Hepatocellular carcinoma

A 50-year-old married man with a family of three children presented chronic hepatitis C that developed to cirrhosis. Hepatitis C was linked to â€Å"intravenous drug used in 1960’s and trauma treatment involving several transfusion in 1975† (Schiff 2004, p. 183). Cirrhosis became complex due to â€Å"bleeding esophageal varice, but endoscopic banding intervention was successful in 2001† (Schiff 2004, p. 183).Advertising We will write a custom case study sample on Hepatocellular carcinoma specifically for you for only $16.05 $11/page Learn More The patient later had ascites and hepatic encephalopathy complications. A computed tomography conducted in â€Å"November 2001 showed a 6Ãâ€"6.5x7cm mass lesion in segment 7 of the liver (fig. 3), which later increased in size to 11.2Ãâ€"9.2Ãâ€"5.8cm on a repeat CT scan two months later while serum alpha-fetoprotein (AFP) was above 16,000ng/mL† (Schiff 2004, p. 183). Introduction Hepa tocellular carcinoma (HCC) is the most â€Å"common main liver cancer and the fifth most widespread cancer worldwide with a poor prognosis and it is the third most prevalent cause of death from cancer† (Ghanaati et al 2012, p. 167; Hennedige, Tiffany and Venkatesh 2012, p. 530). Some studies have recorded that HCC is mainly common in Asia where there are rampant cases of hepatitis B and C infection. The main risk factor for HCC is chronic hepatitis B virus infection (Carr 2012), which could be severe in densely populated regions (Ghanaati et al. 2012). Poor diet and metabolic factors may also influence prevalence of HCC (Abby and Zhu 2009). The condition is common in men aged between 30 and 50 years of age (Yang and Roberts 2010). These authors also observe that HCC diagnosis mainly occur in advanced stages, which make it contribute to high incidence and cases of fatality. Moreover, this later diagnosis also reduces effective use of curative treatments. Early diagnosis and su rgical resection together with local ablation are effective in enhancing conditions of patients with HCC. Imaging has critical role in determining the diagnosis of HCC. HCC has many imaging approaches, which include â€Å"ultrasonography (US), computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET) and angiography† (Hennedige and Venkatesh 2012 p. 530; Ghanaati et al 2012).Advertising Looking for case study on health medicine? Let's see if we can help you! Get your first paper with 15% OFF Learn More These approaches are effective in diagnosis of patients with chronic liver problems and a possible HCC case. Imaging helps in â€Å"screening, diagnosis, medication planning, patient management, and observation after treatment† (Hennedige and Venkatesh 2012 p. 530). In the case study, one can observed that HCC management is difficult because of the changing nature of the condition, factors that affect cirrhosis, and the rapeutic challenges (Ghanaati et al. 2012). Surgical interventions and liver transplant have been effective in managing HCC. However, not all conditions of HCC may require surgical resection. Thus, non-surgical interventions are common because of â€Å"multifocal diseases, proximity to the vital vascular or biliary structures and the insufficient functional hepatic reserve in cirrhosis† (Ghanaati et al. 2012 p.168). In the absence of surgery, radiology options, such as transarterial chemoembolization (TACE), radiofrequency ablation, and microwave ablation (Firouznia, Ghanaati, Jalali and Shakiba 2011) are common in managing HCC (Schiff 2004). Anatomy The liver is the major and most multifaceted organ in the abdominal area of the body. It has several microscopic and functional lobules, which aid in various functions of the liver. The liver originates from the ventral mesogastrium, but the upper section goes beyond the ventral area. Both falciform ligament and ligamentum teres connect the liver to the anterior section of the body while omentum joins the liver and the stomach as the coronary and triangular ligaments link the liver and the diaphragm. The liver supplies blood to the body. It gets blood from the artery and vein. Hepatocytes are in charge for complex metabolic processes within the liver. In addition, they also account for processes related to lipid synthesis, carbohydrate and cholesterol control, secretion of lipoproteins, formation of urea, enzymes, serum albumin, and other proteins.Advertising We will write a custom case study sample on Hepatocellular carcinoma specifically for you for only $16.05 $11/page Learn More Moreover, the liver is critical in clearing drug chemical substances and unidentified bodies in it. Kupffer cells aid in immune functions because they filter foreign particles in the liver. The liver also has biliary passages, which form bile and hepatic ducts. These ducts lead to the duodenum. Fig ure 1: A: Normal Anatomy of the liver, B: Histological view (Gurakar et al 2013) Pathology HCC is also like other forms of cancer, which progress through various stages of tumour (Kojiro 2006). According to Sakamoto Masanori (2007), histopathological and molecular biological studies have revealed that HCC associated with â€Å"chronic liver disease evolves from precancerous lesions called adenomatous hyperplasia (also called dysplastic nodules) and early HCC to a progressed form† (Masanori 2007 p. 138). During the early stages of the HCC condition, it looks like microinvasive carcinoma. Later the condition progresses to a progressed HCC. The early stage of HCC is critical for the development of all other subsequent stages (Sakamoto 2009). In the case study, cirrhosis was in advanced stage, which resulted into several complications (Marrero 2003). However, it is difficult to understand progress processes of HCC during early stages, but recent studies have shown that HCC progre sses from cirrhosis, dysplastic nodules to tumours (Marrero 2003).Advertising Looking for case study on health medicine? Let's see if we can help you! Get your first paper with 15% OFF Learn More Moreover, studies have failed to indicate any possible tumour suppressor genes during the early stages of HCC. Further studies in gene expression may clarify early stages of HCC. As cases of HCC rise, several combined tumours will be available and history of pathologic factors and patients’ history would be critical for understanding the condition. Hepatitis B and C Hepatitis B and C are fundamental conditions that contribute to HCC. There are several cases of HCC in China and Japan because of hepatitis B. In addition, other regions also experience cases of HCC from hepatitis B and C. While the prevalence of the condition is similar, many cases of HCC result from hepatitis C more than hepatitis B (Gomaa, Khan, Toledano, Waked, and Taylor-Robinson 2008). Pathogenesis of HCC availability due to hepatitis B could result from high number of cell increment from chronic liver conditions or due to processes associated with hepatitis B viruses (Gomaa et al 2008). Hepatitis B DNA geno me may interfere with the regulatory roles of the liver and increase the condition. On the other hand, details on how hepatitis C contributes to the progression of HCC remain unclear, but other studies allude that such patients could have suffered hepatitis B prior to hepatitis C (Gomaa et al 2008). Cirrhosis The case study shows that regardless of cirrhosis etiology, it is always a risk factor for growth and progression of HCC. Cirrhosis has higher chances of increasing the development of HCC than hepatitis in any population (Gomaa et al 2008). As hepatocellular progresses, it may cause changes in tumour suppressor genes. Mutation may cause hepatocarcinogeneses. Majority of patients with HCC also have cirrhosis conditions (Carr 2012). Figure 2: Liver biopsy showing presence of cirrhosis, (Schiff 2004) Other Factors There are also a number of etiological factors, which affect HCC. They include alcohol, use of anabolic steroid, aflatoxins, and hemochromatosis (Gomaa et al 2008). Die tary compositions with carcinogenic aflatoxins are usually widespread in some parts of sub-Saharan Africa and Southeast Asia (Gomaa et al 2008). Consequently, there is high prevalence of hepatitis B in these regions. However, details on how hepatitis B and carcinogenic aflatoxins contribute to HCC remain poorly studied and understood (Gomaa et al 2008). In cases of hepatitis C infection, alcohol has played a major role in enhancing the condition of HCC. Still, it is not clear whether alcohol acts independently, or it acts with hepatitis C to increase the condition of HCC (Gomaa et al 2008). Role of imaging modalities in the diagnosis Imaging modalities include â€Å"ultrasonography (US), computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET) and angiography† (Ghanaati et al. 2012). These modalities are useful in diagnosis of severe cases of liver conditions or suspected HCC (Ghariba, Thomasson and Li 2004). Ultrasonography (US) Ultrason ography is the first and commonly accepted form of HCC diagnosis because it is safe, fast, and cost-effective (Lee, Yoon and Kim 2012). However, ultrasonography does not provide optimal image quality in patients with cirrhosis. In this case, other modalities like CT and MRI are effective. The new ultrasound elastrography relies on strain to identify mechanical elements of tissue stiffness during diagnosis. The method may not be possible to apply because of deep and protected location of the liver. In this case, acoustic radiation is necessary in order to improve impulse elastography with short and focused US beam for tissue displacement (Ghanaati et al. 2012). Elastography has the ability to diagnose stiff superficial tissues, but â€Å"acoustic radiation force elastography can estimate the stiffness of the superficial and deep tissues due to application of shear wave† (Choi 2010). This method works well together with other conventional ultrasonography because it enhances con spicuity and differentiates between benign and malignant lesions (Hosseini 2011). Computed tomography (CT) CT images are useful in diagnosis of central liver lesions. This may take place after sonography and normal sonograhphy for patients who may have high-levels of ÃŽ ±-fetoprotein (Sahani, Holalkere, Mueller and Zhu 2007). In the case study, CT imaging showed that the patient had a 6Ãâ€"6.5x7cm mass lesion in segment 7 of the liver (fig. 3), which later increased in size to 11.2Ãâ€"9.2Ãâ€"5.8cm on a repeat CT scan two months later while serum alpha-fetoprotein (AFP) was above 16,000ng/mL (Schiff 2004; Sahani, Holalkere, Mueller and Zhu 2007). CT scan serves different roles during diagnosis. It is applicable during â€Å"HCC staging and post-diagnosis after surgical resection, percutaneous ethanol injection, or radiofrequency ablation† (Ghanaati et al. 2012). CT scan improves contrast in HCC diagnosis. This happens after an injection of extracellular contrast-enhancing a gent, which aid in depicting and identification of HCC. CT perfusion performance involves the use of Multi Detector CT (MDCT) and injection of iodinated contrast materials in order to enhance temporary changes in tissue attenuation (Ghanaati et al. 2012). Figure 3: CT scan demonstrating mass in right hepatic lobe (Schiff 2004) Magnetic resonance imaging (MRI) MRI is suitable for patients who have not shown any diagnostic results in CT diagnosis or patients who may not show positive results with iodinated contrast agents. MRI is better than CT scan in cases of hyperintense malignant lesions. In addition, enhanced MRI yields better images than CT contrast-enhanced scans. Still, MRI shows minute lesions clearly than other modalities of HCC diagnosis. MRI produces better result and efficacy relative to CT scan for effective decision-making on managing patients’ conditions. There is also Magnetic resonance elastography (MRE), which does not attack the body tissues, but reviews me chanical qualities of the body tissue. MRE aids in identification of malignant and benign liver tumours (Choi 2010). MRI uses Diffusion-weighted image (DWI) technology as a non-invasive quantification to enhance the rate of detection of focal liver conditions (Ghanaati et al. 2012). The technique uses cellular necrosis to enhance membrane permeability to facilitate free diffusion of water molecules. Figure 4: MRI HCC (Ghanaati et al 2012) Positron emission tomography (PET) PET is a new modality of HCC diagnosis. However, it is a new technique in terms of functions in HCC diagnosis, particularly in tracing certain hepatocyte. This technique will eventually improve the HCC diagnosis among patients with severe conditions of HCC and liver problems. PET technique yields a three-dimensional image of the body (Bailey, Townsend, Valk and Maisey 2005). It uses gamma rays from tracer in order to construct the image. PET can also use CT scan to accomplish the imaging process. Treatment and pr ognosis Studies have indicated that HCC is not sensitive to radiotherapy or chemotherapy interventions. However, several interventions exist for managing HCC, which include cisplatin gel injection, percutaneous ethanol, cryosurgery, radiofrequency ablation (surgical and percutaneous), hepatic artery chemoembolization, and liver transplant among others (El-Seragemail, Marrero, Rudolph and Reddy 2008). However, the case study focuses on the RFA and chemoembolization for managing advanced conditions. Table 1: Barcelona Clinic Liver Cancer (BCLC) staging classification and treatment schedule Stage Status Treatment Stage 0 Very early HCC Resection Stage A Early HCC Radical therapies (resection, liver transplantation, or percutaneous treatments) Stage B Intermediate HCC Chemoembolization Stage C Advanced HCC New agents in a randomized controlled trial setting Stage D End-stage disease Symptomatic treatment CLT, cadaveric liver transplant LDLT, living donor liver transplant PE I, percutaneous ethanol injection RF, radiofrequency PS, performance status Adapted from (Sala, Forner, Varela and Bruix 2005) Radiofrequency Ablation (RFA) RFA is a relative new method of managing HCC. It relies on ‘heating’ to destroy tumour in the liver. It has a thin probe, which reaches the tumour with the aid of ultrasound (Bruix and Sherman 2005). However, this technology applies to small tumour within the liver. Moreover, it has low-levels of side effects to the HCC patient. RFA is also simple to use because it can work in â€Å"an open or laparoscopic technique, physicians can apply RFA by the use of percutaneous approach (a direct injection through the skin)† (Gurakar et al 2013). Physicians can also use RFA alongside other interventions like liver resection and cryotherapy (Ghanaati et al. 2012). Hepatic Artery Chemoembolization This is the most common intervention method for treating unresectable liver tumours (tumours beyond operation). Chemoembol ization treatment offers many benefits than other intravenous pump infusion interventions (Bruix, Sala and Llovet 2004). It takes the injected drugs to the tumour and controls blood flow without extending contact time for tumour and drug. It reduces oxygen supply to the tumour and improves high drug concentration on the tumour. Chemoembolization also has a long duration for drugs to stay in the liver, which may be more than a month after the treatment. It also enhances high chances of the patient survival after undergoing medication. Chemoembolization has high-levels of vascularity, which enhances neuroendocrine tumour treatments. In fact, Chemoembolization is the most favourable intervention for unresectable hepatocellular carcinoma, and neuroendocrine tumours of the liver (Bruix et al 2004). Figure 5: Liver tissue chemoembolization (Schiff 2004) Summary and conclusion HCC is a common primary liver cancer with poor prognosis and treatment, which have contributed to high numbers of mortality rate associated with it. The condition progresses through various stages as the patient in the case study indicates. Studies have linked HCC with hepatitis B and C, liver cirrhosis and other factors like alcohol, use of anabolic steroid, aflatoxins, and hemochromatosis. However, details on how these factors relate to enhance HCC remain scanty. Imaging techniques (specifically CT and MRI) have critical role in the diagnosis and evaluation of liver problems, tumours, and HCC interventions. Imaging helps patients whose conditions do not require surgery. The patient in the case study required chemoembolization because liver transplantation was not effective due to high chances of recurrence and the intermediate stage of the condition. Reference List Abby, Siegel and Andrew X. Zhu. â€Å"Metabolic Syndrome and hepatocellular carcinoma.† Cancer (ACS) 115, no. 24 (2009): 5651–5661. doi:10.1002/cncr.24687. Bailey, Dale, David W. Townsend, Peter E. Valk and Michael N . Maisey. Positron Emission Tomography: Basic Sciences. Secaucus, NJ: Springer-Verlag, 2005. Bruix, Jordi and Morris Sherman. â€Å"Management of hepatocellular carcinoma.† Hepatology 42, no. 5 (2005): 1208–1236. doi:10.1002/hep.20933. Bruix, Jordi, Margarita Sala and Josep Llovet. â€Å"Chemoembolization for hepatocellular carcinoma.† Gastroenterology 127, no. 5 (2004): S179–S188. doi.org/10.1053/j.gastro.2004.09.032. Carr, Brian. â€Å"Introduction: Hepatocellular Carcinoma.† Seminars in Oncology 39 no. 4, (2012): 367–368. Choi, Bi. â€Å"Advances of imaging for hepatocellular carcinoma.† Oncology 78, no. 1 (2010): 46–52. doi: 10.1159/000315230. El-Seragemail, Hashem, Jorge Marrero, Lenhard Rudolph and Rajender Reddy. â€Å"Diagnosis and Treatment of Hepatocellular Carcinoma.† Gastroenterology 134, no. 6 (2008): 1752-1763. doi:10.1053/j.gastro.2008.02.090. Firouznia, Kavous, Hossein Ghanaati, Amir Hossein Jalali, and M adjid Shakiba. â€Å"Advances of interventional radiology in treatment of hepatobiliary diseases in Iran.† Hepat Mon. 11, no. 7 (2011): 507–10. Ghanaati, Hossein, Seyed Moayed Alavian, Ali Jafarian, Nasser Ebrahimi Daryani, Mohsen Nassiri-Toosi, Amir Hossein Jalali, and Madjid Shakiba. â€Å"Imaging and Imaging-Guided Interventions in the Diagnosis and Management of Hepatocellular Carcinoma (HCC)-Review of Evidence.† Iran J Radiol 9, no. 4 (2012): 167–177. doi: 10.5812/iranjradiol.8242. Ghariba, Ahmed, David Thomasson and King Li. â€Å"Molecular imaging of hepatocellular carcinoma.† Gastroenterology 127, no. 5 (2004): S153–S158. doi.org/10.1053/j.gastro.2004.09.029. Gomaa, Asmaa Ibrahim, Shahid A Khan, Mireille B Toledano, Imam Waked, and Simon D Taylor-Robinson. â€Å"Hepatocellular carcinoma: Epidemiology, risk factors and pathogenesis.† World J Gastroenterol., 14, no. 27 (2008): 4300–4308. doi: 10.3748/wjg.14.4300. Hennedig e, Tiffany and Sudhakar Kundapur Venkatesh. â€Å"Review: Imaging of hepatocellular carcinoma: diagnosis, staging and treatment monitoring.† The Journal of the International Cancer Imaging Society 12, no. 3 (2012): 530-547. DOI: 10.1102/1470-7330.2012.0044. Hosseini, Saiedi. â€Å"Risk factors and incidence of hepatocellular carcinoma in southeast iran.† Hepat Mon. 11, no. 8 (2011): 666–7. doi: 10.5812/kowsar.1735143X.710. Kojiro, Masamichi. Pathology of Hepatocellular Carcinoma. Oxford: Wiley-Blackwell, 2006. Lee, Jeong, Jeong-Hee Yoon, and Kyung Kim. â€Å"Diagnosis of Hepatocellular Carcinoma: Newer Radiological Tools.† Seminars in Oncology 39, no. 4 (2012): 399–409. Marrero, Jorge. â€Å"Hepatocellular Carcinoma:† Current Opinion in Gastroenterology, 19, no. 3 (2003): 243-249. Sahani, Dushyant, Nagaraj-Setty Holalkere, Peter Mueller, and Andrew Zhu. â€Å"Advanced Hepatocellular Carcinoma: CT Perfusion of Liver and Tumor Tissue—I nitial Experience.† Radiology 243, (2007): 736-743. doi: 10.1148/radiol.2433052020. Sakamoto, Masanori. â€Å"Pathology of early hepatocellular carcinoma.† Hepatol Research 37, no. 2 (2007): S135-8. Sakamoto, Masanori. â€Å"Early HCC: diagnosis and molecular markers.† Journal of Gastroenterology 44, no. 19 (2009): 108-11. doi: 10.1007/s00535-008-2245-y. Sala, Margarita, Alejandro Forner, Maria Varela and Jordi Bruix. â€Å"Prognostic Prediction in Patients with Hepatocellular Carcinoma.† Seminars in Liver Disease 25, no. 2 (2005): 171-180. Schiff, Eugene R. â€Å"Case Study in the Management of Patients with Hepatocellular Carcinoma.† In Management of Patients with Viral Hepatitis, Paris, 2004, edited by Fabien Zoulim, 183-188. Paris: Beaujon Hospital, 2004. Yang, Ju and Lewis Roberts. â€Å"Epidemiology and management of hepatocellular carcinoma.† Infect Dis Clin North Am. 24, no. 4 (2010): 899-919. doi: 10.1016/j.idc.2010.07.004. This case study on Hepatocellular carcinoma was written and submitted by user Molecule Man to help you with your own studies. You are free to use it for research and reference purposes in order to write your own paper; however, you must cite it accordingly. You can donate your paper here.

All the Pretty Horses essays

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This explains English as a lingua franca, the term lingua franca describes a language serving as a regular means of communication between different linguistic groups in a multilingual speech community Holmes (1997:86). The participant in this case is happy with the f act that English is used as a medium of instruction. The students response to statement two was that he disagrees that he would be more successful academically if his first language was a medium of instruction. The students reason for this is as follows No, I am more competent in English than my mother tongue when it comes to reading and writing as I last stopped using my first language for reading and writing in standard 3. It is clear, judging by the participants response, that he has lost proficiency in his first language in reading and writing due to being educated in English for so long. As a result of being educated in English for such a long time the student seems to feel more competent with English. This evidence gives rise to the notion that English may be the predominant language for educating a multilingual society due to its global recognition. The participants response to statement three was that he strongly disagrees with the assumption that, other languages are sufficiently developed for use at tertiary level and should not only be used for informal communication. The students reason for this is When it comes to Afrikaans and Xhosa I understand because these are the languages predominantly spoken in the Western Cape, but if its other languages it would not be fair to the other 11 official languages which are not used in tertiary education. The student in this instance feels as that English, Afrikaans and Xhosa are the only three languages developed at tertiary level as there is predominance in the amount of speakers of these languages. However, the participant disagrees that other languages should be used as a medium of instruction at tertiary level because it would be unfair to those who cannot understand the language. The student also feels that should one language, other than English/Afrikaans or Xhosa, be used as a m edium of instruction at tertiary level it would be unfair to the other eleven official languages that are not used in this way. The students answer to statement four was that he strongly agrees that its a good thing that we have a common language at UWC to communicate across linguistic boundaries. The students reason for this is as follows; If it wasnt for English as a lingua franca we would all be lost unless we share a 1st language, So it very good that we have a lingua franca as we connect/communicate well. In this case it is evident that the participant feels generally pleased that there is a language that can break through linguistic boundaries. The student in this case feels that English has the power to do so as a result of its wide range of speakers. It is also clear that the student agrees that English as a lingua franca helps us to communicate with other students from different linguistic backgrounds. The last statement the partaker responded that he agrees that he is pleased he has picked up some words and expressions in other languages. His reason for this is Yes I am this helps to communicate better with student who I do not share the same 1st language with, helps to build friendships and more, it brings people together. With regard to this response it seems that the student is pleased that he is able to pick up words form other languages that help to form relationships. To conclude the findings it is apparent that language attitudes form part of ideologies. Judging by the data I have gathered the participant provided insight of his attitude toward different languages especially English. It is obvious that English is a medium of instruction that the participant is pleased with as he would not have chosen UWC as an institution for higher education if this was not the case. The participant thus has a positive attitude towards English and the ideology (shared beliefs of language forms and practices) that English is a lingua franca common to all, increases this positive attitude. In this instance it brings to mind the assumption that we attain our attitudes from our ideologies. In essence it is apparent that our ideologies influence our attitudes toward various languages and it is these components that constitute as part of our identity. Language thus forms part of identity and in a modernised multilingual society the choice of identity is open to all. To elaborate one can side with the post-modern researchers who suggest that Post-modern accounts of identity have reacted against traditional and essentialist views by proposing an almost unlimited range of identity choices (Wallace, 2008:61). We as South Africans may be faced with the challenge of the battle between predominant and minor languages in a diverse country that consists of many different languages. Yet it is still astonishing to see that an institution such as UWC is able to bring people together even if it is through the use of English as a medium of instruction.

The Role of the Home in Nervous Conditions and Oranges Essay -- Litera

The role of home in Nervous Conditions and Oranges are not the Only Fruit is vital in building and developing the characters and their personalities. The home and its importance are continuously changing throughout both novels and prove to be one of the most dominant factors in shaping the protagonists into the characters we meet at the end. In both texts, we can see that neither family nor home is stereotypical of society. Moreover, the heads of home are not conventional leaders, or so society would deem them. The novels focus on how the diverse images of â€Å"home† ultimately create the own sense of uniqueness both Tambu and Jeanette display in their own right. The novels’ settings are hugely contrasting and as a result, a strong insight of how home and family can develop such different belief systems and scruples is gained. While their homes may be set in opposite corners of the globe, both Tambu and Jeanette deal with a similar oppression of their femininity and t heir own development as of some sort of self. From the onset, both novels convey a strong sense of order in the family home. However, the heads of house are not what would be typically expected. In Nervous Conditions, the leader of the home initially is Tambu’s father. He conveys a home that is reliant on all its members to provide rather than him providing solely for the family. His expectance of his wife and children to provide while he squanders money suggests that home is not necessarily a happy one; instead, it is focused on money and wealth. This focus on greed encourages Tambu to grow disdainful of her original family structure and presents the home as something negative. Similarly, in Oranges are not the Only Fruit Jeanette’s mother is the dominant figure; howe... ...nchanged either. We see that as the characters develop so do their homes, by branching out and their ultimate structure being affected also. Both Tambu and Jeanette are deeply affected by the moral codes that their families try to instil in them. Neither enjoy an ideal home; furthermore, the experiences that their homes present leave them more than wary of their families. Yet the importance of home and family remains the same, it helps to mould you into the person you become whether it is a happy experience or not. In addition, we are left to wonder if the characters we meet at the end are happy with the person they become or are resentful of what their home has made them. Works Cited: Dangarembga, Tsitsi. Nervous Conditions. Oxfordshire: Ayebia Clarke Publishing Ltd, 2004. Winterson, Jeanette. Oranges are not the Only Fruit. London: Random House, 1991.

College Student Should Join Clubs Essay

Students of any university or community college attend school in pursuit of an education and career. Most of the time spent by college students is aimed towards studying, doing homework, and any other activity that will assist their education. What many college students are unaware of though, is by affiliating themselves with clubs and organizations, efforts to their education, social networking, and community can all be accomplished. Joining a club has the ability to enrich any student’s college experience and should be taken into consideration by all college students. Clubs give students opportunities to meet other students and individuals who share the same interests. Not only will they benefit in gaining a friend, they will have the opportunity to meet peers with similar majors and classes. Taking into consideration that incoming freshmen may need an extra boost; clubs will be able to provide the needed attention and information with guidance from the seniority. For example, freshmen can benefit in joining clubs by receiving guidance from other students on what classes or which professors to take. New freshmen tend to enroll into college as an undeclared major and sometimes may require assistance in the selection of classes. College organizations can play as a major factor in helping college students and should not be ignored. According to Jeff Milam, the eHow Contributor, not only will joining a club help â€Å"encourage you to form relationships with your peers, it may also lead to important business contacts in the future† (Milam). All college clubs must have at least one advisor that assists and overlooks the club. By being in a club, students will have the opportunity to meet and communicate with college staffs and instructors. In most scenarios, the advisor of a college club is an administrator of the campus. Thus, straight-forward information can always be received from a club advisor because of his or her credibility. By taking part in college clubs, an individual will also gain a chance at observing specialists in their career fields. Being in a club may even be life changing to college students. There will always be some bashful individuals who are simply too shy to ever socialize. By joining a club, it will provide a gateway to overcoming this personal problem. Whenever a student comes upon an interesting club, it is most notably because that individual has something in common with the club and its members. Students are more comfortable being around people who share the same interests or have particular things in common. In result, this can be the start of getting students out of their comfort zone and leading them to socialize more often. College clubs and organizations should be a part of college students because of the opportunity to establishing a student’s social skills. Most importantly to some students, joining a club is an escape from stress. Sometimes school can be stressful on individuals, or students may have other issues that require relief. School organizations are most certainly not always about accomplishing specific goals; school clubs can be a stress relief to those who may need an escape from reality once in a while. By taking action in a club, a student will be able to achieve great feats and at the same time, have some fun. According to Heidi Coghlan, former About.com guide, by participating in clubs, it can help individuals in â€Å"developing independence† (Coghlan). It helps students stand on their own and make their own decisions. Many school clubs are run for students and operated by students. By being a member, it increases the chance of a student being able to speak out for his or her ideas. This can contribute to a student’s future with leadership skills, communication, and to being a responsible individual. Affiliation with college clubs can also motivate students to do more for the campus or to argue for a cause. The opportunity of becoming a club member should not be missed because it can assist an individual in becoming well-rounded and an open-minded thinker. Many clubs take trips to visit other college campuses. This gives students a chance to explore how other schools function and how other campuses compare. Especially for the students who are planning to continue their education for a great period of time. Joining a college club is great opportunity in meeting other peers from school and establishing social networks. With the affiliation in a club or organization, campus visiting trips can be issued and beneficial to students. Most clubs do volunteer work and this is a good start to building a bond with the community. Students get to experience being in an environment where they can learn and yet have fun at the same time when they are involved with club activities. Joining a club really does make a difference in the world; and by having more students join in, the more impact it will have in establishing better community affiliation. As all students are striving for a professional career in the world, it should be taken into consideration that community involvement cannot be ignored. Thus, with college clubs, an individual can give back to the community. College clubs and organizations are all unnecessary in the pursuit of an education, but can be a factor in developing a well-rounded thinking and professional individual. Clubs provide all that may be necessary to a student. For example, a club provides a variety of peers, educators, and numerous other resources for students. Attending college can be hard on freshmen and anyone who is unaware of opportunities on and off campus. In conclusion, with the aid of school clubs, freshmen and anyone else will receive the chance to utilize any necessary information. School organizations and clubs should not be ignored and every student should instill some effort into a club because of the extraordinary investment it yields. Works Cited Coghlan, Heidi. â€Å"Reasons for Your Child to Join a Club.† Kids’ Clubs — Learn About Clubs, Organizations and After School Activities for Kids. The New York Times Company, 2011. Web. 19 Sept. 2011. Milam, Jeff. â€Å"Reasons College Students Should Join a Club | EHow.com.† EHow | How to Videos, Articles & More – Trusted Advice for the Curious Life | EHow.com. Demand Media, Inc, 1999. Web. 19 Sept. 2011.

Euthanasia Essays (980 words) - Euthanasia, Medical Ethics

Euthanasia Essays (980 words) - Euthanasia, Medical Ethics Euthanasia The term Euthanasia has become well known throughout the country. The word is derived from ancient Greek eu thantos, meaning easy death. Today, euthanasia is referred to as mercy killing. There is much controversy over whether or not the practice is just. Euthanasia raises many religious, medical, and ethical issues. Euthanasia can either be active or passive. Active euthanasia occurs when a physician or other medical personnel induces death. An overdose is administered to the patients in the form of insulin, barbiturates, or morphine, and then followed by an injection of curare. Passive euthanasia, on the other hand, is allowing the patient to die due to lack of treatment. This includes taking the patient off their support system, or respirator. Passive euthanasia also includes stopping the food supply intravenously to comatose patients (Comptons, 1). Debate has flourished against those who accept passive euthanasia, but reject active. Questions are asked why one form is accepted and not the other. The distinction that is made between the two of them is that active is murder, while passive is merciful. Turning off support systems is a positive act of death (Singer, 76). In the Encyclopedia of Bio-ethics, some religious views of euthanasia were given. Hebraic and Jewish denominations strongly oppose the practice. They believe life is a precious and divine gift, and that it must be sustained if possible. Death must never be hastened by intention. Physicians who kill patients in order to spare them pain are considered murderers (554-555). Judaism also rejects euthanasia. They do, however, accept two forms of eu thantos: caring for dying patients, and letting terminally ill persons die. Early Christians opposed self-induced death out of suffering and despair. They also condemn such practices such as infanticide and abortion (556). Roman Catholics permit terminally ill patients to die by forgoing life-sustaining measures. Catholics also allow the refusing forms of treatment that would secure a precarious and burdensome prolongation of life (557). Personal views regarding euthanasia are often influenced by their religious beliefs. With a controversial topic, such as euthanasia, there are strong opinions accentuated. Euthanasia is strongly affiliated to medical and ethical debate. Opponents and advocates of euthanasia have several significant points regarding their view of the practice. Humans have a natural inclination to continue life (Baird, 98). Opponents believe that euthanasia acts against nature. Like animals, humans fight for survival. It is our goal to protect ourselves from harm and do whatever possible to stay alive. When euthanasia is implicated, it goes against our concept for survival (98-99). Those against the practice also believe that some might abuse euthanasia and use it for self-interest. The cost to keep a person alive through means of modern technology can be very costly. Families might, despite their love for the patient, consider the money being spent for what may be a hopeless cause (Baird, 97). Opponents argue the possibility of s pontaneous remission. In many cases a patient recovers with no explanation. With euthanasia, these miraculous recoveries would not exist because there would be no expectation of them happening. If the patient is put to death then they have lost their right to recovery and life (100). Another argument regarding abuse is the professional aspect of euthanasia. In the medical profession, doctors are committed to saving lives (Baird, 100). With euthanasia, death is no longer natural; it is a result of a medical decision. Several questions are asked regarding when, why, and under what circumstances medical personnel should implement the practice. Each patients case has different factors that make the decision to put him or her to rest difficult (Thomasma, 247-248). Proponents feel that euthanasia is an admirable concept; however, the request for death from a patient should be evaluated seriously before administered. Advocates feel that it is a patients right to choose whether or not to remain living. The concern about following a patients request lies on their psychological state. It must be considered whether the patient is feeling depressed and that is why they want to die, or if it is to relieve the pain. Before euthanasia is implemented the question must be asked if it is in the patients best interest (Battin,120). The use of living wills has become popular in

Final Strategic Plan and Presentation

Final Strategic Plan and Presentation Peter Spaans in Holland started Spaans Cookie Co in 1896; later in 1912, he moved to USA and in 1922 opened a bakery selling donuts, potato chips, and pastries. The bakery was formed with the intention of providing the customers their preferences. The company has, in the time of operation, merged with other businesses.Advertising We will write a custom essay sample on Final Strategic Plan and Presentation-Spaans Cookie Co specifically for you for only $16.05 $11/page Learn More It was designed to be a premium priced bakery, which targeted customers of a higher income level. The success of Spaans Cookie Co is not only in terms of having smooth operations throughout the company but also in the fact that in this industry, there is a very large margin for premium pricing if the company is able to develop a strong value with its customers. Creating such value is very difficult because they have to cater to the cultural needs of the area they are operating in so t hat the food provided to the customers is acceptable. Spaans Cookie Co caters on providing the experience to the consumers, and for that experience, we need the right people for the job. The company, just like any other business, has faced tests in its operations but has emerged stronger. This paper will explore the strategic plan to be implemented by the company to improve its services. Vision, mission, values Vision statement: the long-term plans of the company are to increase value in such a manner that they remain market leaders. Due to this reason, the mission statement is such that it allows them to progress globally without any problems. The vision statement guarantees success in the long run as it allows future progress in such a manner that it is acceptable to stakeholders. Unless such windows of opportunities are utilized, it would be very difficult for the company to be in the industry in the long- run. For Spaans Cookie Co, the customers are the most important aspect and providing a value for their money their primary objective. Mission statement- Spaans Cookie Co has a productivity mission statement that has been issued to all employees, the employees actively carry out the tasks in fulfillment of the goals in the mission statement, and the management gives high priority to the achievement of those goals.Advertising Looking for essay on business economics? Let's see if we can help you! Get your first paper with 15% OFF Learn More The productivity norms are integrated with the organizations productivity plans because productivity improvement plan is most effective if it is integrated into the organizations strategy planning. The results of such plans are not evaluated the overall cost of production as far as Spaans Cookie Co is concerned. Value Facet Analysis There is a number of workers of different cultures working in Spaans Cookie Co and as such, cultural issues is a problem in Spaans Cookie Co. However, managers have b een trained to handle cross-cultural teams and to deal with cultural issues within their teams. The top recommendations given have a lot to do with the current organizational culture in Spaans Cookie Co, banking more on complacency, inefficiency, poor communication, less teamwork etc. This trend has to be halted and a new culture of efficiency, competence, effective communication, teamwork etc is brought in. The recommendations suggested would be able to bring in all these traits among the workers as well as in the management. Most of the employees of Spaans Cookie Co seem not to be interested in aligning their values with that of the organizations values. The recommendations suggested would align the values of the employees with that of the organizations values and if any employees values cannot be aligned with that of the organization, then he or she should be forced to leave the organization. There is a good understanding of supplier values in Spaans Cookie Co but the understandi ng can be hampered if supplies of materials are not made on time as agreed upon due to employee negligence and poor productivity at Spaans Cookie Co. There is need to have understanding of supplier values and provide more consideration to their values by Spaans Cookie Co. Any organization should have a better understanding of what the customer values. In the case of Spaans Cookie Co, the customer looks up to company to deliver taste cookies. This goes a long way in meeting those customer values. Spaans Cookie understands the values of third parties like labor unions, the government regulatory agencies etc. If regular employees were sacked for their inefficiency and poor productivity, the labor unions and regulatory agencies would react and from their reactions appropriate steps can be taken that would push Spaans Cookie Co to greater productivity levels and increase efficiency.Advertising We will write a custom essay sample on Final Strategic Plan and Presentation-Spaans Coo kie Co specifically for you for only $16.05 $11/page Learn More The Spaans Cookie Co management is unyielding in front of the labor unions and the regulatory agencies in their determination to make it a productive and efficient organization. Currently the employees of Spaans Cookie Co who are shepherds of the owner’s assets do seem to be interested in increasing the value of their owners assets. However, some of them do work but their complacency hampers their productivity and therefore the increase in value for the owners assets is hampered. External and Internal Environmental SWOTT Analysis Table Factor Strength Weakness Opportunity Threat Trend External Legal Regulatory Highly trained employees understands how to comply laws of the county Possible errors by accounts Tax incentives High taxes The tax rates are changing time and again Economic Economies of scale High costs of production Increasing demand Inflation and increasing interest rat es Increasing costs Technological Invested in new technology and have improved efficiency Resistance from employees on new technology New technology for production Changes in technology making it irrelevant Changing now and then Environment Implemented corporate social responsibility High costs Take advantage of green revolution Changes of government policy on environment Cost of environment management increasing Internal forces Resources Efficiency of production Resources cannot match demand. Many financial institutions are able to offer credit facility. Misallocate resources Increasing Goals Big brands Increase profits Some are not measurable Some brand have increasing opportunities Increasing prices Improving goals Innovations Many flavors and changes of brand name Different customers have different tastes and preferences requiring many brands Increasing of market for cookies Competitors increasing innovation Constantly changing Business environment Spaans Coo kie Company has continued with growth in sales and remained profitable in the past five years. While it has gained market share in the last few years, some flavors have tended to struggle because of market depression. The whole industry has had to put up with, rising fuel costs and a dampened consumer demand. Spaans Cookie Company has however continued thriving, mainly due to its business model, which dwells on cost control and product quality. Competence in management has enhanced efficiency of operations in the company. In addition, the company has a good capital base that facilitates investments in new technologies to diversify the business activities. There are strengths, weaknesses, opportunities threats, and trends that have affected the company both internally and externally. This paper addresses comprehensive factors that affect operations including the Economic, Technological, Legal Regulatory, Social, Goals, Resource, and Innovation. External forces Economic- The Companyà ¢â‚¬â„¢s unique cookies are of many flavors. As a result, Spaans Cookie Company determines the volume of output and the prices at which the products are sold. This increases the market demand significantly and therefore products are sold at prices that maximize the profits of the organization and hence the welfare of shareholders. The economic power that the organization has enables it to control the marketing of its products and maintain a competitive advantage. Customers are usually willing to purchase highly priced products especially if the products are of high quality and if they are of unique types (Gitman and McDaniel, 2008). Spaans Cookie Company has adopted this strategy since it provides high quality products in the market to maintain its market power. This has facilitated the efforts of the company to meet the market demand and maximize the welfare of its stakeholders including the customers, the employees, and the shareholders. Spaans Cookie reduces inefficiency by produ cing the maximum units of products possible in a day.Advertising Looking for essay on business economics? Let's see if we can help you! Get your first paper with 15% OFF Learn More Technological- The Company has invested in innovation to facilitate adoption of the most sophisticated technology in production of different flavors that meets the needs of customer. This has led to production of high quality products that are highly demanded in the market. Technology enhances the efficiency of production, which further minimizes the costs of production under the concept of scale economies. Economies of scale refer to the benefits that accrue to a firm as it increases in size. The marginal costs of production keeps on decreasing as production continue ((Sadler and Craig, 2007). Creativity and innovation is paramount to realization of goals and objectives in an organization. The management of Spaans Cookie has recognized this element and therefore measures have been adopted to facilitate efficiency of operations in the organization. Technological advancements have enabled the company to expand its business through invention of new brands to diversify the portfolio of the organization. Legal Regulatory- The Company is also faced by certain legal threats that may hinder development and realization of the set goals and objectives. It is a requirement of the government of the United States for all companies to pay taxes proportionately to the amount of corporate income received. There are fines that are imposed when the company violates the payments of certain taxes. It is possible for errors to occur in the accounting department of the organization and therefore the taxes could be underestimated. Auditing by the government officers could implicate the organizations to tax omissions whose impacts can be to taint the name of the organization in the general society. Environment There are social threats that face the company, which can have negative implications in the future if they are not addressed. During production of cookies, there is emission gases that are said to harmful to environment and therefore they are likely to have negative implicati ons on people in the future. Internal forces Goals: Spaans Cookie is planning to boost its biggest brands in the United States by producing more advertisements and setting limitations for other new product development. With this initiative, the company is expecting an increase in their profit (Spaans Cookie, 2011). This year, the company is acknowledging its plan to give emphasis on cookies. For Spaans Cookie, their goals are aligned with their current strategies against the soaring price of energy and other ingredients. Along with this, the company aims to increase more its advertisements for the next two years looking forward that it will generate sales growth along with their expansion. In assessing the goals of Spaans Cookie, it shows that most of them are straightforward emphasizing what really they want to happen. The goal of Spaans Cookie is very clear, easy to understand, and measurable. Somehow, they are attainable in a sense that the company already identified certain prod ucts where they could have opportunities. Finally, their goal is realistic and with timetable, they mentioned realistic strategies on how to achieve their goals and set a period. Resource Efficiency of production is enhanced by the capability of an organization to allocate the resources efficiently. Resource allocation depends on the effectiveness of the company to mix the inputs of production to facilitate efficiency. The inputs include capital and labor in addition to entrepreneurship and land as factors of production. The company has not been able to meet the market demand due to the inefficiencies associated with resource allocation. The market demand is large to the extent that the resources available in the company cannot meet it. It is therefore important for the management of the organization to increase resource endowment to facilitate increased production in the organization. The inputs of production such as capital and labor should be increased and be combined in the bes t rations to facilitate efficiency of operations in the organization. Improved efficiency in resource allocation will increase the competitive advantage of the organization, which will lead to coverage of a wider market base (Pearce and Robinson, 2009). In addition, the organization will able to meet the needs of the customers by offering the required units of output to facilitate maximization of the welfare of the employees (Sadler and Craig, 2007). Resource allocation is conducted internally under the productions department and therefore when the organization cannot effectively meet the anticipated demand, then the problem becomes a weakness, which should be rectified to facilitate the smooth running of operations in the organization. It is important for the productions manager to seek the knowledge of economists on the best methods to facilitate resource allocation in the organization. Innovation: Venturing into new markets will require the company to develop new flavors since di fferent customers have different tastes and preferences. In addition, the customers could be willing to consume some products but they can be constrained by several factors for example income. Such constraints means that the customers will not be able to maximize their utilities subject to the incomes they have. It is therefore important for the organization to provide a variety of products some of which should be relatively cheap to enhance affordability of different customers. Implementation Stage- The Balanced Scorecard The strategy implementation stage is considered as the most critical stage in the strategic management process (Dess, Lumpkin, Eisner, 2009). The importance of this stage is because the companies face a number of challenges in making sure that the strategy is properly implemented, and unless these challenges are effectively managed, it will be very difficult for the companies to make sure that they are able to get the maximum results out of the strategic plan. In order to make sure that the strategies are rightly implemented, we would be using the balanced scorecard. The balanced score card works by allowing the company to divide its strategy into a number of concerned areas of operation and then set measurable targets, which have to be, achieved (David, 2008). These targets also define the roles required by the company in order to achieve them. The balanced scorecard is a strategy implementation tool, which works on the concept of developing objectives based on the company’s strategy in four areas: finance, customer, process, learning, and growth. The scorecard helps in defining the management what needs to be done in order to make sure that the strategy is able to turn tides for the company (Kaplan Norton, 1996). In the case of Spaans Cookie Company, they must realize it is highly essential to make sure that they are able to come up with the right strategy as well as the right implementation of the strategy so that the improve gro wth. The resources are highly limited and a failure in the implementation of the strategy would make it difficult for the company to grow (Wheelen Hunger, 2010). To make it easier to understand, each of the factors of the balanced scorecard is discussed separately. Financial Perspective: Finances of the company are very important as they help in creating the resources that would be required for the smooth operation of the company. The Company would find it difficult to continue growing if finances are not kept in check. The appropriate strategies to make sure that the company is financially stable are Increase in the market share of the company to an overall 20%. This would be done through increasing the market share of the company, which would help to attract more investors. Maintain a profit margin of 12.3% so that future investors are attracted. Cost saving is essential as well as a continuous check on the books of accounts while marketing would help in attracting more custome rs Customer Value Perspective: Customers are the most important asset for the company and therefore it is important to make sure that the customers are taken into consideration in all areas of operations. The customer perspective is therefore very important, as it would tell what to do in order to make sure that service is able to add value in the customer’s life. In this regard, the following strategies objectives are set: Maintain a customer turnover to an annual 4% of the overall market. Compensations to be given to customers with negative feedbacks in order to retain customers Achieve and maintain a 90% customer satisfaction in the business. Customer values to be created on what the company can deliver so that gap between customer expectations and the service are reduced. Increase customer value by increasing marketing to communicate the true value of the company. Further, to increase customer value to be done by making the service tangible. Process Perspective: The pr ocesses, which the company takes in delivering the right product to the customers, determine how the company is communicating value to the customers. Delivering the value to the customers depends upon the processes that are employed by the company. The following objectives therefore have to be achieved to make sure that the processes of the company are in line with the strategies: Application of efficient production methods for quality cookies, this would be done through the understanding of the ingredients that make good flavored cookies. Increasing production by 10% every year in order to match market demand, this would also good marketing. Expanding the market by 25% through market development into other surrounding countries and all US states would help to attract more customers. Learning and Growth Perspective: The employees especially the drivers are the only human aspect of the company, which the customers can actually see and interact. It is therefore very necessary to mak e sure that the employees have the right skills to perform their respective jobs. Employees are one of the main driving factors of the company and it is therefore necessary to make sure that the employees are involved in the strategic planning process. Maintain a 90% employee satisfaction rate at all times through the development of employee programs, which help, in developing employee skill as well as in understanding the needs of individual employees. Keep the employee turnover rate to at most 3% a year. Employee has to be interacted with at all times to make sure that the employee’s needs are being well understood. Increasing efficiency by 15% every year through the implementation of modern technology Understanding the Balanced Scorecard The balanced scorecard is a mere reflection of the company’s strategies which have been developed through the understanding of the company’s mission statement, vision statement, the external and the internal factors which w ould affect its operations as well as the SWOTT analysis that was conducted in setting up the business. Unless these parts of the strategic plan are not considered, it would be very difficult to make sure that right strategy is formulated. The vision statement determines where the company wants to be and the mission statement further helps in clarifying the methods that the company would be using in order to achieve its vision (David, 2008). However, while the mission statement tells what needs to be done in order to achieve this vision, it cannot tell how this vision can be achieved. The company therefore needs to develop a strategy, which will determine the right path to pursue the company’s vision. The strategies that have been formulated by Spaans Cookie Company are developed through the company’s vision. In fact, it included in the whole process, which starts with the evaluation of the external and internal factors and then led to the SWOTT analysis. In this way, the opportunities as well as the industry trends of the company are highlighted which identified what strategies should be made in order to grasp these opportunities. At times, it is also necessary for the company to make sure that it operates outside the industry trend creating a blue ocean for itself (Spaans Cookie, 2011). In the balance scorecard that has been developed above is the clear representation of the SWOTT analysis, which was conducted before. This includes areas of opportunity such modern technology and understanding the quality production methods to have been integrated into this scorecard. The measures that have been taken in each of these objectives are also created with the understanding of the capability of the company given its resources. The period that has been put in this balanced scorecard also helps to identify when do the objective needs to be achieved so that the company does not falls behind time. When the employees know about the objectives that are to b e achieved in a particular timeframe, they themselves start to make sure that they play their role in the achievement of these objectives (Hrebiniak, 2005). Thus, balanced scorecard is a useful tool for any company as it helps to determine the right approach to be used by the company. A strategy implementation tool, this scorecard helps in the development of the right set of objectives, which the company would pursue in order to make sure that the company’s vision is achieved. Strategic management is a very delicate process, and usually takes time from the development of the strategy to the implementation of it (Pearce and Robinson, 2009). Managers must make sure that while developing the objectives for the scorecard, they have a complete understanding of the company’s capabilities otherwise the objectives developed would be unreachable by the company. Communication plan The communications mix is comprised of advertising, personal selling, sales promotion, and publicit y or public relations. The company combines these four elements with different emphasis on each. More focus has been given on advertising and sales promotion, as they are the most suitable for an industry. Advertising and sales promotion Personal selling and public relations are important for creating brand equity. Each staff member has a sense of responsibility and capability while being attentive to the needs of the customers. Word of mouth is free but it means ensuring a good reputation. Managing Risks This business is prone to both internal and external risks. The management of these risks has been made possible by the company through preparation. One of the major risks that the company has faced is from the employees who are not be able to perform up to expectations. In order to cope up with this risk, motivational strategies have been used such that the employees are kept motivated at all time. The risk of a very strong competition is also very high simply due to the fact that a new competitor may come up in either one or all of the business locations which would negatively impact the revenues. In order to minimize such a risk, the company has come up with specific operational strategies and also resorted in high levels of marketing so that it is able to communicate brand values with the customers. While these risks are controllable, the company has kept in mind the probability of an uncontrolled risk which may have a very significant impact on the business. Similarly, the economic disasters such as inflation and other economic crisis will significantly impact the costs of operations as well as the overall purchasing power of the customers. Conclusion The successful operations of any business depend upon a number of reasons, each of which has to be understood carefully so that the right strategies can be developed. For existing companies like Spaans Cookie Company, it is very important to make sure that all the industrial factors are carefully analyzed a nd understood in so that the right operational strategies are developed. It must also be kept in mind that the success of the business is not only in the generation of the right strategies but also in the fact that the strategies should be applied in an effective manner. In this regard, the balanced scorecard will be used to make sure that the strategy is applied as it has been intended to be and generates the maximum result expected from it. References David, F. R. (2008). Strategic Management: Concepts and Cases. New York: Prentice Hall. Dess, G., Lumpkin, G., Eisner, A. (2009). Strategic Management: Creating Competitive Advantages. New York: McGraw-Hill/Irwin. Gitman, L. J., McDaniel, C. (2008). The Future of Business: The Essentials. New York: Cengage Learning . Hrebiniak, L. G. (2005). Making Strategy Work: Leading Effective Execution and Change. New Delhi: Pearson Prentice Hall. Kaplan, R. S., Norton, D. P. (1996). The Balanced Scorecard: Translating Strategy into Action. B oston: Harvard Business Press. Pearce, J. A. II, Robinson, R. B. (2009). Strategic management: Formulation, implementation, and control. New York: McGraw-Hill Sadler, P., and Craig, J. (2007). Strategic Management. London: Kogan Page Spaans Cookie, (2011). Spaans Cookies. Retrieved from http://spaanscookies.com/ Wheelen, T. L., Hunger, D. J. (2010). Concepts in Strategic Management and Business Policy. New York: Pearson Prentice Hall.

Why would satanism be called magic Assignment Example | Topics and Well Written Essays - 500 words - 1

Why would satanism be called magic - Assignment Example Satanism controls the world. It is the defining platform for all entertainment sources on Earth. The movie industry is under the satanic forces that help it grow. The satanic forces make use of supernatural powers to influence thinking that leads to liking particular issues and disliking others. It is manipulative in nature. The invoking of satanic influence requires that someone have a special connection with the satanic forces before invoking. For that reason, Satanism only works for those who establish communion with the satanic power proprietors. There will be a desirable outcome if the one was invoking or calling upon the satanic powers to take over their line of duty, has that establishment of a connection to effect the communication. In addition to that, Satanism effectively works with previous connections that were a quality establishment pathways of communication. The music industry predominantly works under some satanic powers. Most artists who establish their names on the international platform get promotions through satanic influence. The artists use mind-influencing powers to make their fans like their compositions and poems. The Satanism itself requires that someone becomes a slave of their own and that they pay tribute to the sanctity of darkness and give in to the demands of the skin rather that control the dignity of the soul. Magic is virtually the definition upon which Satanism takes basis. Magic conforms to two types of manifestations.

Queations Article Example | Topics and Well Written Essays - 250 words

Queations - Article Example To strengthen child’s existing capability is the good choice. Planned ignoring of the naughty child will have some salutary effect on the disposition of the child. Control, coercion and bribery need to be applied in a well-proportioned manner. Parents and teachers must share the responsibility to translate the well-researched set of tools to manage classroom behavior. Q.4.In the screening committee Mary owns prime responsibility. She knows about the ground realities about the day to day handling of children in the classroom environment. The counselor, with his knowledge about the psychological disposition of children should be able to give advice to identify a child having special needs and exceptionalities. The Principal, generally an individual with vast administrative experience, should be in a position to ensure that the student has the support and resources necessary to be successful and to reach his or her full potential. Parents are free to point out any shortcomings in the administration of their child and suggest modifications/improvements in the teaching technique. The final goal of the screening committee is the proper identification of the child’s learning needs. Q.5.The class as a whole was good and accepted her reformation methods, except five or six children, who had severe learning difficulties. Tim was a child with difficult home life and was mostly brought up at a childcare center. He was unable to change for the better and his initial response to her teaching methods was to cry and say, â€Å"Im no good. Im stupid. I cant do this work." But his self-pity soon turned to anger toward Mary and he yelled during a parent-teacher meeting, "Im going to kill you, I hate you, and Im going to kill you." Q.6.The responsibilities of the parents at home and the teacher at school to handle the child are different. Parents generally turn a blind eye to the discipline issue of their children as their feelings are coated