Evaluation of Dental Education Strategies Essay

Evaluation of Dental Education Strategies - Essay Example This paper stresses that the medical and dental education demanded new teaching – learning methods with more formal instructional design and delivery. In professional education like medical and dental education, the common teaching strategies include that of role model, small or large group interactions, lectures, one to one teaching, brainstorming, computer aided case studies and patient model exercise. Among these methods, for clinical teaching, the preferred teaching methods are role model, one to one instruction, small group discussions and patient model assessment. Based on the survey feedback from students, this case study aims to identify the most effective teaching method. Thus the single major aim of this case study is to find out the best teaching method in dental education – whether is it one to one direct teaching? or is it small group discussion teaching? The article also states that the teaching skills need to be developed by a doctor and he / she should b e a competent teacher. The following personal attributes are quoted for a competent and committed medical teacher by Judy and Carol, commitment to profession, enthusiasm, sensitive to needs of students, inculcating the required professional attitude within the students, developing practical teaching skills, interest in serving as doctor as well as a teacher, openness to peer review and change his or her teaching, ability to implement formal assessment of medical students and trainees.

Fiscal Policy Paper Essay Example | Topics and Well Written Essays - 250 words

Fiscal Policy Paper - Essay Example The huge deficits and debts the US is experiencing are attributable to the increased unbudgeted spending in diverse sectors that include Social security and insurance scheme for the disabled. The increased expenses in the sectors have made the nation face serious financial challenges due to the increasing deficits and debts with minimal surpluses (Whitehouse, 2010). The extreme economic conditions explain why the future social security and Medicare users should embrace themselves to challenging times ahead. Indeed, taxpayers in US that include Medicare and social security users have been feeling the pinch of the US economic situation. The increase in overspending has created an imbalance in the economy that in turn is leading to the utilization of the available resources in the sectors in financing other activities. The use of the resources has reduced the amount of money available to facilitate effective service delivery. The unfolding events have resulted in inferior service delivery in the sectors, lack of medical equipments in hospitals, unemployment, and reduced social cover (Whitehouse, 2010). In particular, the taxpayers no longer receive standardized services as before in a timely manner. The level of responsiveness to their issues is also worrying lately. Variably, the meltdown has forced job cuts in various institutions providing Medicare and social security services thereby compromising service delivery. Is because there is limited finance that can be used in sustaining qual ity service delivery as expected in the sectors. The surplus amount obtained can be used to support the ailing sectors in a bid to bridge the gap created by the deficit, as the government may deem necessary. The move can help in correcting the financial imbalance that may lead to the economic recession if not

Treatment of Rituximab in Pemphigus Vulgaris Patients

Treatment of Rituximab in Pemphigus Vulgaris Patients Part 3: Clinical Research 2 INTRODUCTION Pemphigus is the name of a group of life-threatening blistering diseases of the skin and mucous membranes. The base of treatment for this disease is corticosteroids; however, recently, new drugs, such as rituximab, have been verified for more severe forms of it. In the authors previously unpublished study, the effect of rituximab on variation in the laboratory indices of pemphigus vulgaris patients is addressed. After investigation of the files of pemphigus patients who received rituximab in Razi Hospital, Tehran, Iran from 2008 to 2013, 39 patients were entered into the study. All patients had lab sheets containing CR (creatinine), urea, ALT (alanine aminotransferase), AST (aspartate aminotransferase), Plt (platelet), Hgb (hemoglobin), and WBC (white blood cell) before and after receiving rituximab. The patients received rituximab 4 times at a dosage of 500 mg in 4 successive weeks. The lab results before receiving the first dose of rituximab were compared to the results after receiving treatment. The effect of rituximab on the variation in lab indices with the adjustment effect of age, gender, disease duration, sites of involvement, received adjoins, and the background disease were also investigated. In the initial analysis, rituximab only had a significant effect on urea reduction. In the CellCept ® (mycophenolate mofetil) receiving subgroup, the mixed consumption of rituximab led to a significant reduction in WBC. In the subgroup having background disease, rituximab had a statistically significant impact on platelet reduction. In the subgroup having no background disease, rituximab had a statistically significant effect on urea reduction. The lab indices were shown to have no significant relationship with age and disease duration. Thus, it can be predicted that disease duration and age would have no effect in the relationship between rituximab and lab indices variations. Although in stratified single-variable analysis for adjusting the effect of other variables (involvement sites and received adjoins) on the relation of rituximab and lab indices, some of these variables showed interacting effects with rituximab on the variations of lab indices. However, due to the low volume of sample and non-normal distribution of most of these variables, it was impossible to do multivariable analysis for investigation of their independent and interactive effects on variations of lab indices in an integrated manner, therefore, we can not make certain comments about their relationships. Chapter 1 Pemphigus is the name of a group of life-threatening blistering diseases that have characteristic acantholysis leading to formation of intraepithelial blisters in mucus and skin [1]. The acantholysis process is induced via attachments of flowing autoantibodies to adhesion molecules in the cells [2]. Patients with pemphigus have mucosal erosions, blisters, papules, and cutaneous erosions. The different types of pemphigus are pemphigus vulgaris, pemphigus foliaceus, immunoglobulin A (IgA) pemphigus, and paraneoplastic pemphigus. Different types of pemphigus are differentiated by clinical symptoms, related autoantigens, and histological methods. Pemphigus vulgaris has mucosal and mucocutaneous involvement. The blisters are acantholytic and suprabasal. The autoantibodies responsible for the disease are against desmoglein (DSG) 1 or both desmoglein 3 and 1. Pemphigus foliaceus only involves the skin. The blisters are acantholytic and subcorneal. The responsible autoantibodies are against desmoglein 1. IgA pemphigus has the form of grouped erythematous crusts, papules, and vesicle plucks. Blisters can be subcorneal or intraepithelial and acantholytic. The responsible autoantibodies are against desmocollin (DSC) 1 [3]. Paraneoplastic pemphigus involves vast and resistant stomatite along with different cutaneous findings. The responsible autoantibodies are against desmoplakin (DSP) or other desmosomal antigens. Pemphigus vulgaris is the most common type of pemphigus, but is still very rare. The chance of its occurrence is between 0.1 to 0.5 per 100,000 people [4]. Pemphigus often happens among adults and the average age of onset is 40 to 60 years old. It is very rare among children [5,6]. Its prevalence is almost the same in the 2 sexes [7]. Almost all the pemphigus vulgaris patients have mucosal involvement. The mouth is the most common site of involvement and is often the first site of involvement. Other mucosal membranes such as conjunctivae, nose, esophagus, vulva, vagina, cervix and anus are rarely involved [8]. As mucosal blisters are fragile and burst easily, in clinical examination it is difficult to find intact blisters, and instead the examiner tends to find mucosal erosions. Buccal and pa latal mucosa are the most common sites of blister involvement in the mouth cavity [9]. Mucosal involvement can be very painful. This pain often increases by chewing and swallowing, which can result in improper alimentation and weight reduction. Most of the patients also have cutaneous involvement appearing in the form of soft blisters in healthy skin or erythematosus. The blisters easily break, resulting in painful erosions. Pemphigus vulgaris rarely causes pruritis. Almost any part of body skin can be involved, but the palmar aspects of the foot and hands are rarely involved. The Nikolsky sign is often observed among these patients (mechanical pressure on the healthy skin results in blistering). Pemphigus is diagnosed based on the clinical, histological, immuno-pathological symptoms and laboratory findings. Even in cases where the clinical symptoms are intensively supporting pemphigus, laboratory investigation is still needed to confirm the diagnosis, as other diseases may have the same symptoms. The first line of treatment of pemphigus is systemic corticosteroids, an d addition of adjuvants may also be needed. Patients who do not respond to the first line of treatment might need additional interventions. In such patients, cyclophosphamides, rituximab, intravenous immunoglobulin (IVIG) or plasmapheresis may be helpful. Initial treatment of pemphigus vulgaris is systemic glucocorticoid, which is often applied in combination with other non-steroidal immunosuppressants such as azathioprine and mycophenolate mofetil. Pemphigus resistant to treatment is a type of pemphigus that does not respond to the aforementioned treatments. Pemphigus is a chronic disease that needs long-term treatment. A retrospective study was conducted during 1982-1993 on 40 patients [8]. On average, these patients achieved complete remission after 7.7 years; 25% had remission after 2 years; 50% after 5 years; and 75% after 10 years [8]. Most pemphigus vulgaris patients respond to initial treatments [9]. The first step, in the patients who do not respond to initial treatment, is increasing the dosage of systemic corticosteroids (1.5-2 mg/kg of prednisolone per day) or adjuvant drug. The adjuvant drug can also be changed (changing azathioprine to mycophenolate mofetil). In resistant cases, cyclophosphamides, rituximab, IVIG, and plasmapheresis could also be used. As pemphigus is an auto-immune disease caused by autoantibodies, treatments that reduce B cells are investigated [10-13]. Rituximab is a monoclonal antibody that targets CD20, located on B-lymphocytes, as its antigen. This drug has been shown to have profound effects on pemphigus treatments [13,14]. In a multicenter study conducted on 14 pemphigus vulgaris patients and 7 pemphigus foliaceus patients, both groups were resistant to systemic glucocorticoids and experienced several relapses during glucocorticoid tapering. They were then put on 1 cycle of rituximab with a weekly dosage of 275 mg/m2 for 4 weeks, and this addition proved advantageous [15]. Although, severe infections were reported in the patients under rituximab treatment, its effect on risk of infection is not clear, as other immunosuppressants were also concurrently used. Reactions during injection are among the most common side effects of rituximab. Deep vein thrombosis (DVT), pulmonary embolism, long-term hypogammaglobu linemia, and neutropenia were also common among the patients under rituximab treatment. Regarding the excellent impact of this drug on treatment of resistant pemphigus, and also on other diseases such as idiopathic thrombocytopenic purpura (ITP), vasculitis, lymphocytic leukemia, systemic lupus erythematosus (SLE), we decided to evaluate the effects of this drug on the variation of lab parameters such as white blood cell (WBC), Hemoglobin (Hg), platelet (Plt), aspartate aminotransferase (AST), alanine aminotransferase (ALT), urea, and creatinine (CR). So far, no study has been conducted on investigation of these variations due to receiving rituximab. OBJECTIVES AND HYPOTHESES Major Objective Investigation of laboratory variations after injection of rituximab in pemphigus vulgaris patients. Minor objectives of the project: Determination of rituximab impact on laboratory indices Determination of rituximab impact on laboratory indices by adjusting for the effect of age Determination of rituximab impact on laboratory indices by adjusting for the effect of gender Determination of rituximab impact on laboratory indices by adjusting for the effect of other treatment methods Determination of rituximab impact on laboratory indices by adjusting for the effect of disease duration Determination of rituximab impact on laboratory indices by adjusting for the effect of disease involved sites Determination of rituximab impact on laboratory indices by adjusting for the effect of Underlying disease Application objectives: Enhancement of health level among pemphigus vulgaris patients and paying attention to laboratory effect of patients after rituximab consumption. Research questions or hypotheses: Rituximab affects the laboratory indices Rituximab affects the laboratory indices with age effect adjustment Rituximab affects the laboratory indices with gender effect adjustment Rituximab affects the laboratory indices with disease duration effect adjustment Rituximab affects the laboratory indices with previous treatment effect adjustment Rituximab affects the laboratory indices with other disease effect adjustment Rituximab affects the laboratory indices with involved sites effect adjustment Chapter 2 Literature Review In 1997, rituximab was approved by the US Food and Drug Administration (FDA) as a treatment for non-Hodgkins lymphoma of B-cell that was resistant to chemotherapy. After that, it was applied for treatment for other diseases such as rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), Wegeners granulomatosis, idiopathic thrombocytopenic purpura (ITP), and Sjà ¶grens syndrome. Ten years later, its impact on the treatment of blister diseases such as pemphigus was shown [16]. In a 2006 study by Larrar et al, 2 children with autoimmune hemolytic anemia who were treated with rituximab experienced acute thrombocytopenia and neutropenia [17]. They resolved in several days, which showed that these hematologic effects are directly dependent on the toxicity of rituximab. In a study by Chairwatanatorn et al in 2003, neutropenia following application of rituximab was tested in 53 patients [18]. All patients except one were under Hodgkins lymphoma treatment. Eight cases of grade 4 neutropenia were observed after 1 to 5 months of rituximab treatment (5 patients only received rituximab and 3 patients were also under additional chemotherapy); 3 patients advanced toward sepsis. Neutropenia was not related to other diseases or treatments, and was related with reduction of neutrophil precursors, except for one of the patients whose bone marrow had hypoplasia. All cases of neutropenia occurred among the patients whose polymorphonuclear neutrophils (PMN) were normally or weakly reduced [18]. In a study by Tesfa et al in 2008, neutropenia occurred 4 or more weeks after rituximab treatment in lymphoma patients [19]. However, the mechanism of how rituximab causes neutropenia is still unknown. In a retrospective study of 113 lymphoma patients under rituximab treatment (alone or along with chemotherapy), 8 patients (7%) had neutropenia. The average onset was 88 days after receiving their last dosage of rituximab. The average time interval of neutropenia was 54 days. Four of the 8 patients underwent stem cell transplantation, 3 patients had neutropenia with fever and 2 of them needed granulocyte-colony stimulating factor (G-CSF) treatment. In the patients who had neutropenia, a cessation in maturation was observed in the promyelocytes category (the same as congenital neutropenia or Kostmann disease) [19]. A study by Otrock in 2005 addressed 2 patients who had acute thrombocytopenia after receiving rituximab [20]. One of the patients had hairy cell leukemia and the other one suffered from mantle cell lymphoma. In these patients, thrombocytopenia improved without the need of any treatment after several days. The reason for this is unknown. A study by Leo et al was conducted in 2004 for investigating the safety of rituximab [21]. In this study, the mixture of fludarabine, rituximab and cyclophosphamide was applied for treatment of follicular lymphoma. Surprisingly, severe thrombocytopenia with World Health Organization (WHO) grades 3 and 4 were observed in the patients, which resulted in the end of trial. Cytological and serological analysis was based on direct toxicity of rituximab. Chapter 3 Investigation Method 39 Therapy resistant pemphigus patients in Razi Hospital in Tehran, who had received rituximab from 2008 to 2012 were considered for inclusion in this retrospective cohort study. Data was collected before and after rituximab treatment. The variables included WBC, Hg, Plt, AST, ALT, Urea, and Cr and age, gender, involved sites, previous therapies, underlying disease, and disease duration. Test sheets associated to before and after rituximab application, containing WBC, Hg, Plt, AST, ALT, Urea and Cr were compared. Type of Study This study is a retrospective cohort study conducted on the pemphigus patients resistant to therapies who had received rituximab in 2008-2012. Studied Population Therapy-resistant pemphigus patients who were treated with rituximab in Razi Hospital, Tehran, Iran in 2008-2012. Inclusion Criteria Pemphigus patients who did not respond to the initial therapies (therapy-resistant pemphigus), and then were treated with rituximab. Exclusion Criteria Patients with no required tests before application of rituximab in their file Patients with no follow-up after receiving rituximab Patients whose first follow-up, after the last dosage of rituximab, is greater than 1 month. Sampling Method According to the available files, files of all the patients who had received rituximab from 2008 to 2012 were considered for inclusion. Data Collection The data collection tool included a checklist divided into 2 parts: one for the data before and one for the data collection after rituximab treatment. The variables included WBC, Hg, Plt, AST, ALT, Urea, and Cr and age, gender, involved sites, previous therapies, underlying disease, and disease duration. Project Implementation After studying the files of therapy-resistant pemphigus patients, the patients who had required data in their files were entered into the research. Rituximab treatment was defined as receiving 4 doses of 500 mg for 4 weeks, along with normal saline. Test sheets associated to before and after rituximab application, containing WBC, Hg, Plt, AST, ALT, Urea and Cr were compared. (The maximum time interval between the second test sheet and the last dosage of rituximab could be 1 month.) Data Analysis Finally, the finalized cases that had the inclusion criteria, were analyzed in Stata statistical software (StataCorp, Texas, USA) in terms of variations in WBC, Hg, Plt, AST, ALT, Urea and Cr after application of rituximab as the major variable and investigation of minor variables. Problems and Limitations As the base of this research was on filed files of hospital, inadequacy of data either before or after rituximab application excluded a bunch of samples from the study in a way that among 105 available files, only 39 files had the required data. Variables Major variables: quantitative measurement of white blood cells (WBC), Hemoglobin (Hgb), platelets (Plt), aspartate aminotransferase (AST), ALT, urea, and creatinine (Cr) before and after application of rituximab Minor variables: Gender Age Involved sites Previous therapies Underlying disease Disease duration The data of variables were collected according to the positive findings in the patients files (Table 1). Table 1 Patient variables. Title Variable Type Quantitative Qualitative Scientific Practical Definition Measurement Method Scale Independent Dependent Continuous Discrete Nominal Ranking WBC Number of WBC per ÃŽ ¼(mu)L of blood File reading Cell/mCl Hgb Amount of hemoglobin File reading Gr/dl Plt Number of plackets in patient blood File reading Cell/mcl AST * Amount of AST File reading IU/L ALT Amount of ALT File reading IU/L Urea Microgram of urea per deciliter of blood File reading Mg/dl Cr * Keratin amount File reading Mg/dl age * Years from birth File reading year gender * According to patient phenotype File reading Male/female Underlying disease * Existence of systemic disease File reading Having/not having Previous therapies * Received adjoin before rituximab File reading Azathioprine, IVIG Cyclophosphamide, CellCept ®, methotrexate Involved sites * Involved sites before starting rituximab File reading Upper body, lower body, face. Genitalia, sculp, mucus Disease Duration Months passed from onset to receiving rituximab File reading Month WBC white blood cell, Hgb hemoglobin, Plt platelet, AST aspartate aminotransferase, ALT alanine aminotransferase, CR creatinine, IVIG intravenous immunoglobulin Chapter 4 Results Among 105 therapy-resistant pemphigus patients who received rituximab treatment in Razi Hospital, Tehran, Iran from 2008 to 2012, only 39 patients managed to enter the study. The others were excluded due to inadequate data. Also in the included patient group, the maximum time interval between the last dosage of rituximab and follow-up was 1 month. The data of the remaining 39 patients were analyzed by Stata statistical software (StataCorp, Texas, USA) and the following results were obtained: The age of the patients ranged from 16 to 67 with a mean of 36.46 years. Their disease duration from the beginning of the disease until receiving rituximab ranged from 5 to 84 months with a mean of 39.30 months. Of the patients, 25 (64%) were men and 14 (36%) were women. It does not seem that the sex difference is related to therapy-resistant pemphigus, it is rather associated with the data collection method and exclusion of patients with incomplete files. Investigation of the involved sites showed that 25 patients (64%) had mucosal involvement, 20 patients (51.3%) had upper body involvement, 18 patients (46.2%) had lower body involvement, 19 people (48.7%) had genitalia involvement, 23 people had facial involvement, 36 people (92%) had body involvement, and in 22 patients (56.4%) the scalp was involved. The lab result variations of the mentioned patients were investigated in terms of the involved sites. The patients, before application of rituximab, were simultaneously under treatment with prednisolone and other adjoins. To summarize the unsuccessful treatments, 5 patients had cyclophosphamide, 18 of them received CellCept ® (mycophenolate mofetil), 7 people (17.9%) had intravenous immunoglobulin (IVIG), 5 patients were treated with methotrexate, and 22 patients had azathioprine. All these patients did not respond to corticosteroid and had active disease. In terms of variation in lab test results after receiving rituximab, the patients were investigated in terms of the previous adjuvants as well. Among 9 patients, 12 of them (30.8%) had systemic underlying diseases such as hypertension (HTN), diabetes mellitus (DM), Ischemic Heart Disease (IHD) and many more. The major variables were WBC, Hgb, Plt, AST, ALT, Urea and Cr before and after application of rituximab. Before Receiving Rituximab: The WBC range was 4,000-14,800 with average of 10,092. The Hgb range was 9.1-16.8 with average of 13.8. The Plt range was 100,000-683,000 with an average of 243,384. The AST range was 6-64 with average of 24.56. The ALT range was 10-143 with average of 43.92. The Urea range was 12-145 with average of 37.25. The Cr range was 0.5-1.2 with average of 0.87. After Receiving Rituximab: The WBC range was 5,400-19,000 with average of 9,964. The Hgb range was 7.4-16.7 with average of 13.42. The Plt range was 110,000-440,000 with average of 232,512. The AST range was 10-121 with average of 25.43. The ALT range was 12-144 with average of 48.46. The Urea range was 15-54 with average of 29.12. The Cr range was 0.6-1.2 with average of 0.85. The WBC had no statistically significant variations. The Hgb had no statistically significant variations. The Plt had no statistically significant variations. The AST had no statistically significant variations. The ALT had no statistically significant variations. The Urea had statistically significant variations. The Cr had no statistically significant variations. After receiving rituximab and adjusting for the effect of gender: The WBC had no statistically significant variations. The Hgb had no statistically significant variations. The Plt had no statistically significant variations. The AST had no statistically significant variations. The ALT had no statistically significant variations. The Cr had no statistically significant variations. In the case of Urea, we concluded that it depends on gender, as in men the variation was significant while in women the variations were not statistically significant. When investigating the results with adjustment of the involved sites, the following results were obtained: In patients with lower body involvement, rituximab had no significant effect on WBC, Plt, AST, ALT, Urea and Cr, but it had significant impact on Hgb reduction. In patients whose lower body was not involved, Urea significantly increased after receiving rituximab. In patients whose lower body was involved, rituximab caused a significant reduction in Cr, Urea, and Hgb. In patients whose upper body was not involved, rituximab had no significant effect on the variables. In the patients with or without facial involvement, rituximab had no significant impact on any of the variables. In patients whose genitalia region was involved, rituximab has no significant impact on any of the major variables. In patients with no genitalia involvement, rituximab resulted in significant reduction of urea. In patients with body involvement, rituximab resulted in significant reduction of urea. In patients with scalp involvement, rituximab resulted in significant reduction of urea. The adjustment of previous therapies was also addressed. As all the patients received prednisolone, the effect of adjoins (azathioprine, CellCept ®, cyclophosphamide, IVIG and methotrexate) was addressed: In patients who had received cyclophosphamide, rituximab has no statistically significant impact on the major variables. In patients who had not received cyclophosphamide, rituximab led to statistically significant reduction of urea. In patients who had received CellCept (mycophenolate mofetil), rituximab has statistically significant impact on reduction of urea and WBC. In patients who did not use IVIG adjoin, rituximab had a significant impact on reduction of urea. In patients who did not use methotrexate adjoin, rituximab had significant impact on reduction of urea. In patients who used azathioprine adjoin, rituximab had significant impact on reduction of urea. The adjustment impact of systemic underlying diseases (such as HTN, DM, IHD) was also addressed. In patients with systemic underlying disease, rituximab had significant impact on platelet reduction. In patients with no systemic underlying disease, rituximab had significant impact on urea reduction. There was no statistically significant relationship between the lab test result variations and disease duration and age (Table 1 through Table 8). TABLES Table 1 Age distribution in the studied patients Min Max Standard Deviation Average Age 16 67 13.48 36.48 Table 2 Disease duration distribution in the studies patients Min Max Standard Deviation Average Disease duration 5 84 20.28 29.30 Table 3 Absolute and relative frequency distribution of patients based on their gender Number % Men 25 64.1 Women 14 35.9 Total 39 100 Table 4 Absolute and relative frequency of involved sites at the time of rituximab injection. Frequency % Upper body 20 51.3 Lower body 18 46.2 Face 23 59 Genitalia 19 48.7 Body 36 92.3 Mucus 25 64.1 Scalp 22 56.4 Table 5 Absolute and relative frequency of received adjoins before application of rituximab Frequency % cyclophosphamide 5 12.8 CellCept ® 18 46.2 IVIG 7 17.9 methotrexate 5 12.8 azathioprine 22 56.4 IVIG intravenous immunoglobulin Table 6 Absolute and relative frequency of the patients based on having or not having underlying disease. Frequency

Economic System :: essays research papers

Economic System A country’s economic system consists of the structure and processes that it uses to allocate it’s resources and conduct it’s commercial activities.  Ã‚  Ã‚  Ã‚  Ã‚   Types of Economic Systems - Centrally planned economy - Mixed economy - Market economy Centrally planned economy System in which a nation’s resources are owned by the government. Origins: the ideology that the welfare of the group is more important than individual well being. (Karl Marx). Decline: In the 80’s nations began to dismantle communist central planning in favor of market based economy. Failures -economic value ,Provide incentives, Achieve rapid growth, Satisfy Consumer needs. Mixed economy Economic system in which resources are more equally divide between private and government ownership. Origins: the idea that a successful system must be not only efficient and innovative but should also protect society. Decline: mixed economies are converting to market system. (Privatization). Market Economy The majority of nations resources are privately owned. Economic decisions are determined by supply and demand. †¢Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Origins: the belief that individual concerns should be placed above group concerns. †¢Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Features: free choice, free enterprise and price flexibility. †¢Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Governments role: enforcing antitrust laws, preserving property rights, providing a stable fiscal and monetary environment and preserving political stability. Development of nations The economic development is a measure of gauging the economic well being of one nation's people as compared with that of another nation’s people. National development indicators: - national production - purchasing power parity - human development National Production Gross national product: value of all goods and services produced by country during a one year period, including income generated by both domestic and international activities. Gross domestic product: value of all goods and services produced by a country’s domestic economy over one year period. GDP or GNP per capita: nation’s GDP or GNP divided by it’s population. Purchasing Power Parity Purchasing power: the value of all goods and services that can be purchased with one unit of a country's currency. Purchasing power parity: is the relative ability of two countries’ currencies to buy the same â€Å"basket† of goods in those two countries. Human Development Human development index: The measure of the extent to which a peoples needs (healthy life, education, decent standard of living) are satisfied and the extent to which this needs are addressed equally across a nation’s entire population. Classifying countries Developed: highly industrialized and efficient countries that have a high quality of life. -USA,France, Italy, Canada.. Newly industrialized: recently increased the portion of it’s national production and exports from industrial operations ( emerging markets: developed + newly industrialized).

Positive Effects On Social Media Essay

I believe that their is a postitive affect in social media because it builds up confidence and allows people to stay organized and in the loop. It has been around since the 80’s. In an interesting DM article apparently 30 million of us who use the internet visit social networking websites such as Myspace, Facebook, and Bebo. Social media can also help find a missing person. The first reason social media has helped is because it lets you stay in touch with friends and family. You can get to know other students at your school or stay connected with other people who share a common interest. It also helps strengthen long distance relationships. For example, I have a friend whose parents got divorced and his dad lives far away from him. He said, â€Å"The only way we can communicate is through facebook†. I personally think facebook is a neat website that can help with communication. In the article â€Å"Teens in Survey Paint Positive Picture of Effect of Social Media on Their lives† I read that â€Å"Half of teens said social networks have helped their friendship† and I also agree with this. The second reason that it has helped is that it keeps us up to date with what’s going on. A reporter from a social media article stated that â€Å"Many teens express an almost-like wearness with the pressures of constant texting and posting involved in their lives†. People post and text online to express themselves. I talked to my sister this morning, and asked her how social media has helped her in life and she said â€Å"It provides me reminders for meets or practices for cross country†. I thought that was really intersting and I also believe it helps teachers with things like that too. Since theyre always busy and forget things I think they need some kind of reminder to remind them. see more:cause and effect of social media Finally, the third reason that social media has helped is that it makes you feel less lonely or if you’re not having a good day talking to your friends online can change your mood for the day. In the same social media article it said, â€Å"Many teenagers say that using social networking sites makes them feel more confident, popular, out going, and sympathetic to others†. So this is why social media is helpful for your life and others. Most parents I know and some teachers think social media has a negative perspective on it thinking it’s just a waste of time. But in cases like having communication with far away relatives, getting reminders or just by expressing yourself can bring a postive effort in your life style.

Empathy in ‘To Kill a Mockingbird’ Essay

In the novel ‘To Kill A Mockingbird’ by Harper Lee, learning to â€Å"walk about in someone’s skin† is a main theme, particularly as two of the main protagonists Jem and Scout learn to do this as they grow up throughout the book along with the reader. Atticus, the children’s father, educates the children on how to treat and comprehend other people. As Jem and Scout grow older in the novel, they begin to understand this lesson and act upon it both knowingly and sub-consciously. Scout empathises with Walter Cunningham during school at the beginning of the book. When her teacher, Miss Caroline offers Walter a quarter because he has no lunch (Walter’s family can not afford it and so he says he’s forgotten it) and refuses it, Miss Caroline can not see why and so continues to offer it with growing impatience. Scout empathises with how Walter is feeling at the time and so on his behalf explains why he has no lunch and why he will not accept her offer; â€Å"The Cunninghams never took anything they can’t pay back – no church baskets and no scrip stamps. They never took anything off of anybody, they get along on what they have. They don’t have much but they get along on it.† She did this to spare his embarrassment. Scout goes on to say, â€Å"You’re shamin’ him, Miss Caroline.† This shows her understanding of Walter’s perspective at that time and also how she tries to spare him by explaining to t he teacher. Early on in the book, Jem can already step into someone else’s shoes and empathise with them to see their perspective. The reader knows this when Jem confronts Scout after she beats up Walter Cunningham at school and he says, â€Å"Come on home to dinner with us Walter.† This shows Jem’s maturity and ability to empathise with those around him as he knows that what Scout did to Walter was wrong and he was able to see this by looking at it from Walter’s perspective. He also defends Walter when Scout wants to fight him. Scout says, â€Å"I stomped at him to chase him away, but Jem put out his hand and stopped me†. By also having a sense of initiative and good morals, Jem knows to invite Walter back to the house with them for dinner to apologise and show courtesy towards him. Also, Jem knows that Walter will have no dinner that day and that the Cunninghams would not accept anything they couldn’t pay back. He also knows that his family couldn’t afford to eat as  well as the Finches. By empathising with Walter, he sees how hungry he must be and so invites him to eat with them. Scout shows empathy for Jem by voluntarily accompanying him to read to Mrs Dubose when he is made to do so after destroying her flowers because she said horrible things about Atticus. For Scout, Mrs Dubose is a distressing object who then becomes the power over her afternoons forcing her and Jem to read to her. Scout decides to go with Jem a she knew he didn’t want to do it as Jem says, â€Å"Atticus, it’s all right on the sidewalk but inside it’s – it’s all dark and creepy. There’s shadows and things on the ceiling†¦Ã¢â‚¬  She goes with him even though she doesn’t like Mrs Dubose because she knows that Jem wouldn’t want to be alone reading to her and so Scout thinks it would be better if she goes along. Scout also sympathises and shows empathy for Mrs Dubose, despite her feelings toward her. She says, â€Å"I felt sorry for her. She was lying under a pile of quilts and looked almost friendly.† This shows Scout empathising with Mrs Dubose as she sees that she is ill, and can see how much pain she must be in. However, it’s not until after she dies that both Scout and Jem fully understand how Mrs Dubose must have been feeling: Mrs Dubose was a morphine addict who was determined to kick the habit before she died and so enlisted Jem and Scout to help keep her off of the morphine for longer and longer periods of time (without them knowing). Atticus wants them to empathise with her so they can see how much courage she had and learn â€Å"what real courage is, instead of getting the idea that courage is a man with a gun in his hand.† They both begin to understand why she was the way she was and see that she was actually a â€Å"great lady†, â€Å"had her own views about things† and died â€Å"beholden to nothing and nobody.† The reader sees that Jem in particular empathises with her at the very end of the chapter when Scout says, â€Å"He picked up the camellia, and when I went off to bed I saw him fingering the wide petals.† This shows that Jem was now beginning to understand and think about Mrs Dubose in a new light and he could now see her perspective. She was not just a bitter old lady. She was a courageous woman who stuck to her opinions right to the end and was determined to be rid of her morphine addiction before she died. Later in the novel when both the children have matured since the beginning, Scout has found herself involved in the ladies meeting by Aunt Alexandra and realises what it is like to be a lady. After hearing the horrid announcement of Tom Robinson’s death, Scout sees how affected by the news Aunt Alexandra is she till retains her lady-like manners as she has company. Scout thinks, â€Å"After all, if Aunty could be a lady at a time like this, so could I.† Scout allows herself to place others’ problems and emotions into her own perspective and as a result enhances her own actions with those who were affected. Jem not only learns to empathise with people throughout the novel but also other living beings. When Scout is about to kill a roly-poly (an insect), Jem says, â€Å"Don’t do that, Scout. Set him out on the back steps.† He does this because â€Å"they don’t bother you† so Jem knows that they are no harm and killing them would be wrong. This shows that his understanding of empathy has deepened. Finally, Scout empathises with Boo Radley by the end of the novel. Even before Boo Radley saves them, Scout begins feeling guilty about the way they had treated Boo Radley in the past summers; â€Å"I sometimes felt a twinge of remorse when passing by the old Radley place, at ever having taken part in what must have been sheer torment to Arthur Radley – what reasonable recluse wants children peeping in through his shutters, delivering greetings at the end of a fishing pole, wandering in his collards at night.† She understands how Boo Radley feels. After being rescued, she begins to start empathising with Boo without even realising; â€Å"Feeling slightly unreal, I led him to the chair farthest from Atticus and Mr. Tate. It was in a deep shadow. Boo would feel more comfortable in the dark.† She is thinking about what Boo Radley would like and feel more comfortable with, rather than thinking about things just from her view. After standing on Boo Radley’s porch after walking him home, Scout mentally imagines what Boo had seen all these years through the window. She realises she understands that â€Å"Atticus was right. One time he said, you never really know a man until you stand in his shoes and walk around in them. Just standing on the Radley porch was enough.† Boo Radley’s  world was everything outside his four walls. With this final insight of human nature, Scout has learnt what Atticus had been teaching her throughout the novel. Harper Lee’s novel ‘To kill a Mockingbird’ illustrates how to â€Å"walk about in someone’s skin† through the protagonists Scout and Jem as they learn this lesson along with the reader. As their understanding grows – in particular Scout’s as she is the narrator – the reader’s understanding also grows as when the children learn and understand something, we also do. If we could get more people to empathise with others like both Scout and Jem in the novel, we could eliminate the prejudice that still exists in the modern world. Having Jem and Scout grow up during the book make them characters that we can empathise with and so helps enforce the lesson that Harper Lee wanted to communicate to the reader. If everybody did finally â€Å"climb into his skin and walk around in it† then maybe we could understand that we have more in common with all types of people regardless of race, nationality, gender etc. Referring to what Atticus says at the end of the book, most people are nice â€Å"when you finally see them†.

Advertisements Description of Amara Hotels and Resorts, and City Seasons Hotels

Advertisements Description of Amara Hotels and Resorts, and City Seasons Hotels Advert 1 The advert shown below (see Appendix 1) is a magazine advert by Amara Hotels and Resorts; it is an example of a simple but effective advert. From a glance, target market can learn of features and services in the resorts. It has combined bright (shouting) and dull colors (colors of harmony) well to create a pleasant feeling that visitors are likely to get in the hotels and resorts.Advertising We will write a custom report sample on Advertisements Description of Amara Hotels and Resorts, and City Seasons Hotels specifically for you for only $16.05 $11/page Learn More In the advert framework, target customers can learn more than four services offered by the hotels. The advert users get into details of the advert to understand what the hotel offers and its locations. The above attributes of the adverts make it simple and straight-forward. Color mix used in the advert is another strength portrayed; the colors make the viewers feel harmony and peace. They have been used to communicate the feeling customers are likely to get from their stay in the resorts. The advert background is not only made by appealing combination of shades, but the shades also communicate of more features likely to be found in the hotel. Since the advert is divided into different segments, each area seems to address particular service in the resort. The above gives the advert an upper hand and facilitates effective communication with target customers. The words correctly rhyme with the advert tag; they both have been used to bring more information of the resorts/hotels. The marketing team has used selected words to ensure that customers understand more about the facility and how well they can enjoy their time there. As if all above mentioned is not enough, the advert gives the company an opportunity to write to the customers on different issues regarding the resorts. The advert meets all the requirements of an effective advert (Rakesh, 2005). Advert 2 Advert 2 (see Appendix 2) portrays an ineffective advert made by City Seasons Hotels. There is an obvious mismatch between the name of the hotel and what is portrayed in the advert. When making adverts, it is important for the management to consider even the name of the hotel or the product. In this case, the name of the hotel suggests a place with numerous activities that meet the season of a year.Advertising Looking for report on advertising? Let's see if we can help you! Get your first paper with 15% OFF Learn More However, it is not reflected in the advert. According to it, the place has more of indoor activities; it seems so because of the image of a beautiful interior design that the advert portrays. Although the finishing looks superb, the notion created by the name dismisses the good look. The color mix of the advert is not appealing; there is monotony of brown color which is supposed to be a shouting color and color of harmony. The background colors of the ad vert do not also go with each other well, there is nothing else communicated by the advert than what is coming out explicitly. Another problem that the advert has is the use of computer generated/artificial vegetations. The advert should show that the facility has well maintained vegetation. However, a closer look at the picture creates the impression that these trees are made to fit the situation or emphasize a decor and design of the interior, but here they seem to be out of place. The advert has concentrated on one area of its service, provision of accommodation. It has ignored the outdoor services that the resort offers. Since making an advert is expensive to every organization, it would be wiser to take all the possible advantages of it (Kerin Peterson, 2009). However, City Seasons Hotels failed to use their chance. References Kerin, R. A., Peterson, R. A. (2009). Strategic Marketing Problems: Cases and Comments (10th ed.). London: Pearson Education. Rakesh, J. (2005).Interna tional Marketing. New Delhi: Oxford University Press Appendix Appendix 1 Advertising We will write a custom report sample on Advertisements Description of Amara Hotels and Resorts, and City Seasons Hotels specifically for you for only $16.05 $11/page Learn More Appendix 2