Marketing Essay Example | Topics and Well Written Essays - 500 words - 59

Marketing - Essay Example This was a great experience because I was able to master my customers and the products they preferred best and disliked most. Marketing intermediary refers to the involvement of a retailer or a wholesaler in the flow of goods to the consumer. This is the marketing channel that I have been involved in whereby I am a distributor of mineral water for a certain company in our local state (McCalley pp.6-92). Marketing channels solve logistical problems in availing goods to the consumer. This is because they facilitate physical distribution and sorting of goods. Moreover, they also offer facilitative advantages in that they may source of vital information relevant to a business about competition, channel members and customers. . It is also a great experience to research how customers respond to a new product in the distribution business and the grocery shop currently run by mum. These channels are of great benefit to intermediaries in terms of finance since goods can be sold and purchased on credit and financed as they are being sold. In my distributorship business I always encountered financial problems, but courtesy of receiving goods with a 30 days credit payment terms I remained in business Moreover they are opportunities for business to promote their products and companies by offering discounts, advertisement, gifts and after sale services. In several occasions I had to provide discounts to my customers and I realized that with that customers always bought more because products were a little bit cheaper. Most businesses do make profits through giving rewards to their customers as they gain competitive advantage. Marketing channels offers a chance for organization to contact and understand their customers’ needs which goes a long way in facilitating matching supply and demand. Matching the demand and the supply of products leads to efficiency and effectiveness of

The Similarities and Differences Between Hemodialysis and Peritoneal Dialysis Essay Example for Free

The Similarities and Differences Between Hemodialysis and Peritoneal Dialysis Essay Many individuals are diagnose with kidney disease each year, and some individuals face a difficult situation concerning the possibility of doing dialysis, and choosing what type of dialysis treatment is right for the individual. Both Hemodialysis and peritoneal dialysis give patients the quality of life. In contrast both procedures are done differently, Hemodialysis patients are dependent, and peritoneal dialysis patients are self-sufficient. In comparison both removes waste from the bloodstream; however, both procedures are beneficial to treat kidney disease. Hemodialysis is a common procedure that removes waste from the bloodstream in patients’ whose kidneys does not function properly. The hemodialysis procedure consist of using a machine called the dialyzer, and the patients’ own veins, which is often called a fistula, to transfer blood back and forth from the dialyzer to the patients’ arm. However; because the fistula takes approximately six weeks to heal, patients often get a Vortex Graft placed, a Vortex Graft is plastic tubing placed inside of the patients’ vein most patients can use their graft in two to three weeks; However; there are some patients who have to start dialysis immediately; therefore, a Tunnel Catheter is placed, a Tunnel Catheter is a long flexible tube surgically inserted in a large vein in the neck, for immediate dialysis use. Patients often do hemodialysis three days a week, every other day. Most patients’ dialysis treatment runs approximately three to five hours each day, depending on what type of access they have. The day of their hemodialysis treatment, patients weigh themselves at the center and prepare to be seated to start their treatment. The dialysis technicians prep the dialyzer before the patients are ready to start dialyzing. The dialysis technicians take the patients’ temperature and blood pressure before the patients are seated. The dialysis technicians cleans the access site and make sure the site is working properly. Dialysis technicians have to follow a certain protocol when putting dialysis patients on for their treatment. Therefore; patients and technicians wear face mask to keep from cross contaminations of blood and germs. More often; dialysis technicians change gloves throughout the treatment session. The technicians’ monitors the patients’ blood pressure throughout the dialysis procedure, because patients run a risk of their blood pressure getting too low; dialysis technician may have to administer saline solution to bring the patients’ blood pressure back up to a normal range. The dialysis technicians log the patients’ blood pressure throughout the dialysis session. Once the patients are done with their dialysis session, the technicians take their temperature, blood pressure, and make sure their blood pressure is at a normal range before letting the patients leave their chair, once blood pressure is at a normal range; patients weigh themselves, and the technicians log it into the computer. Hemodialysis patients rely on their dialysis technicians for their dialysis treatment needs. In addition, hemodialysis patients run into risk associated with taking hemodialysis. One of the most common risks is clotting of the arteries in the arm. Most of the time patients are sent to a nearby hospital to see a vascular surgeon to have to clot removed. Often the clot can be removed, and the patients can return the next day to restart their dialysis treatment; however, there are times when the clot cannot be removed; therefore patients have a temporary tunnel catheter placed. Tunnel catheter is only placed temporarily placed until the surgeon can either fix the clotted arties, or place a new fistula. Tunnel catheter is the primary cause of most infections in hemodialysis patients and is one the primary reason for hospitalization of hemodialysis patients. Hemodialysis patients often drink too much fluid and in result have to pull off more fluid; therefore, their blood pressure may get too low. When hemodialysis pulls off excess fluid it also pulls off potassium, and patients may experience severe cramping. Furthermore, hemodialysis patients follow a diet called â€Å"The Renal Diet;† patients have to eat foods; low in sodium, low in potassium, and low in phosphorus. Most patients on hemodialysis have a fluid restriction, normally; the fluid restriction is about four cups of fluid a day or six cups a fluid a day. Hemodialysis pulls the protein from the patients’ body; therefore patients have to eat a high protein diet. On the contrary, peritoneal dialysis is a common procedure that removes waste from the bloodstream in patients’ whose kidneys does not function properly. The peritoneal dialysis procedure consists of using a fluid called dialysate, and a catheter; the catheter is placed in the abdomen of the kidney dialysis patients. When patients do peritoneal dialysis the dialysate solution is placed in the abdomen of the kidney patients and sits there for up to four hours; the hours the fluid sits is called the dwell time. Once the fluid has sat for a while the kidney dialysis patients exchange the old dialysate solution with new dialysate solution and start the whole process over again. Peritoneal dialysis can be done in two different ways; Automated Peritoneal Dialysis and Continuous Ambulatory Peritoneal Dialysis. Automated Peritoneal Dialysis is done while the kidney dialysis patients are asleep and Continuous Ambulatory Peritoneal Dialysis is done every four hours approximately five times a day for 30 minutes. Patients who do peritoneal dialysis do it in their own home. Before starting peritoneal dialysis patients are properly trained by a nurse for three weeks. Patients must be able to do own treatments once training is over. Peritoneal dialysis can choose what time a day to do their treatments, and what type of peritoneal dialysis treatment they prefer. Patients must order supplies each month and must have adequate amount of space to store supplies. Typically, patients start the day off by taken their blood pressure, temperature, and weight, and log the results. Before patients start a peritoneal dialysis treatment; patients close doors, window, and clean table with disinfectant. Patients’ then gather supplies for treatment, put on a face mask, and clean hands and exit site. Patients then hook themselves up and began exchanging fluid, after done with treatment patients properly dispose of waste and enjoy the rest of their day. In addition, peritoneal dialysis patients run into risk associated with taking peritoneal dialysis. One of the most common risks is an infection called Peritonitis. Peritonitis is an infection of the peritoneum; a peritoneum is the lining of the abdominal that forms a sack. Most of the time patients are given antibiotics to eliminate the infection. Peritoneal dialysis patients can develop a hernia; a hernia is a tear of the wall where an organ sticks out; therefore, patients should not lift heavy objects. Patients may experience bloating, constipation, weight gain, fluid overload, and dry skin associated with peritoneal dialysis. Furthermore, peritoneal dialysis patients follow a diet called â€Å"The Renal Diet;† patients have to eat foods low in sodium, low in phosphorus; however, patient can eat a potassium rich diet, because they dialyze every day. Some patients on peritoneal dialysis have a fluid restriction; however, most patients who do peritoneal dialysis do not have a fluid restriction, because they dialyze every day. Peritoneal dialysis pulls the protein for the patients’ body; therefore patients have to eat a high protein diet. Peritoneal dialysis patients have to eat a low calorie diet, because they get some of their calories from the dextrose found in the dialysate solution. In conclusion, both hemodialysis and peritoneal dialysis are similar in so many ways; for example both dialysis procedures cleanse waste from the bloodstream of patients whose kidneys does not function properly, patients follow the same type of diet, and both treatments have to be done in a clean environment. Hemodialysis use a machine called the dialyzer and the patients’ arteries to transfer blood to and from the machine, and peritoneal dialysis use a fluid called dialysate and transfer fluid through a catheter placed in the patients’ abdomen. Hemodialysis patients rely on their technician for all their dialysis treatments need, and peritoneal dialysis patients basically do all their on treatments. Hemodialysis patients’ schedules are preset, and peritoneal dialysis patients’ schedules are more flexible. In contrast both procedures are done differently, Hemodialysis patients are dependent, and peritoneal dialysis patients are self-sufficient. In comparison both removes waste from the bloodstream; however, both procedures are beneficial to treat kidney disease.

Spain :: essays research papers

Population The Spanish people are essentially a mixture of the indigenous peoples of the Iberian Peninsula with the successive peoples who conquered the peninsula and occupied it for extended periods. These added ethnologic elements include the Romans, a Mediterranean people, and the Suevi, Vandals, and Visigoths (see GOTHS), Teutonic peoples. Semitic elements are also present. Several ethnic groups in Spain have kept a separate identity, culturally and linguistically. These include the Basques (Euskal-dun), who number about 2.5 million and live chiefly around the Bay of Biscay; the Galicians, numbering about 2.5 million, who live in northwestern Spain; and the nomadic Spanish Gypsies (Gitanos; see GYPSIES). Population Characteristics The population of Spain (1991) was 38,872,268. The estimate for 1993 was 39,207,159; the overall density was about 78 people per sq km (about 201 per sq mi). Spain in increasingly urban with more than three-fourths of the population in towns and cities. "Spain," Microsoft (R) Encarta. Copyright (c) 1994 Microsoft Corporation. Copyright (c) 1994 Funk & Wagnall's Corporation. Forestry and Fishing The cork-oak tree is the principal forest resource of Spain, and the annual production of cork, more than 110,000 metric tons in the mid-1980s, is second only to that of Portugal. The yield of Spain's forests is insufficient for the country's wood-pulp and timber needs. The fishing industry is important to the Spanish economy. The annual catch was about 1.5 million metric tons in 1990 and consisted primarily of tuna, squid, octopus, hake, sardines, anchovies, mackerel, blue whiting, and mussels. Mining The mineral wealth of Spain is considerable. In 1990 annual production included about 36 million metric tons of coal and lignite, 1.5 million tons of iron ore, 255,000 tons of zinc concentrates, 58,400 tons of lead, 5 million tons of gypsum, and 795,000 tons of crude petroleum. The principal coal mines are in the northwest, near Oviedo; the chief iron-ore deposits are in the same area, around Santander and Bilbao; large mercury reserves are located in Almadà ©n, in southwestern Spain, and copper and lead are mined in Andalusia. Other minerals produced are potash, manganese, fluorite, tin, tungsten, wolfram, bismuth, antimony, cobalt, and rock salt. Manufacturing Among the leading goods manufactured in Spain are textiles, iron and steel, motor vehicles, chemicals, clothing, footwear, ships, refined petroleum, and cement. Spain is one of the world's leading wine producers, and the annual output in the late 1980s was about 2.3 million metric tons. The iron and steel industry, centered in Bilbao, Santander, Oviedo, and Avilà ©s, produced about 13.

Primary Prevention of Breast Cancer

Choose a health topic related to primary prevention, secondary prevention, or tertiary care. Explain why this is an important topic of discussion based on your personal belief, and based on valid research. Paper should be 1. 5 – 2 pages. APA format must be followed. Detailed assignment information will be provided. Breast cancer is the most common form of cancer in women and the 2nd most leading cause of their death. It is estimated that 1 in 8 women will be diagnosed with breast cancer in their life time and it will claim as many as 40,000 lives in the US only. ( http://www. nationalbreastcancer. rg/breast-cancer-facts) Primary prevention can play a key role in substantially reducing the chances of developing breast cancer Early detection through screening can make treatment process easier and less extensive. Primary prevention is all about reducing the risk factors that may enhance one’s chjances of getting breasts cancer specially if there is a history of breast canc er in the family. Long term heavy smoking and alcohol consumtion can increase the chances of developing breast cancer. (http://www. cancer. org/acs/groups/content/@epidemiologysurveilance/documents/document/acspc-030975. df American cancer society) â€Å"Prevention is the best cure† is a very wise proverb. Necessary precautions can prevent major health problems altogether. The major focus of primary prevention is to prevent a diseases before it occurs. One of doing so is by controlling the risk factors in healthy people that may lead to the disease. There are several different approaches such as clinical prevention which includes interactions with a health proifessional, community based efforts such as awareness programs, laws and plocies etfc. , and work place health programs that promote healthy life style etc.Family history of breast cancer can almost double the risk of getting breast cancer which makes the Its important to cultivate a healthy life style to avoid this prob lem altogether and promote healthy habits and activities than can reduce the chances significantly. Since breast cancer prevention are risk based Determining the risk factor is the first step in designing a prevention plan. Chemoprevention, tamoxifen although can help reduce the risk factors by as much as half but they don’t come without their own risk are not widely practiced.Therefore, primary prevention which is now evolving itself to include cancer screening, imaging, pathalogial findings and level od suspicion etc along with computer programs and special algorithms can help reduce the chances and early detection. The trends show that breast cancer has been on the rise and many people don’t have access to treatment and affordability is another factor. Between 1975 to 1990 it increases and then dcresed byh 2. 34 percent between 1990 and 2002. Black women have a higher percentage of mortality compared with the rest of the races in the US.Dying of Breast Cancer in the 1800sThere are many factors that determine the risk of getting cancer. In female the risk increases with age which can be coped with adjusting to a new life style and observing high precaution. Family history (first or second degree of relation) can increase the risk higher and if more than one family member had cancer it would increase the risk even further that’s why education of such people right from the first case is very important. Girls from young age should be nurtured in a way to adopt a healthy life style and a life style that decreases the chances of getting breast cancer.Different levels of Reproductive Hormones that change with a woman’s age andfor some other reasons such as pregnancy and nulliparity etc also play a role in determining the risk factors. Mind benign breast malfunction can also increase the chances of having breast cancer in later stages of a woman/s life. Irradiation at early age also increases risks of getting breast cancer. Prevention th rough lifestyle. Diet and nutritions is controversial but fat consumtion has been associated with breast cancer.Different studies have shown conflicting results and therefore this area is open for more research. Obesity, however, has been clearly associated with raising the risk factor just like smoking and long term alcohol consumtion does too. Primary prevention. Life style modification studies have yielded different and controversial results. However, disregarding the impact od life syle change, it can lead to better health over all as well reduce the over all risk factor. This may include physical activity, healthy weight, avoiding smoking and limiting alcohol consumption.Ec. Women with high risk of cancer due to genetic mutation may consider non Some primary prevention measures such as prophylactic oophorectomy in young women(35 and under) has shown to reduce the breast cancer by 60 percent but this surgery comes with many unpleasant symptoms. Such as mood changes, night sweats and hot flashes etc. Prophylactic mastectomy which is the removal of both or one breast is also a primary prevention techniques but its drawbacks may outweigh its benefits. Therefor this practice is limited to women with a very high risk of breast cancer.Chemoprevention techniques such as tamoxifen and raloxifene can reduce the risk to one half. But this form of prentive techniques such as tamoxifen shows an increased risk of endometrial cancer in women over the age of 500 (PRIMARY PREVENTION OF BREAST CANCER, SCREENING FOR EARLY DETECTION OF BREAST CANCER, AND DIAGNOSTIC EVALUATION OF CLINICAL AND MAMMOGRAPHIC BREAST ABNORMALITIES Therese B. Bevers) Although most women may not deveop cancer in their life time but prevention techniques and precautions and habits can ensure early detection. Primary prevention saves time, costs related to the treatment, discomfort and pain.CLINICAL REVIEW Women at High Risk for Breast Cancer—What the Primary Care Provider Needs to Know Nelia A fonso, MD Primary prevention would encompass not only a healthy life style which includes measures to avoid exposure to carcinogen exposure and health promoting activieties and habits . the focus is block the cancer from eve ndeveloping or delay its development to malignancy. And for people who have a high risk of cancer (due to genetic mutation etc ), it includes administration of chemopreventive agents or surgeries that require removal of some body parts. ( http://www. ns. org/ClinicalResources/BreastCancer/Prevention/Types) Environmental factors exposure to insecticides etc can increase the chances of developing cancer. ( http://www. cancer. gov/cancertopics/pdq/prevention/breast/HealthProfessional/page2) http://www. cancer. org/acs/groups/content/@epidemiologysurveilance/documents/document/acspc-030975. pdf self examination. Periodic mammography 40 percent cases of cancer can be avoided just by making lifestyle changes. (http://www. kingsfund. org. uk/projects/gp-commissioning/t en-priorities-for-commissioners/primary-prevention)Regular primary care can reduce mortality rate over a period of just 5 years. (http://sphhs. gwu. edu/departments/healthpolicy/dhp_publications/pub_uploads/dhpPublication_3BBD241A-5056-9D20-3DC72347BA069B17. pdf) having a primary care physician decreases the likelihood of getting diseases and increases the effectiveness and appropriateness of care. Having one particular person as a primary health provider means fewer prescriptions and fewer tests more and decrease of emergency care. Primary health care can reduce expenses. Hospitalization and down time can be avoided. Interventions such as smoking

Leisure Time Essay

In the mid-1800s Americans started to receive a lot of extra time in their hand and had more time to do fun activities. Businesses declining working hours was a major reason for the rise of leisure time but what also had a huge impact was installation of the electric lighting in the city’s streets which made Americans have more time to perform activities at later hours (Lund). So what did Americans decide to do with this time? The recommendation of physical exercise as a way to relive of all the stress raised the importance of physical actives and to also attend spectator sports became part of the leisure activities in the United States. Vaudeville, dance halls, and motion pictures became popular, while new modes of travel allowed Americans to go visit the mountains, seaside resorts and county fairs (Lund). To begin with after the Civil War, the popularity of sports as leisure activities grew as people began to see the importance of exercise to health. While initially only the wealthy could take part in most sporting events because the middle and lower classes couldn’t afford most of the activities .The opening of public available gymnasiums, courts, and fields allowed the middle class to participate in those activities as well (Lund). Athletic clubs such as the New York Athletic Club were organized and the YMCAs began to institute sports programs. These programs mostly focused on track and field events, introduced by communities of European descent, and gymnastics, heavily influenced by German athletics. Gymnasiums, which included exercises using Indian clubs, wooden rings, and dumbbells, were opened in many Eastern cities which helped expand exercise. Also With the extra time Americans gained American sought out to find new ways to keep themselves occupied and entertained. Americans began to seek out new ways to distract themselves so they started to experiment in making new activities to do. As a result of Americans seeking for a new past time they invented Americas greatest past time today, baseball. Different types of Baseball have been played throughout time and before the 1800s but the rise of the sport didn’t come until after the civil war (Bluett). While at war the soldiers had a lot of extra time in their hands the soldiers from New York introduced the game to their comrades from their camps and soon the game also spread to other camps over the north and south. It was said that because of this baseball expanded from the north to the south baseball was recognized more after the civil war ended. After all the soldiers from the camps were taught how to play, they went back home and introduced their sport to their families and friends which helped expand they name of the game (Bluett). In 1870 the first professional team were founded but didn’t last for more than five years. In 1876 the first major professional league that was formed was the National league of baseball clubs which still exist today. Another sport that was created by Americans in the 19th century which they invented to perform as a leisure activity was Basketball. The game was created from the mind of James Naismith in 1891, while he was an instructor at the School for Christian Workers, later called the International YMCA Training School, in Springfield, Massachusetts (McComb). The YMCA was an international organization that focused on the idea that physical as well as religious training was important for humans. Naismith had graduated from McGill University, and after leaving a Presbyterian seminary jo ined the YMCA school in Massachusetts. When he arrived the director of the YMCA name Luther asked Naismith if he could design an interesting indoor sport for physical activity in a gymnasiums Americans can exercise while having fun in the winter when it was cold and couldn’t be outside (McComb). He thought that people were bored of just working out with weights and running around without a purpose. James considered the thought of throwing a ball into a box, like the warm-up exercise he had used when he played rugby but only this time the box was ten feet up and had to dribble the ball (McComb). The game was a success Americans all over the country were playing it and it even expanded internationally. In the 1880s women didn’t really perform any  sports but after they were introduced with basketball they were so fascinated that it became one of women’s favorite sport in the 1880s. Furthermore although men performed the majority of sports activities around the 19th century. Opportunities for women beg an to appear as the century ended. Some of the most popular sports for women in the 19 century were basketball and lawn tennis. Also by the end of the century schools began to offer even more sports activities for females, such as gymnastics and basketball. One of the most popular sports for women was basketball. Girls’ and women’s basketball flourished in the early years of the game. Two days after the invention of basketball, some female teachers who had heard the shouts of players coming from the gym, asked Naismith to instruct them (Woolum). Naismith did so and the women became very fund of the sport. In 1892 after the women new the game better the YMCA hosted the first tournament for women (Woolum). The game for women spread and they even got to play in college, in 1896 the first intercollegiate game was played in Berkeley between the University of California and Stanford. No male spectators were allowed at the Berkeley match because it was considered improper for male viewers to attend (Woolum). Also the other sport the women were very fund of was lawn tennis. Mary Ewing Outerbridge has be en credited with introducing lawn tennis to the United States in 1874. When she went to Bermuda she watched as British Army officers were hitting a rubber ball with spoon-shaped paddles strung with catgut across an outstretched net. Fascinated by the game, Outerbridge brought a box of the tennis equipment with her and returned to New York (Woolum). When she got home she introduced the game to her friends and family. The game rapidly got popular and became very popular not just with women but with men as well and rapidly spread throughout the Northeast as a favorite national pastime (Woolum). In addition Americans didn’t just past their times with sports they also enjoyed other activities like attending vaudeville shows. Within cities, people attended vaudeville shows which would include many acts. The vaudeville shows were usually watched by the middle class, the shows often ran for many hours so the people could come and go whenever they wanted (Ushistory). In the Vaudeville shows the viewers could enjoy a performance consisting of Shakespeare plays, acrobatics, singing, dancing, and comedy (Lund). Vaudeville shows weren’t just for entertaining they also talked  about economic and ethnic situations. Other popular shows of the time included circuses and Wild West shows, one of the most famous plays was Buffalo Bill Cody’s by William F. Motion pictures also served as entert ainment during leisure time for urban audiences. Initially the movies were originalities in kinescope viewers, until they became acts in their own right on the vaudeville stage. As motion pictures became longer, they moved into storefront Nickelodeon theaters and then into even larger theaters (Lund). Finally another activity Americans did as for their leisure time was to go on vacations. Some people wished to go further afield on their vacations and leave the city now that they invented a new way to travel faster which was by trains (Ushistory). Many with limited budgets went to the countryside or the beaches which mostly included the lower and middle class. Towards the late nineteenth century resorts opened in the outskirts of cities, such as the beach area of Asbury Park in New Jersey which was founded in 1870 (Lund). Amusement parks opened in places like Coney Island in New York was founded in 1897.the Park offering rides, fun houses, and scenes from foreign life, and the latest technological breakthroughs, such as motion pictu res. National parks were created by the federal government to preserve nature and many began to tour these areas on vacation (Lund). One such example was Yellowstone Park where people camped or stayed at the hotels, the park was built there in the late 1880s. World’s fairs and expositions held in different U.S. cities offered Americans a chance to tour the world in one place. The fairs celebrated progress and featured exhibits of science and technology, foreign villages, shows, rides and vendors. The first major one was the Philadelphia Centennial Exposition in 1876 (Lund). All in all Americans in the 19th century performed a large variety of activities for their leisure time. Men performed many different physical activities especially when clubs like the YMCA was introduced which helped more Americans become more active, also American performed sports like baseball and basketball in their leisure time. In the late 19th century even women were starting to take place in the sports a nd other activates. Another major activity Americans did for leisure time was to go to vaudeville shows which had all sorts of acts from Shakespeare plays to comedy acts. Finally after traveling was easier Americans started to go on vacations outside the city and go to resorts and world fairs for their leisure time. Bibliography 1. http://memory.loc.gov/ammem/awlhtml/awlleis.html a. Leisure after the civil war b. Lund, Karen C. â€Å"America at Work / America at Leisure, 1894-1915.† America at Work / America at Leisure, 1894-1915. Memory.loc.gov, 01 June 2000. Web. 17 Dec. 2013. 2. http://www.pacivilwartrails.com/stories/tales/baseball-and-the-civil-war a. Baseball and the civil war b. Bluett, Terry. â€Å"Baseball and the Civil War.† Welcome to the Pennsylvania Civil War Trails. Civil War Trails, n.d. Web. 17 Dec. 2013. 3. http://www.elibrary.com/elibweb/elib/do/document?set=search&dictionaryClick=on&secondaryNav=&groupid=1&requestid=lib_standard&resultid=1&edition=&ts=FA9DBE62F456E22634A15DC6F7B76C44_1385528175587&start=1&publicationId=&urn=urn%3Abigchalk%3AUS%3BBCLib%3Bdocument%3B171337845 a. The Great Spectator Sports of North America b. McComb, David G. â€Å"ELibrary: Login.† ELibrary: Login. Proquest, 01 Dec. 1998. Web. 18 Dec. 2013. 4. http://www.ushistory.org/us/39b.asp a. Leisure time b. Ushistory.org. â€Å"39b. Sports and Leisure.† Sports and Leisure [ushistory.org]. U.S. History Online Textbook, n.d. Web. 19 Dec. 2013. 5. http://www.elibrary.com/elibweb/elib/do/document?set=search&dictionaryClick=on&secondaryNav=&groupid=1&requestid=lib_standard&resultid=3&edition=&ts=FA9DBE62F456E22634A15DC6F7B76C44_1385528175587&start=1&publicationId=&urn=urn%3Abigchalk%3AUS%3BBCLib%3Bdocument%3B28013995 a. Women in America sports b. Woolum, Janet. â€Å"ELibrary: Login.† ELibrary: Login. Elibrary, 05 Aug. 1992.

Negative Effects of Slavery Essays

Negative Effects of Slavery Essays Negative Effects of Slavery Essay Negative Effects of Slavery Essay Intro A community can be viewed as a people that portion common linguistic communications. Properties and many other cultural similarities. Strong communities normally signify a integrity or bond. This bond forms a sense of sense of ego and brotherhood . However. this does non look to be in the Black community. Slavery has about destroyed the being of any integrity. When the Africans were taken from African. different folks were assorted together on the ships and stripped of their individualities. The differences between the African folks had a positive affect for the enslavers because it caused disunity. Which helped them keep command both during the ocean trips and one time they arrived to the U. S. recognizing the affect of the disunity. slave proprietors continued to develop tactics that would farther disassociate African Americans from coevals to coevals until today. Slavery Period The disunity among Africans helped the slave proprietors operate their plantations more expeditiously and furthered enslaved the Blacks. Their deficiency of integrity increased because of misgiving for one another and an addition of trueness and dependance on their proprietors The Africans were divided based on physical properties ( Internet Explorer. Skin tone. physical physique ) . Of all the properties. clamber tone was of the most outstanding tactics of division used. The fairer skinned were normally used as house labourers and held a higher position than that of the darker skinned who were used as field hands or given harsher intervention. . Because they were more privileged. a sense of high quality arose among the visible radiation skinned or house labourers. This caused the darker skinned Africans to envy the fairer skinned by distancing Negative Effectss of Slavery and unpluging themselves from each other. they caused division on the plantation. Any mark of integrity. even apparently harmless bonds such as bonds between kids and their parents. posed a menace to the slave proprietors doing most households to be separated and sold to different plantations. African adult females were even taken from their households to go kept womans to their proprietors. Separation of households left the work forces unable to continue their responsibilities as a male parent and caput of the family and left or forced adult females to raise households on their ain or with other work forces. Segregation Period Before bondage was wholly abolished certain slaves were freed. many of which were just skinned or Mullatoes . When bondage was abolished and the other slaves were freed. the Mullatoes feared that blending or tie ining themselves with the other Blacks would decrease their position as the Buffer Class ( more accepted by White persons ) . Even after segregation and Jim Crow. Torahs were implemented and African Americans were limited to all Black life countries. school. eating houses. etc. . Mullatoes were still favoritism in some instances. The bitterness and competition between Mullatoes and Blacks resulted in separate churches. schools and organisations. Some Mullato organisations. schools and concerns had certain processs that determine credence because they were viewed as better than other Blacks’ were. For illustration if you were lighter than a paper bag you could acquire accepted into their organisation. if non your were asked to travel elsewhere. Another cause of separation was the deficiency of employment chances for Black Negative Effects of Slavery work forces. They were unable to continue their place as the adult male of the house by supplying for their household. Womans were offered more occupation chances so their work forces. Resentment grew between both the work forces and adult females because the work forces that were unable to supply for their households felt inferior to the adult females and the adult females were left to supply for the family on her ain. Lack of occupations for work forces was such a major issue that some work forces would seek illegal ways to supply for their households and many were frequently jailed or killed causation and absence of a male parent or adult male in the house. Integration until Present Because of the increased handiness of more freedoms and chances for Blacks since the terminal of segregation and Jim Crow. African Americans now have the pick to sponsor whom of all time they please. Many Blacks stopped sponsoring other Blacks and sought out White concerns. This has resulted from the influence of the Euro-worldview society is under the belief that White schools and concerns are better than that of Blacks. This is a signifier of disunity because there is a lessening in Blacks back uping other Blacks. Much like during the clip of segregation. Black work forces have a trouble being employed. However today public assistance or fiscal authorities aid is in topographic point for adult females who are unemployed with kids or without a adult male in the house ; diminishing the demand for a male nowadayss. THe diminishing demand for the Black male nowadayss is doing non merely a separation of household integrity. but besides the desire to hold household integrity. Negative Effectss of Slavery Conclusion Although we are more than 100 old ages out of bondage. affects of its corruptness still be within the Black civilization. Bondage has about destroyed any nowadayss of integrity among the African American people by coercing them to vie with each other and by aiming their differences and utilizing them as a agency of separation. Aids for minorities such as Affirmative action are nil more than tactics to coerce competition. divide Blacks. and keep a deficiency of integrity whenever there is act to better themselves. Because of fright of an rebellion or addition of power after Blacks captivity slave. proprietors and other Caucasians developed documented tactics in order to keep control and disunity of the community. William Lynch gave a address in 1712 that gives cogent evidence to these Acts of the Apostless by exemplifying their scheme: I have outlined a figure of differences among the slaves. I take these differences and do them bigger I use fear. misgiving and enviousness for control purposes†¦ you must flip the old Blacks against the immature Blacks†¦you must utilize the dark tegument slaves against the light tegument slaves and the light tegument slaves against the dark tegument slaves†¦But it is necessary that your slaves trust and depend on us†¦The must love. regard and trust merely you. Mentions: Noble ( 1986 ) . Breaking the Chains of Slavery . Psychological Legacy of Slavery Retrieved May 29. 2007. Hall. Russell. Wilson. ( 1992 ) . The Color Complex. Retrieved May 29. 2007

Free Essays on Confucianism And Christianity

Confucianism And Christianity The premise of Confucian teachings are centered on the idea of Jen or the virtue of. To accomplish this divinity, five relationships must be honored: ruler and subject, living family to ancestors, father and son, elder and younger brother, husband and wife. These relationships led a push for a revolution of the political system to adopt the methods of Jen. Confucius sought to revive the ancient Chinese culture by redefining the importance of society and government. He described a society governed by reasonable, humane, and just sensibilities, not by the passions of individuals arbitrarily empowered by hereditary status. He felt that this could be achieved through education and the unification of cultural beliefs. He believed that citizens that were cultivated people whose intellects and emotions had been developed and matured by conscious people would benefit a nation. He felt that those born into the feudal system were had a personal duty to excel socially by means of power. Those w ho were of lesser class should also seek out education to better themselves. Confucius felt that love and respect for authority was a key to a perfect society; this strict respect was practiced through rituals and magic. The Confucius traditions have caused a tradition to set within its institution and are extremely active. It has, unfortunately, allowed the political institution to manipulate the Confucius system, as with Christianity. Christianity also preaches a divine, brotherly love. Modern Christianity seeks to discover a rational understanding of the person, as did Confucius; yet, Christianity feels that faith in the Jesus Christ, as a personal savior is essential to this enlightenment. It was also under the guise of Christianity that it had to confront totalitarian systems uses of power in its sphere of influence. Christians believed in an Absolute against all absolving of the relative, can protest in the name of God. ... Free Essays on Confucianism And Christianity Free Essays on Confucianism And Christianity Confucianism And Christianity The premise of Confucian teachings are centered on the idea of Jen or the virtue of. To accomplish this divinity, five relationships must be honored: ruler and subject, living family to ancestors, father and son, elder and younger brother, husband and wife. These relationships led a push for a revolution of the political system to adopt the methods of Jen. Confucius sought to revive the ancient Chinese culture by redefining the importance of society and government. He described a society governed by reasonable, humane, and just sensibilities, not by the passions of individuals arbitrarily empowered by hereditary status. He felt that this could be achieved through education and the unification of cultural beliefs. He believed that citizens that were cultivated people whose intellects and emotions had been developed and matured by conscious people would benefit a nation. He felt that those born into the feudal system were had a personal duty to excel socially by means of power. Those w ho were of lesser class should also seek out education to better themselves. Confucius felt that love and respect for authority was a key to a perfect society; this strict respect was practiced through rituals and magic. The Confucius traditions have caused a tradition to set within its institution and are extremely active. It has, unfortunately, allowed the political institution to manipulate the Confucius system, as with Christianity. Christianity also preaches a divine, brotherly love. Modern Christianity seeks to discover a rational understanding of the person, as did Confucius; yet, Christianity feels that faith in the Jesus Christ, as a personal savior is essential to this enlightenment. It was also under the guise of Christianity that it had to confront totalitarian systems uses of power in its sphere of influence. Christians believed in an Absolute against all absolving of the relative, can protest in the name of God. ...

SSAT Test Dates Complete Guide to Choosing (2017, 2018)

SSAT Test Dates Complete Guide to Choosing (2017, 2018) SAT / ACT Prep Online Guides and Tips When are the upcoming SSAT test dates? How often is this test administered?Students hoping to attend private schools often need to take the SSAT, and since this test is only given a few times a year, it’s important to know SSAT test dates so you can register early enough to ensure you get a spot. In this guide, we have a chart of the upcoming SSAT test dates which makes it easy to see when you can take the test and when you need to register. We also give tips on test fees, explain what to expect on test day, and give advice on when you should take the SSAT. When Are Upcoming SSAT Test Dates? The SSAT is administered eight times during a school year (August 1 - July 31).Middle and Upper versions of the test (for students in grades 5 through 11) are given on every test date, but the Elementary-level SSAT (for students in grades 3 and 4) isn’t administered on the October or November dates. Below is a chart of recent and upcoming SSAT dates and the registration deadlines for each.You should register for the SSAT at least three weeks before the exam date to avoid late fees.You can register for the SSAT up to three days before the exam, but you’ll end up paying $45 to $85 in late fees, depending on how late you register. SSAT Exam Date Regular Registration Deadline Late Registration Begins ($45 fee) Rush Registration Begins ($85 fee) Last Day for Registration Oct. 14, 2017* Sep. 23, 2017 Sep. 24, 2017 Oct. 1, 2017 Oct. 11, 2017 Nov. 11, 2017* Oct. 21, 2017 Oct. 22, 2017 Oct. 29, 2017 Nov. 8, 2017 Dec. 9, 2017 Nov. 18, 2017 Nov. 19, 2017 Nov. 26, 2017 Dec. 6, 2017 Jan. 6, 2018 Dec. 16, 2017 Dec. 17, 2017 Dec. 24, 2017 Jan. 3, 2018 Feb. 3, 2018 Jan. 13, 2018 Jan. 14, 2018 Jan. 21, 2018 Jan. 31, 2018 March 3, 2018 Feb. 10, 2018 Feb. 11, 2018 Feb. 18, 2018 Feb. 28, 2018 April 21, 2018 March 31, 2018 April 1, 2018 April 8, 2018 April 18, 2018 June 9, 2018 May 19, 2018 May 20, 2018 May 27, 2018 June 6, 2018 * No Elementary-Level SSAT testing on these dates If your student needs additional testing accommodations or needs to take the SSAT on a Sunday due to religious reasons, you can apply for testing accommodations.You’ll need to apply at least four weeks before the desired test date and have any requested materials submitted at least two weeks before the test date. What to Expect on SSAT Test Day Once you figure out your SSAT test date, there’s still more work to do! In this section we discuss all the info you need to be prepared on exam day. Where Are SSAT Exams Usually Held? SSAT exams are typically held at private schools and sometimes designated test centers.When you register for the SSAT, you’ll see a list of test center locations nearest to you, with the closest location at the top of the list. What Happens on Test Day? Most exams begin at 9:00AM, but you should double-check your admission ticket to be sure this is the case for the exam you register for.Be sure to arrive at the testing location at least 30 minutes early.The Elementary-Level test is about 110 minutes long, while the Middle and Upper-Level SSATs are about 170 minutes long. The Elementary-Level test includes one break, while the Middle and Upper-Level tests have two breaks. To learn more about what the SSAT tests and the types of questions you can expect, check out our in-depth guide to the SSAT. What Should You Bring to the SSAT? On test day remember to bring the following: Your SSAT admission ticket Sharpened #2 pencils An eraser That’s all you’ll need during the test! When Should You Take the SSAT? The most important factor for deciding when to take the SSAT is the admissions deadline of the school(s) you’re applying to.Scores are sent about two weeks after the SSAT exam dates, so be sure to choose an exam date that’s at least two weeks before the admission deadline. If possible, you may want to choose a test date later in the school year so your child has time to learn more and possibly score higher on the SSAT.Remember, the SSAT you register for is the one for the grade your child is currently in, not the grade they’ll be entering next year. Recap: Choosing SSAT Dates It’s important to know SSAT test locations and dates well before exam day so that you can register in time and meet the deadlines of the school(s) you’re applying to.The SSAT is administered eight times a year, typically at private schools. SSAT Testing dates are pretty consistent, so you can predict future test dates based on the upcoming SSAT dates in our chart.Most SSAT tests begin at 9AM and last between two and three hours. You should pick your test date primarily on the application deadlines of the schools you’re applying to. SSAT test dates later in the year may give your child time to learn more material and earn a higher score. What's Next? Want to learn more about what's covered on the Elementary, Middle, and Upper-level tests? Then be sure to readour complete guide to the SSAT. Looking for free materials to use for SSAT practice? We've gathered links to the best free SSAT practice tests here. Now you know when the SSAT is offered, but how do you register?Learn all the info you need to know in our step-by-step guide to SSAT registration. Want to improve your SAT score by 160 points or your ACT score by 4 points?We've written a guide for each test about the top 5 strategies you must be using to have a shot at improving your score. Download it for free now:

Paper Based on Four Movies Essay Example | Topics and Well Written Essays - 1500 words

Paper Based on Four Movies - Essay Example The title in itself gives a hint of the plot, somehow one feels that it is bound to be a rags to riches story. In contrast, the movie The Pianist describes a man, caught in the horrors of war, who gets by because of his amazing talents and the compassion and humanity of other people. The title The Pianist is somehow still distinct from the Amelie because the latter is a proper name, while the former is not. The movie Amelie and the use of the name of the lead character as the title of the film suggests an intimacy that perhaps is not there in the two other films. The third movie wishes to establish an intimate and personal connection between the movie watcher and the character, drawing the watcher into the life and emotions of the character. So while all three movies focus on characters, the way they choose to do so are in different ways, all of which, however, set the stage for the unfolding of each of the movies’ rich narratives. Second question The depiction of space and pl ace in the movie Slumdog is best seen during the scene when the two boys who come from the slums work as â€Å"tourists† in the Taj Mahal. One can see the resplendence of the Taj Mahal as a towering symbol of Indian elite and it contrasts starkly with the material realities of the two boys who show tourists around. What is striking as well is the ease with which the boys, especially Jamal, walk around the Taj Mahal, as if comfortable in its splendor and luxury. This to me suggests an image of India that is replete with contrasts and dissonances, but somehow these contrasts and dissonances merge seamlessly into each other: as though poverty is used to and not appalled by the obscenity of wealth, and luxury has become so indifferent to poverty. One is jarred to the core by the horrific scenes of child exploitation, as for example a syndicate in the business of collecting beggars and deliberately maiming children so they can bring in more income. And then we are shown the busy s treets of India’s gleaming urban landscape, the call center capital of the world where dreams are fashioned from the magic wand of outsourcing. One too is struck by the scene where Jamal jumps into literal feces, an apt metaphor for the lives the â€Å"slumdogs† lead. And yet the characters, particularly the poor ones, accept this dichotomy with indifference, even acceptance. The images of space and place highlight the contrasts with clarity, and one is left with an image of India as a country straddling between economic greatness and dire poverty, an uneasy mixture that will soon explode in its face. Fourth question Ciki is a Bosniak soldier who finds himself in a trench with a Bosnian Serb during the height of the Bosnian war. He finds himself in an absurd situation with Nino, the Bosnian Serb, as they confront each other while under threat of an exploding land mine but stop short of killing each other. As the media gathers and international human rights observers jo in the fray, the exchange between Ciki and Nino becomes an interesting tableau of both the capacity of human beings for comedy amidst the tragedy of war. Ciki is extremely important to the film because he moves the story forward and delivers the necessary decisions and actions to allow the plot to unfold, e.g., jumping over Cera so the bomb would not explode, shooting Nino. Jane Livingstone is also in the film No Man’

The Effects of Computers on Today's Society Coursework

The Effects of Computers on Today's Society - Coursework Example Refrigerators use built-in computers to regulate the temperature, cars have computers in the form of anti-locking breaking systems and engine controls and smart phones also make use of some very sophisticated computer technology to safe keep our contacts, music and pictures (Frisicaro et al n.d). The biggest advantage of computers is the ease with which knowledge can be made available to the masses. Whether it is journals, databases, blogs or newspapers; anyone with a connection to the internet can now have a wealth of information on their fingertips. Search engines make it easier to look for information. Computer and internet technology has specially changed the nature of education (Frisicaro et al n.d). Students are learning in a whole new fashion which could not have been thought of before the advent of computers. They can now design models, run simulations, conduct extensive research and become a part of the global information revolution at the few clicks of a mouse (Kashmanian, 2000). Research also suggests that personal computers have had a huge impact on students’ decision to graduate from high school. Students who have had access to computers show better academic performance and achieve better test scores (Beltran et al 2008). Computers have completely changed the way we read and write. Now thanks to word processors, spelling mistakes are a thing of the past and even most celebrated writers now prefer electronic writing over traditional text. Computers are also a great interpersonal medium, enhancing our conversations through emails, discussion groups and chat rooms (Ferris, 2002). But despite all the goodness of computers, there are some major drawbacks. Thanks to all the word processors, the ability to express clearly without computers has become virtually nonexistent. Chat rooms and emails have done more damage to our writing and conversation skills than anything else. The Net-Generation speaks in abbreviations and shorthand that are wreaking havoc on language skills. Young children learn this language from an early age which effectively destroys their command over English language. Computer games and the internet mean that children as well as adults these days are spending all their time in front of the computer screen. Physical activity has become virtually non-existent; this is leading to many health issues. As these children grow up, this habit has taken hold and they continue to lead this computer-oriented lifestyle for the rest of their lives (Frisicaro et al n.d..). Office goers often complain of physiological problems such as Repetitive Strain Injuries, Carpel Tunnel Syndrome and DeQuervains Tendonitis which are brought on by non-stop use of computers. But there is an even darker side to the health issue. Computers are now known to cause some very serious psychological problems as well. The first issue is that computers can cause an alienation from society, many computer users are not able to function in social s ettings and are completely dependent on computers for any interaction they have with the world at large. Another issue is stress and burnout brought on by using computers for extended periods of time. Stress can also be brought on trying to keep up with the constant changes in computer technology. Computer addiction is also a very common psychological disorder in our society. People who suffer from it are always online and in search of the latest game, program or any other addiction that may keep them hooked

Marketing principles and applications Essay Example | Topics and Well Written Essays - 1750 words

Marketing principles and applications - Essay Example In fact, a consumer can use the appliance even without reading the instructions leaflet. In opposition with other appliances of the same characteristics the particular coffee maker offers to the consumer the impression of being involved in a unique experience: a series of color icons, showing cups of coffee of different size, helps the user to decide the type of coffee preferred. Then, icons showing spoons full of sugar and coffee help the user to decide on the amount of coffee and sugar that should be used for the type of coffee chosen. Finally, an icon with cup of milk is used for showing to the user his potential to choose a cup of coffee with milk. Particular emphasis has been also given to the components of the appliance. High quality materials have been used ensuring that the flavor of the coffee is strong. In the context of the issues discussed above, the appliance chosen fully supports the firm’s mission statement, which focuses on quality, convenience and innovation, as described in the introduction section. 2.   Classify Company G’s products using the three-way consumer product classification system. The three-way Consumer Product Classification system is based on the following rule: products can be classified in three categories according to specific characteristics. Reference is made particularly to ‘convenience, shopping and specialty goods’ (Boone & Kurtz, 2012, p.352). The particular system is quite helpful for the development of effective marketing strategies (Boone & Kurtz, 2012, p.352). However, the system is also related to an important weakness: consumer preferences worldwide are not standardized (Ferrell & Hartline, 2010). In fact, differences can be identified in consumer trends even within the same market and in regard to the same product. For example, the performance of a product can be changed within the same market under the impact of severe turbulences in the global market (Ferrell & Hartline, 2010). In ge neral convenience products are those that are highly popular, at least more than shopping products which are not necessarily incorporated in consumers’ daily shopping (Boone & Kurtz, 2012). Moreover, specialty goods are goods of specific characteristics and, usually, of high price (Boone & Kurtz, 2012). Using the above classification system Company G’s products could be classified by referring to three categories: convenience, shopping and specialty goods. It should be noted that the Table refers only to the firm’s small appliances and not to all its products. The consumer factors involved in the classification process are presented in the first column. In the three other columns the relevance of the firm’s products to each product category is analyzed. A rounded rectangle is used for showing the product category to which the firm’s products are nearer; the blue color indicates a high relevance, the green color is used for showing an average releva nce while the red color shows the lack of any relevance. Consumer factor (Boone & Kurtz, 2012, p.352) Convenience products Shopping products Specialty products Time spent on identifying the firm’s products The firm’s products cannot be chosen instantly Thought is required before buying the firm’s products The decision-making process in regard to the purchase of the firm’s products may takes a lot of time Location of the firm’s products The firm’s products are not available in all retail stores The firm’

Discuss the pros and cons of unions Essay Example | Topics and Well Written Essays - 250 words

Discuss the pros and cons of unions - Essay Example This implies that if benefits are increased, then workers will increase productivity that translates into profits for the company. Unions are also important for negotiating for better facilities at the work place such as maintenance services, new tools or equipment (Phillips and Gully 443). The introduction of such facilities implies that workers are willing to increase productivity and quality. However, unions also pose challenges to organizations and workers. For instance, unions breed laziness and rudeness in situations where the management fails to act. This causes industrial riots or unrests, which reduces the productivity and earnings of an organization (Phillips and Gully 443). Another setback of unions is that they create social groups in the workplaces where workers spend more time gossiping instead of working. Organizations where social groups are prevalent tend to suffer from misuse of resources and low productivity. This arises because the workers are attached to social groups that subscribe to their preferences. It is also apparent that unions are not good if it leads to shifting of strategic plans to respond to workers’ demands (Phillips and Gully 443). This gives the rival firms a competitive advantage since they are capable of working towards the faulted plans of the

360 Degree Feedback Case Study Example | Topics and Well Written Essays - 1250 words

360 Degree Feedback - Case Study Example This is so because unlike traditional review process, 360 degree feedback involves the ratings and comments of not only immediate supervisors and bosses, but also peers, colleagues, subordinates and even some outsiders. Thus, the person getting rated might feel uncomfortable or not ready to accept feedback from so many people or employees falling below him in the hierarchy level. Thus, 360 degree feedback first needs to be aligned with that of the corporate strategy and specific objective needs to be specified for its implementation. Whatever has been specified above is missing from Landon’s initiative of 360 degree feedback. Sam Glass, who is one of the supervisors and person responsible for looking after 360 degree feedback process is himself unsure of the fact that whether it is used as a performance appraisal tool or for chalking out future compensation plan. Following it, it cannot be denied that even more unawareness will be spread amongst the employees of Landon regardi ng the purpose and benefits of 360 degree feedback process. As already mentioned by Alex in the opening paragraphs, this tool was suggested by the Vice-President of Avant-Garde’s Consumer Products Division. Thus, no evidence of this tool being aligned to corporate strategy or specific objectives charted out is visible. ... Numerous modifications and changes are required in the way Landon is proceeding with its 360 degree feedback process. First and foremost, it needs to state in clear terms what actually it wants to achieve with this tool- just evaluating the performance of its employees or devising compensation, training and development plans based on feedbacks received. One thing important to note here is this tool cannot be used for a single problem employee. Also, it should not be used at times when the organization or one of its departments are going a change or revamping in any way. This might be one of the reasons why Alex is uncomfortable with this system of feedback because he was made responsible to restructure the marketing of two product lines. Definitely he might have used some measures or actions which brought out his tough, uncaring and ambitious personality traits which get accounted for in the feedback and can face repercussion for those temporary actions and behavior. Secondly, organi zation wide communication has to be undertaken by Landon to ensure that each and every member of the organization knows and understand well the concept. Employees cannot connect with this form of rating unless and until they perceive security and benefits for them. Raters should be chosen keeping in mind the surrounding network of the person being rated. Regular query handling session should also be incorporated by Landon to make sure that employees are positive towards this concept and do not feel that organization is using this tool as a means to kick them off their jobs. Question 2 360 degree feedback is a tool to modify behaviors of employees and align them with that of the corporate mission and strategy. The 360 degree feedback tool comprises of data and comments from

Discuss the pros and cons of unions Essay Example | Topics and Well Written Essays - 250 words

Discuss the pros and cons of unions - Essay Example This implies that if benefits are increased, then workers will increase productivity that translates into profits for the company. Unions are also important for negotiating for better facilities at the work place such as maintenance services, new tools or equipment (Phillips and Gully 443). The introduction of such facilities implies that workers are willing to increase productivity and quality. However, unions also pose challenges to organizations and workers. For instance, unions breed laziness and rudeness in situations where the management fails to act. This causes industrial riots or unrests, which reduces the productivity and earnings of an organization (Phillips and Gully 443). Another setback of unions is that they create social groups in the workplaces where workers spend more time gossiping instead of working. Organizations where social groups are prevalent tend to suffer from misuse of resources and low productivity. This arises because the workers are attached to social groups that subscribe to their preferences. It is also apparent that unions are not good if it leads to shifting of strategic plans to respond to workers’ demands (Phillips and Gully 443). This gives the rival firms a competitive advantage since they are capable of working towards the faulted plans of the

Enjoying Horror Research Paper Example | Topics and Well Written Essays - 500 words

Enjoying Horror - Research Paper Example This implies horror film viewers are happy with the frightening scenes, a tendency that becomes habitual making most people prefer watching them once they are free. In addition, Sine contends people tend to develop strong urge for watching terror that characterize these films due to the thrill of seeing abnormal termination of life or undertaking of certain risky ventures. The latter aspect, which Sine contends is the disclosure of horrific existence acting as the only source of excitement to the viewers. For instance, the torture unleashed on victims, which fascinates viewers, compared to their interests of knowing the movie’s story line or its end. He also claims it is not the tragic events that invoke pleasure among horror viewers but the way the whole situation is associated with our real life situation (Sine, n.d). Numerous people deem horror movies are harmless without knowing immense fascination enjoyed by viewers is equal to adverse affects inflicted on them especially to the young people who may end up doing what they see in real life. The author claims, â€Å"These impacts are felt by adults as well as children, by the well-adjusted as well as the disturbed† (Sine, n.d). This is because the effects usually linger in the minds of many viewers, hence haunting them throughout their lives. The article â€Å"The critique of pure Horror† authored by Zinoman Jason generally relays reasons why people find pleasure in watching horror films. In this article, Zinoman claims different writers aim at invoking a sense of curiosity among viewers via using both suspense and fascination created by human-like monsters. He contends, â€Å"The pleasure of horror movies is due not to whatever psychic substratum the monster represents, but rather to the peculiar curiosity it inspires† (Zinoman, 2011). Contrary to Sine, Zinoman highly appreciates the emotional aspects characterizing

Issues in Human Resource Strategies That Improve Organizational Performance Essay Example for Free

Issues in Human Resource Strategies That Improve Organizational Performance Essay A rapidly changing economic environment, characterized by such phenomena as the globalization, and deregulation of markets, changing customer and investor demands, and ever increasing product market competition, has become the norm for most organization. To compete, they must continually improve their performance by reducing costs; innovating products and processes; improving quality, productivity, and speed to market; and more importantly by improving their individual performance within the organization. In order to do this, a set of distinctive human resource strategies, defined as internally consistent bundles of human resource practices (Dyer Reeves, 1995), is clearly essential. Sparrow and Marchington (1998) suggested that HR practices are the most advanced, the most sophisticated, and the most efficient basis for organizing and for obtaining high performance from employees since it seeks to strategically integrate the interests of an organization and its employees. In addition, a number of studies have also indicated that there is a positive relationship between effective HR strategies and organizational performance. Specifically, it is suggested that HR practices can improve organizational and operational performance when matched with quality manufacturing strategies (Stone, 2002). Nevertheless, despite the positive relationship found between HR practices and firm performance, there are a number of issues and questions surrounding them. One problem in relating HRM and performance is the lack of theoretical background; resulting in both terms remain ambiguous concepts. Other questions arise in relation with the link between HR strategies and performance are the inconsistent findings in regards to what constitutes a high performance HR strategy (Becker Gerhart, 1996; Cooke, 2001) and the problems with HRM and performance measurements (Guest et al. , 2003). The aim of this essay is to outline and explain the issues in developing human resource strategies that improve organizational performance. Specifically, the essay shall begin with presenting the issue of theoretical background of the concept of HRM and organizational performance. Subsequently, it shall discuss the issue about diversified strategies used to improve performance, and the problems in measuring HRM and performance. ?HRM and Organizational Performance: The Lack of Theoretical Background Guest (1997) pointed out that to improve our understanding of the impact of HRM on performance; we need a theory about HRM, a theory about performance, and a theory about how they are linked. Unfortunately, there has been a great deal of debates amongst leading researchers and practitioners about the concept and contributions of HRM practice in managing employees in overall organizational objectives (Loosemore, Dainty Lingard, 2003; Analoui, 1998; Sparrow Marchington, 1998). McCarthy and Stone (1986) argued that the concept of HRM is ambiguous and that its contribution to organizational performance remains unclear and is not well understood. In addition, Sparrow and Marchington (1998) pointed out that rather than adding value to the business through its strategic integration with managerial objectives, HRM can remain a disappointingly mechanistic function. Similarly, there is no universal theory about performance (Guest, 1997). It was proposed that the meaning of performance involves two dimensions; the types of criteria and the weight of each. Organizations have different interpretations of performance according to the sector of their industries. Service providers, for example, might consider customer satisfaction as their top performance indicator, while manufacturers might view inventory level as an important criterion to measure their performance level. In addition, some organizations put financial results on top of their performance indicator list and employee’s job satisfaction at the bottom, but others may view this in the opposite position. As a result, it is hard, if not impossible, to define the concept of performance that applicable for all organizations. The impact of HR practices on firm performance is without a doubt an important topic in the fields of human resource management, industrial relations, and industrial and organizational psychology (Huselid, 1995; Jones Wright, 1992). This literature, although largely conceptual, concludes that HR practices can help to create a source of sustained competitive advantage, especially when they are aligned with a firm’s competitive strategy (Jackson Schuler, 1995; Wright McMahan, 1992, both as cited in Huselid, 1995). Specifically, a large majority of published studies found an association between HR practices and firm performance, regardless of whether they are cross-sectional or longitudinal, whether conducted at establishment or company level, whether based on strong performance data or subjective estimates, whatever sector they are based on, whatever operational definition of HRM is used, and wherever they are conducted (Guest et al. , 2003). Nevertheless, despite the positive thrust of most empirical findings, Wood and de Menezes (1998, as cited in Guest et al. 2003) failed to find consistent associations between HRM and performance. Furthermore, Wood (1999) has also argued that the relationship between HRM and performance is relatively weak. One possible explanation lies in the various contingency factors, other than HR activities, that might contribute to organizational performance such as organizational culture (Kotter Heskett, 1992; Van der Post et al. , 1998), business strategy (Richard Brown Johnson, 1999), and political considerations (Ferris et al. 1998). ?Improvement Strategies: Is There One Best Way? Much of the research on the link between HRM and firm performance has looked at single HR practice such as compensation or selection, while others attempted to look on the impact of combining different HR practices to improve firm performance (Becker Gerhart, 1996). Pfeffer (1998, as cited in Tyson, 1997), for instance, put forward a seven-principle best practice which he believed is universally applicable. The seven best practice HRM elements include; employment security, selective hiring, self managed teams, high compensation contingent on organizational performance, extensive training, reduction of status difference, and information sharing. Theoretically, bundling several HR practices should produce greater performance effects than any of the individual human practices (Dyer Reeves, 1995). However, in reality, there is no single standardized bundle of HR strategies that is universally applicable for all organizations. Each firm might require different bundles of HR strategies to improve its organizational performance.

Abnormal Uterine Bleeding (UAB) In Gynaecological Practice

Abnormal Uterine Bleeding (UAB) In Gynaecological Practice INTRODUCTION Abnormal uterine bleeding (AUB) is a common complaint in gynaecological practice, represents a major proportion of out patients attendence. One, in 20 women in UK consulted their GP for menorrhagia. [1] A menstural cycle of fewer than 21 days or more than 35 days or a menstural flow of less than two days or, more than seven days is considered abnormal. [2] AUB can be categorized as excessive menstural bleeding, irregular, bleeding intermenstural including, postcoital bleeding. [3] Different terms, used to describe AUB are: oligomenorrhea (bleeding occurs at intervals of > 35 days usually caused by, prolonged follicular phase). Polymenorrhagia, (bleeding occurs at intervals of 21 days may be caused by a luteal phase defect). Menorrhagia, (bleeding occurs at normal intervals (21 to 35 days)but with heavy flow (80 ml) or duration (7 days). Menometrorrhagia, (bleeding occurs at regular, non cyclic intervals with heavy flow (80 ml). (2) Abnormal uterine bleeding, includes both DUB bleeding from structural causes. Dysfunctional bleeding can be anovulatory, which is characterized by heavy but regular periods. (I-e, menorrhagia). Structural causes include: fibroids, polyps, endometrial carcinoma pregnancy complications. Abnormal bleeding can also results from contraceptive methods. (4) In peri postmenopause women, it is essential to exclude endometrial carcinoma. In younger women, endometrial hyperplasia anatomical anomalies: such as uterine fibroids, comprise the main pathology. (5) Perimenopause is the period, 2 8 years preceding menopause 1 year after the final menses. (WHO). However, a better practical definition is, the phase preceding the onset of menopause, generally occurring around 40-50 years of age, during which the regular cycle of a women transition to a pattern of irregular cycles. (6) A variety of methods, have been used to investigate patients with AUB, such as, endometrial cytology, transvaginal ultrasound, hysteroscopy, D C and endometrial biopsy . (7) The recommendation regarding, investigation of AUB is that women, over the age of 45, should be investigated with endometrial biopsy. Frequently, this is performed as an inpatient procedure with the biopsy being obtained by uterine curettage (D C). (5)This is the most common procedure used, to evaluate the endometrial cavity of a patient with AUB. (8) However, the value of endometrial curettage is great, in the establishment of histopathologic diagnosis. (6) The operation involves a G. A often a two day stay. Originally, the procedure was thought to have a therapeutic effect or AUB, But studies have failed to support this. This procedure is performed for diagnostic purposes, to exclude endometrial malignancy. (9) REWIEW OF LITERATURE ABNORMAL UTERINE BLEEDING Abnormal uterine bleeding (AUB) is a symptom it is not a disease, but is a common debilitating condition. Dysfunction uterine bleeding (D. U. B) is the diagnosis, given to women with AUB in whom no clear etiology can be identified. [10, 11]. An approach accurate diagnosis depend on recognizing the following types: Menorrhegia: is cyclic bleeding at normal intervals, which is excessive is larger than 7 days o and amount more than 80 ml frrom normal secretory endometrium after normal ovulation is caused by conditions affecting the uterus. (10, 11) Polymenorrhea: is cyclical bleeding which is normal in amount but which occurs at too frequent intervals of Polymenorrhegia: is cyclical bleeding which is both excessive too frequent. Eg: 9/20-12/20. It implies a disturbance in the hypothalamic pituitary ovarian uterine axis. (10) Metrorrhegia: It is bleeding of any amount whch is cyclical which occur irregularly or continuously in between normal cycles. It is caused by benign or malignant growth with ulcration. (10) Dysfunctional Uterine Bleeding continuously occurs at the extreme of reproductive (adolesence perimenopausally). The abnormalities of ovarian activity may be classified as follows. Upto 90% of cases of DUB result form menstrual cycles in which ovulation does not occur (anovulation) (Dodds). The remainder of cases arise from problems associated with ovulation such as dysfunction of the corpus luteum or prolonged progesterone secretion. (12) Anovulatory Occasionally anovulatory cycles occur in all women. Upto 90% of cases of D. U. B result from menstural cycles in which ovulation does not occur(anovulation. The remainder of cases arise from problems associated with ovulation such as dysfunction of the corpus luteum or peolonged progesterone secretion. Chronic anovulation in associated with an irregular unpredictable pattern of bleeding ranging from short cycles with scanty bleeding to prolonged period of irregular heavy loss. In anovulatory cycles, the endometrium is unable to produce factors whose sysnthesis is controlled by progesterone, eg. PGF2a (Smith et al, 1982). This may account for the painless bleeding. Anovulatory bleeding may be associated with cystic glandular hyperplasia of the endometrium. This occurs in some older women also in peripubertal girl, where unopposed oestrogen secretion occurs. Endometrial hyperplasia may cause excessive bleeding, anaemia, infertility even endometrial carcinoma. (13) Ovulatory: (idiopathic bleeding) It appears that there are a number of endometrial products, which alters the degree of vadoconstriction thus may effect the volume of menstrual blood loss. In the mid 1970s, a relationship b/w prostaglandins (PG) production menorrhegia was suggested by work showing that total endometrial PG content was proportional to menstrual loss. It appears that a shift in endometrial conversion form the vasoconstrictor PGF20( to the vasodilator PGI2 occurs. Another important factor is endothelin, which is very potent vasoconstricter, produced within the endometrial vessels. Marshs group showed reduced endothelin immunostaining in the endometrium of women with monorrhegia , implicating this peptide in the pathophysiology of increased menstural blood loss. (Marsh 996) (13) Etiology of Abnormal Uterine Bleeding Before Menarche: Malignancy, trauma sexual abuse or assault are potential causes of abnormal uterine bleeding before menarche. Child bearing years: Pregnancy is the first consideration in women of childbearing age who present with AUB. Potential causes of pregnancy related bleeding includes miscarriage, ectopic pregnancy , placenta previa, abrutio placentae trophoblastic disease. Next, iatrogenic causes of AUB should be explored. Bleeding may be induced by medication, including anticogulants, selective serotonin reuptake inhibitors, antipsychotics, cortiosteriods, hormonal medication, tamoxifen (Nolvadex). Herbal substance including ginseng, ginko, soy supplement, may cause menstrual irregularities by altering estrogen levels or clotting parameters. (14), (15) Systemic Disorders: Includes thyroid, hematologic, hepatic, adrenal, pituitary, hypothalamic conditions menstural. Irregularities are associated with both hypothroidism (23. 4% of cases) hyperthyroidism (21. 5% of cases). Coagulation Disorders: Inherited coagulopathy may be the underlying cause of AUB in 18% of white women 7% of black women with menorrhagia. Others causes include polycystic ovary syndrome or diabetes mallitis present with obesity, acne, hirsutism acanthosis nigricans. Genital tract pathology may be associated with intermenstural, postcoital and heavy menstural bleeding, Any history of abnormal Papanicolaou (Pap) smear, sexually transmitted disease, gynaecologic surgery, trauma or sexual abuse should be elicited. Uterine fibroids, endometrial polyps, adenomyosis, endometrial hyperplasia and atypia and endometrial cancer should be excluded. [14, 15] Differential Diagnosis Pregnancy complications: Threatened abortion   Incomplete abortion   Ectopic pregnancy Nonuterine bleeding: Cervical ectropion/erosion   Cervical neoplasia/polyp   Cervical or vaginal trauma   Condylomata   Atrophic vaginitis   Foreign bodies Pelvic inflammatory disease (PID): Endometritis   Tuberculosis Local factors: Endometrial polyps   Endometrial neoplasia   Adenomyosis/endometriosis   Uterine myomata (fibroids)   Intrauterine device (IUD) Uterine sarcoma Coagulation disorders: Thrombocytopenia, platelet disorders   von Willebrand disease   Leukemia   Ingestion of aspirin or anticoagulants   Iatrogenic Causes: Anticoagulants Antipsychotics Corticosteroids Herbal other supplements(ginkgo, soy) Hormone replacement intrauterine devices Oral contraceptive pills Thyroid hormone replacement PATHOPHYSIOLOGY OF ABNORMAL UTERINE BLEEDING: The hallmark of normal menstrual bleeding is the final result of fluctuations in the hypothalamic-Pituitary-Adrenal-Ovarian axis leading to predictable denudation and slough of the endometrium. Hemorrhage followed by prompt hemostasis and repair causes stabilization and regrowth of the endometrium. Physiologically, constant flow levels of estrogen prime the endometrium. Normal secretion of progesterone from the corpus luteum stabilizes the endometrium, decreases vascular fragility and supports the endometrial stroma. Patients with menorrhagia typically have an imbalance of prostaglandins levels and increased fibrinolytic activity . Specifically, women with heavy bleeding often have elevated levels of plasminogen activators compared to those with normal menstruation. [16] An intact coagulation pathway is important in regulation of menstruation. Mensturation disrupts blood vessels and in the face of normal hemostasis, the injured blood vessels are rapidly repaired . Restoration of blood vessels requires successful interaction of platelets and clotting factors. Defficiency of platelets, abnormal platelet function and an intact coagulation pathway may be associated with profound changes in the menstrual ctcle. [16]. Anovulatory D. U. B is usually due to failure of the corpus luteum to sustain the developing endometrium. The decline of inhibin levels and rise in FSH levels reflect the loss of follicular activity and competence as the perimenopausal transition occurs, [16]. Ovulatory D. U. B occurs when ovulatory cycles coexist with intracavitary lesions including polyps, endometrial cancer or fibroids which cause erractic bleeding, [16]. NATURE OF ABNORMAL UTERINE BLEEDING: The studies have shown mean menstrual blood loss to be ~ 30 ml per cycle in most societies, with loss > 60-80 ml per month being associated with an increased tendency towards iron deficiency and anaemia( Hallberg ET AL, 1996 ;Code et al, 1971). An upper limit of 60 ml may be more appropriate clinically. [17]. The duration of normal menstruation also varies greatly, with an average of 5 days and the heaviest loss usually on the first 2 days(Matsumoto at al, 1962 ; Rubin and Crosignani, 1990). Duration of flow is considered abnormal when it lasts 7 days. [17]. Abnormal uterine bleeding may involve any disturbance of regularity, frequency, duration or volume of menstrual flow and the causes may be physiological, pathological or pharmacological (Fraser and Sngertekin, 2000), [17]. MECHANISM S INVOLVED IN AUB: MENORRHAGIA: Menorrhagia is caused by certain pelvic diseases. The mechanisms by which these conditions cause excessive bleeding are poorly understood, but evidence suggest that large , thin walled and fragile surface vessels underlies the menorrhagia occurring with myomata and endometrial carcinoma. This disturbed angiogenesis is most likely a consequence of unco-ordinated release of angiogenic factors from the tumor themselves(Jane and Harris, 1998), s/a VEGF, bFGF, TGF-beta( Stewart and Nowak, 1996)[17]. The mechanism of increased blood loss with copper IUCDs is thought to be due to a combination if increased cytokine- producing endometrial leukocytes ( Sheppard, 1987), increased local fibrinolytic activity and epithelial surface erosion due to contact with the device(Shaw et al, 1979_. Release of PG and activation of mast cells and macrophages may be the underlying mechanisms. [17]. A quantitative reduction in platelets s/a in autoimmune thrombocytopenia or chronic renal failure can lead to increased menstrual loss. DYSFUCTIONAL UTERINE BLEEIDNG: Dysfunctional uterine bleeding accounts for ~50% of all cases of excessive uterine bleeding, 9Barley, 1972)[17] Anovulatory Dysfuctional Uterine Bleeding: The exact mechanisms behind anovulatory bleeding are unknown(Fraser et al, 1996) but it is known that unopposed estrogen can lead to excessive endometrial proliferation and hyperplasia with increased and dilated draining veins and suppression of spiral arterioles ( Beilby et al , 1971). Large thin walled, tortuous, superficial endometrial vessels can often be demonstrated on the surface of hyperplastic endometrium(Hamou, 1985) and increased fragility is a probable contribution to increased blood loss. Unopposed estrogen has a direct effect on the uterine blood supply by reducing vascular tone (Fraser at al, 1987) and possibly an indirect effect through inhobiting vasopressin releae( Akerlund et al, 1975) leading to vasodilation and increased blood flow. Unopposed estrogen also stimulates stromal VEGF expression which may contribute to disturbed angiogenesis ( Zhang at al, 1995 ; Smith , 1998). [17]. Ovulatory Dysfunctional Uterine Bleeding: The main defect in ovulatory DUB appears to be in the control of processes involve in the regulation of the volume of blood lost during menstrual breakdown of the endometrium, primarily the processes of vasoconstriction and haemostasis. [17] Endometrial glandular and stromal estrogen and progesterone receptor levels may be increased in the late secretory phase in women suffering from DUB (Gleeson et al, 1993 )[17] There may be some role of endothelins, which increase in at the time of normal menstruation. ( Cameron et al , 1992)[17] Reduced levels of endothelins may lead to an increase in the volume of blood lost. An increase in total PG release and disappropriate rise in PGE2 have been demonstrated in ovulatory DUB (Smith et al, 1981 ). It also has been shown that there is an increase in PGE2 and PGI2 receptors predisposing to vasodilation, in women with menorrhagia ( Adelantado et al, 1988 )[17] Prevention of platelet aggregation by PGI2 release may be an important contributing factor in ovulatory DUB ( Smith et al, 1981 ) as may increased endometrial tPA content, increased local fibrinolytic activity ( Bonner et al, 1983;Casslen et al, 1996;Gleeson et al, 1993 ) and excessive endometrial heparin like activity ( Paton et al , 1980 )[17} Endometrial lysosomal enzyme activity in women with ovulatory DUB is increased, and this activity is also observed in women with menorrhagia secondary to IUCD use (Wang , 1994 ){17 ) Matrix metaloproteinases may be important in contributing to abnormal endometrial breakdown and abnormalities of menstrual bleeding ( Salamonson et al, 2000 ){17, 18 ]. Granulated stromal lymphocytes, macrophages and othe migratory leukocytes may contribute to mechanisms of excessinve loss. [18] In DUB, delayed or incomplete endometrial repair could prolog menstrual bleeding episodes, but nothing is known about such mechanisms. [18] SIGNS AND SYMPTOMS OF ABNORMAL UTERINE BLEEDING: Frequent complaint include: heavy or prolonged menstural flow, social embarrassment, diminished quality of life, sexual compromise and alteration in life style. Pain is not a common presenting symptom unless associated with passage of large blood clots. Prolonged menstrual blood loss can be associated with anaemia. Typical complains of anaemia include fatigue, unusual desire of eating starch or dirt and headaches. Severe anaemia may cause fainting, congestive cardiac failure, exercise induced fatigue, shortness of breath. Hemorrhagic shock death are rare sequelae for DUB. [16] EVALUATION OF AUB IN PERIMENOPAUSAL WOMEN: 1.  History: History focuses on identifying the type of AUB:ovulatory, anovulatory or anatomic in order to guide treatment. Ovulatory bleeding is more common, usually cyclic, and can be associated with mid cycle pain, premenstrual symptoms and dysmenorrhea. Anovulatory bleeding occurs more frequently at the axtremes of reproductive age and in obese women. It is usually irregular and often heavy. Any history of easy bruising and tendency to bleed suggests coagulopathy. History of jaundice and hepatitis gives the evidence of liver sisease. [19] 2. Physical Examination: Physical examination includes looking for evidence of systemic disease. Pelvic and bimanual examination are done to detect disease in the genital tract. Cervical cytology analysis should be current and normal and cervical and vaginal swabs should be assesses to rule out infection. [19] 3. Laboratory tests: Beta subunit human chorionic gonadotropin for pregnancy. Complete blood count with platelet count for coagulopathy LFT, PT for liver disease. TSH for hypothyroidism and hyperthyroidism. Free testosterone for ovarian or adrenal tumor. [19] 4. Assessment of the uterine cavity: The main indications for assessment of the uterine cavity is to exclude pathology, most often seen in women over 45 years of age with anovulatory cycles. [19] A wide variety of methods are available for endometrial assessment including: Ultrasonography Endometrial Biopsy Hystroscopy Dilatation and curettage Sonohysterography Hysterosalpingography 1. Ultrasonography: Ultrasonography to look for ovarian or uterine disease. Transvaginal ultrasound is 80% sensitive and 69% specific for fibroids and polyps and is superior to transabdominal ultrasound. If possible, transvaginal ultrasound should be performed on days 4-6 of the menstrual cycle. [19] 2. Endometrial Biopsy: Endometrial biopsy is a simple office procedure that can be done by family physicians, [19]despite its convenience , cost effectiveness and safety, it is a blind endometrial sampling procedure. [20]It is a useful method to exclude malignancy in perimenopausal women. The annual incidence of endometrial cancer is 19. 5 per 100, 000 women. One in 4 cases of endometrial carcinoma occurs before menopause, so biopsy should be considered for high risk premenopausal patients, even in the presence of fibroids. Endometrial biopsy produces an adequate sample more that 85% of the time and detects 87-96% of endometrial carcinoma. [19] 3. Hysteroscopy: Hysteroscopy permits direct visualization of the cercical canal and uterine cavity, enabling observation of intrauterine abnormalities. Hysteroscopy is considered an accurate gold standard in uterine cavity evaluation. Despite the lack of adequate information about the diagnostic accuracy, it is used in many studies with and without endometrial sampling as a reference standard, [21] Hysteroscopy was reported to have sensitivity, specificity, negative predictive value (NPV) and positive predictive value (PPV) of 94. 2, 88. 8, 96. 3 and 83. 1% respectively, in predicting normal or abnormal endometrial histopathology (Garuti et al, 2001). The highest accuracy of hysteroscopy was in diagnosing endometrial polyps, where as the worst result was in estimating hyperplasia. In a recent study the sensitivity and PPV of hysteroscopy without endometrial biopsy in diagnosing endometrial carcinoma was only 58. 8 and 20. 8 % respectively (Lo and Yuyen, 2000 ). There, since the incidence of focal lesions in patients with AUB is 46-74% (Nagele et al, 1996;Pal et al, 1997 ), it seems that the most cost effective approach is to proceed with hysteroscopy complemented by endometrial biopsy, early in the assessment of AUB. [22] 4. Dilatation Curettage: Dilatation is a common surgical procedure done on women to scrape and collect the tissue from inside the uterus. Dilatation is a widening of the cervical passage. This is done using smoothy conical and tapered, graduated metal rods of various sizes and these appropriately called the dilators, which dilates the tight cervical passage slowly. Curettage is the second part of the procedure and is done to scrape the inside contents of the uterus. For this, a sharp spoon like instrument called curette is used. The procedure is usually performed under general anaesthesia. [23, 24, 25] Indications:[23, 24, 25]s Dialtation and curettage may be done as a diagnostic or a therapeutic procedure. Diagnostic: Diagnose conditions by collecting tissue samples for biopsy. To diagnose endometrial cancer. To investigate the causes of infertility. To investigate the cause of abnormal bleeding in postmenopausal women taking HRT. Therapeutic: Treat intermenstural bleeding To remove polyps in the endometrial or inner lining of the uterus. To treat irregular and heavy bleeding. To remove an embedded IUD used for contraception. To perform abortion in the early stages of pregnancy. To evacuate spontaneous abortion product. [23, 24, 25] Preoperative procedure: It is recommended that the patient take nothing by mouth, for at least 6 hours. Pain killers and antibiotics may be prescribed before the procedure. A sedative may be useful to relieve the anxirty of srgery. The genital area may be shaved and prepared for the surgery. An enema may be administered to clear the bowels. [23] Anaesthesia: General Anaesthesia: Most D Cs are done under general anaesthesia. The procedure is normally very short and the general anesthetic can be quickly reversed, with the patient going home soon afterwards. Spinal Anaesthesia: The advantage of spinal anaesthesia is that the patient is awake but at the same time does not have any sensation below the waist. It avoids all the complications of general anaesthesia. Local Anaesthesia: Occasionally, D C s are done under local anaesthesia, if the patient is not ready for general or spinal anaesthesia. [23, 25] Procedure: The vagina and cervix are cleaned with an antibacterial solution that may be iodine or alcohol based. The cervix is visualized using an instrument that is locatedin the vagina called the speculum. Lights are so adjusted to visualize the cervix so that its upper lip can be grasped with a special curved forceps called the Vulsellum. This helps both in stabilizing and bringing the cervix down towards the vaginal opening to ease with rest of the procedure. Dilatation is next done using sequential metal round tapered dilators and the opening to the uterus is gradually widened to about the size of a large pencil. Once this dilatation has been completed, the curette is inserted into the uterine cavity and is used to gently scrape the lining of the uterus. When the surgeon feels the gritty layer of cells just above the muscle of the uterus, then he/she knows that the scrapping has gone deep enough to sample the tissue adequately. This scrapping is done throughout the uterus and the tissue is sent to histopathologist. [23, 24, 25, 26] Post operative care: There may be mild abdominal discomfort after a dilatation and curettage, if pain is severe, consult a doctor. Medication should be taken as advised by doctor. Ensure to take antibiotics. Avoid the use of any contraceptive device or sexual intercourse for a week. Use sanitary napkins during this time period. If there are any signs of infection s/a fever , pain or discharge, consult the doctor immediately. [23, 24, 25] Contraindications: If a patient is too ill to undergo surgery. If the patient is unable to move her legs apart, s/a with severe arthritis in the hips. If the patient has problem with clotting mechanism of the body. [23] Complications: Complications are usually rare: Anaesthetic Complications: Reactions to anaesthetic medications. Breathing difficulties. Surgical Complications: Perforation of the uterus. Laceration of the cervix. Scarring of the endometrium. Infection of the uterus or other pelvic organs. Hemorrhage. [23, 24, 25] 5. SONOHYSTEROGRAPHY: Sonohysterography is being used more frequently for evaluation of women with many gynaecologic conditions. In 1992, it is reported the use of sonohysterography for detecting endometrial polyp in 14 of 148 infertility patients. In 13 of the women, polyps were asymptomatic. [27]This procedure is to be done by use of saline infused through a catheter into the endometrial cavity provides slight distention and separation of cavity walls, allowing the better visualization of uterine cavity. [28] Sonohysterography not only aids in diagnosis of intrauterine pathology but also in decision regarding surgical versus medical management of patients and and directs the approach and instrumentation required when surgical treatment is warranted. [28] It can be performed in any phase of cycle but the best time is during the first phase of the cycle especially when the indication is sterility or thickened endometrium at transvaginal sonography. [28] 6. HYSTEROSALPINGOGRAPHY: Hysterosalpingography requires the use of radiations and iodinated contrast material. It is expensive and provides indirect information about the uterine cavity. One can delineate fibroids and polyps but cannot comment on endometrial thickness. [28] 7. MEGNETIC RESONANCE IMAGING: Magnetic resonance imaging , an expensive modality provides excellent images of the uterus and myometrial pathology disrupting the endometrium, however, intracavitary lesions are not well demonstrated. [28] EMBRYOLOGY OF THE FEMALE GENITAL SYETEM Although genetic sex is determined at fertilization, gender is not apparent until approximately the 12th week of embryonic life. By the 6th week embryonic life, both male and female embryos start to develop the following structures on either side of the midline. :[29, 30] Genital ridge (proliferation of coelomic epithelium ) Mesonephric (wolffian )duct (lateral to the genital ridge ). Paramesonephric ( mullerian ) duct which consists of: Upper vertical part lateral to the wolffian duct. Middle horizontal part crosses in front of the wolffian duct ( both upper and middle parts form the fallopian tubes ). Lower vertical part fuses with the similar part of the opposite side to form the uteri-vaginal canal (the upper part forms the body and cervix of the uterus while the lower part forms the upper 4/5 of the vagina ). The lower 1/5 of the vagina develops from the sino-vaginal bulbs in the posterior wall of the uro-genital sinus. [29] Origin and derivatives of the Mullerian Ducts: Mullerian ducts persists, in females to develop into the fallopian tubes, the uterus and part of the vagina. [31]. Mullarian duct grows , at first it is solid, but later it becomes canalized. It deviates more and more medially till it meets its fellow of the opposite side. The septum between the two mullerian ducts disappear. The proximal parts of the mullerian ducts form the fallopian tubes, while the distal parts meet together to form the body and cervix of the uterus and the upper 4/5th of the vagina. The stroma and muscles develop from the surrounding mesoderm. The fusion of the two mullerian ducts brings together two peritoneal folds which become the broad ligaments. [29] Ovary: Development of the ovary passes into three phases: Migration of the germ cells from the yolk sac to the posterior body wall at level of 10th thoracic level to enter the genital ridge The germ cells differentiate into oogonia then primaryoocytes and become arrested until puberty. Descent of the ovary to reach the pelvis along a ligamentous cord called the gubernaculums that is attached inferiorlyot the inguinal region. The gubernaculums becomes incorporated into the uterine wall at the point of entry of the fallopian tube and persists in the adult as the ovarian ligaments and the round ligament. [29] External Genitalia: Clitoris develops from the genital tubercle (by slight elongation ). Labia minora develops from the genital folds (by remaining separate ) Labia majora develop from the genital swelings (by enlarging greatly ). Vestibule develops from the lower most part of the urogenital sinus. [29]. ANATOMY AND HISTOLOGY OF FEMALE GENITAL TRACT Uterus: The uterus is a fibromuscular organ and is a hollow and pear shaped highly vascular organ present in the pelvis between the bladder and the rectum. It is about 8 cm long and 5 am broad, within which fetal development occurs. Uterus is usually divided into a lower cervix and an upper corpus of uterine body. 1. Cervix; The cervix is narrow region at the bottom of the uterus that leads to the vagina. It has a convex round surface with a circular or slit like opening (the external os ) into the endocervical canal, ehich is approximately 2 -3 cm in length and opens proximally into the endometrial cavity at the internal os. [30, 32, 33] Histologically, the cervical mucosa generally contains both stratified squamous  epithelium (exocervix) and mucus secreting columnar epithelium (endocervix). The mucus secreting glands are confined to the endocervix. The area where the two types of epithelia meet is called the squamocolumnar junction. [30, 34]. Cervical mucus secreted by the mucosa layer of the cervical canal serves to protect against bacteria entering the uterus from the vagina . [33]. In the cervix, the stroma is firmer, more fibrous and less cellular. [34] 2. Uterine Corpus: The body of the uterus varies in size. At birth , the cervix and corpus are approximately equal in size, in the adult women, the corpus has grown to 2-3 times the size of the cervix. The uterine corpus is divided into different regions: Isthmus: where the endocervicla canal opens into the endometrial cavity. Uterine cornu: Funnel shaped area on each side of the upper uterine body receives the insertion of the fallopian tubes. Fundus: The portion of uterus above uterine cornu. [30] Histologically, the wall of the uterus consists of the following three layers: Perimetrium: It is serous membrane that covers the outside of the uterus. Myometrium: It consists of several layers of smooth muscles and imparts the bulk of the uterine wall. Contractions of these muscles during childbirth help to force the fetus out o