Marketing and Soft Drink Concentrate Essay Example for Free

Marketing and Soft Drink concentrate on EssayThe brand Rasna is owned by Pioma Industries that introduced the concept of Soft Drink Concentrate (SDC), a segment that had been created and nurtured by the comp whatever(prenominal) in the Indian beverages Market. The brand was originally launched by the put forward of Jaffe in 1976 and market placeed with the help of Voltas, but was re let outd to Rasna in 1979. When the proceeds did not do as wellspring as it was expected, in 1983, the advertisement was handed over to an advertising agency named Mudra Communications Ltd. Pioma Industries Limited is perhaps not a familiar name for the average Indian consumer.But Piomas brand Rasna is very well known. In fact, the name Rasna is al well-nigh a generic name for gentle imbibe concentrates in Indian beverages market. Rasnas extremely popular advertisements with the tagline I bash you Rasna had become an integral part of the Indian advertising folklore. In March, two hundred 2, Pioma announced a radical overhauling of its strategies for the Rasna Brand. This development was rather unexpected, as the brand had been lying hibernating(a) since keen-sighted. Rasna is the market leader in the 250 Crore Indian soft drink concentrate industry. The SDC industry is miniscule comp ard to the calciferol0 crore carbonated soft drink industry (CSD).The powdered soft drink concentrate industry is worth around 90 crore. During the 80s, Soft Drink Concentrate (SDC) was not a known concept. For the consumers, Soft Drinks were just the charged drinks which could be purchased in bottles and were usually consumed outdoors. Rasna came, and changed the whole mind set. COMPETITORS IN THE MARKET As the pioneers in Concentrated Soft Drink Industry in India, Rasna, neer had to hardiness any threatening from any of its competitors, be it a global player or a small local company.Powder concentrate accept 85% of the total soft drinks concentrate market. Here, in this study, w e ar considering both Powder and Syrup CSD as competition for the Brand Rasna. Following argon somewhat(a) of the competitors who tried to make their mark in the 250 Crore Indian soft drink concentrate industry 1. Tang- Kraft Foods. 2. Sunfill- Coca Cola. 3. Fanta Fun times- Coca Cola. 4. Sugarfree Dlite- Zydus Cadila. 5. Kissan Mr Fruit- Hindustan Unilever. The travel of a brand is not perpetually easy. The market is very dynamic and a brand needs to keep a track of the changes in the market. Rasna had to face such challenges as well.But it is the resurrection this brand has shown, through strategic marketing, in all instances that makes it stand out and lead the market. MARKET SHARE Rasna has always been recognised at large for Brand and Company. It ranks No. 1 in the beverages category as Most Trusted Brand of India. It is listed among the top 15 brands in the country. It was awarded as the most preferred brand in the SDC category at the FMCG Most Preferred Awards 2003 and 2004 and Consumer World Award 2004. It has pioneered not only with its arduous marketing strategies but overly with its proper scaled statistical distribution chain.Rasna has always concentrated on its marketing and brand building and has achieved an expertise in flavour technology. Its efficient management in production and market environments has harnessed to bring to the global consumers, technologically superior products in fruits, vegetables, beverages and confectioneries and to stand as the leader in processed food industry. Rasna has fitted and in-depth knowledge and information on Market sizes and behaviours, Growth prospects, Project Viabilities, Government Policies, Finances etc.and access to more, enabling the company to respond fast to any end with suitable recommendation.It believes that there is a huge and emerging market for Rasnas kind of product range, all over the world. Rasna is capable of managing global size manufacturing set-ups working on the most advance d technologies to cater to the huge markets, locally and globally. Rasna has managed to dominate the colossal SDC market because of its massive International operations. One of Rasnas biggest strength is its marketing and barters set-up, through which millions of customers worldwide is experiencing the flavour of satisfaction.It provides a strong and pro-active marketing support to its distributors and importers around the world- just so that their products stand out and apart on the shelves. Timely delivery schedules of its products anywhere in the world are what defecate helped them to reach a strong position in the global market. Rasna has its offices in the pastime countries * USA and Canada * UK and Europe * Saudi Arabia * Russia * Fiji This strong chain of distribution to large number of countries within a stipulated period of time has helped the brand gain a reputation in the market.It has also helped Rasna in creating enormous business relations all over the globe. The co untries which imports Rasna products globally are as under In new-fashioned years, the brand has had to face off challenges, though not from its direct competitors. International soft drink giants like Coca-Cola (Sunfill) and Kraft Foods (Tang) assimilate introduced competitor products in the market. PepsiCo India too is gearing to launch a glucose-based ready-to-drink beverage under the Lehar brand that bequeath be sold at price point of Rs. 5 for a 200 ml stock-keeping unit.All of them puzzle deep marketing pockets and standard products to lure customers away from Rasna. Even the profile of Rasnas target audience is changing. Kids today are a lot more aware, and their parents dont mind buying more expensive ready-to-drink products, which the MNCs have. But, true to its entrepreneurial spirit, Rasna is not about to give any ground to its rivals. Though some analysts feel that Rasna has been slow to react to the competition, Piruz Khambatta, Chairman, Rasna, still dismisses the challenge saying water is our only competition. According to the 2010 data, Rasna leads the SDC market.The market bundles of Rasna and all the competitors are as hold fasts * Rasna- 97. 2 % * Coca-Colas Sunfill 2% * Sugarfree Dlite- 0. 2% * Kissan Mr Fruit- 0. 1% and * Tang- 0. 5%. COMPARTIVE STUDY ON 4 Ps SCALE The Marketing meld Here in this study of the Brand Rasna, we are comparing the brand with its competitors available in the market on the scale of the 4 Ps. The 4 Ps of the marketing mix are 1. Product. 2. Price. 3. Promotion. 4. Place. Product Line of Rasna Rasna began with 9 flavours in 1982, and added the 10th in the year 1987. The company was revamped in the year 2002.* In 2002, Rasna changed its attend to and came up with a new logo. * The tagline of the company was also changed and with a new tagline Relish a Gain, Rasna has tried a deep penetration in the rural and semi-urban market. The recent product line of Rasna is as follows Name Pack Size Flavour Price () R asna Frootfun 32 provide Orange, Mango, Lemon, Pinaple 35 Rasna Frootfun 12 glasses Orange, Mango, Lemon 10 Rasna Freshfun 32 glasses Shahi Gulab, Keshar Elaichi, Kool Khus, Cola Cola 35 Rasna Freshfun 12 glasses Shahi Gulab, Cola Cola 10 Rasna 1 ka 2 2 glasses Orange, Mango, Lemon 1.Rasna FrootPlus Jar 500 grams Orange, Mango, Lemon 85 Rasna FrootPlus Pouch 750 grams Orange, Mango, Lemon 105 Rasna FrootPlus Pouch 500 grams Orange, Mango, Lemon 75 fisticuffs Details The operating product line of Rasna consists several sku. The company follows different take aim size on carton basis. These pack sizes may vary depending on local market demand. The following table will give a general idea of the pack sizes. Sr. No. Product Units per Carton 1 Rasna Instant Drink (powder beverages) Laminate Pouch Packings A 3 gm hammock pack 50*60.B champion Serve pouch pack (12 gm pouch-orange) 10*12*6 C 25 gm single serve sachet 12*2*12 D 250 gn replenish packs 36 E 500 gm refill packs 24 F 75 0 gm standby refill packs 15 G 1 kg standby refill pack 15 H Litro packs 1 ltr 12*10 Glass Jar Packings A 250 gm glass jar 40 B 500 gm glass jar 20 C 750 gm sleek glass jar 15 Plastic jar packing 1 kg 15 OTS tin Packing 900 gm tin 15 1. 5 kg tin 6 2. 5 kg tin 6 2 Litro Pack Instant Drink Pouch suitable to make 1 litre 12*10 3 Gofrut Instant Drink (5gm pouch) 72*10 4 Shakeup Instant Drink . 25 gm single serve pack 24*30 150 gm standby pouch 108 5 Rasna Lite 250 gm jar 15 6 Rasna Soft Drink Concentrate 32 glass pack 200 7 Rasna Single Serve Iced Tea 9 gm 14*24*20 Whereas Rasna has so many different varieties of drinks (flavours) and in so many different sized packets its competitors are lacking behind in both flavours and availability of different quantity packs. The Price of Rasna Accessing all socio-economic class Rasnas sole goal has been always to make profit with the volume sale. The pricing strategy has always been the key of Rasnas success.It targeted the mass r ather than the class. * Rasna has always made its products in such a way that it domiciliate be accessible to all socio-economic classes. * Its volume sale starts at as low as 1 popular in the name of 1 ka 2. * The added sugar product Rasna Frootplus starts from 2 and goes up to 105 for the family pack. * The box pack has a starting price of 10 which can make 12 glasses of drink and is known popularly as 10 ka 12. * The family box pack is available at 35 which is enough for 32 glasses of water. * Rasna has some skus which are very interesting for regular use.The air tight jar has different pack size with price range starting from Rs. 75. The company is forever focussing on the rural market of India. So, accurate pricing is very important for the companys growth. For Rasna, accurate pricing has been the key growth driver. They unsounded that the Indian market is highly segmented. And making products targeting each segment has helped a lot. Whereas pricing has been the key growth f actor for Rasna, the competitors have not been able to bang that benefit of pricing. Only Tang is available at a sachet of 2 which is again meant for making 1 glass of drink.Likewise, the other competitors cannot even come reason out to the pricing strategy of Rasna. Promotion Adding an Emotional Touch Rasna has from its inception relied heavily on advertisement. The famous mass media campaign, I love you Rasna was one of Indias interminable running TV ad. * The promotion of Rasna always highlighted a strong connection with its customers through brand association. * Rasna has always created a brand value by emotionally attaching the customer to their brand. * Focus of the promotion is always to promote the quality of Rasna.* Rasna spends a lot on Research on the target audience, and promotes there products accordingly. * Rasna has used babe characters in their advertising campaigns, and through them the company emphasised on the quality of products which was an effective way of promotion. * Rasna has done a great deal to understand the suffering of summer and to deliver a product which will ease the pain. This kind of unique and innovative marketing ideas and campaigns made Rasna the monopoly in the Soft Drink Concentrate industry till the time the competitors entered the market.Even now, no brand has been able to beat the promotional campaigns of Rasna. Going by the set standards of Rasna, we can say that the competitors have spent very less time and money understanding the Indian market and the promotional activities that works in the India. Place Distribution Channel of Rasna The distribution channel of Rasna follows 3 to 5 tier architecture. It follows the Super-Sub concept of distribution. The steps are as follows 1. First the product produced in a factory which is strategically fixed to minimise the transportation court.2. The packed product is sent to various company depots across the country to distribute and meet the respective market demand. 3 . From the company depot, the product is delivered to the different super stockists according to their previously placed order. 4. Then the goods are sent to the sub stockists or in some cases to the wholesale store. 5. The secondary sale from the super stockist or the sub stockist is ensured by the constant monitoring by the company personal. Rasna follows different distribution channel model according to local market demand.But for every model the end goal of the company is to deliver a quality product to the end user. With a distribution channel consisting of 35 depots across the country and 1. 8 million retail outlets Rasna is bound to be the leader. Among the competitors the only one that has a good and competitive network of distribution is Sunfill by Coca Cola, but still they are not able to compete as availability with retailers is not as widespread as Rasna. COMPETITIVE favour The competitive advantages of Rasna are listed below* macrocosm the Pioneer in the market Rasna is well known and very much trusted in the Indian market. * Being in the market for a long time, Rasna knows the Indian taste the best. * Having 7 state of the art production units across the country, the production is never disturbed for any reason. * Because of the widespread distribution network, it is more close to the public. * The marketing strategies used by the company are of superior standard. * Last but not the least, the pricing of the product, which is so low that it is affordable by the lowest segment of the pyramid also.The competitive advantages of Tang are * Being one of the largest brands of the world, Tang has the sustainability even if it is hit at the beginning. * Tang is available in variety of flavours based on local consumers preference. * Tang is fortified with vitamins and minerals. * It is available as powdered and ready to drink bottles. * The powdered Tang is available at low cost. The combative advantages of Sunfill are * Being a brand owned by Coca Col a, the distribution cost is cheaper, so can offer the product at a low and competitive price.* The taste is superior compared to other competitive brands. * Setting up of a production unit close to the target customer segment will help in better marketing. * The company can spend substantial come up on advertising and promotion. The Competitive advantages of Sugarfree Dlite are * It is a brand owned by a medical company, so people have trust in the product. * It contains no sugar, so it is healthier. * Has medicinal advantages. * Helps in controlling blood sugar level, at the same time gives the pleasures of a soft drink.The Competitive advantages of Kissan Mr.fruit are * It is there in the market for a long time, so knows the customer taste and preferences. * Tastier than many of the competitor products. * Supply chain is quite strong as its a product owned by Hindustan Unilever. SUGGESTIONS FOR GAINING UPPER MARKET SHARE As we conclude the study on the No. 1 Soft Drink Concentrat e in India, Rasna, I have the following suggestions to make so that the company can gain more market share and continue to be the leader of the industry Product- In terms of product, the following can be done1. Try to minimise waste in production, so that the cost of production comes down further. 2. Venture into new products, like ready to drink bottled drinks. 3. Try producing sugar free products so that even a diabetic patient can enjoy the drinks. 4. Health drinks and energy drinks is another field where the company can venture into. 5. Backward integration is another option that can be suggested to minimise the cost of production. Price- the Company can be more price effective and in turn can gain more market share if, 1.More products are offered in the lower price category. 2. Price be reduced for the larger quantity cartons or bottles. 3. New and introductory products are sold for lesser price so that people are interested in trying the new things. Promotion- In terms of prom otion, the company can follow the following suggestions 1. Use newer and cheaper modes of advertisement, like the social networking sites. 2. Spend more on Banners, posters, Hoardings. 3. Stop the use of sportspersons and celebrities, as the same doesnt have a long standing effect on the general public.4. Remove the time lag between the promotion and the availability of new products in the market. Place- Place plays a rattling role in the success of a company or a brand. The following are my recommendations for improving the market share 1. Go to the newer potential places which have not been tapped earlier. 2. The untimely dispatch of goods from the depot to the super stockist needs to be taken care of as it may lead to cancellation of order bookings. 3. Unavailability of goods at certain periods needs to be taken care of with a proper distribution control.4. Promotional events along with the distribution of brochures, stickers and leaflets should be done through sub-stockists and retailers which will help in increasing the brand value.References During the preparation of this project, help and references has been taken from many web sites and blogs and articles. They are mentioned here -Rasna Pvt Ltd. Official site. -Wikipedia-the free encyclopaedia -Puneet Tandon Blogs -Economic Times -Times of India Articles -4psbusinessand marketing. com.

Industrial facility Essay Example for Free

Industrial facility Essay1. Describe how the use of a overblown smoke stack might improve denudate quality near a large industrial facility. 2. How can squeezeography contribute to pollution in a city or region? 3. From where do hurricanes derive their energy? What factors tend to weaken hurricanes? Would you expect a hurricane to weaken more quickly if it moved over land or over cooler water? 4. Where is the Bermuda high located during the summer and fall? How might the path of a hurricane, moving toward the west from Africa, be affected by the Bermuda High as the hurricane approaches the United States? 5. How do you think pollutants are outback(a) from the atmosphere? Does this occur quickly or slowly?1 The smoke coming from a uplifted smoke stack doesnt mix with the pollutants below it. When a temperature inversion comes in at night, the smoke from the tall smoke stack is above the top of the inversion and doesnt go away trapped with the air below. The air below doesnt get polluted as it would with a much shorter smoke stack, and doesnt affect the air quality. 2 Topography plays a major role in trapping pollutants. Cities like Denver and Los Angeles, that take a breather in a valley or between mountains get better temperature inversions. Cold air mixing with the polluted air sinks to the bottom of valleys and low-lying basins. The top of these inversions creates a blanket-like effect and traps the pollutants so that they mix with the frigorific air below. In these poorly ventilated areas winds cant mix and carry out the cold air or polluted air. In cities like Los Angeles, mountains surround the sides of the city, but the cold air from the Pacific Ocean comes onto land and helps trap pollutants.3 some(prenominal) factors are required to create a hurricane. Hurricanes often start off as a Tropical wave from the west coast of Africa. The diverging air moves from east to west with storms behind it with the converging air. Hurricanes come from 5-2 0 degrees north or south of the Equator and move with the coriolis effect. These storms must have a light wind surcharge in the upper atmosphere, warm ocean waters (26.5 degrees celsius +), instability in the atmosphere and a trigger (like a tropical wave). They form into a meet of rotating thunderstorms around a low pressure system and release latent heat from the waters. However, strong vertical wind shears, cold water and land go out dissipate a hurricane quickly. A hurricane moving over land will weaken a hurricanemore because hurricanes need the warm moist air that it cannot get from land.4 Through the summer and fall the Bermuda high is located in the Atlantic, close to Bermuda. Since hurricanes are attracted to the heat and high pressure, the Bermuda high creates a perfect environs for the storm to form. Since the diverging air moving west from the African coast moves in an anticyclonic motion, it moves into the area of the Bermuda high before strengthening. The east coas t of the US is very likely to receive hurricanes or the strong storms from the hurricanes rain bands. Hurricanes normally move from west, to north west to northeast. 5 Pollutants can be slowly removed from the atmosphere by various methods. Growing trees naturally filter the air. There are man-made machines to do so as well. These machines filter the air apply scrubbers, house filters and other methods. These can also be installed in home air conditioning systems. After the filters are cleaned, they can be easily disposed.

History and Evolution of Leadership

History and Evolution of LeadershipA loss drawing card. as incessantly said, is born, not made, but lead is certainly a continual evolution process of qualities like vision, commitment, discipline, trust, integrity, innovation, motivation, authority, dedication, humility, creativity etc., within leaders. Most of these qualities, if not all, in a leader contribute to the success of an organisation. For a reputed business school like Cardiff Business School, choosing a leader who bottomland shape the aspirations enhancement of the institution to rifle ideal Business establishment is very vital. at the same time intricate. Choice of new Dean to replace Professor McNabb should be influenced inspired by the facts that how much the new Head is able to contribute towards the institutions achievement perform greatly in the new role. To evaluate this we need to return a legal brief idea about leadership theories proceedings.A look on the history of leadership finds that the litera ture on leadership performance dismiss be in general categorized into a number of important phases. (Ogbonna, 2000 Harris, 2000). Early studies on the leadership skills concentrated on identifying the personality characteristics which characterized successful leaders, and are known as trait studies (Argyris, 1955 Mahoney et al., 1960). Trait theories assume that successful leaders are born and that the leader has certain innate qualities which distinguish them from non-leaders (Stodgill, 1948). Ralf Stodgill reviewed hundreds of trait studies (1948, 1974, p.81) over a period of time, which can be summarized as the personality traits and other in-born qualities of the leader can be identified it is possible to select those individuals promote them into leadership positions, they then emerge to make do power, regardless of the social organization or historical context. Another set of approach is Set Behavioural theories. It summarises about the behaviour style that a leader ch ooses or adopts to solve problems. (Hemphill and Coons, 1957 Likert, 1961). Similarly the Viewpoint of theories like situational contingency is that leadership efficaciousness is dependent on the leaders diagnosis understanding of situational factors, followed by the acceptance of the appropriate style to deal with each circumstance. (Ogbonna, 2000 Harris, 2000).All the theories reviewed above illustrate that leader plays a very important role in the progress performance of the organisation. But if one critically evaluates the affect that a leader has on the organisation then, one can say that the decision a leader takes can sometimes be restrained by certain factors. Some people argue that constraints placed on leaders are due to situational factors. Although there have been few studies that have a direct bearing on this important issue, research on sports organisations has tended to support this argument. In practice however, this argument has rested intemperately on the find ings of just one major study that of Lieberson and OConnor (1972), which has become the most commonly cited evidence of this issue and which is widely regarded as the major counterpoint to the mesmerism that leadership makes a difference. (Thomas, 1988)One more key aspect to discuss here is that of fetch up differences in leadership, as our main concern is to look for the leader that can be Head of Cardiff Business School, we should not be biased to only one gender. Male leaders are rated as more effective conscientious then female leaders, but A Meta-analytic review of 17 studies examining sex differences in leadership indicates that male and female leaders exhibit tally amounts of initiating structure and consideration and have equally satisfied sub-ordinates. (Platz, 1986). More More women are becoming managers this rise in trend is because of the federal implication which prohibits sex discrimination in employment. Despite this rise many individuals still believe that men a re better leaders. (Bass, Krusell, Alexander, 1971 Bowman, Worthy, Greyser, 1965 Rosen Jerdee, 1978 Schein, 1973) there are some evidence to renounce this argument indicating that men and women may differ in personality characteristics which affects the leadership styles effectiveness. (Hoffman, 1972 Maier, 1970 Megargee, 1969 OLeary Depner, 1975 Templeton Morrow, 1972) Furthermore several studies have demonstrated that men and women differ in leadership behaviours also. (Bartal Butterfield, 1976 Petty Lee 1975)

The Un Global Compact Politics Essay

The Un global Compact Politics EssayThe coup conduct Nations world-wide Compact (UNGC) is a worldwide initiative started by the fall in Nations in order to encourage businesses to take up to a greater extent sustainable and socially responsible policies, and to to a fault report their implementation. It consists of ten guiding principles pertaining to the areas of serviceman rights, push back, the environs and anti-corruption.It is the worlds largest corporate citizenship initiative with over 7700 members in 130 countries. UNGC is a unique platform that gives a strategic edge to its participants to advance their corporate commitments to the sustainability. UNGC is endorsed directly by the CEOs. It has been structured as a public- snobbish initiative. The UNGC is a policy framework to advance the development as well as implementation, and also the disclosure of sustainability principles and practices. It offers its participants an array of specialized work streams, management similarlyls and resources, and special programs and projects which have been designed to advance sustainable business models and markets in order build a more sustainable global economy.UNGC has two main objectives First Mainstream the ten principles in business activities around the world and Second Catalyze actions in support of panopticer UN goals, much(prenominal) as the millennium Development Goals.TheUN Secretary-General at that conviction Mr. Kofi Annan in an address to The World Economic Forum announced the UNGC on January 31, 1999. Itwas officially launched at UN Headquarters in raw(a) York on July 26, 2000.The first two principles pertain to gentleman rights. The next 4 principles deal with labor standards businesses should follow. The next 3 deals with milieu protection and the last unrival direct advocated anti-corruption.The spheric Compact is a voluntary initiative and a company that wants to subscribe to the rationales has to make a clear statement of sup port and has to include references in its annual report or in any other publically available documents detailing the progress it has made in adhering to the Principles. The company also needs to submit a brief description of this report to the Global Compact website. If the company fails to submit this description within two years of signing to be a part ofthe Compact (and after that every two years), the company will be removed from the list of participants. The participants to UNGC intend to lead through near example and setting a high moral tone. The main purpose of the Global Compact is to focus on the moral purpose of business. Kofi Annan summarizes it well in a quoteLet us choose to unite the power of markets with the authority of universal ideals. Let us choose to reconcile the creative forces of private entrepreneurship with the needs of the disadvantaged and the requirements of future generations.Then ten principles are as followsHuman RightsPrinciple 1Businesses should s upport and respect the protection of foreignly entitle human rights within their sphere of influence andPrinciple 2 Make sure that they are non complicit in human rights abuses.LaborPrinciple 3Businesses should uphold the freedom of association and the effective recognition of the right to collective bargainingPrinciple 4 The elimination of all forms of forced and compulsory laborPrinciple 5 The effective abolition of child labor andPrinciple 6 The elimination of discrimination in respect of employment and occupation.EnvironmentPrinciple 7 Businesses should support a precautionary approach to environmental challengesPrinciple 8 Undertake initiatives to elicit greater environmental responsibility, andPrinciple 9 instigate the development and diffusion of environmentally friendly technologies.CorruptionPrinciple 10Business should work against corruption in all its forms, including extortion and bribery.Is the Global Compact a Product of Occidental Liberalism?International regimes are be as social institutions around which actor expectations converge in a given area of world(prenominal) dealing. Being true for any social institution, the participants discretion to act on issues that fall within the realm of the institution is by themselves limited by the international regime. The occidental international economic order that emerged post the Second World War was a highly advantageous combination of factors that led to long and continue economic growth. The economic power was distributed worldwide in such(prenominal) a manner that it favored an open approach to organizing international economic relations. Worldwide on that point existed an ideological consensus regarding the role state should play to ensure domestic employment, price stability and social security. The body of economic analysis and policy prescriptions at that time prescribed the governments to act in this manner. about of the major corporations were national in scope and the internationa l economic relations more or less comprised of proceedings amongst separate and distinct national economies. The Bretton Woods institutions, the GATT and the United Nations were the few international organizations that had been put in place to express and support the post WWII compromise of imbed liberalism.Major changes have taken place in the last half-century that has undermined the effectiveness of this set of understandings and arrangements. However, Globalization is the single greatest factor that has brought about these changes. Globalization has led to a complete disconnection between the world of production and the world of finance leading to an overall change in the system of institutional relationships. This has led to two disequilibria in the worlds political economy.The first disequilibrium exists between the economic sphere, and the broader frameworks of shared value and practices of which the economic sphere is a part.The second disequilibrium exists within the inte rnational politics structures. The major capitalist countries can withstand even the worst effects of this imbalance since they have the domestic and the institutional capacity to protect themselves but the equalizer of the developing world is extremely vulnerable, and this vulnerability has been further exacerbated by the neo-liberal orthodoxies of the so-called Washington consensus.Therefore, the international community has to devise the kind of institutional equilibrium that use to exist in the post WWII international economic order. The international community has to focus here on the long-term interaction between two draw actors in the global economy, the multinational corporations (MNCs) and multinational Non-Government Organizations (NGOs).The key players of civil society have started to increasely target MNCs and the international trading system as supplement to pursue social and environmental concerns. This dynamic interplay between the two creates a potential for to b ridge the disequilibrium between economic globalization and the international regime structures.The United Nations Global Compact is one such initiative that challenges the international business community to help the UN in implementing the social values of human rights, environment and labor. behind Gerard Ruggie who is the Kirkpatrick Professor of International Affairs at the Harvard Universitys Kennedy School of Government says that the basic problem is that MNCs, acting as non-territorial spaces and management, have given rise to global governance gaps and governance failures. Ruggie is well known in academic circles for coining the term embedded liberalism, that he uses to describe the post-WWII coupling of multilateralism with the aim to achieve domestic stability and for having emphasise the roles that ideas play in world politics. He has explored the emergence of such gaps in governance in several of his works (e.g., Ruggie, 1998b, 2003, 2004).Ruggie helped UN Secretary- G eneral Kofi Anan in designing and establishing the UN Global Compact, as the Assistant Secretary-general and Chief Adviser for strategic planning to Kofi Annan. Without speculating on the importance of Ruggies role in the creation of the compact, the speech Kofi Annan used to launch the Global Compact at the World Economic Forum in Davos in 1999, strongly suggests that John Ruggies influence was substantial. It appears that Kofi Annans suggestion thatGlobalization is a fact of life. scarce I believe we have underestimated its fragility. The problem is this. The spread of markets outpaces the ability of societies and their political systems to ad retributive to them, let alone to guide the course they take. History teaches us that such an imbalance between the economic, social and political realms can never be sustained for very long.Seems to have been directly informed by Ruggies work on embedded liberalism (e.g. 1982, 1998b)According to Ruggie (2003), theten principles of the UNGC are drawn from the Universal Declaration of Human Rights, theILOs Fundamental Principles on Rights at Work and theRio Principles on Environment and Development. The UNGC is found on beliefs that have been universally recognized bygovernments, thus spelling out the goals of the whole international community. The UNGC partners with members of the corporate world and the civil society to overthrow the gap betweendreams and reality It aims to pop off an agency for the promotion of social customs. Thus, UNGC is another measure to the growing number of responses to globalizationschallenges that also partner with the private sector.The argufyThe UNGC is based on an ideology of the benefits of open markets. Various high-ranking UN officials describe the UN Global Compact as the only if remotely viable means of drag billions of people out of utter poverty. The term open markets sounds nice, but in the real world they translate into the skewed rules created by the WTO that benefit the developed nations at the expense of developing countries, poor farmers, consumers and the environment.It is apparent that most of the UN officials along with the corporate and government officials believe that globalization is principally beneficial and all it needs is just a bit of tinkering here and there. An editorial in the Washington Post on the UN Global Compact read that globalization only needs a s a good dealer to dull its sharp edges and increase the allocation of its benefits.In his speech to corporate leaders in 1999 at Davos, Switzerland, the Secretary General of UN Mr. Kofi Annan warned of a threatening shrink against globalization, he advocated that recognition of human and labor rights, and environmental principles are absolutely essential to avoid any threats to the open global market, and especially the multilateral trading regime. Mr. Annan by proclaiming that globalization must be protected by putting a more human face on it, and by declaring that social values need to be advanced as part and parcel of the globalization process, has clearly taken sides with the corporate order of business at a time when this agenda itself is increasingly under scrutiny.In order to keep it simple and attractive for companies, the ten principles of the UNDC are basically one-liners. They are just an example of the minimalist enactment of corporate conduct. The ten principles do not provide adequate guidance to corporations about the conduct that is expected from them and their responsibilities. Most of the UN Global Compacts ten principles cannot be defined with the precision that is required for creating a practical code of conduct. The ambiguity of the ten principles is in essence counter-productive from the perspective of both the sincere as well as the insincere corporate citizens. The language with which the principles are defined is so general that insincere corporations can easily side step or conform to the principles without doing anything to pro mote human rights or labor standards.The Secretary General of UN along with various agency heads have displayed very poor judgment by letting numerous known and parentn human rights, labor rights and environmental violators to sign up with the UNGC. Specific partners of the Compact include companies like Shell (Oil major), Nike (Human rights violator), Rio Tinto, BP (Oil Major), Novartis, Aracruz, Daimler Chrysler, BASF, Bayer and DuPont (environment troubles).In a few of these cases, the choices are blatantly violating UNs own guidelines that read, Companies which violate human rights are not eligible for partnership.Many other companies are part of the compact that are not accused explicitly of such clear violations, but they are giants of industries like oil and petroleum, genetical engineering and heavy chemicals. People broadly oppose the concussion of these companies on the community, the workers and the environment. Additionally, the International Chamber of Commerce, which mostly represents big businesses, has been a major force for the corporate side of the UN Global Compact. The International Chamber of Commerce more than often lobbies for diminishing the impact of international controlments that governs their members behavior-accords that are often brokered by the UN.One often sees Public-private partnerships being used for specific projects with definite goals. The UNs is however is utilise this term much more generally. One would normally assume that a partnership is created only when all the partners have the same goals. Its tough to understand why UN is partnering with corporations that have completely different goals.Modern corporations acknowledge that there are various other stakeholders than their shareholders, but in concrete terms they are only accountable to their shareholders, on the other hand the UN is based on a promise to promote ethical principles and is accountable to the people. Sometimes the UN and corporate agenda bear but most of the times they are at odds. The Director of UNICEF Carol Bellamy once said that it was dangerous to assume that the goals of the private sector were somehow synonymous with those of the UN, because they most emphatically were not. It is quite obvious to everyone that its not possible to forge a partnership with an institution whose interests are antithetical to yours own. It is not possible for the UN to at the same time regulate as well as partner with the same corporations. Its not that The UN can avoid all interactions with corporations it has to interact with then when it needs to buy goods and serve or to hold the corporations accountable, but UN should take care not to partner with them except when the organizations share its goals.Every company wants to project certain values and a certain image. Disney wants to represent wholesome family entertainment. McDonalds advertises itself as fast, friendly food. Nike is associated with the joy of sports and Shell, Chevron a nd BP and other oil companies promote their own commitment to environmental stewardship.But, to many people, Nike also means sweatshops in poor Asian countries, McDonalds often signifies unhealthy junk food that causes obesity and, Disney means sweatshops and promotion of stereotypes, Shell is linked with various human rights violations and environment destruction, and the whole oil industry is notorious for global warming, greed and abuse of its power.When Kofi Annan joins the CEOs of such companies on the main stage, or whenever a UN agency partners with such corporations in a joint venture, the message that is sent out to the public is very disturbing. As it is described in the UNDP guidelines, whenever a UN agency is engaged in a public relations activity within the framework of a corporate relationship, a mutual image graft inevitably takes place.The image transfer that takes place tarnishes the pure UNs image, and gives the chance to big corporations to bluewash their bad ima ge by associating themselves with the UN. When pharmaceutical majors like Novartis and Aventis are seen by the public as a part of the UN Global Compact, the public gets an impression that the UN has officially endorsed their products despite the enormous controversy surrounding these companies.The UN represents values such as world peace, security, human rights, environment consciousness and global well being. These values should remain distinct from the commercial values of companies. Once the image of UN is tarnished with corporate logos, the compromising of its noble values whitethorn follow.The most crucial aspect relating to the Global Compact is accountability. The reluctance of U.S. based companies to enlist with the Global Compact focuses on the issue of accountability. In todays environment of increasing skepticism about the true motives of the corporations, the authenticity of the UN Global compact comes into question if it operates without a traditional accountability s tructure.The Global Compact does not have a monitoring or an enforcement mechanism. This means that the companies that enlist with the Compact get a chance to declare their commitment to UN principles without making any promise to follow up on them. The corporate partners of the UNGC have made it explicit that such a lax arrangement is precondition for their participation. Maria Livianos Cattui, the secretary-general of the ICC recently said that businesses would not agree to any suggestion that involves external assessment of their performance, whether it is by any special interest groups or by any UN agencies. The Global Compact is not a qualification the corporations have to meet it is merely a joint commitment to shared social values. It is imperative that the Global Compact does not become a tool by which the governments burden business with prescriptive regulations.The critics on the Global Compact fall into two major categories and both need to be addressed. Most scholars res earching on codes of conduct regard the Global Compact as just another code of conduct without any accountability, its merely a public relations document. The question that arises is that how can the public know that a business that claims to be following the principles prescribed under the Global Compact is actually doing so? These scholars repugn that an independent monitoring group that translates general principles into operating standards with quantifiable and objective measures is the only way to insure that the companies are held accountable.A much more aboriginal criticism arises from the Non Governmental Organizations and other organizations that are critical of economic globalization. Their view is that the Global Compact is a cover-up story that provides legitimacy to an idea, which has yet to prove itself. They argue for the creation of a mandatory legal framework that guarantees that the companies are held accountable even to the least advantaged in the global economy .Another difficulty with the accountability issue is the ambiguous nature of the Global Compacts principles on human rights. Is it possible to reach a consensus that genuinely captures the expectations of society? Most of the companies are in broad agreement with the Global Compacts principles relating to human rights, but there is a fear amongst them that enlisting with the Compact would create societal expectations that these companies are obligated to correct human rights abuses. Where and how can a line be drawn on the responsibilities of companies in the area of human rights? Few MNCs have come to understand that it is imperative for them to become proactive and live up to the expectations of society in a global economy, but these companies also understand that these expectations in the area of human rights are often unclear. In the litigious business environment of the United States, companies display reluctance in signing the Compact without having a clear idea of what their responsibilities are and what is their accountability.The Global Compact is not a state focused corporate citizenship program, but in spite of that nations are amongst the key stakeholders from which the Global Compact requires support. Blackett suggests that it might be necessary to highlight the role of governments in successfully implementing the Compact principles. But till now the UN has failed to work out a proper role of governments in ensuring that the participant of the Compact live up to their commitments. On the contrary, the Shanghai Declaration has suggested that businesses could use UNGC to set demands and exert undue influence over governments. If this go too far and the businesses start dictating the business of the Global Compact Office and international law generally, then even this partnership might face a crisis of legitimacy among states and other stakeholders.

Patient Diagnosis: Lack of Energy Presentation

Patient Diagnosis Lack of Energy PresentationSummaryThis dissertation is ground on dickens tolerants who presented to medical services with a presenting complaint of a drop of push tone ending?. My number one patient, Mrs W, 61 years, has Diabetes Mellitus, type 2 and my second patient, Mr H, 59 years, has laborious genus Anemia from unknown lowerGastrointestinal course loss.I sh every(prenominal) stimulate by focusing on the clinical aspects and basic medical sciences of their dis sculptural reliefs and then(prenominal) go on to discuss psycho complaisant aspects, management, investigations and the role of professionals involved in their health cargon. I posture kayoed then intuitive feeling at research and evidence establish trials to explore the scope of their stops and look at each(prenominal) current research that is be carried out.Throughout my dissertation I aim to reflect and convey what I take for learnt and how I felt well-nigh my get downs.From writ ing this report I soak up developed as an individual and confirm gained personal advancements that I didnt conceptualise to achieve. I have been able to widen my understanding of unsoundnesss and patients consume of their disease.Furthermore, I have gained an appreciation for research and evidence based medicine and developed a respect for other health cargon professionals. I have learnt the vital importance of taking on a holistic near when dealing with a patient, earlier than right looking at the basic science behind a disease.All in all, writing this dissertation has enabled me to truly understand how a disease house affect a patient and I now appreciate that it is not always most curing a patient, but about treating, advising and working towards a better quality of disembodied spirit for the patient and their family.1. IntroductionIn my dissertation I aim to explain, explore and reflect on my experience of the People and Disease course. In particular I w fed up(p) fo cus on my experience of meeting with two individual patients with the same presenting complaint a lack of energy?.Both patients seem to be patronageed with the prognosis of their disease but from very(prenominal) antithetic points of view. My offshoot patient wants to overcome her diabetes and not let it worsen whereas, my second patient does not wish to know the energise of his anaemia, but is maladjusted about the associated symptoms of his condition and how they go forth procession.Before contacting my outset patient, Mrs. W, I felt apprehensive and quite anxious about the idea of having my own patient. I was worried about what she would moot of me, how we would be able to have a rapport and what sort of questions I would ask her. In all honesty, I had naturally stereotyped her as a typical old chick?, but on meeting her, my initial thoughts were soon corrected. From this I have learnt that when given details about a patient you shouldnt necessarily stereotype and ca tegorise them into a certain group in society.When asking her the initial questions that I had ready I felt that it made the conversation very in soural, so to set to the situation I just literally let her speak and tell me whatever she precious to. This was very helpful to me as she had a lot of things she wanted to tell me and talk about. However, I do catch from intercourse skills seminars that not all patients will be as open as this in the next and in that respectfore I do need to have the ability to speak to patients that are perhaps a bit more reluctant and unwilling to destiny their problems and thoughts. For example, you mickle use a lot of open questions to allow the patient to answer what they feel is comfortable for them and just gradually develop the conversation from what they say, rather than chit chatting?, which is what I found with my first patient.After asking Mrs.W about her recently diagnosed diabetes she seemed very unsure how to explain to me what she thought was wrong with her, she seemed to resent the event she has a disease and questioned what she had done to deserve be coming ill. She said that even though the Doctor had explained everything to her, she was unsure of what to expect in the time to come and seemed quite worried about the aspect of not being able to care for herself. From telling me all of this, I felt quite overwhelmed and unsure of how to reassure her. Even though I wanted to help, I found myself in a situation where I physically couldnt, which was very frustrating. On my second and third visits I asked a bit more about her family situation, her social activities and her thoughts, ideas and feelings ( mental factors). From taking on this broader approach, I began to realise the true picture of Mrs Ws life and how it contributed to the worries of her illness. She told me about her husband leaving her and her missy and son becoming quite distant, she explained that she ofttimes felt lonely and at times it made her feel quite depressed. This seemed to be more of a concern to her than her actual illness, but it demonstrated why she is concerned about her diabetes worsening because she has very little family support and would have to cope by herself.From the meetings with Mrs W, I have learnt the vital importance of taking on a holistic approach when speaking to a patient. I have learnt that its not just a biological illness that contributes to the wellbeing of a patient you have to take into consideration the home office/family env smoothing ironment and the social and psychological factors. Not only have I had the opportunity to see an illness in the context of real life but I have greatly meliorated my confidence and patient communication skills by being able to gather information, take family history and cope in a one-to-one based home environment.However, my experience from meeting my first patient contrasted completely with my second patient experience. Initially I had some difficul ties dressing my second patient, as the consultant I had contacted only ran morning clinics so I took the initiative to go into the hospital and find a suitable patient myself. Even though I felt quite nervous, I went onto the haematology ward and simply explained to one of the nurses about my course and what had happened so far with trying to find a patient. She was extremely helpful and understanding, which put me at ease and she more or less found me a patient right there and then (which I hadnt expected). However, even though I hadnt really prepa ruby- redness anything I already felt that I had developed some good skills and awareness of communicating appropriately with patients, both from my first patient and communication skills seminars, to be able to build up a good report with my second patient.Mr. H (my second patient) was very unalike to my first patient in the sense datum that he wasnt as open when talking about his illness. He is suffering from sodding(a) anaemia and has to have job transfusions every week (so like my first patient, had the presenting symptom of no energy). However, he didnt seem to recall any dates of his illness and didnt want to explain what had ca employ the anaemia. However, after reading his medical records and meeting with his consultant, I came to realise that Mr. H had had a bad experience with a doctor and had adamantly refused further investigation, so his severe/worsening anaemia remains an unknown cause.Also, in comparison to my first patient, he had a frequently more considerable loss of energy, so even though he gave consent for me to talk to him, I felt at times he needed a break so I ensured that I did not stay too long and extend him during my visits. Nevertheless, I found that meeting a patient in a hospital environment is completely different to meeting them in a home environment. In a hospital environment you need to be very aware of everything around you, how you are acting towards other staff and pa tients and there is a real need to realise certain cues from the patient (as they are in a more severe situation than a patient in a home environment).Overall, the People and Disease course has been a really enjoyable learning curve. Ive been able to put my communication skills to practice and see how to adapt to different situations, which has boosted my confidence enormously. Even though there is much more to learn, I really look forward to doing so and I hope that I will develop the skills needed to become a good doctor in todays society.2. Clinical FeaturesIn this section I aim to discuss clinical features of my patients diseases and derivative instrument diagnoses.My first patient was diagnosed with vitrine 2 Diabetes Mellitus and my second patient suffers from severe anaemia both of these conditions have similar clinical features and the same presenting complaint of a lack of energy and dull. Both of my patients recorded symptoms of lethargy, dizziness, fainting and hoarse ness of breath exploring these similar symptoms demonstrates the importance and accuracy needed for a diagnosis, as these symptoms could be indicative of a variety of other diseases. It is also vital to have a correct diagnosis, as a misdiagnosis would lead to unnecessary grievance, treatments or investigations which would cause a patient a lot of stress.Fatigue is the common presenting complaint in both of my patients and is clinically difficult to define it is related to tiredness, exhaustion and a general lack of energy. Fatigue is a very common health complaint and around 20% of people in the United Kingdom claim to have fatigue intense enough to interfere with them having a normal life. Physical causes are estimated at 20-60%, and emotional causes are the other 40-80% (1).The fact that fatigue alone can disrupt ones life so severely indicates the important role of a doctor to be able to make a correct diagnosis for the cause of it.However, my individual patients descri spot th eir fatigue in very different ways. Mrs W described her lack of energy in coitus to feeling lethargic and very tired all the time, whereas Mr Hs fatigue was very much to do with a sudden onset of shortness of breath and chest pain.The symptoms that patients with anaemia normally present with are highlighted in the image below (2)Mr. H has anaemia with haemoglobin levels often as low as 3.2gm/dL with the normal range being 13 18 gm/dL for a male and 12 16 gm/dL for a female (2) indicating that his anaemia is very severe and therefore explains why he would experience fainting, chest pain and angina as shown in the image above. And in comparison to Mrs. W, highlights the difference in their experience of their clinical presentation of a lack of energy.Type 2 diabetes was previously referred to as adult onset diabetes and is related to insulin opposite and a relative, rather than an absolute, insufficiency of insulin secretion (3). Due to the fact that this type of diabetes is conc erned with gradual insulin resistance/deficiency nub that individuals do not always (or initially) require insulin to achieve okay diabetic control.The common symptoms associated with Type 2 Diabetes are (4)Polyuria the need to urinate more often repayable to the body trying to excrete the extra glucose that is in the rent and in turn creating an osmotic gradient resulting in more water system production.Polydipsia feeling thirsty more often than usual, referable to the loss of fluids ( attachd urine production).Weight loss this is due to the fact that glucose is not being taken up by cellular telephones due to insulin deficiency/resistance, so the body starts to burn up fat instead, which results in weight loss due to fat storage depletion.The majority of diabetic patients experience lack of energy because the cells in the body are not getting the glucose that they need, resulting in lethargy and tiredness. As type 2 diabetes progresses, patients may also experience blurred v ision, yeast infections and prolonged time for wound healing.Mrs W was diagnosed with type 2 diabetes in February 2007 initially only experiencing a lack of energy. Over the months that I met with her she also started to experience polyuria and polydipsia. She was concerned as to how much her diabetes would progress and worsen because it had not been made very clear by her Doctor. This demonstrates the important need for a Doctor to be aware of patients concerns and level of understanding of their disease process.However, when speaking to Mr H about his clinical presentation and symptoms he had a very nonchalant attitude towards the cause of his disease. I later discovered that his anaemia was in fact due to unknown lower Gastro-intestinal (GI) job loss and on questioning Mr H about this he explained that he refused investigation to find the cause of the blood loss due to dissatisfaction with the way he was treated. He explained that during a scheduled procedure for a colonoscopy, the doctor carrying out the investigation was extremely rough and caused him a lot of distress and discomfort. And even though Mr H asked for the procedure to be stopped, the doctor proceeded against the patients wishes this aggravated Mr H and led to violent behavior towards the doctor and the dispute was later taken to court.I was very shocked to hear of his experience and also felt deeply concerned that he refused future investigations as his symptoms and anemia are very severe and have lead to angina and disabling conditions with him being unable to walk and get out of bed unassisted due to such severe lack of energy. This emphasizes the crucial need for a good doctor-patient similitudeship, as shown in this case, without it, a doctor may be unable to make a proper diagnosis and prescribe ideal treatment.Differential Diagnosis-Diabetes-The process of looking at a differential diagnosis involves weighing the probability of one disease against the possibility of other diseases a ccounting for a patients illness. For example, Mrs W presented with a lack of energy for her diabetes mellitus, but this complaint could have been diagnosed as any other kind of condition such as, hypothyroidism or Cushings disease as they can also present with fatigue.Differential diagnosis to Diabetes Type II-Why is the condition considered to be a differential diagnosisHow to make the correct diagnosis-HypothyroidismAlso results in a lack of energy and fatigue.Often diagnosed via a blood test, examining the levels of T3,T4 and TSH in the blood.Cushings DiseasePolyuria (and associated polydipsia) insulin resistance (especially common in ectopic ACTH production) (5)which can lead to hyperglycaemia (high blood sugar levels), which can in fact lead to diabetes mellitus.Dexamethasone suppression test or/and a 24hour urinary measurement of cortisol(6).HyperglycaemiaHigh move blood glucose levels this is a symptom of diabetes, but could also be due to physiological stress, critical ill ness or certain drugs.Blood test which indicates a glucose level of 10+ mmol/L (180mg/dl) also a test for diabetes, therefore, need drug/medical history.Anaemia-The differential diagnosis of anaemia would be any condition relating to the presenting complaint of a lack of energy?, or any other condition relating to the symptoms of anaemia, as discussed in the clinical features section. In particular relation to Mr Hs lower gastrointestinal bleeding the differential diagnoses are as followsDifferential diagnosis for lower GI bleeding-Why is the condition considered to be a differential diagnosis?How to make the correct diagnosis-HaemorrhoidsSwelling/inflammation of veins in the rectum commonly due to straining in constipation. These can often falling out and bleed.Physical examination of external haemorrhoids, digital rectal examination for internal haemorrhoids.Colorectal CancerCancerous growths in the colon (thought to be adenomatous polyps) can rupture, olibanum causing a bleed.Di gital rectal examination, Fecal occult blood test (testing for blood in the stool), endoscopy (7).Ulcerative ColitisA form of inflammatory Bowel Disease, includes ulcers and open sores which lead to constant diarrhoea mixed with blood.Endoscopy involving both colonoscopy and sigmoidoscopy.From exploring the differential diagnosis of my patients conditions it has made me more aware of the vital importance of qualification the correct diagnosis as there are a number of conditions that certain symptoms could be caused by. Furthermore, considering Mr Hs anaemia it does highlight the fact that his condition could be a number of quite serious conditions, which shocks me even more as he has chosen not to find out the cause of his worsening anaemia due to his troubled experience with a doctor.3. PathophysiologyIt is quite complex to discuss the aetiology of both my patients conditions as the exact cause of type 2 diabetes is not richly understood, although clear risk factors have been id entified. Furthermore, Mr H refused investigation into his GI bleeding, which results in the cause of his anaemia remaining ambiguous.Diabetes Mellitus Type 2-Diabetes Mellitus is a group of metabolic disorders characterised by continuing hyperglycaemia (high blood glucose concentration), due to insulin deficiency, insulin resistance, or both. There are two main types of diabetes type 1 and type 2. They can understandably be distinguished by their epidemiology and probable causation, but not always so easily separated clinically.Type 1 diabetes is due to autoimmune ravaging of insulin-producing beta cells of the pancreas therefore, causing an increase in fasting blood glucose. However, diabetes type 2 is a disorder that is characterised by high blood glucose due to insulin resistance and relative insulin deficiency (8).Since diabetes is a disease that affects your bodys ability to utilize glucose, it is important to understand what glucose is and how your body would normally cont rol it. Glucose is a monosaccharide (simple) sugar that comes from the aliment we eat, cells take in glucose from the blood and break it down for energy brain cells and red blood cells rely solely on glucose for fuel.The Pancreas-The pancreas (where Insulin is synthesised) has both endocrine and exocrine gland functions. The exocrine function involves the secretion of digestive enzymes that are secreted from acinar cells and released into the small intestine via a system of ducts.Additionally, the endocrine part of the pancreas consists of millions of clusters of cells called Islets of Langerhans that produce hormones. Within the islets there are four main cell types cells secrete glucagon, cells secrete insulin, cells secrete somatostatin, and PP cells secrete pancreatic polypeptide (9).Glucagon and Insulin are hormones secreted from the pancreas that work concomitantly to control the level of glucose in our blood. Glucagon is released when blood glucose levels fall, therefore re sulting in stored glycogen being converted to glucose and thus increasing blood glucose levels, preventing a hypoglycaemic state.Insulin is a hormone that causes cells to take up glucose from the blood and store it as glycogen, thus a deficiency or resistance of this hormone will result in a high concentration of glucose in the blood.Insulin Release-Beta cells release insulin via the following processThe glucose uptake takes place through with(predicate) a specific transporter protein called GLUT-2. The pancreatic ?-cell membrane contains several K+ channels, and two of them are directly involved, the K+-adenosine triphosphate channel and the maxi-K+ channel.The hyperglycaemia (high blood sugar level) accelerates the glucose uptake and metabolism and thus increases the ATP/ADP ratio.Increased ATP closes the K+-ATP channels, so the cell depolarises. During deploarisation from the normal resting membrane potential of -70 mV, a threshold is reached at 50 mV, resulting in the opening of Ca2+ channels.The Ca2+ influx triggers exocytosis of insulin and C-peptide containing granules following vesicular fusion with the cell membrane. ne.This process is demonstrated in the diagram below (10)However, in an insulin resistant individual normal levels of insulin that are released (via the process described above), do not have the same effect on muscle, adipose and liver cells, therefore resulting in glucose levels staying higher than normal.Increased levels of glucose in the bloodstream over a sustained length of time result in damage to blood vessels. Poorly controlled glucose levels can lead to complications such as nephropathy, retinopathy, neuropathy and cardiovascular diseases. Even though these complications may take a while to develop, it is important to realise that type 2 diabetes is often diagnosed at a relatively late stage.From looking at the pathophysiology of diabetes, Mrs Ws main symptom of lack of energy/tiredness can be explained. Due to her slow progres sion of insulin resistance means that more glucose remains in the blood and is not utilised by certain cells, such as muscle cells. Therefore, due to the fact that her cells are not able to use the glucose, she experiences flunk and tiredness. This lack of energy will progressively become worse and she may develop other complications if her diabetes is not controlled appropriately.Anaemia-Anaemia occurs when there is a subside in the level of haemoglobin in the blood and occurs when the production rate of red blood cells does not match the loss rate.It is a common condition in which all forms can be define on the basis of physiological mechanisms. There are three broad categories decreased/defective red blood cell production increased destruction of red blood cells and a mixture where both mechanisms operate simultaneously (11).Haemoglobin-Haemoglobin is a substance contained within red blood cells and is responsible for their colour. It is composed of haem (an iron-containing po rphyrin) linked to a protein, globin (12). Adult haemglobin consists of two and two globin bondage. The iron containing porphyrin in the haem group is bound to each globin chain and a ferrous atom that can reversibly bind one atomic number 8 molecule (as shown below (13).The biconcave shape of red blood cells enables a self-aggrandising surface area for the uptake and release of both atomic number 8 and snow dioxide. Haemoglobin becomes saturated with oxygen in the pulmonary capillaries where the partial pressure of oxygen is high and haemoglobin has a low affinity for oxygen (therefore, binds easily). group O is then released in the tissues where the partial pressure of oxygen is low and haemoglobin has a low affinity for oxygen (therefore, oxygen offloads easily).The haemoglobin molecule itself exists in two conformations, relaxed (R) and tense (T). The tense state is characterized by the globin units being tightly held together by electrostatic bonds when oxygen binds to th e haemoglobin these bonds are modify and broken, resulting in the relaxed conformation. The covert of one oxygen molecule leads to an increased affinity for the remaining hold fast sites, this is known as co-operativity, and is the reason for the sigmoid shape of the oxygen dissociation curve (below (14)).The binding of oxygen to haemoglobin can also be influenced by secondary effectors (as seen in the above image) i.e. hydrogen ions, carbon dioxide, and 2-3 diphosphoglycerate. The binding of 2, 3 DPG stabilizes the tense state and therefore, reduces haemoglobins affinity for oxygen (15). In conditions with lowered haemoglobin/oxygen levels, such as anaemia or hypoxia the concentration of 2, 3 DPG increases to raise oxygen availability for tissues.Haemoglobin Synthesis-Haemoglobin is synthesised in a series of complex steps, it takes place in the mitochondria of the developing red blood cells. The major rate limiting step is the conversion of glycine and succinic acid to ?-aminol aevulinic acid (ALA), this occurs via ALA synthetase. Two molecules of ?-ALA condense to form a pyrrole ring, called porphobilinogen. The pyrrole rings are then grouped together in fours, to form protoporphyrins. Iron is then inserted into the rings to form haem and then finally, haem is attached to the globin chains to form haemoglobin.Production and removal of red blood cells-Red blood cells are formed and develop in the red bone marrow of large bones the process by which they are produced is called erythropoiesis. The organ responsible for turning on the faucet of red blood cell production is the kidney. The kidneys can discern low levels of oxygen in the blood. When this happens, the kidneys respond by releasing a hormone called erythropoietin, which then travels to the red bone marrow to stimulate the marrow to begin red blood cell production. Within the bone marrow there are many stem cells from which red blood cells can be formed. As these cells mature, they extrude their nu cleus and fill with haemoglobin, forming reticulocytes which can circulate around the body. After 3/4 months, approx 120 days, red blood cells begin to weaken and their cell membranes become very fragile. The red pulp of the spleen allows mechanical filtration and removal of red blood cells, and any leftover components i.e. iron from the haemoglobin are recycled to form new red blood cells (16).There are several different types of anaemia such as B12 deficiency, iron deficiency, diseases of the bone marrow and in relation to Mr H, chronic loss of blood. His severe loss of blood has subsequently led to his anaemia as there is a mismatch in production of red blood cells and loss of blood. Due to his deficiency in circulating reticulocytes, oxygen, via haemoglobin is insufficiently supplied to his body, resulting in severe lack of energy. Complications of his condition have led to shortness of breath and angina.Angina Pectoris-Angina pectoris literally means a choking sensation in the chest?. It is an episodic pain that is usually felt in the centre of the chest, often radiating to the neck and left arm. Angina occurs because myocardial oxygen requirement is greater than what it is supplied with. This results in a buildup of metabolites, causing pain (17). mere angina occurs after exertion, excitation or emotion and is caused by insufficient oxygen supply to meet its demand however, the pain normally subsides with rest. Due to Mr Hs chronic blood loss, there is insufficient blood supply to the heart and subsequent stress is placed on the organ which has led to his angina.4. Psychosocial aspects of Illness and DiseaseThe uphold of chronic illness and disability is far reaching, extending beyond the patient to all those whom the individual has contact. Illness and disability affects all aspects of life, including social and family relationships, economic status, activities of daily living, and amateurish activities. Even though several factors influence the exte nt of impact, every illness or disability requires some adjustment to everyday life. The extent of the impact can depend on (18)The nature of the conditionIndividuals pre illness/disability personalityThe meaning of the illness to the individualIndividuals current life circumstancesThe degree of family/social supportWith reference to my patients, they each had different outlooks on their illnesses as mentioned previously. However, they do have certain similarities when considering the psychological aspect of their diseases. Both patients were shocked to find out their conditions as neither of them had expected to be diagnosed with a lifelong illness. This is known as biographical disruption, which is a key sociological concept as it identifies severe illness or disease as a major disruptive and unexpected experience.The illness/disease leads to a biographical shift from a sensed normal trajectory to an abnormal one, with the development of a new consciousness of the body, fragility of self and grief for a former life. For instance, Mrs W had future intentions to look after and care for her grandchildren and Mr H wanted to carry on working as a HGV driver but due to their conditions they cannot achieve these former life plans and now have to adapt to a new ones.Additionally, they both explained to me how they experienced the feeling of facing stigma. Stigma refers to the identification and recognition of a negatively defined condition, attribute, trait or behaviour in a person or group of persons (19) . There are different types of stigma, such as enacted or felt. Mr H explained how he felt shunned from his friends and some relatives which refers to enacted stigma the real experience of prejudice, discrimination and disadvantage as the consequence of his illness. Whereas, Mrs W spoke about her fear of being discriminated against and what people would think/say, which falls under a felt stigma a fear of enacted stigma, also encompasses a feeling of shame associ ated with being diabetic?.I feel that this notion of facing stigma is perhaps underestimated in health care because it is not necessarily something a Doctor would automatically think about and therefore, perhaps wouldnt advise the patient on how to deal with such feelings. However, from talking to my patients about how they feel about having an illness they both emphasize how psychologically disruptive it is, and how the feeling of being categorised as an ill individual has often led to depressive moods and anxiety. Therefore, from this experience I have learnt the importance of considering the patients thoughts and feelings rather than just focusing on how to treat their disease.Biological-psychosocial Model (Engel, 1977)-This is a model that incorporates psychological, sociological and biological factors in contribution to well being and health of an individual (20). It suggests that all three of these factors together and individually play an important role in relation to health and emphasises the importance of taking on a holistic approach when caring for a patient.The obvious factor of health is the biological factors of disease, the process of the disease and the individuals genetic make-up. Sociological factors include individuals family and friend support network as well as financial status and social class. Psychological factors include peoples disposition, their emotional status, whether they are stressed, depressed or anxious all contribute to ill health. From learning about this model it is important to note what factors affect a patient and how to deal with them accordingly when it comes to management and treatment of their disease.Both of my patients spoke of their psychological and social aspects and how they thought these factors had affected their illness. Mrs W, for example often felt quite depressed and lonely as she recently divorced her husband, and due to her illness often felt too tired to see her grandchildren. She also explained how s he felt useless?, as she would get tired grocery shopping and house cleaning and she would get frustrated with herself, which often made her feel worse. This highlights how illness can be affected by more than just a biological aspect, and as a Doctor it is important to recognize other factors that affect a patients life.In comparison to Mrs W, who quite openly spoke about her psychological and social problems, Mr H was much more reluctant to tell me how he felt about his illness and how it was affecting him. However, over time I felt that he became much more comfortable talking to me and we were able to build a good rapport. He later went on to explain how he felt he had to prevent a bravado about himself, being an ex army sergeant and that he was embarrassed that he often felt severely depressed and stressed about his worsening condition, but felt that by standing his ground and refusing investigation heMechanisms Of Granule Formation Pharmaceutical painsMechanisms Of Granule Fo rmation Pharmaceutical IndustryFor the production of solid oral dosage forms nearly fine pharmaceutical compounds require granulation to improve their flowability and processing properties prior to tabletting. http//www.pharmamanufacturing.com/articles/2008/096.htmlhttp//www.scribd.com/doc/6601180/Tablet-GranulationTablets are the most common drug dosage form today, and thus granulation, which allows primary powder particles to pose and form granules, is one of the most important unit operations in drug manufacturing. Understanding granulation grows more complex each year. This article reviews the most current methods and mechanisms of pharmaceutical granulation, including factors that can lead to improved control.Particle-bonding Mechanismsa) Adhesion and ropiness forces in immobile films. If sufficient liquifiable is present in a powder to form a thin, immobile layer, there will be an increase in contact area among particles. The bond strength between particles will increase, as the Van der Waals forces of attraction are proportional to the particle diam and inversely proportional to the square of the distance of separation 1.b) Interfacial forces in mobile liquid films. During wet granulation, liquid is added to the powder mix and distributed as films around and between the particles. There are three states of water distribution between particles. At low moisture levels, the pendular state, particles are held together by surface tenseness forces of the liquid/air interface and the hydrostatic suction pressure in the liquid bridge.ADVERTISEMENTOn Pharma BlogGet the latest abridgment and commentary on manufacturing and the drug industry at our editors blog. On Pharma looks at the drug industry with a special focus on manufacturing, which is coming into its own as a strategically important area.When all the air has been displaced from between the particles, the capillary state is reached, and the particles are held by capillary suction at the liquid/ai r interface. The funicular state represents an intermediate stage between the pendular and capillary states. Moist granule tensile strength increases about three times between the pendular and the capillary state. These wet bridges are, however, a prerequisite for the formation of solid bridges formed by adhesives present in the liquid, or by materials that discount in the granulating liquid.Solid bridges can be formed in two waysHardening binders. When an adhesive is included in the granulating solvent it forms liquid bridges, and the adhesive will harden or crystallize on drying to form solid bridges to bind the particles.Crystallization of change state substances. The solvent used to band the powder during wet granulation may partially dissolve one of the powdered ingredients. When the granules are dried, crystallization of this material will take place and the dissolved substance then acts as a hardening binder.c) Attractive forces between solid particles. In the absence of l iquids and solid bridges formed by binding agents, there are two types of attractive force that can operate between particles in pharmaceutical systems, electrostatic forces and Van der Waals forces. Van der Waals forces are about four orders of magnitude greater than electrostatic and add to the strength of granules produced by dry granulation.Mechanisms of Granule Formationa) Nucleation. Granulation starts with particle-particle contact and adhesion due to liquid bridges. A number of particles will join to form the pendular state. Further agitation densifies the pendular bodies to form the capillary state, and these bodies act as nuclei for further granule growth 2.b) Transition. Nuclei can grow in two achievable ways either single particles can be added to the nuclei by pendular bridges, or two or more nuclei may combine. The combined nuclei will be reshaped by the agitation of the bed. This stage is characterized by the presence of a large number of small granules with a fairly wide size distribution.c) lout Growth. If agitation is continued, granule coalescence will continue and produce an unusable, over-massed system, although this is dependent upon the amount of liquid added and the properties of the material being granulated 1.There are four possible mechanisms of ball growth, which are illustrated in Figure 1 3Coalescence. Two or more granules join to form a larger granule.Breakage. Granules break into fragments which adhere to other granules, forming a layer of material over the surviving granule.Layering. When a second batch of powder mix is added to a bed of granules, the powder will adhere to the granules, forming a layer over the surface and increasing the granule size.Abrasion Transfer. Agitation of the granule bed leads to the attrition of material from granules. This abraded material adheres to other granules.Granulation Methods4Dry Granulation. This requires two pieces of equipment, a machine for compressing the dry powders into compacts or flakes, and a mill for breaking up these intermediate products into granules. The dry method may be used for drugs that do not compress well after wet granulation, or those which are sensitive to moisture.Wet Granulation. In this method, the wet mass is forced through a sieve to produce wet granules which are then dried. A subsequent screening stage breaks agglomerates of granules. Organic solvents are used when water-sensitive drugs are processed, as an alternative to dry granulation, or when a rapid drying time is required. Because direct compressing is not the best technology for many active substances, wet granulation is still a preferred method. Even if the active substance is sensitive to hydrolysis, modern equipment (e.g., a fluidized bed) eliminates all problems in wet granulation 2.http//www.investopedia.com/terms/l/leptokurtic.aspDawar Qhoraish (k0920236) Nazmul Islam (k)IntroductionGranulation can be used toFor the production of solid oral dosage forms most fine pharmace utical compounds require granulation to improve their flowability and processing properties prior to tabletting. Method and Materials The experiment was carried out as explained in PY2020A practical booklet, without any amendments. Paracetamol (25g), lactose (265g) and sodium starch glycollate (2.945g) and PVP solution 15% (30ml) was used. 1 Erweka AR402 oscillating granulator with the finer sieve was used to granulate the drug without too much force with variables of turns (rpm) and time (minutes). The machine had an emergency switch off button and safeguard on top which turns off machine when you put your hand in. Sieve shaker used was Retsch A5 200 basic was used to separate the particles into different sizes by vibration with variables of amplitude and speed. The top sieve was fixed by parallel bars with screws and bottom of sieves contained rubber bands to control any overflow and stability. discussionModal Low so most particles are fine. (low) Relate to flow rate. Better flow rate.Small IQR-data close to each other.Positive skewness means more particles with finer particles, so flow rate is better.What Does Leptokurtic Mean?A description ofthe kurtosis in adistribution in which thestatistical value is positive. Leptokurtic distributions have higher peaks around the mean compared to normal distributions, which leads to thick tails on both sides. These peaks result from the data being highly concentrated around the mean, due to lower variations within observations.Limitations 7.9% MC was lost after 45 minutes in 75oC oven compared to 9.51% in 130oC heater balance. Tray was exposed to air for different amount of periods each time, errors as tray was allowed to cool down. Not dried properly Granulators normally used for large quantities. If lubricant used, particle size would be higher. Improvements More repeats, heat for long-life and at high temperature.

Pauls Ministry to Thessalonica Essay examples -- Bible Christianity R

The Apostle Paul was a traveling man. One must simply look at the various places where he preached and established churches to confirm this fact. The garners of Paul found in the canonical Bible establish connections with Rome, Corinth, Galatia, Ephesus, Philippi, Colossae, and Thessalonica. Paul was heavily involved with the formation of the church in the final location, a city now known as Thessalonki, and continued to support it through his letters. The church in Thessalonica dealt with much oppression and persecution during its formative years. That variety show of beginning contributed to much uncertainty in the young church, especially considering that Paul, its founder, was not always with them. Pauls ministry to the church can be found in the recordings of his initial visit to Thessalonica, found in Acts 17, and his subsequent letters, 1 and 2 Thessalonians. These sources show a minister trying to answer the questions of new converts dealing with persecution, the fleck com ing of Jesus Christ, and what their faith actually meant.The very beginning of the church in Thessalonica was bread in violence and persecution. According to the book of Acts and the apostles first letter to the Thessalonians, Paul and Silas first came into Thessalonica on the heels being beaten and imprisoned in Philippi. Despite such an event, Paul continued to preach once he arrived in the city. The author of Acts states that the apostle found a synagogue And Paul went in, as was his custom, and on three sabbath days argued with them from the scriptures, explaining and proving that it was necessary for the Messiah to suffer and to rise from the dead, and saying, This is the Messiah, Jesus whom I am proclaiming to you.1 Over several weeks, a diverse gro... ...nnotated Bible, new-sprung(prenominal) Revised Standard Version.4 1 Thessalonians 34, New Oxford Annotated Bible, New Revised Standard Version.5 Bridges, Linda McKinnish, 2 Thessalonians, Mercer Commentary on the Bible, (Ma con, Georgia Mercer University Press, 2005), 1247.6 2 Thessalonians 14, New Oxford Annotated Bible, New Revised Standard Version.7 Bridges, Linda McKinnish, 1 Thessalonians, Mercer Commentary on the Bible, (Macon, Georgia Mercer University Press, 2005), 1245.8 1 Thessalonians 415, New Oxford Annotated Bible, New Revised Standard Version.9 Bridges, 2 Thessalonians, 1249.10 Bridges, 1 Thessalonians, 1245.11 Ibid., 1245.12 Ibid., 1245.13 1 Thessalonians 515-22, New Oxford Annotated Bible, New Revised Standard Version.14 1 Thessalonians 217, New Oxford Annotated Bible, New Revised Standard Version.

Simon as Christ in Lord of the Flies Essay -- Lord Flies Essays

Simon as deliverer in Lord of the Flies The role of the prophet changes with the society in which he lives. In new(a) society, a prophet is a visionary, telling people what they can blend in in Biblical times, a prophet was the voice of God, telling his people what they had to become to fulfill their covenant with God. In William Goldings Lord of the Flies, the prophet is a peaceful lad, Simon. He alone saw that the jungle, which represented freedom and the lack of civilization, was not to be idoliseed but to be understood he alone knew that the mythical Beast of the island, feared by all the boys, was, in fact, their own inherent savagery. Through these truths Simon represents a Christ figure paralleling Christs misunderstood message and Christs death. Simon was the observant character, the quiet philosopher. He was often alone, sometimes by his own choice, and he liked to wander into the peaceful jungle. He sincerely cared about the other boys, sometimes helping the young o nes to fetch fruit, yet Simon turned away from them and went where the just perceptible path led him. before long high jungle closed in (56). He loved solitude and yet felt loneliness he was alien to the other boys. The boys did not mobilise anyone would be stupid enough to go into the jungle by night The assembly grinned at the thought of going out into the darkness. Then Simon stood up and Ralph looked at him in astonishment (85). Many of the boys even thought he was batty because he left the group to spend time alone. He did not fear the jungle, and he did not fear the Beast. Maybe, he said hesitantly, maybe there is a beast . . . maybe its only us (89). The Beast takes many forms in the boys imaginations once, t... ...The prefatory premise of Lord of the Flies is that human beings naturally live in savagery and ignorance, without any idea of how to live together. The most terrifying death in the novel is that of Simon, who symbolizes the eyes of a blind and stumbling grou p of children digressing into savagery. As Christ lived, so lived Simon, as Christ died, so died Simon. Each died because human nature hates prophets, because humans naturally live in savagery and ignorance. Comments You state that Simon knew the jungle represented freedom and the lack of civilization. However, in your paper you only prove that the other boys were triskaidekaphobic of the jungle while Simon was not. You need to tell us how Simon knew what the jungle represented, why he was not afraid. What makes him seek out the jungle for solitude? Why does Simon encounter when the other boys do not?