Walmart's Implementation, Strategic Controls, and Contingency Plans Essay

Walmart's Implementation, Strategic Controls, and Contingency Plans - Essay Example One of the main issues that had become the root of all problems was its core values of providing low prices always. Some of the strategies that the company had implemented into achieving these policies were called into question. One of the important objectives of implementing the strategy for change management was to revive the falling sales and get the company back on growth platform. One of the turnaround factors for wall mart that is going to lift it out of the stage that it is currently in is to grow leaders at all stage. To grow leaders at all stage of the organizations among both the managerial and non managerial workforce is to impart them adequate training. Since wall mart is a large multinational organization so to impart training at large scale will require adequate planning. The plan to grow leaders at all stage of the organization should be done step by step (Walmart Inc, 2006b). The plan should be first inducted as a training module for a single branch and then slowly spread into other branches at first in a country, then in a continent and then through all the continents. Before going into next step of the process the company must first ensure that the first step has been successful with clear and positive results. The company by utilizing its innovative CRM tools has huge pile of customer data that it has collected over the years. A simple strategy would be look into what has changed in the customers buying behavior. If the customers are moving towards other store why on earth are they doing so? The key is to analyze the key lacunas and fix them. One of the key areas where wall mart might be lacking as compared to its competitors is that in a drive to give its customers â€Å"Always low prices. Always† the company gives discriminatory wages to its employees. So the company suffers from low employee productivity as compared to many of its competitors (Cascio, 2006b). Costco produced $21,805 in operating profit per hourly employee. This is

How Islam responds to Relationships Essay Example for Free

How Islam responds to Relationships Essay Introduction Throughout this project, the intention of the information is to answer the question: How does the religion of Islam respond to issues on relationships? All through this Booklet, I have kept in mind to focus on the ideas of Islamic relationships and what this means to a Muslim, in the Islamic definition. In Islam a definition of relationships means marriage, contract, sex, families, children etc. Therefore, if applied to Islam in liaison to the now modern everyday life this would involve issues such as * Men Womens Roles in the family * Beliefs about the ethics of Divorce * Beliefs about sexual Relationships * Religious attitude to the use of contraception These are the subjects I will be talking about and looking over at the Islamic perspective on these topics of concern. To portray the view Islam has over these issues I will be using: * The genuine teachings from the word of our God `Allah` himself, doing this through the Quran. * Referring to important hadiths (lessons) and quotes from the prophet Mohammed (pbuh) * The message given out today by the most knowledgeable top scholars. These should give a clear message of what, the view on these issues used to be like, how they have progressed and possibly altered over the years, the differences on these matters from today in contrast to when the religion began, and how it is today, right now in Muslim houses and nations across the world. Islamic Marriage Ceremonies Marriage (nikah) is a solemn and sacred social contract between bride and groom. This contract is a strong covenant; `Mithaqun Ghalithun` as expressed in Quran 4:21. The marriage contract in Islam is not a sacrament. It is revocable, both parties mutually agree and enter into this contract. Both bride and groom have the liberty to define various terms and conditions of their liking and make them a part of this contract. Mahr The marriage-gift (Mahr) is Gods command. The giving of mahr to the bride by the groom is an essential part of the contract. And give the women (on marriage) their mahr as a (nikah) free gift (Quran 4:4) Mahr is a token commitment of the husbands responsibility and may be paid in cash, property or movable objects to the bride herself. The amount of mahr is not legally specified, however, moderation according to the existing social norm is recommended. The mahr may be paid immediately to the bride at the time of marriage, or deferred to a later date, or a combination of both. The deferred mahr however, falls due in case of death or divorce. One matrimonial party expresses `ijab` willing consent to enter into marriage and the other party expresses `qubul` acceptance of the responsibility in the assembly of marriage ceremony. The contract is written and signed by the bride and the groom and their two respective witnesses. This written marriage contract (`Aqd-Nikah`) is then announced publicly. Sermon The assembly of nikah is addressed with a marriage sermon (khutba-tun-nikah) by the Muslim officiating the marriage. In marriage societies, customarily, a state appointed Muslim judge (Qadi) officiates the nikah ceremony and keeps the record of the marriage contract. However any trust worthy practicing Muslim can conduct the nikah ceremony, as Islam does not advocate priesthood. The documents of marriage contract/certificate are filed with the mosque (masjid) and local government for record. Prophet Muhammad (pbuh) made it his tradition (sunnah) to have marriage sermon delivered in the assembly to solemnize the marriage. The sermon invites the bride and the groom, as well as the participating guests in the assembly to a life of piety, mutual love, kindness, and social responsibility. The Khutbah-tun-Nikah begins with the praise of Allah. His help and guidance is sought. The Muslim confession of faith that There is none worthy of worship except Allah and Muhammad is His servant and messenger is declared. The three Quranic verses (Quran 4:1, 3:102, 33:70-71) and one Prophetic saying (hadith) form the main text of the marriage. This hadith is: By Allah! Among all of you I am the most God-fearing, and among you all, I am the foremost held responsible to save myself from the wrath of Allah, yet my state is that I observe prayer and sleep too. I observe fast and suspend observing them; I marry woman also. And he who turns away from my Sunnah has no relation with me. The Muslim officiating the marriage ceremony concludes the ceremony with prayer (Dua) for bride, groom, their respective families, the local Muslim community, and the Muslim community at large (Ummah) Marriage (nikah) is considered as an act of worship (Ibadah). It is honourable to conduct it in a Mosque keeping the ceremony simple. The marriage ceremony is a social as well as a religious activity. Islam advocates simplicity in ceremonies and celebrations. Prophet Muhammad (PBUH) considered simple weddings the best weddings: The best wedding is that upon which the least trouble and expense is bestowed. Primary Requirements 1) Mutual agreement (Ijab-O-Qubul) by the bride and the groom. 2) Two adult and sane witnesses. 3) Mahr (marriage-gift) to be paid by the groom to the bride either immediately (muajjal) or deferred (muakhkhar), or a combination of both. Secondary Requirements 1) Legal guardian (wakeel) representing the bride. 2) Written marriage contract (Aqd-Nikah) signed by the bride and the groom and witnesses by two adult and sane witnesses. 3) Qadi (State appointed Muslim judge) or Mazoon (a responsible person officiating the marriage ceremony) 4) Khutba-tun-Nikah to solemnize the marriage. The Marriage Banquet (Walima) After the consummation of the marriage, the groom holds a banquet called a walima. The relatives, neighbours, and friends are invited in order to make them aware of the marriage. Both rich and poor of the family and community are invited to the marriage feasts. Prophet Muhammad (PBUH) said: The worst of the feasts are those marriage feasts to which the rich are invited and the poor are left out. (Mishkat) It is recommended that Muslims attend marriage ceremonies and marriage feasts upon invitation. Prophet Muhammad (PBUH) said: and he who refuses to accept an invitation to a marriage feast, verily disobeys Allah and His Prophet. (Ahmad Abu Dawood) Roles of Men and Women within an Islamic Family Islam teaches that men and women are equal and that Allah will judge them equally according to the way in which they have lived. Men and women are quite obviously different from each other and each have their own qualities, both of these joined together in the act of marriage is what makes a family work well. Due to the differences and qualities, men and women have different responsibilities to their children and to each other. These responsibilities are in no terms biased against women, the responsibilities laid upon the parents are balanced and equally as important to one another. Men do have the quality of normally being physically and mentally stronger than women, and for this, they are expected to provide his wife(s) with sufficient money to allow her to buy food, take care of the house and look after the children. But this does not mean that the father just has a financial role, not at all, the father is the leader of the home in Islam, it is his responsibility to set the social and emotional nature for the home and family. Mens responsibility in Islam goes far beyond only financial. If the father is emotionally distant, perpetually angry, or closed off, chances are this will reflect throughout the rest of the family. Thus, the role of the father and husband as a tone-setter is a key element in the leadership running of the household. I notice in my own home that when my father is engaged in reading/activities, I will take interest and want to join him. Rather than get upset at me for interrupting him, he will usually try to include me in what he is doing in a way that is playful and educational. This allows me to take an interest in it as well, increasing the bond and emotional connection between us. Islam gives fathers and mothers a great deal of responsibility for raising their children. It was narrated that Abd-Allaah ibn Umar heard the Messenger of Allah (peace and blessings of Allah be upon him) say, Each of you is a shepherd and is responsible for his flock. The leader is a shepherd and is responsible for his flock. The man is the shepherd of his family and he is responsible for his flock. The woman is the shepherd of her husbands household and is responsible for her flock. The servant is a shepherd of his masters wealth and is responsible for his flock. He said, I heard this from the Messenger of Allah (peace and blessings of Allah be upon him). Women are expected to cook food, clean the house, and take care of the children but the fathers do also have a part in the upbringing of the children and the daily house chores as Mohammed (pbuh) used to help his wife Khadija at the housework as well. Also equal rights are given to both the women and men in Islam; Women do have the right to study if they which, to refuse a marriage, to divorce, to inheritance, to keep their own names, to own property, to take part in politics, whether they are married or not. Women are owed more respect in Islam than men and the pathway to heaven is at your mothers feet. Muslim Beliefs about the Ethics of Divorce Muslim marriage is supported by Islam and is classified as a very good act between a man and women however Muslims are not so ignorant to think that marriages dont fail. They do, it is acknowledged that they do, and since marriage is a legal contract between two people and if the continuation of a marriage brings misery to the couple and their children, it can be undone. In a hadith it states; `If a wife fears cruelty or desertion on her husbands part, there is no blame on the, if they arrange an amicable settlement between themselves; and such settlement is best; even though mens souls are swayed by greed` Also it is said that of all things allowed in Islam but disliked (this is known as `makrooh` e.g. smoking) Divorce is the most hated of them all. A man cannot seek to have a divorce from his wife until it is certain that she is not pregnant, as they may change their mind and try and give it another go if the woman is pregnant. Also as divorce is much hated and is not to be done lightly at all, once divorce has been announced there is a period of three months called `iddah` this is a period of three months to allow for a possible reconciliation of the marriage. If there is no reconciliation then the divorce is permitted to take place. A woman is also allowed to have a divorce, either by an agreement with her husband or because of his treatment of her. Children are regarded as illegitimate if their parents are not married and, according to Shariah law, the father has no legal responsibility. These are the complete conditions of marriage in the contract and the circumstances in which it is permitted, backed up by quotes from the Quran. Requirements; * Marriage implies that both husband and wife are able to live with one another with kindness, respect and cooperation. It is their responsibility to raise a family and it is a covenant binding on both parties. * There are times when marriages fail and no solution can be found except divorce. * The Quran orders men to either live with their wives on good terms or divorce them, but they are not to hold them hostage: When you divorce a woman and they are about to fulfill their Idda, either take them back on equitable terms or set them free, but do not take them back to injure them. Chapter 2, verse 231. * A woman has the right to seek a divorce from her husband if she feels that their marriage is doomed. If you indeed fear that they would be unable to keep the limits ordained by God, there is no blame on either of them if she gives something for her freedom. Chapter 2, verse 229 Muslim Beliefs about Sexual Relationships In Islam, sexuality is considered part of our identity as human beings. In His creation of humankind, God distinguished us from other animals by giving us reason and will such that we can control behaviour that, in other species, is governed solely by instinct. So, although sexual relations ultimately can result in the reproduction and survival of the human race, an instinctual concept, our capacity for self-control allows us to regulate this behaviour. Also, the mere fact that human beings are the only creatures who engage in sexual relations once they are beyond the physical capacity for reproduction, sets us apart from all other species, which engage in sex for the sole purpose of reproduction. Beyond childbearing, sexual relations assume a prominent role in the overall well being of the marriage. In reading hadith, one is impressed with the Prophets ability to discuss all issues including those dealing with human sexuality. The topics range from questions about menstruation to orgasm. He apparently was not embarrassed by such inquiries, but strove to adequately guide and inform the Muslims who asked. Both Quran and hadith allude to the nature of sexual relations as a means of attaining mutual satisfaction, closeness and compassion between a wife and husband. Permitted to you on the night of the Fasts is the approach to your wives. They are your garments and you are their garments.(2:187) Adultery Also, Muslims are advised to avoid sexual intercourse during menses so as not to cause discomfort to the woman. It could be said that Islam has a very realistic attitude towards sex and realises that both men and women can be tempted to have a sexual relationship outside of marriage. Sexual activity of any kind is explicitly forbidden and adultery by the husband or the wife is a serious crime. `Nor come night to adultery: for it is a shameful deed and an evil, opening the road to other evils` (surah 17:32) Sex Before Marriage Naturally, attraction between individuals is necessary to initiate a relationship that leads to marriage. But sexual relations can obviously take place between any couple, consenting or not. Because of the far-reaching ramifications of sexual relations outside of marriage, God prohibits Muslims from such behaviour. And because the process that leads to physical attraction and ultimately intimacy is part of human nature, Muslims are advised to behave in a way and avoid circumstances that could potentially result in extra- or pre-marital sex. Modesty in dress and behaviour between women and men figures prominently as a means of exhibiting self-control. Similarly, unmarried couples are admonished against spending time alone in isolated places where they would be more likely to act on their feelings and thus be less inhibited. Homosexuality Human beings are capable of many forms of sexual expression, orientation and identification. The existence of such a variety again is not found in any other species and thus further demonstrates our uniqueness among Gods creations. The potential for behaviour, such as homosexuality, does not mean that its practice is lawful in the eyes of God. Therefore, individuals are expected to control themselves and not act on their desires if such action is contrary to the guidelines of Islam. Homosexuality, like other forms of sexual relations outside of heterosexual marriage, is thus prohibited. In any discussion of prohibited acts follows the question of what happens if they nevertheless occur. The Quran and hadith are explicit regarding severe punishment by the State if a person is convicted of such a crime. However, in order for conviction to take place, the individuals must confess or be accused by at least four eyewitnesses of the act of actual intercourse. Obviously, the likelihood of these criteria being met is small which means that most couples who engage in unlawful acts will not be punished by the State. They will then deal with the consequences of their behaviour in this life and will be accountable to God on the Day of Judgement. Only He knows how He ultimately judges. Muslim Beliefs about Contraception Contraception Although Muslims are encouraged to have children, contraception is not prohibited. The method used during the time of the Prophet was `coitus interruptus` (known as azl`) about which several hadith exist. His basic response when asked if such a practice was lawful was that individuals can do as they will, but if God intends for a child to be born, she/he will be born. Some interpreted this to mean that preventing pregnancy is not recommended because childbearing is preferred; yet the act is not specifically prohibited. Also, other hadith stipulate that azl could not be practiced without the wifes consent as it might interfere with her sexual satisfaction or desire to bear children. The Quran does not make any explicit statements about the morality of contraception, but contains statements encouraging procreation. Various interpretations have been set forth over time, and at the time of this writing, discussions on the web can be found easily that take various positions. Early Muslim literature discusses various contraceptive methods, and a study sponsored by the Egyptian government concluded that not only was azl (coitus interruptus) acceptable from a moral standpoint, but any similar method that did not produce sterility was also acceptable. It is permissible to use condoms so long as this does not cause any harm and so long as both husband and wife consent to their use, because this is similar to azl (coitus interruptus or withdrawal). But it reduces the sensation of pleasure, which is the right of both partners, and reduces the chance of conception, which is also the right of both partners. Neither one of them is allowed to deprive the other of these rights. And Allaah is the course of strength. islamic-paths.org, Sex and Sexuality in Islam Condoms (2005) [4] By analogy, the methods that exist today as contraceptives are lawful for Muslims to use at their discretion. Basically, it is our position that any method that does not involve pregnancy termination is permissible. Imam al-Ghazzali lists a number of legitimate reasons for practicing contraception, including; * Financial difficulty * Threat to mothers health * Chance of child being born with mental or physical deformities * Emotional or psychological hardship * Already having many children * Preservation of beauty and health. It should be clear from this discussion, that since sexual relations should be confined to marriage, contraception is so limited. It is not considered a means of easing the difficulties associated with sexual relations outside of marriage and should most certainly not be used in this way at all. Conclusion Overall, all in all in my total truthful opinion, I do believe that Islam the true words from Allah does promote marriage among society, does accept that marriages do fail and permits divorce and the use of contraception. I accept that marriage breakages can happen and that they cannot be forbidden as the continuous misery of two people is worse than the split of their marriage so it should be permitted. However I do think that in todays modern society people are getting married with the thought that they can just divorce if it goes wrong but I believe this is truly wrong! People should seriously contemplate whether or not the time is right for them to get married before they just go into it. Also despite being Muslim myself I feel that the permittance of a man having more than one wife is wrong and unfair on the women themselves, because no matter how fair the man wants to be, hell never be able to treat all them with the same fairness. Also I dont feel that a man is able to truly love more than one woman at the same time, so having more than one fair would make one think that the man doesnt actually love any of his wives but keeps them for pleasurably reasons only. I also have to disagree with a certain Shariah law stating that `Children are regarded as illegitimate if their parents are not married and, according to Shariah law, the father has no legal responsibility` I believe this to be unjust as women cannot become pregnant by herself; the man in full knowledge of what he was doing had sex with her, giving him responsibility for any offspring created from it. Also men may very well use this law as a means of taking advantage of women as they will not be held responsible for any children created as a result of it. Apart from those, Islam has a very modern and fair way of looking at relationships, and apart from those mentioned I dont believe that women are treated unfairly in anyway at all. Bibliography The holy quran the companions of the prophet book2 al-nawawis 40 hadiths Religion equality booklet www.islamonline.net www.islam101.com www.bbc.co.uk/gcse/bitesize www.islamicforums.com

Combined Pulmonary Fibrosis and Emphysema (CPFE)

Combined Pulmonary Fibrosis and Emphysema (CPFE) Ong Wei Jun Dan The Causes, Consequences and Differences Between Pulmonary Fibrosis or Emphysema Alone   Abstract Combined pulmonary fibrosis and emphysema (CPFE) is a complicated disease and untreated disease which consists of two diseases. It is difficult for respiratory therapists or respiratory physicians to differentiate between CPFE versus idiopathic pulmonary fibrosis (IPF)/emphysema alone. There is an increased recognition of the coexistence of emphysema and pulmonary fibrosis in individuals. The association of two diseases results in chronic dyspnea, upper-lobe emphysema and lower lobe fibrosis, and severely diminished diffusion of gas exchange with preserved lung volumes. CPFE is also frequently complicated by pulmonary hypertension, lung injury and even lung cancer. This causes CPFE patients to feel have a low quality of life and a low 10-year survival rate. Currently, there are no known treatments for CPFE patients with the exception of lung transplantation. Thus, clinical evaluations are needed to differentiate between chronic obstructive pulmonary disease (COPD) and pulmonary fibro sis, and to recognize that CPFE is a unique entity by looking at the difference in radiological, pathological and metabolism features in order to find better treatment for CPFE. Introduction About 11 million Americans have Chronic Pulmonary Obstructive Disease (COPD) and out of these, most are diagnosed with pulmonary emphysema. The etiology of emphysema found that 80% of cases are caused by cigarette smoking, which causes alveolar membranes to break down, creating huge alveoli (called blebs) that lesser surface area and weaker walls than normal alveoli. This causes the low perfusion of oxygen due to decrease in surface area. In addition, approximately 50,000 new cases of Idiopathic Pulmonary Fibrosis (IPF) are diagnosed each year.   IPF is a restrictive respiratory disease, and it is the most common of the idiopathic lung diseases. IPF causes thickening of the alveolar capillary membrane, which results in minimal gas exchange between the alveolar and the blood capillaries. Both diseases lead to the decreased efficacy of oxygen delivery. CPFE is a combination of both IPF and emphysema. However, it is usually treated as IPF and ignored or excluded in the diagnosis of emphysema.   COPD and pulmonary fibrosis have different pathologies, metabolic pathways and radiological characteristics, and were therefore regarded as separate entities for a very long time. However, in recent years, there is some recognition of the coexistence of pulmonary fibrosis and emphysema in patients. As such, it is very important to know the differences between CPFE versus emphysema or pulmonary fibrosis alone in order to find a treatment or prevent the patients conditions from further deteriorating. In the following years, studies had shown that CPFE patients have a coincidental occurrence of early emphysema and at later age of IPF, especially for smokers with many pack years.1   However, in recent studies there is a correlation between the occurrence of the combination between lower lobe pulmonary fibrosis and upper lobe emphysema. These two diseases have been observed coexisting in greater frequencies which are therefore called combined pulmonary fibrosis and emphysema (CPFE) and there is a need to distinguish them as distinct entities. There are some studies taking place to better understand the pathophysiology of the condition and find the possible causes of CPFE such as genetic factors or any biological metabolism pathways which may encourage its development. CPFE is normally caused by heavy smoking, exercise hypoxemia, upper lobe emphysema and lower lobe pulmonary fibrosis, unexpected lung volume and severe reduction of carbon monoxide transfer.2 Whether the combination of both emphysema and pulmonary fibrosis is a unique clinical entity still remains unknown. For some of the population in the medical community, it is a coincidental occurrence of two smoking-related diseases on one person, versus the coexistence of the similarities of COPD and lung cancer. However, many different studies have shown and suggested that interstitial lung abnormalities, which are normally caused by IPF, have are inversely related to emphysema in smokers. In fact, based on the chest X-Ray images, most patients who have many pack years with IPF do not have any signs of having emphysema. Similarly, most patients who have emphysema do not have any signs of IPF in their chest X-Ray. Hence, the combination of both pulmonary fibrosis and emphysema may be a direct result of heavy smoking or many pack years which reflects the uniqueness in individual susceptibilities. Even though medical professionals tend to use chest X-Rays for any respiratory distress, as it is inexpensive and considered a fast diagnostic tool, it is unable to properly diagnose the CPFE syndrome. Another alternative would be to use High-Resolution Chest Computed Tomography (HRCT), which is the only tool to diagnose the syndrome. The CPFE syndrome consists of heterogeneous syndromes, in which syndromes differ from one individual to another and resulting in no actual definition of the syndrome for CPFE. This makes it difficult to diagnose CPFE with the current pulmonary function test, as CPFE patient results look similar to those of patients diagnosed with pneumonia. From past research and observations, CPFE is frequently complicated with pulmonary hypertension, acute lung injury and the possibility of lung cancer, resulting in very poor prognoses. Treatments for CPFE patients with severe pulmonary hypertension have not been found and have largely proven ineffective in curing the disease apart from a wholesale lung transplant. The identification of patients with CPFE is needed due to the uniqueness and complication of the diseases history. Since CPFE has not yet attracted the attention of researchers and healthcare practitioners, there have not been many studies focused on finding the differences between pulmonary fibrosis, emphysema and CPFE. Currently, there is no consistent way to differentiate the factors, signs and syndromes when diagnosing CPFE patients from other obstructive respiratory diseases. This has resulted in many medical practitioners failing to immediately recognize CPFE in patients diagnoses. Population distribution of Emphysema, IPF and CPFE The prevalence of the disease emphysema was reported to be at about 24.5 per 1,000 in America, while the prevalence of IPF varied from 14 to 42.7 cases per 100,000. Therefore, emphysema is a more common disease as compared to IPF. However, there are no studies that account for the prevalence of CPFE. Some of the reported observations show that the proportion of patients with CPFE detected on HRCT scans range from 8% to 51% in IPF patients. On the other hand, the proportion of pulmonary fibrosis found in patients with emphysema is less than 10% using the HRCT. This variation of proportion of prevalence in CPFE may be due to the different types and complications arising from the diagnosis of emphysema when evaluated by chest X-Ray and HRCT. Patients with CPFE tend to be older men who tend to have many pack years of smoking. Previous studies have shown that there is no significant difference when varying the number of pack years against the occurrence of COPD such as emphysema and CPFE. However, patients with CPFE and those with COPD usually have a long history of smoking as compared to patients with IPF.   Many studies have reported that male have higher prevalence then female in having respiratory disease syndrome, and could be due to men tending to have more pack years as compared to females. It may also be due to the genes of men which predispose them to succumbing to COPD or CPFE. Even though both IPF and emphysema have proven to be more common in male smokers than female smokers, it does not necessarily mean that gender plays an important risk factor in the contraction of CPFE. More studies are needed to determine how gender differences affect this syndrome. Pathology pathway of CPFE Till now, there are no conclusive findings for pathogenies of CPFE. There are no clear conclusions on the development of CPFE, whether emphysema and or pulmonary fibrosis progress independently or whether there are synergistic qualities between the two. There may be some mechanisms involving cytokines, beta receptors or signaling pathways which have not been discovered. Thus, both pulmonary fibrosis and emphysema may tend to occur in genetic susceptibility individuals with from exposure to environmental factors such as smoking or occupational hazard and chemicals. Case Study of a CPFE patient (Occupational exposure) A case study journal report on a male patient aged 73 years old in 2015 gives one of the more detailed analysis of Microscopic Polyangiitis (MPA), a disease that precedes by CPFE. The patient worked as a metalworker and had 25 pack years. He was admitted to the hospital due to progressive dry coughing and he was later diagnosed with CPFE. He eventually died due to complications from CPFE, which resulted in severe pneumococcal pneumonia with acute lung injury. His arterial blood gas result was normal with a fairly abnormal range in his pulmonary function test (PFT). There were clear signs of emphysema and IPF from his CT scan and Chest X-Ray (Kyoko Gocho, 2015). MPA is a systemic necrotizing vasculitis of small vessels associated with numerous types of antibodies in particular myeloperoxidase- antineutrophil cytoplasmic antibody (MPO-ANCA). Oxidation induced by MPO-ANCA may trigger pulmonary fibrosis due to alveolar hemorrhage, resulting in pulmonary capillaritis (an inflammation of p ulmonary capillary). This causes pulmonary fibrosis as the alveolar capillary wall thickens (Kagiyama, 2015) Correlation of smoking with CPFE patients A common etiology factor for CPFE is smoking. Tobacco smoke contains 4000 chemical substances, including Kaolinite or aluminum silicate, an organic industrial material. Studies show that inhalation of this organic industrial substance will result in hyperactive macrophages, which in turn will lead to respiratory bronchiolitis and emphysema (King, 2005). Currently, there are no studies for the association of tobacco smoking resulting in IPF, other factors such as environmental factors in genetically-predisposition individuals may play a key role in resulting IPF. The association between CPFE and lung cancer may reflect the susceptibility linked to long term smoking which causes chronic smoking-induced inflammation. These were done on several other studies on the relationship between emphysemaand IPF.3,4 Pathological findings (Diagnostic Imaging) Patients who have acute respiratory distress syndrome such as COPD, pulmonary fibrosis or even CPFE, will tend to have more difficulty breathing due to the use of accessory muscles and the need to constantly supply supplemental oxygen to meet the oxygen level demanded by the body. For some of the patients, a high flow of oxygen is required (flow rate of more than 60L/min) to meet their inspiratory demand. Patients with CPFE have a confused and undetermined ventilation/ perfusion ratio due to emphysema causing low perfusion and IPF having low ventilation. This results in both ventilation of oxygen to the alveoli and perfusion of capillaries to be diminished, leading to dead space and shunt. Emphysema results in the reduction of alveoli-capillary surface membrane by forming a bleb that causes air-trapping, whereas pulmonary fibrosis scars the alveolis tissue, creating a shunt that causes ventilation of the oxygen to the alveoli to be inefficient, resulting in the patients body tissue b eing unable to get a sufficient amount of oxygen. Other remarkable syndromes found in COPD patients are chronic cough and sputum production in volume greater than one shot full glass due to inflammation of bronchi and impairment of the mucociliary clearance, presumably due to the effects of smoking. Patients with IPF may show progressive shortness of breath, loud expiratory wheezing sounds and if the condition is worse cyanosis may appear on the patient. CPFE from previous clinical studies shows that it is similar to IPF. On close physical examination, by doing chest auscultation, it was found that more than 80% of CPFE patients will emit inspiratory dry crackles sounds due to the underlying pulmonary fibrosis. About 40 to 50% will have digit clubbing and poor capillary refill. As of now, there is no consistent definition for CPFE. However, it is very important to diagnose it early. Diagnostic criteria for CPFE include radiological findings by using either chest X-Ray or HRCT these images will appear as upper-lobe emphysema with fibrosis like blebs, lower-lobe honeycombing with subpleural reticular opacities, thick wall cystic lesions, and sometimes ground glass opacities.2 Table 1: Comparison of clinical characteristics difference between CPFE, emphysema and IPF patients group (measures of Framingham variables) CPFE IPF Emphysema p-value Sample size 22 8 17 Age (in years) Median 73.5 74 78 0.7 Range 59-96 56-89 48-86 Number of pack years Median 64 43 75 0.64 Range 20-50 30-80 15-65 Table 2: Comparison of clinical characteristics difference between CPFE, emphysema and IPF patients group (Pulmonary Function Test) CPFE IPF Emphysema p-value Vital capacity 2.52 ±0.72 2.34 ±0.86 2.85 ±0.61 0.52 Vital capcity (%) 83.1 ±22.1 68.0 ±27.7 87.0 ±12.4 0.29 FEV1 2.01 ±0.19 1.60 ±0.24 1.57 ±0.22 0.28 FEV1/FVC(%) 76.8 ±3.31 81.8 ±4.45 55.6 ±4.06 70%, this results being emphysema to be ignored or overlooked. Physician, healthcare workers and respiratory therapists should be aware of its existence. More autopsies should be recognized such as thick-walled cystic lesion and idiopathic interstitial pneumonia should be recognized as both of these can be found in CPFE patients but are seldom found in emphysema/IPF alone patients. A deeper understanding of the pathophysiology is needed for CPFE and the factors that causes the syndrome of CPFE should be explored further with more clinical studies so as to develop effective treatments or therapeutic strategies for CPFE patients. References       Hiwatari H., S. S. (1993). Pulmonary emphysema followed by pulmonary fibrosis of undetermined cause. Respiration, 60(6). Cottin V., H. N. (2005). Combined pulmonary fibrosis and emphysema: a distinct underrecognised entity. European Respiratory Journal, 26(4). Kaplan R. M. (2015). Quality of Well-being Outcomes in the National Emphysema Treatment Trial. Chest Journal, 147(2). Kagiyama C., N. T. (2015). Antineutrophil cytoplasmic antibody-positive conversion and microscopic polyangiitis development in patients with idiopathic pulmonary fibrosis. BMJ Open Respiratory Research, 2(1). Inomata M., A. M. (2013). An autopsy study of combined pulmonary fibrosis and emphysema: correlations among clinical, radiological, and pathological features. BMC Pulmonary Medicine, 104(14). King, C. G. (2005). COPD: a dust-induced disease? Chest Journal, 128(4). Kyoko G. (2015). Microscopic polyangiitis preceded by combined pulmonary fibrosis and emphysema. Respiratory Medicine Case Reports, 10(2). Papaioannou A. I., E. A. (2016). Combined pulmonary fibrosis and emphysema: The many aspects of a cohabitation contract. Respiratory Medicine, 117(10). 9.  Ã‚   Portill K., J. M. (2011). Combined Pulmonary Fibrosis and Emphysema Syndrome: A New Phenotype within the Spectrum of Smoking-Related Interstitial Lung Disease. Pulmonary Medicine , 2012(1).

Free Essays: The Themes of Mary Shelleys Frankenstein :: Frankenstein essays

The Themes of Frankenstein Mary Shelley discusses many important themes in her famous novel Frankenstein. She presents these themes through the characters and their actions, and many of them represent occurrences from her own life. Many of the themes present debateable issues, and Shelley's thoughts on them. Three of the most important themes in the novel are birth and creation; alienation; and the family and the domestic affections. One theme discussed by Shelley in the novel is birth and creation. She does this through the main character, Victor Frankenstein, who succeeds in creating a 'human' life form. In doing this, Frankenstein has taken over the roles of women and God. Shelley discusses how Frankenstein has used his laboratory or 'workshop of filthy creation' (page 53) as a kind of 'womb' as he has worked on his creation. He also refers to his task as his labour, suggesting that he has literally given birth to his creation. After so much time spent in painful labour (Page 51) The passing of time from when Victor first began his creation and finished it is also significant. Winter, spring, and summer passed away during my labours (Page 54) The length of the three seasons is nine months, representing the time a natural human baby takes to be formed in its mother's womb. This once again suggests that Frankenstein has found a way to take over the role of women, and they become powerless, weak and flimsy. They no longer have a purpose in life, as Victor Frankenstein can now create new life forms - a process which women needed to be involved in previously. An example of women's powerlessness in the novel is the condemnation of Justine for a crime she did not commit. Had she been a man, she would probably have been set free. Frankenstein succeeds in removing the only powers that women had, as well as stripping God from his role. Through the theme of birth and creation, Shelley criticises Victor not only for creating the new being, but also for abandoning it when it comes to life. Victor first wishes to create the being because he thinks: A new species would bless me as its creator and source ... No father could claim the gratitude of his child so completely as I should deserve theirs. (Page 52-53)

Analyzing a Written Essay Essay

The two essays that I read were â€Å"A Soul as Free as the Air: About Lucy Stone† and, â€Å"How to succeed as an Online Student†. The four types of essay organization discussed in the course readings were; 1. Topic: This development organizes information about the topic in the most logical way. 2. Time order: It is using sequential order to write an essay. It organizes the information from one time period to another. 3. Space order: This deals with location of people, places or things. 4. Informative process: This is written in a step-by-step arrangement in their natural occurring order. The characteristics that make these essays expository, is that it has facts to inform about the topic. It is used in facts form and not biased.  What distinguishes space organization from time organization or informative-process organization in an essay is that Space order deals with location, Time organization refers to placing information in chronological order by date or a specific time, and Informative essay would be one that takes on a step-by-step process. The organization of each essay help the reader understand the subject matter of that essay in the essay â€Å"How to Succeed as Online Student†, it list steps to teach online students what it takes to be successful in an online atmosphere. The reader understands you must follow these steps to succeed. On the essay, â€Å"A Soul as Free as the Air: About Lucy Stone† it helped to learn about Lucy Stone, it showed the order of her achievements. On the essays that I read, the one that has the most effective organi zation was â€Å"A Souls as Free as the Air: About Lucy Stone†. I chose this essay, because it was organized from the beginning to the end, it was in the order of each of her achievements. A different type of organizational style for â€Å"How to Succeed as Online Student† if you change it to a time order or space order, then it would confuse some of the online students. The main part would be lost in the reading. It would definitely have students wanting to go to class instead of online, so the teacher could clarify things. The type of essay organization that is more suitable for my essay topic on â€Å"Warming Global; Drought,† would be Time Order, due to the heat and water levels at the time.

How to write annual reports - Emphasis

How to write annual reports How to write annual reports Annual reports should be focused, well written and dynamic – and, above all, they mustnt shy away from giving a clear and accurate message. A good place to begin when you need to write one (or, indeed, any other document), is with a question. Why do you write? This isn’t as foolish a question as it seems. We all write, but the style will differ depending on the medium and the audience. Criticising government policy in a column in the Financial Times needs a certain degree of logic and rhetoric. Criticising government policy on the wall of a public convenience, however, demands a style that is less formal and more succinct. Oh, and a good-sized permanent marker. (A biro will make you look like an amateur.) Every business action – including communication – must be targeted, with a clear result in mind. Internal actions are almost always intended to improve efficiency, while external actions have three main aims: 1. to increase sales 2. to promote the brand 3. to reassure current or potential shareholders. A lot of bad business writing is born of an obsession with number three. We are so afraid of saying something that might be construed negatively that we opt to say nothing at all. Sometimes that’s fine, when your purpose is to reassure; to show that the writer and his organisation conform to preconceived notions. Like a parent saying there, there, there to a crying baby, the words themselves don’t matter. If you’re a listed company, then there are rules about what’s in your annual report and too often the summit of achievement is to get it written without attracting any attention. A simple description of the business position is all that’s called for. Here’s a middling example – neither good nor bad – from Tesco chief executive Philip Clarke: In the UK, we have an outstanding core business. It made progress in the year but some aspects of our performance can improve. Stronger sales momentum here is a key priority and I am confident that the focus and energy our new UK leadership team is bringing to the business will see a return to form in the months ahead as Tesco tries to do its bit to help customers who face pressure on their household budgets. The increasing scale and competitiveness of our international businesses are now driving strong growth in sales, market share, profits and returns, supported by the generally improving global economic environment. We have built some excellent springboards for future growth, and whilst there is still work to do, particularly in the United States, I am delighted with our performance in Europe and Asia, where I expect further strong growth this year and beyond. Taken from the Tesco annual report 2011 It uses fairly plain English to describe the situation in Tesco’s main markets in guardedly optimistic terms, while refusing to promise anything. You might point out that Tesco’s share price dropped by a quarter following publication of the results, but we expect the CEO’s spectacles to be rose-tinted. But things can go badly wrong if you try to impress your readers. Lucy Kellaway of the FT gave her award for Outstanding Services to Bunkum to Angela Ahrendts, CEO of Burberry, for this horror from the company’s annual report: In the wholesale channel, Burberry exited doors not aligned with brand status and invested in presentation through both enhanced assortments and dedicated, customised real estate in key doors. Such clichà ©-ridden jargon only invites ridicule. So how do you avoid becoming the target of mockery? What rules can you follow if you actually want to say something, to convey a message, to change minds or inspire action? Whole books have been written on this subject, but some of the basics can be summed up here. 1. Write it three times Your first draft is simply a list of the points you want to cover. Your second draft gets those points into some sort of coherent narrative. Don’t worry about it being an unreadable mess or that you’ve used the wrong word here and there. No-one will ever read it but you, although you might be surprised to find your prose is more vigorous than normal – especially if you’re the sort of executive who can speak with charisma. The third draft will tidy it up, ideally without smothering the vibrancy of the writing. Then get someone to check it and edit it. If it’s for publication, use an outside professional. 2. Avoid clichà ©s Your readers will switch off the moment you synergise an ecosystem. As soon as you leverage solutions to issues going forward, or, worse, exit a door not aligned with brand status, you are doing exactly what teenagers do when wearing the uniform of whatever subculture is cool this week. They are masking their individuality in an effort to conform. Clichà ©s are the calling cards of a mind that has stopped thinking for itself and is using thoughts that are off-the-shelf, one-size-fits-all, microwave-for-three-minutes-for-a-delicious-individual-meal. Clichà ©s are verbal clip-art, which means mediocrity. If you are familiar with seeing a word or phrase in print, don’t use it. 3. Use the right imagery We use imagery all the time, because it brings our prose to life and paints pictures in the mind. It also reveals a lot about a writer’s attitude. So, when my local health trust writes about delivering healthcare, I know that they think of healthcare as a commodity. Their language implies that the personal, human activity of caring is beneath their dignity and a long way from their thoughts. Try to use words that have literal, rather than abstract, meanings, and never forget what the word actually means. Try to picture it, and ask yourself if the picture makes sense. David Gillespie, author of the book Charisma, describes Bill Clinton as a man who does exactly what it says on the tin!; a horribly wonderful blend of mixed metaphor and clichà ©. Just try to picture it. 4. Write simple sentences Keep your sentences short and simple, but not so short that they become staccato. Keep the verb close to its subject, and always use a short word instead of a long one. When you come to cut your piece, as you almost certainly will, delete as many adjectives and adverbs as you can, starting with ‘ongoing’. 5. Use strong, active verbs Verbs are the engine of language. Nouns are the cargo; adjectives and adverbs the packaging. If you overload your prose with heavy nouns and drive them with weak verbs (‘to be’ is the weakest), then your writing will plod along like an old lady lugging twelve bags of shopping. Compare the sporting clichà © it’s a must-win game with we must win this game. The second sentence is so dynamic it almost demands an exclamation mark. Why? Compare the verbs: ‘is’ versus ‘must win’. Now compare the subjects: ‘it’ versus ‘we’. By saying ‘we’, the second speaker is taking responsibility by focusing on himself and his team, while the first speaker is looking at the game: a distant, abstract thing. The first speaker has turned the important thing – ‘must win’ – into a feeble adjective. The second speaker has made it the main verb. Above all, let your own personality come through. For more on how to write reports that yield real results, take our one-day Business report writing course. To learn more about making writing annual reports a much easier and less painful task, check out our free webinar  recording How to turn your expert analysis into exceptional reports.  Its ideal if you have to write reports to colleagues and clients as part of your day-to-day job – whether thats as a traditional written report or as a slide deck.

Evaluate the effectiveness of the responsive regulation model with reference to the regulatory powers and responses available under the Consumer Protection from Unfair Trading Regulations 2008. The WritePass Journal

Evaluate the effectiveness of the responsive regulation model with reference to the regulatory powers and responses available under the Consumer Protection from Unfair Trading Regulations 2008. Introduction Evaluate the effectiveness of the responsive regulation model with reference to the regulatory powers and responses available under the Consumer Protection from Unfair Trading Regulations 2008. ), 41 Common Law World Review 1. Case Law Esso Petroleum Co Ltd v Harper’s Garage (Stourport) Ltd [1968] AC 269 Lloyd Shuhfabrik Meyer Co GmbH v Klijsen Handel BV [1999] ETMR 690 Lloyds Bank v Bundy [1974] 3 WLR 501 Macaulay v Scroeder Publishing Co Ltd   [1974] 1 WLR 1308 (HL) Office of Fair Trading v Purely Creative Ltd and Others [2011] EWHC 106 (Ch) Tiscali UK Ltd v British Telecommunications Plc [2008] EWHC 3129 (QB) [1] F Sudweeks and C T Romm., Doing Business on the Internet Opportunities and Pitfalls with 39 Figures (United States: Springer, Business Economics) 9. [2] [1999] ETMR 690 [3] P Stokes., ‘New OFT Powers in the Credit Clamp-Down’ (2005) 155 New Law Journal 236, Issue 7164. [4] [1974] 1 WLR 1308 (HL) [5] [1968] AC 269 [6] [1974] 3 WLR 501 [7] M J Trebilcock., ‘The Doctrine of Inequality of Bargaining Power: Post-Benthamite Economics in the House of Lords’ (1976) 26 University of Toronto Law Journal 4, 359. [8] S Brown., Protection of the Small Business as Credit Consumer: Paying Lip Service to Protection of the Vulnerable or Providing a Real Service to the Struggling Entrepreneur?’ (2012), 41 Common Law World Review 1, 59. [9] Office of Fair Trading., ‘Consumer Protection from Unfair Trading Regulations 2008’ (2008) Information for Businesses on the Consumer Protection from Unfair Trading Regulations, oft.gov.uk/business-advice/treating-customers-fairly/protection [Accessed 13 April, 2014].