Imagery Sinners in the Hands of an Angry God Essay

Sinners in the hands of an angry God† as a constant threat to all human beings When our view turns to North America in the first half of the 18th century, the brightest phenomenon is the â€Å"Calvinistic Great Awakening,† which began with the sermon of Theodor Frelinghuysen in the Dutch Reformed communities of New Jersey in 1726. One of the greatest representatives of that time was Jonathan Edwards.   Due to Jonathan Edwards’ sermon â€Å"Sinners in the hands of angry God†Ã‚   he can truly be called as â€Å"one of the greatest theologians and pastors of America, who stood at the origins of the Great Awakening.† Jonathan Edwards’ sermon â€Å"Sinners in the hands of an angry God† is the most famous sermon in the history of America. The sermon was read in Enfield, Connecticut, July 8, 1741, at the peak of the First Great Awakening. This is a typical Puritan â€Å"awakening sermon,† which warns of a court that hangs over unbelieving people. It also tells about the mercy of God, who keeps his enemies from instantly overthrowing Hell. One of the most important moments for Edwards was that every person should feel his sermon, that’s why he carefully selected the words to make his listeners take the topic exactly as reality. To achieve this goal, he used bright images in his explanations together with the biblical teaching. As a result of this sermon, the listeners experienced a dramatic revival. There are many meaningful quotations from the sermon, but we want to concentrate your attention on the one, that is being discussed enough.      Ã‚  Ã‚  Ã‚   † Their foot will slip in their time†¦ when their foot is shaken† (Deuteronomy 32:35). In this verse there is a threat to God of the wicked, unbelieving Israelites who were the chosen people of God and lived under His mercy; but who, despite His tremendous work on them, resembled stiff, reckless people (Deut. 32:28). After all that was done for them, they brought a bitter and poisonous fruit, as you see in 32 and 33 verses of the same chapter. The citation â€Å"their foot will slip in their time† seems to imply something very close to the punishment and death of sinful Israelites, who were left by God to their fate. Another truth that is laid down in this verse says that they are in danger of falling, as well as those who stand or walk on the ice. They do not need any interference; their weight will knock them down. The reason why they haven’t fallen yet is only one – the time appointed by God has not come. Therefore, it is said that when it comes – â€Å"their foot will slip.† God will no longer support them in a slippery place; He will leave them alone. And then they will instantly perish, because they are similar to people on the edge of a slippery sloping plane, which, as soon as they are released, will fall and break. Image of hell in the sermon. Jonathan Edwards was a consistent opponent of Arminianism and perceived freedom of the action from the position of compatibilism. He first gave the clearest definition of â€Å"free will,† that human freedom is not an opportunity to do what a person decides to do, but rather what he wants. He also pays a lot of attention to the explanation and meaning of hell. God keeps all unconverted in His hands over the hellish abyss. Everyone by nature deserves this hell; God is angry with sinners, and unless they believe in Christ, they can’t feel secure. They have nothing to grasp. Edwards’ vivid descriptions of hell and eternal torment are examples of the emotional appeal pathos. For example, Edwards’ states, â€Å"The devil is waiting for them; hell is gaping for them, the flames gather and flash about them, and would fain lay hold on them, and swallow them up†¦Ã¢â‚¬ . In this example the audience can imagine the horrors of hell, which encourages them to look to God for salvation, thus also making use of logos as the audience rationalizes and considers the situation. God has enough strength to drop sinners into hell at any moment. When He rebels, people become helpless; and even the strongest of them can’t resist Him, and no one can deliver them from His hand. For Him there is no difficulty in instantly plunging corrupt people into hell, He can do this very, very easily. Sovereignty of God, original sin, and salvation in the sermon. Jonathan Edwards describes hell to make the sinners aware of what is waiting for them in the nearest future. Also, he is disturbed by the next questions: The sovereignty of God. The doctrine of God’s dominion permeates the preaching, writings and the entire theological system of Edward. God predestines and fully controls all things, and He can never be disappointed in His will. The world exists in complete and absolute dependence on God, and God’s sovereign purpose extends to all His actions in creation, providence, and By the historic Reformed tradition, Edwards examines the truths about God’s sovereignty and human responsibility as a paradox that is humanly incomprehensible, but not contradictory. Original sin. Edwards believes that the whole human race sinned through the fall of Adam. All mankind inherited sinfulness, guilt and moral corruption because of their relationship to Adam. Falling from the original righteousness caused alienation of humanity from the rest of creation and distorted the image of God in people. Edwards emphasizes that the heart of a sinner has hardened, and his violation of the law enslaves him. Therefore, he manifests an open opposition to God and disrespect for Him. This sober and pessimistic view of human nature contrasted sharply with the optimism that arose in the colonies before the Revolution and continues to this day. Salvation is only in grace. The view of Edwards on the absolute necessity of God’s grace for salvation follows from his understanding of the sinful and spoiled state of man. In his â€Å"Sinners in the Hands of an Angry God,† he argues that human is not an independent ability. Rather, it reacts to its nature, its predominant motives or traits, which, since the fall, are marred by sin for all people. Thus, Edwards concludes that man is helpless to save himself or even cooperate in this process. He is convinced that a sinner by nature never chooses God unless God interferes with His special, effective and irresistible grace. That theme can be important to everyone. Edwards tries to convey that in the souls of sinners reign the infernal principles which, without God’s limitations, could have already inflamed in them, flaring up with infernal fire. Edwards’ sermon and especially his later writings reflect this diagnosis of the fallen human condition. In the â€Å"Sinners in the Hands of an Angry God,† Edwards tries to show all the horror of the lives of sinners after death. He explains that the only one salvation is a faith in God. It’s never too late to change; God will always listen to you.

Strategic Branding on UK Broadband Services

Following the deregulation of the telecommunication industry in United Kingdom, a number of competitors and substitute products have emerged. With the mandate under the Communications Act 2003, the Office of Communication (OfCom) was established as a regulatory office for the UK communications industries, which includes television, radio, telecommunications, and wireless communications services.Its scope, under the Communications Act 2003, is as follows: 1. to further the interest of citizens in relation to communication matters, and 2. to further the interests of consumers in relevant markets, where appropriate by promoting competition.The British Telecommunications (BT) is one of the world’s leading providers of communications solutions and services, which operates in 170 countries around the world. In the United Kingdom, BT serves over 20 million business and residential customers with more than 30 million exchange lines, as well as providing network services to other licen sed operators. Its BT Retail subsidiary is UK’s largest communication service provider, by market share, to the consumer and small business markets. It supplies a wide range of communication products and services, including voice, data, internet, and multimedia services (online BT.com). Once a nationalized company, BT plc has traditionally dominated the UK’s fixed line telecom market, controlling over 80 percent of the UK’s access lines, earning ? 8,507 million in revenues for 2006 (BT Annual Report 2006). However, the passage of the Communications Act 2003 has been intended to increase competition to the once monopolized of the fixed line industry in UK. Industry experts predicted that BT Retail’s share of the UK’s fixed line market will fall from 82 percent to 45 percent over the next decade as increased competition begins to bite.At the moment, around 93 percent of UK households have a fixed line, with eight in ten supplied by BT. However, despi te the predicament of many industry experts, the benefits of increased competition has not been achieved as BT continue to have strong market dominance within the UK fixed line industry (Richardson 2005). Table 1. British Telecom’s Retail connections Year end 31 March 2003 2004 2005 2006 Total Retail connections (‘000) 29,566 29,661 29,630 28,293 Business 9,208 9,111 8,780 8,353 Residential 20,358 20,550 20,850 19,940 Source: British Telecom Group plc (2006).BT Group plc Annual 2005 Report. (United Kingdom: BT Group) [Online] Available: http://www. btplc. com/Sharesandperformance/Annualreportandreview/Annualreports/Cautionarystatement. htm Table 2. British Telecom’s Broadband customers Year end 31 March 2003 2004 2005 2006 BT Wholesale ADSL end users (‘000) 803 2,226 4,973 7,949 of which are LLU lines 3 11 41 356 of which are BT retail customers 439 967 1,752 2,584 Source: British Telecom Group plc (2006). BT Group plc Annual 2005 Report. (United Kingdom: B T Group) [Online] Available: http://www. btplc.com/Sharesandperformance/Annualreportandreview/Annualreports/Cautionarystatement. htm Despite the high penetration of fixed line business of British Telecom, the level of penetration for broadband services is still very low in the United Kingdom. Project Aims and Objectives The primary objectives of this dissertation will be to determine why many British consumers still opt to use the dial-up as internet connection in the United Kingdom and how companies can attract users to use broadband services. We also review the current market environment such as policies of Ofcom that could affect a company’s marketing strategy.The following is a list of objectives which the author aspires to accomplish in the dissertation: 1. A background study on the current internet access industry in the United Kingdom and prospects on the industry’s growth. 2. An exploration on the relevant theory on the impact of brand equity and brand position ing on company’s profitability and market share. 3. A proposal on effective branding approaches to mitigate the increasing competition with the deregulation of the telecommunication industry in United Kingdom. Importance and Relevance of the ResearchPrimarily the research will be valuable to any business industry or body attempting to build on its business strategies, customer relations and competitiveness in a competitive industry. The research would make businesses more aware of the importance of business strategies in a very competitive industry. It gives you an idea about how businesses can know more about their markets segments and attract more markets. Secondary impact of the research will be on a long term scale, it will aid retail marketing initiatives. The trends of the industry and the markets will have a significant impact on the whole field in the future.The research may also be essential to other interested parties such as the educational institutions business un iversities, news papers and government. The paper will also be useful later on in academics for future references. The Overview of the Study The remainder of this study is as following statement: Chapter 2, Internet Access industry background and market analysis, will provide first a concise information on the industry market value, market segmentation, and leading companies. We will provide a strategic competitive analysis of the industry using Porter’s Five Forces of Competition and SWOT Analysis using BT Group.We will also briefly discuss Ofcom’s strategic review of the telecommunication industry and its effect on industry players in particular British Telecom. Review of brand management, will review related literature on the brand management such as brand equity and brand positioning. Identify the long-term effects of the effective brand positioning in increasing market share within the industry. Chapter 3, Methodology, will present the methods of collecting primar y data from consumers and the chosen research method for the dissertation. Chapter 4, Results and Discussion, will present and discuss the results of the survey.The discussion will also relate the relevant literature and the results that have been obtained from the survey. Chapter 5, Summary, Conclusion and Recommendations, the â€Å"Summary† section will first provide a comprehensive summary of the major findings of this study. The â€Å"Conclusion† section will highlight the implications of the research findings. Finally, â€Å"Recommendations† will be proposed to on the possible approaches to effectively implement an effective branding strategy to mitigate the increasing competition in the telecommunications industry. CHAPTER 2: Review of Related LiteratureThe literature review will consist of three parts: (1) Environmental Analysis, highlighting the recent deregulation and increasing competition within the industry, (2) Competitive Position of British Teleco ms for the market segment of broadband services, and (3) Review of related literature on brand management. In the Environmental Analysis section, the research will discuss the competitive landscape of the broadband market in UK, and define the nature of competition within the industry. The research will describe the role of Ofcom in promoting competition within the industry and specific market segment.The research will describe the market size, volume and growth of the industry. Second, the research will discuss the competitive position of the British Telecom in the market. It will provide an assessment of BT’s strengths and weaknesses and how BT has a very strong foothold of the market. Lastly, the review will also highlight the importance of brand management in growing the broadband services business of British Telecom. In this paper, we follow the framework of Delta model which has been proposed by Hax and Wilde.The Delta model defines three points (1) strategic positions that reflect the fundamentally new sources of profitability, (2) aligns these strategic options with a firm’s activities and provides congruency between strategic direction and execution, and (3) introduces adaptive processes capable of continually responding to an uncertain environment (Hax and Wilde II 1999). The Delta model integrates the structural analysis and value chain framework from Porter with the resource-based view on the Firm and complement those with new Extended Enterprise perspective and with offering Total Customer Solutions.The Internet Service Providers’ Association United Kingdom defines the internet access market consisting of total revenues generated by Internet Service Providers (ISPs) from the provision of narrowband and broadband Internet connection through both consumer and corporate channels (Datamonitor, 2007). The United Kingdom Internet access market generated total revenues of $8. 2 billion in 2006, this representing a compound annual gro wth rate (CAGR) of 6. 4% for the period spanning 2002-2006 (Datamonitor, 2007).In a survey conducted by the Office of Telecommunications, 93 percent of homes currently own a fixed line phone, this proportion has remained stable at just over 90 percent for the last year. At least 4 in 5 households are using BT for their fixed line; however, at least a quarter of BT customers would consider using another supplier if they offered services of equal quality. Furthermore, 18 percent of the respondents mentioned barriers to switching as their reason for remaining with BT rather than positive reasons.These consumers were largely living in non-cabled areas with less choice of fixed line suppliers (Office of Telecommunications 2003). Brand name and the Quality of service The main reason BT customers gave for not switching to another operator was satisfaction with BT, this being driven by the fact that the vast majority of satisfied customers (72%) have never experienced any problems with thei r services. Generally, BT customers value the service quality and reliability above cost, suggesting that the trustworthiness of other suppliers alone is not sufficient incentive for these consumers to switch (Office of Telecommunications 2003).Barriers to switching A quarter of customers that would remain with BT if other suppliers offered an equal service, mentioned barriers as their reason for remaining with BT. This equates to 18 percent of all BT customers. The barriers mentioned included: switching being too much hassle, cost of switching, unaware of other suppliers, always used BT, and the additional services. The research, however, notes that the respondents are more likely to live in a non-cabled area – hence limited availability of alternative providers (Office of Telecommunications 2003).Key trends in the telecommunications industry The key word in today’s technology is convergence. In the last two years, global telecommunications company have been developin g the next-generation voice services that could cut corporate call costs by automatically routing traffic between fixed line and mobile infrastructure (online ITWeek). One key development has been the development of Fixed Mobile Internet Convergence, where IT and media industry deliver both content and the infrastructure to consumers.The widespread adoption of Voice over Internet Protocol (VoIP) has been a promising to consumers yet holds a mixed fate for the fixed line telecoms market. On a positive note, it offers cheap or often free long distance calling to consumers and can therefore boost market share. However, this may be at the expense of diverted traditional sales and loss of line rental and call revenue on fixed lines. On the other hand, VoIP take-up could spread with the proliferation of wireless broadband, as opposed to wireline broadband, which will serve to expand the fixed line market and encourage a more rapid take up of wireless technologies.The development of more s ophisticated mobile phones and PDA also threaten to detract from fixed line sales as these devices develop the same quality of capabilities as fixed line services (online IT Week). Analysis of Competition The Delta Model builds on the structural analysis of Michael Porter to gain insight and understand the external factors determining the industry attractiveness and match it with the firm’s resources to be successful in the industry (Hax and Wilde II 1999).In his book Competitive Strategy: Techniques for Analyzing Industries and Competitors, Michael Porter discusses the five forces of competition in an industry. He illustrated the five competitive forces as: (1) Rivalry between competing sellers in an industry, (2) potential entry of new competitors, (3) the market attempts of companies in other industries to win customers over to their own substitute products, (4) the competitive pressures stemming from supplier-seller collaboration and bargaining, and (5) the competitive pr essure stemming from seller-buyer collaboration and bargaining (Porter 1985).Porter’s five forces of competition is a widely used tool to determine the company’s current strengths and competitive position. Having a clear picture of the balance of power in a competitive industry will help in planning for a sustained growth in the industry. In the Figure 5, the researchers analyzed and plot the competitive forces in UK’s fixed line telecom industry (Porter 1985). Rivalry of Sellers: Moderate The UK market is relatively fragmented, with no one company dominant.For end users, switching costs are not very high, and in fact ‘customer churn' is often cited as an issue that ISPs must cope with, particularly in the consumer market. A typical company offers a diverse range of communication-based services, such as TV and telephony, so success in the Internet access business need not be vital to its survival. Furthermore, rapid market growth means that players are not fighting to win a share of a static market from their competitors. Rivalry in this market is assessed as moderate.Buyer Power: Moderate ISPs offer their Internet access services to customers ranging from consumers to large corporations. As fairly similar services can be offered to customers of all sizes, the typical size is quite small. Switching costs are moderate, and include the time required to leave one contract and move to a competing contract. There is some differentiation: for example, one player may offer consumer Internet access as a standalone service, while another bundles it with cable TV services.Also brand loyalty may be significant if an ISP gains a particularly good (or bad) reputation among users. As the Internet has high penetration in the UK, corporate customers in particular will consider the service of vital importance to their business. Overall, buyer power is assessed as moderate. Supplier Power: Strong ISPs act as intermediaries between their customers and the telecommunication infrastructure that underpins the Internet (and telephony): ADSL lines, servers, packet switching software, and so on.Some ISPs, especially telecoms incumbents such as BT, own and operate an extensive physical network themselves. For these companies, key suppliers are manufacturers of the hardware and software involved, such as Cisco Systems. ISPs that do not own a network can purchasing wholesale access to the necessary infrastructure from an owner-operator, and then offer it at retail to end-users. For ISPs using this business model, key suppliers are BT and other network owners.While it is unlikely that ISPs of either type will integrate backwards, since the upstream businesses are very different to their own, most network owner-operators have already integrated forwards into the retail ISP market, and are competing directly with ISPs that do not own networks. Network manufacturers are not completely reliant on the ISP market for their revenues, as they can also operate in markets such as corporate intranet; network owners usually generate revenue from telephone services and their own ISP retail business as well as wholesale Internet access.Overall, supplier power is strong. Threats of New Entrants: Strong The threat of new entrants is strong. New players will be attracted by the continuing strong growth rates in this market. The physical infrastructure needed is usually already available. For example, a cable TV company can move into the Internet access market by making use of the cable network it has already installed; while players without their own infrastructure can buy access to telecom networks.This reduces the capital requirements for market entry – although customer demand for ever-increasing bandwidth may mean that investment in infrastructure will be needed for future growth. Retaliation in terms of price competition is very likely in this market, and new entrants need to differentiate themselves from incumbents †“ not an easy task when selling a commoditized service that can be specified completely with a few parameters such as bandwidth and downtime. Threats of Substitute: WeakThe threat of substitutes is weak: the Internet has developed as rapidly as it has because it is itself a substitute for many other services and products. These include traditional forms of advertising, news providers, music (and increasingly video) physical media such as CDs and DVDs, ‘bricks and mortar' outlets for supplying goods and services, and communication services such as mail and telephony. The benefits of these older substitutes are assessed as small, as the Internet alternatives have clearly demonstrated their popularity with consumer and corporate customers.However, to take two examples, for consumers with concerns over the security of online financial transactions, or businesses who wish to advertise to segments of the population who are not online, the older substitutes may retain advantages. B ritish Telecom’s Competitive Position A company’s strategy consists of the competitive efforts and business approaches that managers employ to please customers, compete successfully, and achieve organizational objectives.It represents management’s answers to such fundamental business questions as whether to concentrate on a single business or build a diversified group of business, which cater to a broad range of customer or focus on a particular market niche. A strategy thus reflects the managerial choices among alternatives and signals organizational commitment to particular products, markets, competitive approaches, and ways of operating the enterprise (Hooley et al. 2001). Sustainable competitive advantage as argued by John Kay is only achieved if the company has distinctive capabilities or resources that its competitors does not have.Kay (1999) argues that resources can be considered as unique or reproducible. A unique resource, for example the brand name of BT, can be considered as an important asset that can be a basis of sustainable competitive advantage. A reproducible resource and capabilities, on the other hand, pertains to assets that can be easily copied or reproduced by competitors and does not offer the company the distinctive competitive advantage. A good example of a reproducible resource would be the process of delivery voice calls.Many are now able to voice call services on their own and can learn the process more very quickly and easily; however, what differentiate BT is its extensive network infrastructure which it has built over the years to gain scale economies, and build on their strategic brand name (Kay 1999). In understanding the sources of competitive advantage, Hooley & Broderick (1998) introduced two fundamental approach in creating sustainable competitive advantage based from Micheal Porter’s Competitive Advantage.Micheal Porter suggests that companies undertake two roads towards establishing itself as a market leader. First, a company can position itself through cost leadership or differentiation. The former strategy requires that a company to operate more efficiently, thereby lowering its operational cost relative to its competitors. The later strategy requires that a company identify a resource that add value for the customer and modify the product or service in a way that will entice the customer to buy (Hooley & Broderick 1998).Hunt and Morgan (1996) recommends a resource-based model as a way to investigate competency and superior firm performance through a more intimate integration of organizational theory, marketing and economics. Furthermore, strategic resource improves a firm’s performance over time. If a firm mobilizes unique and immobile resources to create sustainable competitive advantage, then a firm can enjoy generating greater economic rents than competitors in the industry.In addition, the resource-based theory asserts that distinctive competencies of a fir m can ultimately result to superior outcomes and performance (Luo, Sivakumar, & Luo 2005). Kay (1999) also defined the three primary sources of sustainable competitive advantage as: (1) the market’s barriers to entry; (2) a unique firm history and experience which has transformed the firm and industry; (3) the tacitness of relationship with customers or suppliers. In this section, we assess BT’s competitive position in the market using SWOT Analysis to identify its sources for competitive advantage. SWOT AnalysisAs we have analyzed the competing forces that could affect the overall success of BT in the fixed line telecom industry in UK, we also recognize the need to be able to identify the strength and weakness of BT as well as external opportunities, and threats. Exhibit 3 illustrates a SWOT analysis of BT strategic capabilities. The value of the SWOT analysis is its ease of use, its simplicity, and its flexibility. In addition, SWOT analysis allows the synthesis and integration of various types of information which are generally known but still provides the possibility to organize and synthesize recent information as well.The insight to be gained in performing the SWOT analysis is the understanding of the core competency of the company that would give it a distinctive competitive advantage over its rival. More importantly, it provides the groundwork on (1) how the company’s strategy can be matched to both its resource capabilities and its market opportunities, and (2) how urgent it is for the company to correct which particular resource deficiency and guard against to particular

Brain Tumour Glioblastoma Multiforme Problem Health And Social Care Essay

Glioblastoma, which is besides known as spongioblastoma multiforme ( GBM ) is the most common signifier of malignant encephalon tumor of grownups. It is the highest class ( grade IV ) astrocytomas, tumours that start in glial cells in the encephalon [ 1,25-27,36 ] . Each twelvemonth, about five out of 100 000 people populating in United State are diagnosed with this disease [ 28,29 ] . GBM normally affects people who older than 50 old ages old although the disease can happen in patients from all age group [ 2,25,28 ] . Patients suffer ictus, concern, ocular perturbation and sometimes personality alterations which can do great emotional hurt [ 25,30,31 ] . The average endurance of GBM patients is hapless, with about 12 to 14 months [ 7 ] . At this minute, the exact causes of GBM still remain vague to the scientists.Figure 1 GBM tumor is normally found in frontal and temporal lobe.Beginning: hypertext transfer protocol: //ebsco.smartimagebase.com/brain-tumor/view-item? ItemID=4027Accum ulative Word Count: 131Possible TreatmentsSurgerySurgery is normally the initial measure to handle GBM by taking every bit much tumor as possible. It is non healing but aims to cut down the tumor ‘s size every bit much as possible so that other therapies right after the surgery can be more effectual. Furthermore, surgical resection Acts of the Apostless to alleviate hydrops by debulking tumor every bit good as being a alleviative intervention for neurologic symptoms such as ictus activity [ 7 ] . The surgery includes standard surgical process craniotomy which removes a subdivision of skull to expose the encephalon underneath in order to unclutter the tumor. Besides, patients may choose to undergo optical maser microsurgery or supersonic aspiration to hold their tumors removed.2134Figure 2 Craniotomy hypertext transfer protocol: //ebsco.smartimagebase.com/surgical-craniotomy/view-item? ItemID=40345 Accumulative Word Count: 242Radiation TherapyNormally, radiation therapy ( RT ) is administered instantly after surgery. It works chiefly by damaging the Deoxyribonucleic acid of tumor cells, killing any residuary tumor cells after surgical remotion of the tumour [ 3-6,32 ] . A research has shown that the average endurance clip has increased from 17 hebdomads ( treated with conventional attention ) to 37.5 hebdomads when the GBM patients were treated with RT entirely while combination of BNCU ( carmustine ) and RT produced a 40.5 hebdomad average endurance [ 11 ] . Table 1 Randomized surveies of post-operative radiation compared with no radiation therapy in malignant gliomaa [ 23 ]Study [ Ref. ]Study groupRadiation dose Gy/ no. of fractionNo. of patients randomized ( analyzed )Median endurance ( hebdomads )Overall endurance P valueShapiro et al. , 1976 [ 62 ] Connecticut RT + CT–60 16 ( 16 ) 17 ( 17 ) 30 44.5 NR Not important Andersen, 1978 [ 1 ] Surgery entirely RT–45/25 57 ( 57 ) 51 ( 51 ) 15b 23b †¹0.005 Survival at 6 months Walker et al. , 1978 [ 78 ] vitamin D Surgery entirely RT–50-60/25-35 42 ( 31 ) 93 ( 68 ) 14c 36c 0.001 Walker et al. , 1980 [ 79 ] vitamin D Connecticut RT–60/30-35 111 ( 111 ) 118 ( 118 ) 31 37 0.003 Kristiansen et al. , 1981 [ 36 ] vitamin D Surgery entirely RT + / – Connecticut–45/25 38 ( 38 ) 80 ( 80 ) 23 47 NR Significant Sandberg-Wollheim et al. , 1991 [ 60 ] Connecticut RT + CT–58/27 87 ( 87 ) 84 ( 84 ) 42 62 0.028 a CT, chemotherapy ; NR, non reported ; RT, radiation therapy. B Calculated from survival curve. 500 Multi-arm survey that included a radiation plus chemotherapy arm. For both surveies by Walker et al. , merely information from the radiation entirely arm are shown in Table 2. Kristiansen et Al. reported combined informations from the radiation entirely arm and the radiation plus chemotherapy arm. In each of these surveies, there was a important survival benefit favouring radiation plus chemotherapy compared with no radiation therapy but no important difference in endurance between radiation entirely and radiation plus chemotherapy ( informations non shown ) . degree Celsiuss Merely consequences for the evaluable patients were reported ( 31 patients in the surgery entirely arm and 68 patients in the RT arm ) . Accumulative Word Count: 329 RT is normally administered through external beam radiation but internal radiation called Brachytherapy is besides possible. Each manner differs in how the radiation beginnings are delivered to the tumour [ 4-6,32 ] . Using IMRT ( Intensity-Modulated Radiation Therapy ) , a machine such as additive gas pedal delivers precise high-energy radiation doses ( eg: X raies ) to the tumor accurately and kills the affected cells [ 6,33 ] . Most patients will have the intervention for five to seven hebdomads [ 6,32,34 ] . Typically, around 6000 to 6500 units of radiation are delivered over seven hebdomads [ 6 ] . In contrast, brachytherapy topographic point the radiation beginnings every bit near as possible to the targeted cells in shorter clip comparison to external radiation. It consists of radioactive implants in the signifier of catheters or seeds which has impermanent radioactive beginnings in the tumor [ 8 ] . Figure 3 Brachythrapy hypertext transfer protocol: //ebsco.smartimagebase.com/brachytherapy/view-item? ItemID=24923 Besides, stereotactic radiosurgery, a noninvasive method of presenting an intense and focused dosage of radiation to a little country can be used for GBM excessively. Treatment dose is individualized but the typical dosage is about 2500 units of radiation per intervention [ 6 ] . Other signifiers of radiation intervention such as installing of inflatable balloon incorporating liquid radiation or interpolation of monoclonal antibodies tagged with radioactive substances may be used [ 8 ] . Accumulative Word Count: 519ChemotherapyChemotherapy may be given after surgical resection and radiation. In this therapy, chemotherapeutic drugs play an of import function in impacting retroflexing cells by damaging the Deoxyribonucleic acid of these cells. The most normally used drugs are carmustine ( BNCU ) , lomustine ( CCNU ) , temozolomide ( Temodar ) and procarbazine. They are classified as alkylating agents which are DNA-damaging drugs. These drugs alkylate the Deoxyribonucleic acid in the tumor cells, doing the dual strands to be cross-linked to each other in an inappropriate manner. This thereby, blocks DNA reproduction and bit by bit leads to cell decease [ 4,5,8 ] . Soon, Gliadel Wafer – a biodegradable wafer soaked with BNCU is prevailing among the interventions. This is done by engrafting wafers in the pit after surgical remotion of the tumor. The wafers so easy let go of high concentrations of BCNU straight into the tumour country over a period of 2-3 hebdomads. Gliadel does non supply a remedy for GBM but is believed to be capable of protracting endurance. Apart from that, temozolomide is more frequently administered orally on monthly rhythm for 6-12 months after surgery and radiation as a care therapy [ 6,8,28,29 ] . Traditional chemotherapy drugs can be effectual, but most of them do non separate between healthy and tumour cells, thereby forestalling the disposal of high doses to kill the unnatural cells. What is more, their generalised toxicity can do terrible side effects. Targeted therapy drugs like Avastin ( bevacizumab ) are more precise than some chemotherapy drugs and tend to hold fewer side effects. It has been approved by FDA in 2009 as a new biologic drug to handle GBM. Avastin acts chiefly as an angiogenesis inhibitors by decelerating the growing of new blood vass environing the tumor. It selectively blocks VEGF to suppress the activation of VEGF receptors tyrosine kinases VEGFR1 and VEGFR2 [ 13-15 ] . There are some surveies to turn out that approximately 20-30 % patients with GBM do react to the drugs [ 27 ] . Accumulative Word Count: 823AGraph 1 Kaplan-Meier endurance curves for patients treated with steroids and ( A ) resective surgery merely, ( B ) resective surgery and radiation therapy and ( C ) resective surgery, radiation therapy and chemotherapy. [ 12 ]BacillusCAccumulative Word Count: 848Social and Economic DeductionsThe trouble to digest with the side effects of the medicines such as sleepiness and hair loss may do GBM patients to experience down and hurt. They may be easy frustrated by concerns they suffer often or experience suffering and hopeless after the diagnosing [ 34 ] . This could take to serious societal impact and would worry the people around them. Furthermore, most of the patients find it hard to return to work due to decrease in productiveness. A study has shown that with 91 % patients were employed before diagnosing, merely 33 % of them continue working after interventions. While health professionals who were still working experience employment alterations such as taking leave of absence to be with their loved 1s for interventions or taking on extra paid work might experience stressed and have to fight difficult to get by with the tough life [ 9 ] . In order to run a normal life, patients require undergo a plentifulness of interventions including hospitalization after surgery which would do great fiscal load. It is estimated that cost of GBM interventions ranged from ˆ10 893 to ˆ125 275 [ 22 ] . Trouble of obtaining insurance makes the status even worse. Drugs that are necessary for GBM interventions are expensive and are normally administered over long period of clip. All this becomes a beginning of depression which affects non merely the patients but their households and friends [ 9 ] . The return of GBM after conventional therapy is inevitable. This so creates unstoppable medical crisis every bit good as fiscal hurt to the patients and their households. Accumulative Word Count: 1084Benefits and HazardsI believe a combination of surgery, radiation therapy and chemotherapy is the most effectual intervention for GBM presently. In malice of its forecast has remained hapless for the last few decennaries, patients do acquire better after adhering to this standard therapy. Although GBM can non be cured, the patients had have their survival clip prolonged, acquiring a opportunity to pass their last few months with their loved 1s in a meaningful manner [ 34 ] . Nevertheless, the interventions do enforce distressing side effects to human wellness. Despite killing tumour cells, alkylating agents used are considered toxic, ensuing in suppression or lowering of blood counts. They have been associated with important sickness, hair loss, weariness and sterility [ 5 ] . High doses of BNCU may take to damage and marking of the lungs while procarbazine can do raging concern, purging and numbness. Hence, doses of drugs administered have to be carefull y monitored by doctor to avoid taking to unwanted effects. Recently invented drugs temozolomide, has comparatively mild side effects but they are still inevitable [ 6 ] . Meanwhile, hazard of developing acute leukaemia old ages subsequently is increased when patients are exposed to alkylating agents [ 5 ] . Avastin, a freshly developed drug, provides a more effectual therapy for GBM. However, it potentially creates fatal toxicity, doing the late closed surgical lesion interruptions down. Some claim that the development of toxicity by avastin may shorten endurance in some patients when it is added to radiotherapy and temozolomide. Thus, researches on the effectivity and safety of use of avastin should be carried on continually until desirable consequences are obtained [ 20 ] . In add-on, the return of the tumor is ineluctable, with the average endurance rate of patients who relapse runing from 3-6 months despite aggressive intervention [ 10 ] . Patients may develop the feeling that the medicines are useless or may give up because of the intolerable side effects and the unstoppable backsliding of disease. This will take to non-adherence to therapy and increase the hazard of mortality. However, in my sentiment, the multimodal treatments I discuss above are still considered the best solution for GBM as they outweigh the hazards by protracting the patients ‘ survival clip. Accumulative Word Count: 1432Alternate TreatmentsGene therapyAnother promising attack of handling GBM is cistron therapy. Herpes simplex virus thymidine kinase/ganciclovir ( HSV-tk/GCV ) has evolved as a cytotoxic cistron therapy. In this instance, recombinant adenoviral vectors are used to give favorable consequences. Adenoviral HSV-tk ( AdHSV-tk ) is able to assail the residuary dividing tumour cells while go forthing the non-dividing nerve cells unharmed. What ‘s more, it can destruct the malignant neoplastic disease cells through bystander- consequence [ 19 ] . HSV-tk first converts GCV to GCV-monophosphate [ 16,17 ] . Then, cellular kinases farther convert this merchandise to GCV-triphosphate which is a hapless substrate for uninterrupted DNA elongation due to the lacking of 3 ‘ hydroxyl group that is needed to organize phosphodiester bond in chain-elongation-reaction. Ultimately, nonfunctional Deoxyribonucleic acid fragments are formed, triping programmed cell death in malignant neoplastic disease cells [ 18 ] . Nowadays, AdHSV-tk /GCV is going preferred comparisons to conventional radiation therapy and chemotherapy due to its fewer inauspicious effects. Figure 4 The rule of HSV-tk/GCV cistron therapy. hypertext transfer protocol: //www.gtmb.org/VOL4A/GTMBVOL4AHTML/23_Adachi_files/image001.gif Accumulative Word Count: 1575 Table 2 Surveies by Sandmair et Al. and Immonen et Al. demo a singular protraction of endurance in patients treated with AdHSV-tk [ 19 ] . Patients Vector Phase Gene Transfer Method Adverse Effectss Survival ( Months ) Response

Marketing Essay Example | Topics and Well Written Essays - 2500 words - 8

Marketing - Essay Example Concept of Marketing The marketing concept can be described as the achievement of corporate goals through meeting and exceeding customer needs and expectations better than the competition or competitors. This can be done by three steps: 1. Customer orientation – the company’s main focus should be on its target market i.e. customer satisfaction rather than solely improving costs and methods for the company itself 2. Integrated effort – fulfilling customer satisfaction is not a one-man job, it requires a management team and workforce with the common motive to achieve this task through production, finance, research and development 3. Goal achievement – for integrated work to run smoothly and successfully, the management must have strong belief in the fact that corporate goals can be achieved through consumer satisfaction. Marketing Mix A marketing mix is a company strategy that helps boost a company customers, profits and innovations with the help of four ste ps (known as the 4 P’s) i.e. product, price, promotion, and place. These 4 Ps are the key decision elements that marketers must follow in order to achieve the wants and needs of their clientele above their competitors. This marketing mix however has been extended to 7 Ps with the three additions of people, progress and physical evidence due to the rapid growth of the service industries. The emphasis of every individual element varies depending on the commodities the organization offers. Product. The product decision includes choosing which goods and services the company is willing and able to produce and supply to its target customers. This includes product creation as well as integration and development where by the products supplied and new and improved with the advancements in technology and taste. This phase also includes the branding image of the company i.e. its name, packaging and promotions and offers. It seems that Britvic seems to rely on the porter’s model o f differentiation to keep its products relevant to the UK’s beverages market. Hence there is more focus on offering the customers a good variety and availability of product, importantly, along with a focus on development of the products to keep the customers interested rather than offer the highest standards of quality (taste) or uniqueness of product and taste. This might be because a large part of Britvic’s business activity consists of distributing drinks of established brands such as PepsiCo and hence the company can choose to rely on provision of quality service to other businesses to maintain relevance to the consumer market rather than on maintenance of quality. Placement. Placement deals with decision making regarding distribution channels. Key management decisions stress upon locations of its outlets, transportation facilities, and inventory levels of stock and stock needing to be reordered. The main goal is to ensure products and services are available in the desired and sufficient quantities, at the desired time durations and venue. These distribution channels consist of organizations such as retailers and wholesalers who act as an intermediary through which commodities pass on their way to customers. Producers need to manage their relationships with these organizations in order for them to provide cost-effective access to that specific firm and the market they belong to. They also need to be familiar with new methods of

Assigment two Essay Example | Topics and Well Written Essays - 1750 words

Assigment two - Essay Example Conducting a training needs analysis significantly helps in the process of evaluating the lacking areas of the teams and individuals of an organization and can significantly lead to the process of development of skills of the employees, thereby increasing their individual productivity as well as the productivity of the entire organization on a whole. Training needs analysis is increasingly considered as a highly important tool for planning and management as it aids in the process of growth and development of the individuals and the organization (Drummond, 2008, p. 5 - 6) Talking in terms of Wal-Mart, it can be said that since Wal-Mart is a global organization, with interests and stakeholders present in major and emerging markets of the globe, there are some specific areas of development that Wal-Mart can focus on for the process of providing better opportunities towards individual development and resources on a global note. The most important areas of development that Wal–Mart can focus on at the present moment are the processes of educating and developing the front line associates in the emerging markets to go for better customer engagements as well as imparting relevant product knowledge and required rack arrangement. Another important area where Wal-Mart can conduct a training needs analysis is the process of evaluating the need of technological and process developments in the emerging markets which can in return lead to achieving of better production and efficiency. The organization also needs to conduct training need evaluations of the customers in the emerging markets for the purpose of generating better responses in the e-retailing formats. Also, the company needs to conduct the analysis for the purpose of assessing the gap of technology experts’ team of the organization and their efficiency in generating the valuable insights from customer information by using data analytics technology. 2. It is of considerable importance to state that Wal -Mart is a global organization, which increasingly focuses on generating extreme value for customer through its product and service offerings (Annual Report, 2012, p.4). Hence, its key strategies are more focused in generating more value to the customer, while increasingly going through various evolutionary phases and individual development techniques of the internal stakeholders of the organization. Training Need Analysis for Wal-Mart is being provided through the following format Training Need Type of Training For Whom Objectives Front line associates of the various Wal-Mart outlets in some of the key emerging markets needs training in regards to style and fashion of involving in customer engagements. Role Playing Front line associates in Wal-Mart stores located in key emerging markets. To provide a superior shopping performance to the customers by providing high level of customer satisfaction through customer engagements. Front line associates of the Wal-Mart outlets in the key e merging markets needs training for rack arrangement as well as developing product knowledge. On job training Front line associates in Wal-Mart stores located in key emerging markets. To enable the front line as

The Influence of Age on the Perception of Decriminalizing Marijuana Research Paper

The Influence of Age on the Perception of Decriminalizing Marijuana - Research Paper Example Cannabis refers to products which may be obtained from the hemp plant, which is scientifically known as cannabis. Marijuana is obtained from cannabis(Jenkins, 2006). Pacula, et al. (2005) defined the term decriminalization almost literally as the â€Å"removal in the criminal status of cannabis possession offenses† (P. 348). However, Pacula, et al. (2005) observed that decriminalization remained undefined in the field of international policy. It is also worth mentioning at this point that a number of countries and sub-jurisdictions who were publicized to have decriminalized marijuana actually just reduced the penalties for offenses pertaining to possession of marijuana or cannabis for amounts specified by law (Pacula, 2005). The following studies were reviewed either for their direct or indirect bearing on the topic of this study: McCoun et al. (2009) suggested that the effect of the law on decriminalization of marijuana varies among age groups. In adult populations, the law h as a significant effect on marijuana use. Inversely, youth populations appear to be unfazed by regulations and sanctions (as cited in McCoun, et al. 2009). McCoun, et al. (2009) also argued that the impact of legal sanctions differs significantly depending on the age group being studied. Results of their analysis of Australian cannabis consumption show that the youth have a lower tendency to be swayed by legal sanctions. In contrast, adult subjects are largely influenced by government policies.   The authors expressed concern about immediately concluding that the youth are less sensitive to marijuana-related arrests because young people are more impulsive and prone to risky behavior. The McCoun, et al. (2009) study has the most bearing on the current study in the sense that the study tackled decriminalization of marijuana and that the effect of age was studies as a predictor variable. However, the McCoun (2009) work is different from the present study since the effect of age on pr ohibition was studied, instead of the effect of age on perceptions about decriminalizing marijuana as proposed in this study.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Reyda and Farley (2006) supports the popular notion about young people and marijuana use. The authors cited evidence revealed in their study that vulnerability of adolescents to be influenced to use marijuana is lessened as they grow older. In addition, it is shown that adolescents are prone to miscalculating risks and developing biases in terms of decision making and judgment than when they grow older. Reyda and Farley’s work has indirect bearing on the study, but nonetheless, their findings bolster this researcher’s position that college students as young people would be supportive of decriminalizing marijuana since marijuana use is tagged to younger people.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Meanwhile, Fetherston and Lenton (2005) investigated public perception on the legalization of cannabis by conducting randomized ph one surveys on 809 residents of Western Australia. The respondents were asked regarding their views on cannabis legalization, attitudes towards a proposed legislative model, and their opinion of its perceived effects. Initial participant responses show that majority of respondents share a negative view regarding cannabis. However, most participants consider criminal sanctions against cannabis use as inappropriate and ineffective.

Leadership Style Term Paper Example | Topics and Well Written Essays - 1000 words

Leadership Style - Term Paper Example He is an American-born hip hop star who established his own music production company in 1993 in New York City. Sean Combs is known for growing and mentoring artists such as Mary J. Blige and more in his company, Bad Boy Entertainment (Clifford, 2014). In this case, Sean Combs is portrayed as a charismatic leader because he inspires artists and motivates them to progress in their singing careers. At Howard University, Combs reveals his love for business practices when he holds entertainment activities in order to get monetary returns. His company, Bad Boy Entertainment, made billions of money in the late 1990’s as he sold his music recordings across the world. He portrays entrepreneurial success due to traits such as courage, intelligence and persuasiveness. Sean ‘Diddy’ Combs was raised in a middle class family in Harlem, New York. He shows his determination to achieve global change by educating the youth. In his messages, he states that the youth should be given opportunities to pursue their dreams so that they can become the CEOs in the future (Clifford, 2014). According to Neider, (2002), the great man theory states that great leaders are born, but, not made. These theories can be used to analyze Sean ‘Diddy’ Combs since he seems to have possessed some leadership qualities from birth. The theories portray leaders as heroic and with strong personalities. Today, Sean ‘Diddy’ Combs is a successful leader particularly, in his multi- billion company, Bad Boys Entertainment (Clifford, 2014). Although, he comes from a poor background, he seems to have been destined to rise in leadership even before he was born because he has established wide range of businesses and initiatives that have registered great success. He has established businesses, which deal with music recording, publishing, as well as, film and television production. He seems to be more of a charismatic leader because he is gifted and intelligent both in