience a sense of escapism. To be able to broadcast my fashion film with music, I need to follow the rules set by The I-J Copyright Service. The law set by them states 1. Using the work of others If you use samples of music by other authors in your work, ensure that you get permission to use the work before you attempt to publish or sell your work. Similarly, f you use loops or samples available via sample collections etc. Ensure that these are licensed as free to use, or obtain permission first. 2. Obtaining permission If you need to get permission to use a piece of music, normally the best place to start is with the last know publisher for the work. They will certainly know how to get permission to use the work, (as they must have permission themselves), so they will certainly know who you would need to contact. If the work is by an U. S. Artist, you could contact the American Society of Composers, Authors and Publishers, IBM (Broadcast Music, Inc Band members agreements Where music is written as a group effort, we recommend that you draw up an agreement to clarify issues, such as which rights belong to which member, and how royalties would be distributed in the event that members of your group leave. For successful commercial bands, incorporation is also an option. As with a normal incorporated company, the band members would own shares in the band/company. In this situation, a band member would typically sell his shares to the other members if he decided to leave. This states that I need to obtain permission by the DC/Producer that produced this song. How to cite Fashion Film, Essays

Google vs Baidu in China free essay sample

Case Study Baidu vs Google The goal of this case is to broaden our knowledge of new business models and that of how local companies may struggle against foreign competition. You are asked to answer the following questions: 1 / What led to Baidus market dominance? Compare the two business models and their evolution 2 / How do you recommend Google to do in China? Compare Google position with the one of other companies in the internet-related industries. What can we learn from this comparison? / How do you recommend Baidu to do in the international market? Question 1 China witnessed the highest economic growth in the world since the adoption of its reform and openness to the outside policy. This growth has affected the Internet market in a very remarkable way, where the annual average in China’s Internet usage exceeded 39%. Many factors have led to Baidu’s dominancy in the Chinese market even over more experienced and global players as Google, Yahoo. We will write a custom essay sample on Google vs Baidu in China or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page . . etcLinguistic advantage: the Chinese Language is the dominant language in China which is read and spoken by the whole population. This gives a better advantage to local start up like Baidu to efficiently design an engine that is more relevant to the country culture. Social Cultural Advantage: Baidu as A local player knows the taste and preferences of the Chinese Internet users’ way more than its Competition does, there for solutions Were designed to better fit the requirements of the locals For example, typing replaced by a click on a menu list.Introduction of customer oriented technologies based on the Chinese internet habits ( for example Baidu MP3 music, Post bar, Baidu Zhidao, Baidu space featuring Blog + Space) New online advertising spaces and payment techniques were perceived more cost efficient for the advertisers as they better monitor the return on investment. More over Baidu launched â€Å"Baidu Alliance† which made it one of the strongest advertising al liance in China. The well designed Advertising techniques (pay per click, pay per erformance) helps them to generate money for the company). Governmental restrictions: The Chinese government placed restriction on outsiders and is this case on Google which was shown in the case when they clearly stated that in September 2002 its site was down with an error in the page and users automatically redirect on a Chinese search engine it was impossible for users inside china to access Google’s search engine in addition to that Google site was recently inaccessible and very slow.This will make Google lose customers for his direct competitor Baidu (if the website is slow or not even accessible people will not postponed their researches until the website is fixed, what they will do is using other possible alternatives, and with time they get familiar with other search engine and never reconsider using Google again. China is a closed communist community which have a clear preference for local Companies, therefore, whatever Google do it will still not be accepted and adopted in he Chinese market as Baidu is (they will not acce pt that a capitalist company as Google to be dominant in their market over their local companies). Google acted to the Chinese market consider it as a simple part as its international market. Despite the huge cultural differences between this two countries, Google transferred products that they were successful in the US into the Chinese market. They didn’t take into consideration the Chinese internet users habits that differ for any other country of the world.Google actually ignored the fact that China is the biggest internet users market which could generate huge revenue to the market, more research and people from the Chinese origin should have been involved from the beginning so that the site will have a Chinese tailor-made â€Å"look and feel. Google had a lake of local presence, they used to be from the US , this is why at the beginning they were struggling with services, where google. com appears to be down 10% of the time. never to mention that it was always slow and some services they were never available, such as Google Image who were available only half of the time. Due to those reasons Google had to break company’s rules and to work in an un consistent way with their mission and values where they had to hide some of the information. Google was trying to have a name that is more relevant to the Chinese market and they changed the name to a Chinese name called â€Å"song of the valley†. This was a clever move to signalling the start to Google’s localisation plan.They gave local managers more authority. Once Google moved to China (a local company), they start designing products based on the Chinese needs. Baidu’s Business Model Baidu’s Tag Line * Their mission is to provide the best way for people to find information . To do this they listen carefully to their users’ need and wants. * Search-side strategy Baidu’s success was based on its focus and responsiveness to the Chinese internet users this gave a good advantage to Baidu to offer the best solutions to local people, so Baidu went on in launching their own Chinese ndependent website, this made them anticipated the urgency to improve its search technology within a short period of time which led to the creation of the light Plan, and that made Baidu surpass Google in terms of traffic in China. Their search engine gives more focus on matching-meaning that better fit the Chinese language. These continuous efforts by Baidu not only increase users’ experience but also help them sustain their leaders hip in the Chinese internet market. * Advertise-side strategy:Baidu’s advertisement model was option based such as paid for performance and paid search model other that they also made a model based on Bid for priority placement of the links in keyword search and this bid model was a tremendous success to Baidu as the competition for the keywords goes the higher the Bid goes leading to more revenue generation. Baidu’s advertisement model increased the ability to search the needs on the customers and show them the advertisement they need. Nevertheless the Paid for performance model helped in decreasing the advertising cost for the advertisers which helped in getting new and larger number of customers. Development strategy: Baidu’s development strategy was expending it’s market from domestic into International by introducing Baidu into the NASDAQ on August 2005 that is 5 years after the dot-com peak within which it has broken the record as the one of the biggest trade ever where it’s share saw tremendous increase from $27 to $122 representing 354% of its growth and that was a remarkable move which allowed Baidu to gain more revenue and made it valuable with $4 Billion company and customer recognition , boost users confidence, and attract more and more investors in the long term.Google’s Business Model While on the other Hand was based on their Tag li ne * We always distinguish ads from the search results or other content on a page we don’t sell placement in the search results themselves, or allow people to pay for a higher ranking there. * Development strategy Google has merely focused on few strategies in other to establish a well suited Business model for the Chinese internet market however the main sources of google’s revenue were advertising and Licensing after which they have designed Adwords for advertisers who want to reach qualified customers.Google thought diversification in product range will help them increase their market share so it stared introducing new services such as Gmail a combination of e-mail and instant messaging services, GTALK but no phone based where most people in china use mobile phone rather than PCs, Google news, Desktop search and other series of applications, all these were new online services that google launched as a way of expansion in the Chinese market.Still we can see that Goog le’s Business model couldn’t succeed in Chinese market as it has accepted the defeat by the domestic player Baidu by cooperation with Baidu’s biggest investor and invested $5million dollar for 4% of Baidu’s stock and tried to cooperate with Mr Li the CEO of Baidu who prefers Baidu’s independent growth. * Sales strategy: Google’s sales strategy in china was to club up with 3 local Chinese companies who will a medium to reach Google’s services to small medium enterprises while maintaining larger enterprises that have been reserved the right to direct sales.Question 2 How do you recommend Google to do in China? Compare Google position with the one of other companies in the internet-related industries. What can we learn from this comparison? a-) * First of all, Google should treat the Chinese market as a unique market with unique customer preferences and needs. Tailor made marketing strategies should be used to better fit the uniqueness of the market; therefore applying the same strategies used previously on other markets will not be effective in this case. Google should set up an independent unit in china that will operate independently from the international standard and procedure where all important decisions are made by Chinese managers and employees that are part o f this culture and know better what is perceived as valuable to the Chinese people. Adding to this, Google page should be redesigned into a more simplistic form because as per the case, Chinese prefer to click and choose from a list rather than typing, doing this will prevent its direct competitor in the market â€Å"Baidu† from having a major customer advantage over Google.Google should invest in intensive research to better understand the Chinese culture and its uniqueness, more over to understand the reasons behind their failure and behind the success and dominancy of Baidu. Knowing those facts will help them to find better solutions for them to start gaining market share in China. * Google should lose a bit of its pride and start investing more in advertising to increase the brand awareness so that the people will be more exposed to the brand which will makes it more familiar to them (As Baidu did with KFC) Google should definitely understand deeply the governmental rules and regulations before taking any step in the Chinese market so that they make sure that their strategy is 100% aligned with the government rules in order to avoid being punished with bad connection or limited information which will lead customers loss while switch directly to another competing search engine (People that are searching on the web will not stop their research aiting for Google to be reactivated again, they will choose from other alternatives, therefore they will switch to one of Googles competitors). * Google strategy should be based on research and should be tested be fore applying it in the market, because once in the market it is less likely to change it again, as for example for the name and web address of google which were changed several times, this inconsistency will lead to bad customer perception vis a vis the brand as they will feel that something is going wrong, this why the company is always changing things. Google should get involved in corporate social activities in order to show good intentions toward the country as this will help them gain positive image from the locals and they will start to perceive it more as part of the culture and not as an outsider who’s trying to invade their markets. b-) After doing the comparison between Baidu and Google in the Chinese market and knowing that Baidu is the dominant one, followed by Google and Yahoo is the 3rd player with a market share much lower than its competitors which pushes him out of the dominancy completion.In order to better understand the facts behind Baidu’s domin ancy, we thought that comparing Google to Yendex (A Russian search engine and market leadert in Russia), will help us see the similarities in both cases (China and Russia) therefore we will be able to have a better understanding of the situation and of what is playing against Google in the countries with high level of pride and attachment to local products. elow is a study comparing Google and Yendex in the Russian market: The estimated Global market share of Google is the highest with 86% of market share, but looking in a micro sens, Google, have been facing regional competitors apart from Baidu in china such as Soshu, ZhongSou, and Yandex in Russia. * A good example will be Yandex an internet technologies company that operates in Russia and Turkey. It is the largest Russian and fifth-largest world internet search engine. As of December 2011, this company had 59. 6% of the Russian search market and their ‘’mission is to give the answer to the user anytime and anywhere.Company, similar to Google provides its services for desktop and mobile users and develops embedded solutions as well’’. The company specializes on highly-targeted sophisticated web search and information retrieval services. Yandex provides localized services for its users, as well as enables them to search for websites in other languagesOther tan that they provide many free online services, granting access to extensive local, national and international information. The services include maps; traffic jams information; photo hosting; news service; blog search; spam-free email and so on * Yandex a well advanced technology after Google , got their stock risen as much as 68 % since it was listed on Nasdaq in 2011. According to financial times, Yandex has earnings multiple of about 85 times net income, higher that Google`s, at 19 times earnings, and almost matching that of Baidu, China’s top search site, at 87 times earnings. According to Nasdaq, Yandex generated 64 per cent of Russian national search traffic. In other to understand a more recent market one need to rewind as on why Yandex made its way to the top in Russia in the first place. One of the main reasons is Yandex’s focus on the Russian language. Western search engines and algorithms are generally built from English language structures which are then adapted. This was not the same as Yandex which is descended from a Russian-language indexing project built developed w ithin a company called CompTek the success of the project led to the formation of the search engine. Russian is a slavic language which has a particular shape and structure which makes it very different than English — it is definitely not the alphabet itself which causes the issues. Russian verbs also come in pairs and the regularly used ones often don’t even look very much alike — so a search engine would need to understand that â€Å"I buy† could be interpreted with different verbs and the meaning behind the phrases would be different but potentially still relevant to the searcher. In the early days, Google did not do a good job of handling these language differences whilst Yandex did leading it to grab the preeminent position.

Slavery in the Roman Empire

The Roman Empire had mixed complexities with ruthlessness and could suddenly heave from civilization, dictatorship, and extreme greed. Besides, it had different leaders who exercised their powers in unusual ways. Consequently, the unworthy empires abused their offices by infuriating their subjects. They employed several ways of ruling over the Roman Empire (Gordon 94).Advertising We will write a custom essay sample on Slavery in the Roman Empire specifically for you for only $16.05 $11/page Learn More For instance, the emperors established the top most social order in Rome where the less privileged especially the poor and the slaves were discriminated. As a result, the administration interfered with the social status of many citizens negatively (Duiker and Spielvogel 83). Actually, they rarely had freedom since others who felt that they were highly placed in the society could mock some of the subjects. Apparently, there were several conflicts and anxious ness among the citizens within the Roman community. Certainly, this was because of the social classes that were in place between different groups of people. The elite were the rich people, and majority of the population that comprised of the common farmers, artisans, and merchants known as the plebeians occupied the low status (85). Slavery in the Ancient Roman Empire was highly abusive and degrading. Joining the likes of Ancient Greece and Egypt, Rome practiced slavery that was not based on race. The empire had captured sailors, prisoners of war, and pirates who could be mistreated, branded and whipped. The harsh treatment is evident in the manner in which their owners possessed them as properties, and could sell or kill them at will, with no punishment for human right’s violation. Even though the concept of slavery was wholly accepted within the empire, Seneca, a poet and philosopher, held that slaves, just like other humans, should be given fair treatment. The empire pract iced manumission in which slaves could either buy their freedom or get outright release from their masters (Gordon 95). Such slaves were accorded fewer rights since the manumission was informal. However, slaves who were freed formally had to go to the magistrate, and were given rights to become full citizens of Rome, but could not hold public offices. On the other hand, their off springs had full rights of citizenship. So orchestrated was the slavery aspect within this society that even after full freedom, former slaves could not overcome the slavery stigma.Advertising Looking for essay on ancient history? Let's see if we can help you! Get your first paper with 15% OFF Learn More Since the Roman population was incredibly sensitive about the social status of every individual, it was made up of various groups and domestic slaves, which were the fundamental groups in the society. In fact, the less advantaged had no right to influence the decisions made by other people con sidered great in the society and, subsequently, the older citizens sold most young citizens into slavery. Worst of all, some were even killed especially those who attempted to oppose the actions by the elders and the most respected people in the society (105). On the other hand, this form of inequality resulted into a governance structure where there was a shared advantage among the citizens. For instance, most of the rich showed a lot of respect to those whom they employed; they could go with them to the social places and business forums. The Roman Empire preferred slave labor to any other job. Consequently, most people who were arrested and detained during the war became slaves in the Empire. Most bosses exploited the slaves, as they worked in large agricultural firms and were beaten up ruthlessly. Besides, Greek slaves were in high demand because most of them were professionals. Businesspersons also employed them as shop assistants and artisans. However, most slaves from other re gions were household workers who could cook and take care of gardens (Gibbon 202). As a result of the exploitation, there was an episodic slave revolts revolutions which was founded to help them come out of the bondage . The movement was led by Thracian Gladiator Spartacus; he succeeded in overpowering most of the Romans. Nonetheless, the Roman government later killed him. Even though most of the girls in some well-to-do families went to primary schools to where they received basic education, they were forced into early marriage at their teens. This culture led largely to discrimination on women. Definitely, they had no voice in the community and they could not question any move by men (Duiker and Spielvogel 95). Further, most men viewed them as children and even the law required the males to be their advocates. They could not even own property or even attend any function presided over by men. The Roman law considered slaves as personal properties that owners could possess, mistreat , and dispossess at will. With poor living and working conditions, slaves contributed to the growth of the Ancient Rome’s economy. There are several reasons for the fall of the empire. Some of the combined dramatic events that led to the fall of Rome include political incompetence, invasion by the Visigoths and Huns tribes from central and northern Europe respectively, corruption, inflation and military overreach (Gordon 99). Historians have suggested that the infighting within the army coupled with the infiltration of Germanic tribesmen into the ranks diluted and weaken the once powerful force. Moreover, the extraneous expenses by the military in defending the borders of the empire from barbarian attacks drained the government.Advertising We will write a custom essay sample on Slavery in the Roman Empire specifically for you for only $16.05 $11/page Learn More With such overspending in the military, the government could not provide vital service s, such as public housing and maintain quality roads (Gibbon 245). Frustrations set in among the Romans and they went on to lose the need to fight for the interests of the empire. Sensing lose of desire to defend the Empire, the government hired soldiers from foreign nations and unemployed city mobs. The new crops in the army were not only unreliable, but also expensive to maintain, thus pushed up inflation. The increase in prices of essential commodities that began after the reign of Marcus Aurelius arose due to less gold to mint coins, as the Romans were spending them to pay for luxury items. The coins lost value due to the reduction in the number of gold, thus forcing merchants to increase the prices of their products. Wealthy men carried out large-scale farming in large estates, latifundia, and used slaves as the source of labor (Duiker and Spielvogel 100). The large-scale aspect made it difficult for citizen farmers to compete with the low prices. Consequently, they abandoned f arming and moved to cities with unemployed people. Evidently, unemployment among the working class became rife in the Roman Empire; it went on to cause instability in the operations of the empire. Nevertheless, the Roman Empire later failed due to inadequate support from a section of citizens who were disappointed by the manner it carried out its duties. Evidently, the subjects of Justinian were the most affected group. The Empire experienced poverty; this was after the monks took over Europe and Asia (Gibbon 240). Acts of oppression are evident in the fall of the Roman Empires. Works Cited Duiker, William J., and Jackson J. Spielvogel. The Essential World History. 7th ed. Belmont, Calif.: Wadsworth;, 2013. Print. Gibbon, Edward. â€Å"The History of the Decline and Fall of the Roman Empire.† International Journal Political Thought 140 (1977): 200-250. Print. Gordon, William D. â€Å"The Nationality of Slaves under the Early Roman Empire.† Journal of Roman Studies 14 ( 1924): 93-111. Print.Advertising Looking for essay on ancient history? Let's see if we can help you! Get your first paper with 15% OFF Learn More This essay on Slavery in the Roman Empire was written and submitted by user Libby Le to help you with your own studies. You are free to use it for research and reference purposes in order to write your own paper; however, you must cite it accordingly. You can donate your paper here.

Enigmatic Crohn’s Disease Essays

Enigmatic Crohn’s Disease Essays Enigmatic Crohn’s Disease Paper Enigmatic Crohn’s Disease Paper Physicians and scientists are always in the search for ways of curing diseases which until this time do not have known cure. One of these diseases is called Crohn’s disease which affects the intestinal tract. Its discovery by three outstanding men has enabled scientific, medical, and public communities to understand the mechanism behind this disease. Crohn’s disease has five types, with no known cause and manifests through various symptoms that can be alleviated through medications or surgery, and involves risk factors and complications. Discovery In 1900s, before the Crohn’s disease was given such name, the public identified it as an infectious disease. Specifically, they knew it as intestinal tuberculosis. But by 1930s, there was no proof about the infectious nature of the disease. In addition, the disease became widely known as Crohn’s disease when Burrill Crohn was not able to prove that there was an infectious cause in 1932. As a result, the search for the cause was discontinued. Due largely of these reasons, the research was concentrated in â€Å"immunology† (Paratuberculosis Awareness Research Association, 2003). In 1932, Burrill B. Crohn, along with Leon Ginzburg and Gordon Oppenheimer, published a medical literature which described the features of a disease which is now known as Crohn’s disease. Burrill Crohn was a gastroenterologist, and the disease was named after him because his name appeared first in the landmark paper (Crohn’s and Colitis Foundation of America, 2007). After 60 years, they have deeply studied the manifestations and natural history of Crohn’s disease but they were not able to know the cause yet. During such time, the three men conducted studies and experiments which gave them a lot of information about the inflammatory process in the bowel. In addition, during the times when they were studying the disease, they assumed that the lesions in the intestine were some form of tuberculosis or other chronic infection. Later on the men realized that the lesions did not have acid-fast organisms. They have also taken materials from different specimens and injected them into animals. However, it did not produce the desired results (Prantera Korelitz, 1996, p. 3). During this period, the men were thinking that there could be an infectious cause. During an interview with these men, Crohn firmly stated that the disease was caused by an infectious agent. They have found that a sulfa-containing drug called sulfathaladine had some positive effects on some patients. However, they did not use antibiotics to combat intestinal organisms. When steroids were introduced, they have seen that it was useful for inflammatory bowel disease (IBD). After more than four decades, researchers from the United States, Australia, and other countries started again the search for the cause despite the possibility of coming up with nonexistent findings (Paratuberculosis Awareness Research Association, 2003). Although there was still no known cure, they have found lots of information about Crohn’s disease and the larger group to which it belongs, the inflammatory bowel disease (IBD). Inflammatory Bowel Disease (IBD) Man’s immune system serves as the body’s defense against foreign substances such as bacteria, cancer, and viruses. Researchers have found out that among the people who have Crohn’s disease (CD) and ulcerative colitis (UC), the immune system attacks against the gastrointestinal system. However, they are not sure why this is the behavior of the immune system among Crohn’s patients. When the immune system attacks the GI tract, it becomes inflamed (Warner and Barlo, 2006, p. 2). IBD causes chronic inflammation in the gastrointestinal tract which then leads to various symptoms. When the disease progressed, other organs can also be infected other than the intestines. Once IBD is acquired, it becomes a lifelong disease characterized by periods of active disease and periods of disease control. IBD is different from irritable bowel syndrome (Achkar, 2006). In 2006, there were one million Americans inflicted with IBD. This number is split evenly between CD and UC (Crohn’s. net, n. d. ). The rate by which people acquire this disease is 10 per 100,000 people. Researches have shown that for every year, IBD accounts for more than half a million physician visits and 100,000 cases of hospitalization. This disease also infects young people as it develops between 10 and 30 ages. There are small cases of IBD development between 50 and 60 (Achkar, 2006). In addition, Caucasians have a higher risk than non-Caucasians. In addition, Caucasians lead the list of racial groups with the highest risk of IBD. Blacks and Hispanics are next in line, while the Asians have low risks of acquiring IBD (Targan, Shanahan, and Karp, 2003, p. 22). Moreover, whites are more prone to acquire IBD than non-whites. Jewish population is also more prone than those of non-Jewish background. Among Jewish people, those of Ashkenazi Jewish decent are at a higher risk of developing IBD (Achkar, 2006). The prevalence of IBD seems to ascend from north to south. In addition, IBD is less common in developed countries (Targan, Shanahan, and Karp, 2003, p. 22). In Western countries, one in 1,000 and one in 1,500 will have ulcerative colitis and Crohn’s disease, respectively. IBD is said to be more common in North America and Europe (Kamm, 1999, p. 2). Around one million Americans have IBD today (Eisenhower Army Medical Center, 2009). Crohn’s disease (CD) and another disease, the ulcerative colitis (UC), are both under a larger group of illnesses called inflammatory bowel disease (IBD) (Crohn’s and Colitis Foundation of America, 2009). However, Crohn’s is also known as IBD (Crohns. net, n. d. ). IBD was rare until the 20th century. By the end of the 20th century, gastroenterologists encountered this illness in the Western countries on a daily basis (Ekbom, 2003). Genetics of IBD Genes is an important factor in the causes of IBD. About 20 to 25% of people have a relative that have either CD or UC. The risk of a person for acquiring either CD or UC is 10 times greater than the general population if the person’s relative has the disease. The risk is 30 times if the relative is a brother or a sister (Crohn’s. net, n. d. ). Past researches have shown that both CD and UC are determined by genetic predisposition and have proven the role of genetic predisposition in acquiring either CD or UC. Genetic predisposition is the best explanation why differences occur between Jewish and non-Jewish populations (Targan, Shanahan, and Karp, 2003, p. 22). Furthermore, empirical data were gathered regarding the familial epidemiology of IBD. The disease seemed to be more common within families. Data also showed that compared to community-wide prevalence, the prevalence of the disease among siblings increases 10 to 30 fold. The prevalence of UC increases among the relatives of those who have UC and the prevalence of CD increases among the relatives of those who have CD. There were also data which suggest the existence of both UC and CD in one family. This incident points to an â€Å"increased frequency higher than just the co-occurrence by chance alone, suggesting an etiologic relationship between UC and CD† (Targan, Shanahan, and Karp, 2003, p. 23). Other studies suggest that a positive family history appears greatly among CD patients than UC patients. In addition, the relatives of those who have CD are at a higher risk of acquiring IBD than those who have UC. This means that in most cases, Crohn’s is often more familial than UC. Moreover, this means that Crohn’s has a more important role in terms of genetic predisposition (Targan, Shanahan, and Karp, 2003, p. 23). Crohn’s Disease Crohn’s disease is one type of IBD whose cause is still unknown (Warner and Barto, 2006, p. 2). According to the outstanding men who conducted extensive study on the disease and whose work gave birth to the term Crohn’s disease, Crohn’s disease cannot be cured, compared to UC which can be cured with surgery (Achkar, 2006). Crohn’s is a chronic disease affecting the gastrointestinal (GI) tract and usually attacks the intestine (ileum) and the large intestine (colon) (Eisenhower Army Medical Center, 2009). It also affects the patches surrounded by healthy tissues in the intestine (University of Maryland Medical Center, 2008). When the disease is not treated sooner, it can affect the gastrointestinal tract from the mouth to the anus (Crohn’s and Colitis Foundation of America, 2009). Causes Until the present time, Crohn’s disease is an enigma to the scientific and medical communities and to the public. There have been many attempts to understand this disease, but there were only few answers. This shows how extensive the nature of Crohn’s disease is. Those who studied Crohn’s assumed that the reason why Crohn’s disease is not fully researched is because it represents many illnesses and its clinical manifestations may be unpredictable. Moreover, researchers attribute the lack of definite causative microorganism to the fact that there is no such microorganism or many microorganisms cause Crohn’s disease (Prantera and Korelitz, 1996, p. 9). However, no one can completely establish the definite cause of Crohn’s disease. Certain theories were made pointing to a faulty immune system, diet, and genes (University of Maryland Medical Center, 2008). Man’s immune system is protected from infections by cells and proteins. One theory about what possibly causes Crohn’s disease indicates that there is an abnormal reaction in the immune system of people with Crohn’s disease, and thus mistakes foods, bacteria and substances as foreign substances (antigens). The normal response of the body’s immune system is to attack these substances. This then leads to white blood cells accumulating in the lining of the intestines. This produces chronic inflammation, which then further leads to bowel injury and ulcerations along the intestines (National Institute of Diabetes and Digestive and Kidney Diseases, 2006). Some scientists assumed that antigens either cause or stimulate the body’s defenses in producing inflammation in the GI tract without control. In addition, it was believed that once the immune system of the person with Crohn’s disease is â€Å"turned on,† it does not know how to â€Å"turn off† at the right time. Symptoms of IBD arise because the inflammation has damaged the intestine (Crohn’s and Colitis Foundation of America, 2009). Despite the theories, scientists are not sure if the abnormality existing in the immune system of people who have Crohn’s disease is a cause or a result of CD. Scientists are constantly faced with the findings of studies which showed that the inflammation in the GI tract is connected to three factors including the immune system, inherited genes, and the environment. Studies also showed that antigens, the foreign substances, are present in the environment. Scientists have also assumed that inflammation may be caused by the body’s reaction to the antigens. Others postulated that antigens cause the inflammation. Another theory is that the anti-tumor necrosis factor (TNF), a protein that the immune system produces, causes the inflammation of GI of those who have Crohn’s disease (National Institute of Diabetes and Digestive and Kidney Diseases, 2006). Furthermore, researchers assumed that the environmental factors cause the increasing prevalence of Crohn’s disease around the world. The researchers have also noted the countless experiments done with regards to drugs and diets that did not yield the desired results. This indicates that every approach taken is justified because different patients with different illnesses were treated, with only Crohn’s disease as the only thing they have in common. These perspectives can be viewed in two ways. One, Crohn’s disease is a very complex clinical entity that is beyond man’s comprehension. Two, Crohn’s disease is not a distinct clinical entity but â€Å"represents a syndrome with multiple etiologies that are lumped under one heading for lack of sufficient knowledge. † Either way, both medical and scientific communities are faced with the challenge of determining what causes the disease, the mechanisms of the inflammation, and further developing ways to treat the Crohn’s disease (Prantera and Korelitz, 1996, p. 9). In connection to the possibility of microorganisms as causative factors of Crohn’s disease, certain infectious agents have been under examination to determine whether these agents are etiological agents. A long list of bacteria and fungi and viruses ranges from Bacteroids to Y. paratuberculosis (Prantera and Korelitz, 1996, p. 11). Symptoms The symptoms of Crohn’s disease may be mild or severe. The most common among these are persistent diarrhea, abdominal pain, which is usually in the lower right area, rectal bleeding, fever and weight loss (Achkar, 2006). If rectal bleeding is serious and persistent, it can lead to anemia (National Institute of Diabetes and Digestive and Kidney Diseases, 2006). Diarrhea, on the other hand, is usually characterized by frequent and watery bowel movements (Crohn’s and Colitis Foundation of America, 2009), sometimes with blood (Rhodes, 2008). Some patients have experienced diarrhea between 10-20 times a day (Rhodes, 2008). In one study, 90% of the patients with Crohn’s disease had diarrhea (Doherty Way, 2005, p. 669). The authors have found out that stools are characterized as semi-solid or liquid. The bloody diarrhea of some patients resembled those of patients with ulcerative colitis (Doherty Way, 2005, p. 669). In abdominal pain, meals initiate mild colic. The pain can be relieved by defecation. The pain is caused by partial blockage in the small bowel, colon, or both. Patients who experienced complete blockage also experienced vomiting, cramping, and abdominal distention. The usual case is that when both diarrhea and abdominal pain manifest, the patient can experience weight loss, fever, anemia, and fever (Doherty Way, 2005, p. 670). Nausea, vomiting, floating stools (University of Maryland Medical Center, 2008), and fatigue are also associated with Crohn’s disease (Crohn’s and Colitis Foundation of America, 2009). Other less common symptoms include night sweats, abscesses, ulcers, and fissures, and fistulas. Abscesses are collections of pus that develop in the rectal area and can cause tenderness around the anus and fever (Crohns. net, n. d. ). Ulcers and fissures are tears that develop in the lining of the anus. These can cause bleeding and pain during defecation (Crohn’s and Colitis Foundation of America, 2007). Fistulas, on the other hand, are tunnels leading one loop of intestine to another. This loop can also connect the intestine to vagina, bladder, or skin. Fistulas develop around the anal area. When these are present, one can notice a â€Å"drainage of mucus, pus, or stool from the opening† (Crohn’s and Colitis Foundation of America, 2009). Skin problems and arthritis can also manifest. In children, symptoms include delay in growth and sexual development (National Institute of Diabetes and Digestive and Kidney Diseases, 2006). These symptoms can result from complications of Crohn’s disease (Achkar, 2006). There are also other body parts which are affected by Crohn’s disease. Some people can also experience symptoms from other body parts such as redness and itchiness in the eyes, swelling and painful joints, osteoporosis, bumps and other lesions in skin, sores around the mouth, and, in rare cases, cirrhosis and hepatitis. These symptoms involving body parts outside of intestines are called extraintestinal manifestations. These can be the first signs of Crohn’s disease for some people. In some cases, these symptoms appear before a flare up. These symptoms â€Å"come and go. † The time that these symptoms do not manifest can be months or years (Crohn’s and Colitis Foundation of America, 2007). Types of Crohn’s Disease There are different types of Crohn’s disease, depending on the affected area in the GI tract. These types have varying symptoms and complications. The five types are presented below: Ileocolitis. This is the most common of Crohn’s disease which afflicts the ileum and colon (Crohn’s and Colitis Foundation of America, 2007). At least two thirds of those with Crohn’s disease have ileocolitis and ileitis. From a study, many of these patients experienced an indolent course which lasted four years. There were periods of relapses when they use and continue using immunomodulators (Bayless and Hanauer, 2001, p. 339). Diarrhea and abdominal pain are the common symptoms of ileocolitis (Crohns. net, n. d. ). Ileitis. Ileitis generally affects the ileum (Crohns. net, n. d. ). Symptoms that manifest include persistent abdominal cramps or pain, usually at the lower portion of the abdomen. In some cases, a patient may experience diarrhea which can be frequent. Pain is also associated with diarrhea. In addition, fatigue and exhaustion and weight loss can be experienced (Irons, 2006, p. 1). Treatment can include medication, antibiotics or surgery. At times, doctors may recommend a change in the diet (Irons, 2006, p. 2). Complications associated with Ileitis are fistulas and abscess (Crohns. net, n. d. ). Gastroduodenal Crohn’s Disease. This affects the stomach and duodenum. Duodenum is the highest portion of the small intestine (Health Information Publications, 2004, p. 5). At most 13 percent of people that have ileocolonic disease also suffer from gastroduodenal disease. Symptoms that manifest include nausea, vomiting (Bayless and Hanauer, 2001, p421), loss of appetite, and weight loss (Health Information Publications, 2004, p. 5). In addition, patients that suffer from this disease were found to have bleeding in the upper GI tract. There are also fistulas which develop in the ileum (Bayless and Hanauer, 2001, p421). Jejunoileitis. This disease affects jejunum, which is the upper portion of the small intestine (Crohn’s and Colitis Foundation of America, 2007). Jejunoileitis is an unusual manifestation of Crohn’s disease. It usually manifests in young patients. From studies, it was found out that there was a connection between high morbidity and frequent surgical management. In addition, this disease usually coexists with other types of Crohn’s disease. Symptoms include abdominal pain, diarrhea and weight loss (Bayless and Hanauer, 2001, p425). Its symptoms include abdominal pain after meals, malnutrition, and diarrhea (Health Information Publications, 2004, p. 5). Crohn’s (granulomatous) Colitis. This disease affects the colon only (Health Information Publications, 2004, p. 5). It is characterized by deep ulcers from rectum to cecum (Kouklakis et. al, 2007). Symptoms include rectal bleeding, diarrhea, ulcer, abscess, and fistulas. Skin lesions and joint pains are also associated with this disease (Crohns. net, n. d. ). The symptoms can vary from person to person, and patients should know which treatment options are effective in alleviating these symptoms. Treatments include medications such as Aminosalicylates (5-ASA), Corticosteroids, Antibiotics, Immuno-modulators, and biologic therapies, and surgery. Treatment Although there is no cure for Crohn’s disease, there have been recommended treatment to ease the symptoms. Treatment can be in the form of medications, diet, and surgery. These treatment options aim to restrain the inflammatory response (Crohn’s and Colitis Foundation of America, 2009), relieve symptoms, and alleviate nutritional deficiencies. In addition, treatments can help control any recurrence. Treatment would also depend on complications, severity of the disease, and the body’s response to previous medications (National Institute of Diabetes and Digestive and Kidney Diseases, 2006). Thus, treatment approach would vary from person to person (Crohn’s and Colitis Foundation of America, 2007). Because Crohn’s disease is chronic, or on-going, sometimes long-term treatment is required (Achkar, 2006). There are several medical therapies that can help alleviate Crohn’s disease. The categories for medications include Aminosalicylates, corticosteroids, antibiotics, immuno-modulators, and biologic therapies (Patel, 2007, p. 2). Aminosalicylates (5-ASA). Aminosalicylates contain sulfasalazine and mesalamine. Mesalamine can control inflammation (National Institute of Diabetes and Digestive and Kidney Diseases, 2006). The most active component of Aminosalicylates is called 5-aminosalicylic acid, or ASA. 5-ASA functions to lessen inflammation in the GI wall. Most of the drugs under 5-ASA are pills taken orally, but there are also suppository forms (Achker, 2006). Patients that have mild to moderate symptoms are recommended this drug, which includes Pentasa, Asacol, Canasa Enemas, Colazal, and Rowasa Enemas. Other forms of this durg, such as Rowasa and Canasa, can be administered rectally (Crohn’s and Colitis Foundation of America, 2009). Side effects of these drugs can range from nausea to headache. In some cases, cramps and gas and heartburn occur. But if aminosalicylates are effective, they can bring the symptoms under control and can prevent recurrences (National Institute of Diabetes and Digestive and Kidney Diseases, 2006) Corticosteroids. This group of drugs can treat moderate to severe symptoms and can substitute for aminosalicylates if the latter is not effective (Patel, 2007, p. 3). Some people consider corticosteroids as very effective (National Institute of Diabetes and Digestive and Kidney Diseases, 2006). Prednisone, hydrocortisone, and prednisolone are the ones commonly used (Patel, 2007, p. 3). Doctors usually prescribe a large dose of prednisone when symptoms are at their worse. When these symptoms are under control, the dosage is lowered (National Institute of Diabetes and Digestive and Kidney Diseases, 2006). Unlike 5-ASA, corticosteroids need no direct contact with inflammation. Corticosteroids function to create an anti-inflammatory reaction to body areas, even the affected intestine. However, doctors found out that this group of drugs does not maintain remission or control flare ups (Patel, 2007, p. 3). There can be multiple side effects which develop due to high dosages and long duration of therapies. Mood changes, sleep disturbances, increased blood sugar levels, irritability, and increased appetite are early common side effects. Cataracts, acne, round face, osteoporosis are side effects associated with long-term use (Achkar, 2006). Other common side effects include swelling in the legs, susceptibility to infections, depression, blurred vision and hair growth (Crohns. net, n. d. ). Antibiotics. Antibiotics suppress bacterial overgrowth in the small intestine (National Institute of Diabetes and Digestive and Kidney Diseases, 2006). Flagyl is the commonly used antibiotics in IBD. Flagyl can treat infections that parasites and bacteria cause. Flagyl is also used for anal fistulas (Patel, 2007, p. 3). Other commonly used antibiotics are ciprofloxacin, metronidazole, ampicillin (Crohn’s and Colitis Foundation of America, 2009). Metronidazole is usually used to manage perineal Crohn’s disease (Mayo Clinic, 2009). However, the bad thing about antibiotics is that they kill good and bad bacteria. When metronidazole and alcohol are taken together, it can cause severe side effects such as nausea, headache, and vomiting. Some of the uncommon side effects include loss of appetite, rash, permanent nerve damage (Crohns. net, n. d. ). Immuno-modulators. This class of drugs can help decrease costicosteroid dosage and heal anal fistulas. In addition, they can help in maintaining remission (Crohn’s and Colitis Foundation of America, 2009). Immuno-modulators include 6-MP (6-Mercaptopurine), Methotrexate, and Azathioprine. These drugs can substitute corticosteroids when the latter are not effective. Reducing immune cells and obstructing protein cells can lessen inflammation (Patel, 2007, p. 3). 6-MP and azathioprine are taken orally. Their effects are not immediate. Thus, steroids are taken on a short-term duration to help control the disease during the first stages of taking 6-MP and azithioprine. Their side effects include pancreatitis, allergic reactions (Achkar, 2006), inflammation of the liver, and bone marrow toxicity (Patel, 2007, p. 3). Other side effects include susceptibility to infections, loss of appetite and nausea (Crohns. net, n. d. ). Methotrexate, on the other hand, functions by reducing the activity of the body’s immune system. It can also help bring Crohn’s disease into remission. Methotrexate can also be taken orally, although it can also be injected under the skin. Side effects associated with Methotrexate are infections, inflammation of the liver, and scarring in the lungs on rare occasions (Achkar, 2006). Biologic therapies. In 1998, the Food and Drug Administration (FDA) introduced a new biologic therapy in the form of Remicade (Infliximab) (Patel, 2007, p. 4). Remicade contains antibody which prevents the immune system from producing tumor necrosis factor (TNF). TNF is a chemical that worsens inflammation (Crohn’s and Colitis Foundation of America, 2009). Remicade is used for patients who have moderate to severe IBD. It is used when other medications are not effective and is given intravenously (Rhodes, 2008). In addition, Remicade works by blocking TNF, which is a part of the immune system. Through this blockage, inflammation in the intestine can be reduced. From clinical studies, it was found out that one or three infusions can bring inflammation into remission state and allow fistulas to heal (Achkar, 2006). Another biologic therapy is adalimumab, which FDA approved in 2007. It is a man-made protein which blocks TNF. Adalimumab attaches itself to TNF and blocks its effects. Natalizumab is another antibody which â€Å"inhibits certain types of white blood cells. † The latest addition to the biologic therapies is Certolizumab which the FDA approved on April 2008. It aims to reduce signs and symptoms of Crohn’s disease (Crohn’s and Colitis Foundation of America, 2009). Side effects of using Remicade include fever, chills, abdominal pain, itching, chest pain, nasal congestion, sore throat, nausea, vomiting, fainting and cough. Less common side effects are skin rash, low or high blood pressure, back pain, pain, diarrhea, and white patches in mouth or tongue. In rare occasions, a patient may experience weight loss, constipation, abscess, and stomach pain (Crohns. net, n. d. ). Surgery The three indications for surgery are perforation, stricture, and bleeding (Norton, Barie, Bollinger, Chang, and Lowry, 2008, p. 1021). In addition, surgery is needed when Crohn’s disease is in a very serious state and the medications were not effective (Achkar, 2006). Other indications for surgery are recurrence of symptoms, worsening of symptoms, occurrence of complications, intestinal blockage, hemorrhage, growth retardation, and carcinoma (Norton, Barie, Bollinger, Chang, and Lowry, 2008, p. 1021). Seventy percent of those who have Crohn’s disease will be required to undergo surgery to remove some part of their digestive tract Achkar, 2006). In some cases, surgery can repair fissures or fistulas. In addition, surgery is required especially if there is an intestinal blockage or intestinal abscess (Crohn’s and Colitis Foundation of America, 2007). Conservative resection is usually the preferred surgical procedure. Surgeries are seen to preserve the intestinal length. However, surgery is only limited to the area where complications arise (Doherty and Way, 2005, p. 672). When the diseased segment of bowel is removed, this is referred to as resection. The process of joining two healthy bowel ends is called anastomosis. Ileostomy can also be preferred if the diseased area is the colon. When colon is removed, surgeons attach the small bowel to the skin in order for waste products to be emptied into a pouch in the abdomen. This type of surgery is done when rectum has been diseased (Crohn’s and Colitis Foundation of America, 2007). Another type of surgery is colectomy, wherein the entire colon is removed when Crohn’s disease has affected the large intestine (Crohn’s and Colitis Foundation of America, 2009). Although surgery can allow symptom-free years, it is not a cure for Crohn’s disease. In addition, certain patients need to have more than one operation because inflammation appears near the area where the affected intestine was removed (National Institute of Diabetes and Digestive and Kidney Diseases, 2006). Furthermore, those who are considering surgery should first weigh its benefits and risks. Surgery is also not appropriate for every patient. Thus, it is of importance to consult their doctors who had experience regarding Crohn’s disease. Risk Factors Several risk factors have been associated with Crohn’s disease, as shown in Table 1. Risk factors refer to those that make a person more inclined to getting a disease (Warner Barto, 2006, p. 204). Table 1. Risk Factors that are Associated with Crohn’s Disease. Familial aggregation Stressful events Nicotine Early life exposures Smoking Weaning Oral moist snuff Hygiene Oral contraceptives Infections Diet Dairy products Refined sugar Passive smoking Cereals (cornflakes) â€Å"Sheltered child† â€Å"Fast food† Infections Margarine Mycobacteria Baker’s yeast Measles Physical activity Nonspecific virus infections Socioeconomic status Source: Prantera Korelitz, 1996. Familial aggregation. As mentioned previously, those who have relatives with Crohn’s disease are at a higher risk of developing the disease. Previous analytical studies have established familial aggregation as the most established risk factor. There were countless documented cases which established the positive history of IBD in 23% of Ashkenazi Jews in California. There were also studies of monozygotic twins which showed that there was a 58. 3% concordance rate for developing the disease. The same level of concordance rate for Crohn’s disease was found in diabetes and bronchial asthma. The concordance rate was lower for dizygotic twins. The reason why the concordance rate for monozygotic twins is higher is because of genetic and not environmental factors. Additionally, the concordant twin siblings developed Crohn’s disease within two years of each other (Prantera and Korelitz, 1996, p. 63). Smoking. A person’s history of smoking is said to be the â€Å"most established† (Prantera Korelitz, 1996, p. 63) and the â€Å"most important† (Michetti, 2005, p. 50) environmental and external risk factor for the disease. Past researches found out that smoking can worsen symptoms (University of Maryland Medical Center, 2008). Additionally, those who smoke are more likely to develop Crohn’s disease than the non-smokers. There were also empirical data to support the finding that smokers have an aggressive form of Crohn’s disease than non-smokers. However, researchers were not able to determine the exact effects that cigarette smoking has on the GI tract (Achkar, 2006). From the past researches, it was found out that there was no consistent increased risk among those who smoke. This means that smoking is a promoting factor of Crohn’s disease. Smokers who have Crohn’s disease are also seen to be more prone to relapses, surgery, hospitalization, diarrhea, and pain compared to former smokers or nonsmokers. And as smoking is associated with lung cancer, those who smoke and have Crohn’s disease are at a higher risk of experiencing respiratory malignancies. However, there was no association found from the studies done in relation to cancer morbidity and mortality. This added to doubts regarding the smoking’s etiological attributable fraction in Crohn’s disease (Prantera Korelitz, 1996, p. 63). The association between Crohn’s disease and smoking is further complicated because smokers have a lower risk of developing ulcerative colitis and former smokers are at a higher risk. The opposite results of studies regarding the role of smoking in both Crohn’s disease and ulcerative colitis prompted researchers and experts to assume the possibility of smoking as a determinant of either Crohn’s or colitis developing in an individual (Prantera Korelitz, 1996, p. 63). Oral contraceptives. This is another risk factor of Crohn’s disease, wherein women who take oral contraceptives are more likely to develop the disease (Crohn’s. net, n. d. ). However, there were other studies whose results showed that the causality of oral contraceptive is weak (Crohns. org, n. d. ). One such

Student Participation Essay Example | Topics and Well Written Essays - 750 words

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