1.Women into senior management. Gender communication barriers Essay

1.Women into senior management. Gender communication barriers - Essay Example , from their colleagues also they do not receive a friendly approach rather their â€Å"work lives had been made intolerant by constant harassment.† In her work, Suppressed, Forced out and Fired: How Successful Women Lose Their Jobs, the Reeves (1951, 65) has remarked, while taking about tragic plight of women at workplaces, â€Å"Several of the women faced bullying and eventual termination from more than one job.† There are also various cases, where, â€Å"women were not technically fired or formally made redundant,† (Reeves, 1951, 65) and those victims have described their situation as â€Å"being forced out.† (Reeves, 1951, 65) Many people can argue that such incidents are mostly frequent in the developing nations. The author has studied cases of ten women and most of them were working in developed nations like UK or Australia. The truth behind such observation we understand not only from analysis of the author but also from our daily experiences. There is no denial of the fact that even in job scenario of the 21st century gender discrimination is a major issue and women are mostly victimized under the prevailing patriarchal atmosphere is the companies. Despite their talent, efficiency and commitment for the company, most often, women have to strive more in comparison with their male counterparts to reach the senior managerial level. Even after reaching such height, she cannot communicate with her subordinates properly due to gender communication barrier. According to the social scientists and psychologists basic features or behaviorist approach of a woman does not suit are not in accordance with modern work culture. Since the post globalization period, the private enterprises have expanded to a great extent and the work culture that is followed there, has also affected huge effect even over the public enterprises also. When a person is elevated at the managerial position he or she is supposed to fulfill a lot of job responsibility, managing and planning for his or

An investigation of public health responses to diabetes Essay

An investigation of public health responses to diabetes - Essay Example This results in increased amounts of sugar in the blood, causing complications usually involving the heart and kidneys. (Wikipedia, 2011) There are three main types of Diabetes. Type 1 Diabetes, or insulin-dependent diabetes, occurs when the pancreas fails to secrete insulin, thus the glucose taken in from food cannot be broken down. The result is a buildup of sugar in the blood that causes complications like kidney failure, retinopathy, heart failure, and hypertension. A patient with this condition requires artificial insulin to be injected regularly in order to control the blood sugar levels. Type 2 Diabetes, or non-insulin dependent diabetes, is similar. In this case, the pancreas is able to secrete small amounts insulin, but the body’s cells cannot receive it. The result is identical. The sugar builds up in the bloodstream, and causes the above complications. The third type is Gestational Diabetes. This occurs in pregnant women only. During pregnancy, the overworked body o f the mother is unable to secrete the excess insulin required, leading to increased blood sugar levels. Women with gestational diabetes are most likely to have large babies. Diabetes is caused by different factors. Obesity is a big predisposing factor. In obese persons, insulin is less able to facilitate the entry of glucose into the liver and adipose tissues. In addition, fat buildup presents a suitable environment for circulatory overload. As sugar builds up in the blood, the density and concentration gradient increases, making the blood thick and viscous. This prevents it from properly circulating around the body. And because the hands and feet are the furthest from the pump center, the heart, they receive the least amount of blood. Lack of nutrients from the blood kills the tissue surrounding the area. Eventually, the hand or food necrotizes, or dies, leaving amputation as the only solution. Not surprisingly, most amputees are a result of Diabetes Mellitus. Heredity also plays a big role. If one of your ancestors or family members had a health history of diabetes, you have more chances of acquiring it, and as you age these chances increase. In spite of all these, the principal factor is a sedentary lifestyle. When your body lacks enough exercise, the heart pumps less blood to the extremities, causing tissue death. (Black, 2001) Classic signs and symptoms of Diabetes are increased thirst, increased hunger, and frequent urination. The thirst occurs when the body mistakes the concentration of sugar in the blood for lack of water, thus it triggers the thirst center in the brain, causing the person to drink more water, which in turn causes him to urinate more. The hunger occurs because the cells cannot utilize the sugar and nutrients, causing them to â€Å"starve†. The body interprets this as lack of food; hence, the person eats more and more. Increase of blood sugar also affects the eyes. Absorption of glucose causes the lens to change shape, resulting in vision changes. The heart usually suffers the most. Because of an increased workload, the heart muscles grow, causing cardiomegaly. As this progresses, the heart, out of exhaustion and overwork, eventually gives up and stops pumping, causing heart failure, and death. Heart attacks are common in chronic high blood pressure. Kidney failure also occurs. The main job of the kidneys is to remove waste from the blood and return the cleaned blood back to the body. In diabetes, the high levels of sugar damage the nephrons, the

Comparative Essay Example | Topics and Well Written Essays - 750 words

Comparative - Essay Example This paper exemplifies various similarities and differences between â€Å"Drunken Master† and â€Å"Fist of Fury†. Firstly, both films are nationalistic and portray the Chinese masculinity. Nationalism and Chinese cinema have always been intertwined. â€Å"Fist of Fury† is situated at the period when China was recovering from degradations and humiliations in the hands of Japanese and other colonial powers. Lee acts as a strong Chinese man who confronts all humiliations and challenges and triumphs over them thus portraying his nationalism. Lee defeats Japanese clearly indicating the triumph of Chinese martial arts over external forms and illustrates how customary martial arts were deeply ingrained in Lee. Additionally, Lee’s triumph and devotion to defending the society is depicted when he uses his Chinese martial arts skills to defend and protect his community against external interference, a factor that further indicates the role that men were supposed to play in the traditional Chinese community. While many analysts document Lee’s nationalism as hugely controversial and th e entire process of defining who a Chinese is as multifaceted and dubious, Lee’s character embodies a Chinese who is anti-Japanese and the avenge against the slaying of his master portray the antagonism that existed between Chinese Nationalists and the ‘others’, typically represented by Japanese villains (Louie, 92). Similarly, in the â€Å"Drunken Master†, the nationalistic spirit and Chinese masculinity are featured through the character of Jackie Chan. Chan, despite being dreadful of Chinese martial arts, is forced to train in it which later enables him to defend his father against being butchered by Yan Ti San who was hired by a business opponent to kill Chan’s father. Chan was to be trained by Beggar who is legendary for crippling students when training. When Chan finds it hard to survive in Beggar’s school, he leaves for Drunken Master’s school and learns

An investigation of public health responses to diabetes Essay

An investigation of public health responses to diabetes - Essay Example This results in increased amounts of sugar in the blood, causing complications usually involving the heart and kidneys. (Wikipedia, 2011) There are three main types of Diabetes. Type 1 Diabetes, or insulin-dependent diabetes, occurs when the pancreas fails to secrete insulin, thus the glucose taken in from food cannot be broken down. The result is a buildup of sugar in the blood that causes complications like kidney failure, retinopathy, heart failure, and hypertension. A patient with this condition requires artificial insulin to be injected regularly in order to control the blood sugar levels. Type 2 Diabetes, or non-insulin dependent diabetes, is similar. In this case, the pancreas is able to secrete small amounts insulin, but the body’s cells cannot receive it. The result is identical. The sugar builds up in the bloodstream, and causes the above complications. The third type is Gestational Diabetes. This occurs in pregnant women only. During pregnancy, the overworked body o f the mother is unable to secrete the excess insulin required, leading to increased blood sugar levels. Women with gestational diabetes are most likely to have large babies. Diabetes is caused by different factors. Obesity is a big predisposing factor. In obese persons, insulin is less able to facilitate the entry of glucose into the liver and adipose tissues. In addition, fat buildup presents a suitable environment for circulatory overload. As sugar builds up in the blood, the density and concentration gradient increases, making the blood thick and viscous. This prevents it from properly circulating around the body. And because the hands and feet are the furthest from the pump center, the heart, they receive the least amount of blood. Lack of nutrients from the blood kills the tissue surrounding the area. Eventually, the hand or food necrotizes, or dies, leaving amputation as the only solution. Not surprisingly, most amputees are a result of Diabetes Mellitus. Heredity also plays a big role. If one of your ancestors or family members had a health history of diabetes, you have more chances of acquiring it, and as you age these chances increase. In spite of all these, the principal factor is a sedentary lifestyle. When your body lacks enough exercise, the heart pumps less blood to the extremities, causing tissue death. (Black, 2001) Classic signs and symptoms of Diabetes are increased thirst, increased hunger, and frequent urination. The thirst occurs when the body mistakes the concentration of sugar in the blood for lack of water, thus it triggers the thirst center in the brain, causing the person to drink more water, which in turn causes him to urinate more. The hunger occurs because the cells cannot utilize the sugar and nutrients, causing them to â€Å"starve†. The body interprets this as lack of food; hence, the person eats more and more. Increase of blood sugar also affects the eyes. Absorption of glucose causes the lens to change shape, resulting in vision changes. The heart usually suffers the most. Because of an increased workload, the heart muscles grow, causing cardiomegaly. As this progresses, the heart, out of exhaustion and overwork, eventually gives up and stops pumping, causing heart failure, and death. Heart attacks are common in chronic high blood pressure. Kidney failure also occurs. The main job of the kidneys is to remove waste from the blood and return the cleaned blood back to the body. In diabetes, the high levels of sugar damage the nephrons, the

Odysseus vs Rama Essay Example for Free

Odysseus vs Rama Essay Two exciting epics that are widely read and well-known across the globe hold many likenesses between the heroes. The Odyssey by Homer and The Ramayana by Valmiki, tell the tales of two heroes who hold many similarities between them even as their stories differ. Both poems are epics because their heroes are great men, well-known to their worlds, both suffer long difficult journeys, and both are aided by as well as taunted by gods and goddesses of their religions and cultures. But in the end both men overcome great tragedy and catastrophes to rightfully rule as kings of their own lands. Odysseus and Rama were both strong warriors of great stature. Athena speaks of Odysseus to his son and calls him â€Å"a mighty man† (Homer, Odyssey, Book I,p. 7). Griffith describes Rama as â€Å"Tall and broad-shouldered, strong of limb,† (Griffith, Book I, stz. 1) who has â€Å"†¦massive jaw and ample chest† and â€Å"strong arms reach below his knee† (Griffith, Book I, stz. 1). Throughout the story these men both are challenged and use their great strength of the warrior to defeat their challengers. Odysseus is challenged by the sea many times and with great strength survives the power of the sea against him. In the house of King Alcinous he describes many a plight where he fought against the drowning waves and the storms of Poseidon. â€Å"†¦. Zeus with white bolt crushed my swift ship and cleft it in the midst of the wine-dark deep†¦. I clung with fast embrace about the keel of the curved ship, and so was I borne for nine whole days†¦. † (Homer, Osdyssey, Book VII, p. 105). Only a man of great strength and endurance could cling in the moving waters for nine whole days without fail. Then, against Poseidon’s enormous waves, Odysseus later survives a storm at sea by swimming through the forcible waves to reach land. For Poseidon, shaker of the earth, stirred up the same, who roused against me the winds†¦. Thus the storm winds shattered the raft, but as for me I cleft my way through the gulf yonder†¦. † (Homer,Odyssey,1950, Book VII, p. 105). Odysseus exhibits godly strength against the seas and her challenges. Rama displays an unconquerable stamina in Griffith’s epic. Rama slays a giant to gain the friendship of Agastya but this leads to his being attacked by the giantess Surpanakha and her three sisters. Still they are no match for Rama as â€Å"†¦. they and myriad fiends beside Beneath the might of Rama died† (Griffith, Book I stz. ). Both heroes are challenged by enormous odds and yet both are victorious proving stout strength and stamina above all other men. However, physical strength is not the only weapon these heroes wield. Cunning and strategy play an important role in defeating more powerful enemies. Odysseus exhibits such mental strength against Cyclops when he helps his companions to escape the Cyclops’ cavern. Odysseus devised a plan to deceive Cyclops and in his cunning is even smart enough to predict Cyclops’ call for help from his brethren. And in knowing this, he tells Cyc lops his name is â€Å"Noman. Thus does Cyclops call out for help after Odysseus blinds him with the torched end of a stake and cries â€Å"My friends, Noman is slaying me by guile, nor at all by force† (Homer,Odyssey,1950, Book IX, p. 137-8). Thus his friends who thought â€Å"no man† was assaulting their brother determined his suffering to be a sickness sent by Zeus and bade him to call upon his father Poseidon for help and went their ways. Odysseus further exhibits his craftiness when he devises a plan of escape. When Cyclops is blinded, he sets himself before the cave entrance with arms wide to prevent the men’s departure through the cavern mouth. However, Odysseus is more clever than he and fastens three sheep together across and ties a man beneath the middle one’s underbelly. For himself he hangs on beneath the magnificent ram until sunrise when they are allowed through the mouth of the cavern by Cyclops out to pasture to graze. Once far from Cyclops Odysseus comes out from under his ram and then unfastens his men, and they are all able to escape. By their hiding beneath the sheep, Cyclops only felt the fleece and thereby allowed the men to pass through. This is a grand display of cunning. Rama also portrays some semblance of intelligence when he chooses his allies against the demon king, realizing that he can win their loyalty by defeating their enemy and convincing the king of the monkeys that they share a suffrage because they both have been banished from their homelands, Rama is able to convince the monkey army to come to his aid (Griffith, Book I, stz. 1) . â€Å"Who, knowing all the tale, before The sacred flame alliance swore. Sugriva to his new-found friend Told his own story to the end: His hate of Bali for the wrong And insult he had borne so long. And Rama lent a willing ear And promised to allay his fear† (Griffith, Book I, Stz. 1). With his crafty ways, Rama knew since he had slain the object of Sugriva’s , the monkey king’s, hatred, that he would be allied at once with the monkey armies. This was his key to finding his wife, Sita, and rescuing her. Odysseus and Rama were both intertwined with the deities of their cultures. Odysseus had the help of Athena throughout his entire trip home after the war in Troy and his exile with Calypso on her lonely island where he was a kept man by the goddess (Homer, Odyssey, Book I, p. ). Athena bodes Zeus â€Å"O father†¦. if indeed this thing is now well pleasing to the blessed gods, that wise Odysseus should return to his own home, let us then speed Hermes the Messenger†¦. to the island of Ogygia. There with all speed let him declare†¦. our unerring counsel, even the return of the patient Odysseus, that so he may come to his home† (Homer,Odyssey,1950, Book I, p. 3). If not for Athena’s plea and reminder to Zeus, Odysseus would have remained with Calypso forever. But Athena provides further assistance and stays beside Odysseus along the way. She is with him when he travels to the house of King Alcinous and tries to protect him and to guide him. â€Å"At that same hour Odysseus roused him to go to the city, and Athene shed a deep mist about Odysseus for the favour that she bare him, lest any of the Phaeacians†¦. should meet him and mock him†¦. † (Homer,Odyssey,1950, Book VII, p. 97). And disguised as a maiden she journeys with him home on the ship and stays until he has defeated his wife’s wooers who have consumed the spoils of his home. She lends her assistance when needed such as when she cloaked Odysseus and his son and his men in darkness so that they may leave the town to come back to defeat the wooers in battle. Athena provides even more aid as she convinces his son Telemachus to search for his father and to bring him home. She also gives him advice such as having his mother hide Odysseus’ bow that no man can string other than Odysseus, foreseeing the contest to prove his identity later after his journey (Homer,Odyssey,1950, Book II, pp. 25-7). Rama himself is a god although he does not know this. He is the born human entity of the god Vishnu Narayana who has a premeditated plan to take human form and then to defeat the demon god, Ravana hated by all supernatural gods and goddesses alike. But it is not until the end of his epic journey that Rama remembers that his true essence is the god Narayana (Griffith, Book I, stz. 19). This is unlike Odysseus who was favored by the gods and knew of their help and their interest in him as he bore them many sacrifices in return. One such sacrifice being in the cave of the Cyclops as they awaited his return from shepherding his flock. â€Å"Then we kindled a fire, and made burnt-offering†¦Ã¢â‚¬  (Homer,Odyssey,1950, Book IX, p. 132). Such offerings are made throughout the story before and after challenges are met. Once the Cyclops was defeated, Odysseus took the best ram for offering â€Å"†¦the ram for me alone my goodly-greaved company chose out, in the dividing of the sheep, and on the shore I offered him up to Zeus†¦. and I burnt the slices of the thighs. † (Homer, Odyssey,1950, Book IX, p. 142). From this a conclusion could be drawn: it is expected of a hero to make offering to the gods who find favor with him. Likewise, Rama shows respect to the gods and his father, King Dasaratha, when he unfailingly responds to their commands without question. When asked by Queen Kaikeyi if he promises to honor his father’s vow and do his bidding, Rama replies, â€Å"I, at the bidding of my sire, Would cast my body to the fire, A deadly draught of poison drink, Or in the waves of ocean sink: If he command, it shall be done,My father and my king in one† (Griffith, Book II, stz. 8). Rama leaves for his banishment without delay and without question to honor his father’s vow to Kaikeyi. He meets his challenges without hesitation and follows what the Indians name â€Å"dharma†, the will of the gods (Brockington, 1984, p. 33) or what the Greeks refer to as fate, a story of life darned out by the Muse (Homer, Iliad, 1950, p. 175). Both epics contain heroes who follow their dharma or fate without question and praise and honor their gods. It is when the heroes anger or disrespect the gods that evil befalls them. For example, when Odysseus tells king Alcinous how he injured Cyclops and this angered the creature’s father, Poseidon who aided Cyclops as he attacked the ship with hilltop and large boulder causing waves to drive the ship back to shore. (Homer, Odyssey,1950, Book IX, p. 141-2). Or when Rama slays the giant and angers the demon king Ravan, because Rama is vigilant in his respect to the gods, he overcomes the challenges brought before him when his wife is stolen from him. Rama is the example of true dharma and a great hero to the Indian religion of Hindu. Brockington, 1984, p. 8). Odysseus and Rama both face a great journey and banishment. Odysseus takes twenty years to return from the battle of Troy and suffers many hardships along the way that detain him from reaching his homeland for which he desires. One such suffering be at the hands of Calypso on the Isle Ogygia for seven years where she forced his stay as he had no means by which to depart until Calypso was bade by the gods to sent him adrift on a raft (Homer, Odyssey,1950, Book V, pp. 74-75. Among these misadventures that halted Odysseus’ return, was the Isle of the Lotus-Eaters, where the men ate of the Lotus which made them lose their desire to continue their journey home, and the Sirens who attempted to attract them to their own deaths (Homer, Odyssey, Book IX, p. 128-130). The Odyssey is the story of Odysseus’ journey home once he has befallen these challenges after the War of Troy. This journey takes more time as he meets hardships mostly set upon him by Poseidon, who â€Å"†¦. saw Odysseus as he sailed over the deep; and he was mightily angered in spirit†¦. (Homer, Odyssey, Book V, p. 79) and reveals â€Å"it must be that the gods at the last have changed their purposes concerning Odysseus†¦. But methinks that even yet I will drive him far enough in the path of suffering† (Homer, Odyssey, 1950, p. 79). Thus another journey begins and Odysseus is troubled once again, taking a total of twenty years before he reaches his homeland. If not for Athena’s aid and the aid of the other gods, Odysseus would not have been successful. Rama is also taken from his homeland. On the eve of his preparations to take over the throne for his father, one of his father’s other wives, Queen Kaikeyi , to whom King Dasaratha owes two vows as she had saved his life previously, beseeches the king to throne her son, Bharat and exile Rama for fourteen years to the forest. â€Å"These rites in Ramas name begun Transfer them, and enthrone my son. The time is come to claim at last The double boon of days long-past, When Gods and demons met in fight. And thou wouldst fain my care requite. Now forth to Dandaks forest drive Thy Rama for nine years and five, And let him dwell a hermit there†¦. (Griffith, Book II, stz. 11). With these words Kaikeyi reminds Dasaratha of his promise to her when she saved his life by caring for a fatal wound. She then asks for her son to be throned without challenge from Rama and also that Rama be exiled for fourteen years to live as a hermit in the forest. Kaikeyi only does such a greedy act because her maid Manthara has convinced her that horrible tidings await her future and that of her son if Bharat does not take the throne and Rama is enthroned (Griffith, Book II, stzs. -8). Still, honoring his father’s lamenting bid, Rama departs, ready to make a life anew with his wife and his one half-brother, Lakshmana (Griffith, Book II, stz. 19). As did Odysseus, so did Rama face many sufferings once he left in exile and his journey was not yet over. Sita, his wife, is stolen from him while he is away. Thus Rama, takes on the tasks of allying with the monkey armies to have aid in finding and saving his beloved wife. Then he faces Ravan, the demon king, to save her (Griffi th, Book IV, V, VI). Odysseus’ and Rama’s stories both reveal the importance of a warrior’s weaponry and strength in their respective cultures. When Odysseus returns home, with the deviousness of Athena, he and his son and wife, Telemachus and Penelope, devise a contest to prove his identity so that Odysseus may overtake his kingdom of Ithaca once more. Whosoever can string Odysseus’ prominent bow will have Penelope for his wife and all the kingdom of Odysseus for his own. So does Penelope set the bow and quiver before the wooers. And one by one they attempt to string Odysseus’ mighty bow. But none can accomplish this feat. Once Telemachus convinces the wooers to let the beggar who is his disguised father attempt the feat, â€Å"†¦. Odysseus straightaway bent the great bow, all without effort, and took it in his right hand and proved the bow string, which rang sweetly at the touch, in tone like a swallow â€Å" (Homer, Odyssey, 1950, Book XXI, p. 336). All at once he revealed his true identity and all was lost to the suitors of his wife.

Singapore Airlines: Business, Marketing and Operations

Singapore Airlines: Business, Marketing and Operations This paper study is based on Singapore Airlines (SIA), in this case study the project has discuss about the SIAs Business, Marketing and operational strategy, what are the changes is the SIAs facing in future, how this airline company has changed its strategy and how this airline from a small country-state with a population of about three million people, on an island no larger than the Isle of Man, earn a reputation for being the most constant money-making airline in the world, in spite of the various world-wide recessions. The paper study also discuss about, how the Singapore Airline retained employees and the customers. QUESTION 1: Evaluate SIAs Business, Marketing and Operational Strategies and assess their effectiveness in relation to the competition? Over the last decade Singapore Airline has grown from a local airline into one of the worlds leading passenger and cargo carriers. In an attempt to survive, many of the organization which is working in the same business tried to observe and investigate the approaches or strategy which are using by Singapore Airlines (SIA, 2007). Finally it became clear and understandable that SIA are more competitive because of its business and operations strategy. The long term growth of a business design to provide and maintain shareholder value is called the business strategy. So, this part of the paper contains the business, market and operation strategy of Singapore Airlines. As we all know the SIAs has developed a status for being an industry innovator as well as doing things in a different way than its competitors who are in the same industry line, for example, As the study says SIA was the first airline to introduce free drinks, a choice of meals and free headsets back in the 1970s. Not only this, the Singapore airlines are the first who start a two year programme to install Kris World, that is a new in-flight entertainment scheme, for passengers in all three classes of its Megatop B747s. KrisWorld provides around 22 channels of video entertainment, around twelve digital audio channels, around ten Nintendo video games (Nintendo was best known for console industry and famous for home video game), and always alert the destination information and provides a telephone at each seat. By using this innovative ideas and creativity techniques the SIAs has done wonder in this airline business and earn a reputation for being the most consistent money-making airli ne in the world. Not only this, SIAs has done many changes in the history of airline and they provide numerous innovative ideas and doing things differently than its competitors. SIAs is the one who spend lot of millions in order to install KrisWorld movies; by doing this they had given an amazing entertainment to their customers while traveling and this lead to make them a different from their competitors and by adding this KrisWorld they are the first one to do so and this types of strategy help them a lot in becoming a number one in these business. SIA is the first in the market for discoverer and performer of the mostly innovative live teletext news service (KrisNews) and also for an interactive in-flight shopping service for its aircrafts. These creative and innovative developments by SIA, eventually won numerous awards for the best air lines. SIA was the first airline which bought a collection of finest chefs from all over the world to serve best in-flight cooking for its passengers as well as it was the first airline which tried to accomplish the wants of individual passengers by launch the special meal service with lighter and better options plus the unique in-flight meal service which is specially introduced for young flyers and enabled them to choose their desired meals up to 24 hours before the flight departure. Besides that, SIA started to update its menus monthly and even weekly to create an impression among its frequent travelers and also to keep track of flyers tastes. These were the main line of attack for SIA to compete among its competitors in the market and also to shore up its business strategy1. The main success of SIAs is Singapores Changi airport, Changi is situated in eastern end of the Singapore. Changi airport is one of the world busiest airport QUESTION 2: Using change management models evaluate how the company has changed; in strategic terms. QUESTION 3: What challenges is SIA facing in the future. What should SIAs business and operations strategies be for the future and why? Provide justification for your recommendations. As we know that SIAs is the one of the leading airport in the world but due to the large number of competitors in the world. SIAs have to maintain their top ranking in the future by maintaining their operations and business strategy and by developing more innovative ideas. The challenges which a SIA facing in future is mainly due to their competitors, as we all know in airline business the profit is very less and its mainly because of growing airline industry, passengers have many choices to select the low fare flight, so they must provide the better facility in a lower price that may affect their capital turnover. Recession is also the one of the factor for affecting then in future. Like in recession, there is a reduction in number of fliers. In future there is my advance airplanes/crew because of the competition and so the availability of the best crew is very important. There are more challenges that airline industry is facing like escalating costs and stiff competitions. As this part of the paper contains that which type of business as well as operations strategies should SIAs makes for their future and which makes them different from there competitors. Before going to this we must know about the operations strategy, operations strategy is the total guide of decision made the management which leads to the long-term growth for any type of operations, it is the long term process. Basically operations strategy is the method or tools that help us producing goods and services to the consumers. Operations basically deal with the producing or delivering of goods. This paper study discuss the competitive strategies of Porter, In 1980s Porter has argued that there is two types of competitive advantages which can be shared with either a broad or narrow competitive scope to create four well known business strategies: 2 Cost leadership, Differentiation, Focused low-cost, and Focused differentiation The Porters four competitive strategies are shown in table below:- Competitive Advantage Lower Cost Differentiation Cost leadership Differentiation à ¯Ã†â€™Ã… ¸ broad target Low cost focused Focused differentiation à ¯Ã†â€™Ã… ¸ narrow target Cost leadership technique or strategy is normally used by the companies for generally generating the profit even though the low price of the product or the services offered. In this strategy company mainly focused on the decreasing of price and retaining their old customer and generating the new one, so by applying this rule to the airline business SIAs have to take some initiative for lowing there prices in spite of that providing the full facility to their passengers. By doing this the SIA is always be a head from its competitor in present as well in future because doing this the high, medium and even low class passenger get attractive towards it and SIAs will make even more profit than earlier. Differentiation strategy, in this strategy a companys offers a service that consumers perceived it as a different and ready to pay a high amount or cost for that. So, SAI have to innovate some new facilities like new entertainment programs while travelling and some advance technology features with some extra cost, and it must be different as well as a new thing for passengers so that they are ready to pay a high amount for it. Or do offering the old facilities but offered it in that manner that passengers are ready to pay a high amount. This type of innovation or creativity make them different from there competitor and good for future also. Focus Differentiation strategy focus on a narrow sector and within that sector, they are attempting to achieve either a price advantage or differentiation. The principle is that the sector which is focusing must be better served by entirely focusing on it. So, SIAs must use this strategy for be a top in their business by focusing in a small small sector and offered better services to the passengers and then they will definitely be a head in the airline business. Reflection on Career Goals: Becoming an Ophthalmologist Reflection on Career Goals: Becoming an Ophthalmologist 1. Please provide evidence of activities and achievements which demonstrate your commitment to a career in this specialty and/or which have led to the development of skills relevant to a career in this specialty.(250 words) My inspiration for becoming an ophthalmologist stemmed from working in DARUL-HIKMAT DARUL-SHIFA, a charity eye hospital in Pakistan, which I have attended biannually since first year in medical school. There I observed how a small procedure brings a remarkable improvement in the quality of a patients life. Out of my own interest, I undertook 2 ophthalmology electives. I was privileged to observe practice on an incredible elective at MOORFIELDS EYE HOSPITAL. It was a great experience and further motivated me to become ophthalmologist. I achieved Distinction in Ophthalmology during my MBBS. As a Foundation year doctor, I regularly attended eye clinics and theatres in my free time. I did a week of a TASTER SESSION and managed to arrange a SPECIAL MODULE in ophthalmology during my GP rotation. I have made several international presentations and have published in peer reviewed journals. I have excellent hand to eye coordination and dexterity. I am competent in Objective Subjective Refraction. The combination of medicine and surgery, along with the variety of cerebral and fine motor skills necessary has drawn me to the specialty. It is the only specialty that has satisfied me to practice medicine at the highest level. Sight is the most valued of senses for many people, and to be in a position to improve and restore sight, as well as prevent eye disease, gives me great pleasure. I am a dedicated, hardworking, and energetic person. In addition, I have passed RCO exams and my experience in ENT, neurosurgery, diabetics and oncology make me a great candidate. 2. Please provide details of outstanding achievements outside the field of medicine. (250 words) I have regularly arranged clinical courses for the junior doctors and GP since 2008. The courses consist of â€Å"ECG interpretation day† â€Å"Pain Management Course† â€Å"Eye ENT day†. This involves a great deal of organizational and managerial skills. This has also given me experience of developing a successful business plans and dealing with the finances, which will be very beneficial for me, in the future, to set up new services in the NHS. Following additional demand, I have setup a company with a name of AR MEDICS to organise courses more widely. We won the first prize of  £5000 in South Asian Federation (SAF) Quiz competition, 2004. As Sports Coordinator at Medical College, I reformed the Sports Society and wrote its new rules and regulations. For the first time in its 25 year history, I arranged sports fixtures with other universities and introduced new sports. This improved college sports reputation remarkably. I was the captain of the basketball team and was awarded â€Å"Colours†. I learned to cope under pressure and improved my leadership decision-making skills. I enjoy hiking mountaineering. I have hiked up to the base camp of Nanga Parbat- the worlds 7th highest peak- and won first prize. 3. Clinical Audit: What experience of clinical audit do you have? Please state clearly where and when this was undertaken and indicate specifically your role. (250 words) â€Å"Evaluation of Glaucoma Management Services† M Amjad, R Job, S Walker. 01/02/2009 at Leighton Hospital. I initiated the study and formulated the pro-forma and collected data, which was presented in the Divisional Audit Meeting. I made recommendations to improve the system. I then re-audited to complete the cycle of the audit.. My material was later presented as poster at the Royal College of GP Annual Congress Nov 2009. A pilot Glaucoma care pathway was initiated from my recommendations., and Glaucoma Medisoft was installed to document and print clinic letters instantly. Improved documentation was made available for the GP ‘Management of Eyelid CA M. Amjad, S Raja. 01/09/2008 at Blackpool Victoria Hospital. Once again, I initiated the literature research, formulated a pro-forma, collected data, and analysed it. I presented this in the departmental audit meeting. â€Å"An Audit of Ophthalmology Emergencies presenting in AE† M Amjad, W Khan. 30/03/2007 at Blackpool Victoria Hospital. I researched the literature, formulated a pro-forma, collected, and analysed data. My conclusions were presented in the Divisional Audit meeting. â€Å"Management of Corneal Abrasion in AE† M Amjad, W Khan. 01/04/2007 at Blackpool Victoria Hospital. Again, I researched literature, formulated the pro-forma, collected, and analysed data, all for a presentation in the Divisional Audit meeting. Guidelines from Kings College Hospital have now been taken up inn the AE department. Management of Gastro-oesophageal CA six years audit† M Amjad, MU Javed. 01/03/2007 at Blackpool Victoria Hospital. I researched literature, formulated a pro-forma, collected, and analysed data. A presentation was made at the North West Regional Meeting for Upper-GI Carcinoma. â€Å"Major Limb Amputation, Environmental Study† M. Amjad, MU Javed, G Riding. 01/06/2007 at Blackpool Victoria Hospital. I designed pro-forma, reviewed literature, collected and analysed data for a presentation in the Divisional Audit Meeting. 2. Managing Teams: Please provide evidence of leadership skills, managing and/or working in teams. You may give examples from both inside and outside medicine. (250 words) I was elected as a Sports Coordinator at Medical College in my final year, which was a great honour and position of responsibility. In order to make this successful, I needed a good team and representatives from each year, whom I appointed. Working through the team and using my leadership skills, I was able to make significant changes. I reformed the Sports Society and devised its rules and regulations. For the first time since its foundation, I arranged fixtures with other universities and introduced new sports. I took on board ideas from team members and organized sponsors and a concert to generate funds. Our efforts improved the colleges sports reputation. This was because of the good management, delegation of responsibilities to team members and proper use of the recourses generated. I also captained the basketball team and was awarded â€Å"Colours.† This experience not only improved my team working and leadership skills, but also improved my ability to perform under pressure and make clear decisions. 5.Teaching Experience: What experience do you have of delivering teaching? (250 words) I have attended the â€Å"How to Teach Course†, in order to learn new teaching skills and develope a methodology. I have been regularly organizing and coordinating a full day study course for junior trainee doctors and GPs on â€Å"ECG interpretation† â€Å"Pain Management† ‘Eye and ENT day since 2008. The feedbacks has been excellent and the courses are very popular. I regularly delivered formal lectures to foundation and AE doctors on the use of slit lamp and management of acute eye problems. The feedback has always been good and higher than that given to my peers. I organized formal teaching and mock OSCE for final year Manchester medical students. In addition, I regularly present and attend the weekly regional teaching to keep up-to-date with advances within the specialty. My written feedbacks from the sessions have been very encouraging. I enjoy teaching and endeavour to continue it. 6. Research: Please provide evidence of research whether past or in progress. If you have undertaken or are undertaking a research project, please give details and indicate your involvement. (250 words) I worked as a junior Research Fellow Gastroenterology under Prof M Umer in Holy Family Hospital. I was involved in two projects, both presented as poster and also published â€Å" CHRONIC HEPATITIS-C RESPONSE TO ANTI-VIRAL COMBINATION THERAPY† A prospective study of 200 patients. The objective was to study the response of chronic hepatitis-C patients to combination antiviral therapy. I reviewed the literature, collected and analyzed data using SPSS. The results showed that combination therapy with interferon and ribavirin for CAH-C helps to treat the disease as well as to improve the symptoms of the patients. â€Å"SYMPTOMATOLOGY OF CHRONIC HEPATITIS-C† A case control study involving 1000 patients. The purpose was to study the common symptoms in patients with Chronic Hepatitis-C. I formulated the pro-forma, collected data and analyzed using SPSS. This was my first experience in research. Moreover, it was presented internationally. It gave me a lot of confidence and motivation. I learned the skills needed to search the literature, design a research project and to statistically analyze the results. It also improved my communication and presentation skills. Recently I was involved in two small studies and presented them as poster in RCO annual congresses. They are â€Å" The Impact of GDX in the management of new glaucoma referrals† and â€Å"Post-operative ocular complications after acoustic neuroma surgery† 7. Additional Achievements: Please note any prizes, awards and other distinctions (include specialty and qualifying distinction) which you may have. Please indicate undergraduate or postgraduate award, the awarding body and date awarded. (250 words) Grade A+ in MBBS Examinations, Rawalpindi Medical College, Jun 2005 Distinction in Ophthalmology (MBBS Exams), Rawalpindi Medical College, Apr 2004 Distinction in Forensic Medicines Toxicology (MBBS Exams), Rawalpindi Medical College, Jan 2001 Awarded Gold Medals for best in academics, Education Board, Jan 2000 Won Merit Scholarship for 5 years, Education Board, Jan 1999 8. Presentations: In this section please provide details of your most relevant presentations at local level (state whether departmental, hospital or trust). Please give a statement about your personal contribution to the work. (250 words) I have initiated these projects and presented the using PowerPoint at different meetings. Morbidity and mortality meeting. Presented in divisional meeting. 2009 â€Å"Negative dysphotopsia: Long-term study and possible explanation for transient symptoms.† Oral presentation in Journal Club, Leighton Hospital 2008. â€Å"Management of Eyelid CA† M. Amjad, S Raja Presented in departmental audit meeting in Sept 2008 â€Å"Major Limb Amputation, Environmental Study† M. Amjad, MU Javed, G Riding Presented in departmental audit meeting in Jun 2007 â€Å"An Audit of Ophthalmology Emergencies presenting in AE† M Amjad, W Khan Presented in departmental audit meeting in Apr 2007 â€Å"Management of Corneal Abrasion in [emailprotected] Amjad, W Khan Presented in trust annual review meeting in Mar 2007 â€Å"Management of Gastro-oesophageal CA six years audit† M Amjad, MU Javed Feb 2007 9. Presentations: In this section please provide details of your most relevant presentations at regional and/or national level. Please give a statement about your personal contribution to the work. (250 words) I have initiated, written and presented the following work. â€Å"Patient with previously undiagnosed Autoimmune Hypophysistis (AH) presenting with bilateral recurrent cystoid macular oedema secondary to Intermediate uveitis.† M. Amjad, A Sachdev, V Kotamarhi Submitted for Poster presentation at Royal College Ophthlmology Annual Congress, 2010. â€Å"Post operative complications affecting eyes after acoustic neuroma surgery.† A. Garrick, M. Amjad, I Marsh, C Noonan. Submitted for Poster presentation at Royal College Ophthalmology Annual Congress, 2010. â€Å"Restructuring and Innovating the Glaucoma Services. Role of Primary and Tertiary Care.† M. Amjad, R Job, A Asghar, S Walker. Poster presentation at Royal College of GP Annual National Conference, Glasgow, 2009. â€Å"The impact of GDX in the management of new glaucoma referral.† M. Amjad, R Job, S Walker Poster presentation at North of England Ophthalmology Society, Allensford UK, June 2009. â€Å"Patients perspective of new Intra-vitreal Anti-VEGF treatment† V. Kotamarthi, M. Amjad Poster presentation at Royal College Ophthalmology Annual Congress, Birmingham 2009. â€Å"Chiari malformation with the symptom of photopsiae as the only ocular symptom and no ocular signs.† M. Amjad, V. Kotamarthi Poster presentation at The 10th Congress of International Ocular Inflammation Society, Prague. May 2009 â€Å"Value of Ultrasound in detecting pathology in vitreous haemorrhage.† T. El-kashab, M. Amjad Oral presentation The 10th Congress of International Ocular Inflammation Society, Prague. May 2009 â€Å"A Case of Idiopathic Sclerochoroidal Calcification associated with Primary Open Angle Glaucoma.† M. Amjad, T. El-kashab, R Job, A Needham Poster presentation at The 10th Congress of International Ocular Inflammation Society, Prague. May 2009 Communication and interpersonal skills: Please give a recent example that demonstrates that you possess these skills. (150 words max) A 59 year old gentleman was referred over the weekend with a six month history of left temporal ache. All the examinations and bloods were normal, except for a disc swelling on his left side. I informed my consultant and devised a plan. Then, I liaised with the ENT and on call radiologist to review the patient. I kept the patient and his partner informed about all the progress throughout this time. After arranging an urgent scan, which showed a mass compressing his orbit, I arranged for the admission and booked theatre for removal of the mass compressing orbit. As the focal point of communication between concerned groups, I enabled us to work as a large team, efficiently and effectively, to save the patients eye from future complications. My ability to communicate and delegate facilitated the effective success of a multi-disciplinary team approach to patient care. Initiative: Please give a recent example that demonstrates initiative. (150 words max) In October 2008, I attended a busy eye camp in Pakistan. During my stay, I was astonished to find that operations are cancelled on-table by the surgeons due to high IOP. Only high risk patients were having their IOP checked due to high patient turnover. This resulted in a huge waste of resources. After discussion with the management, I took the initiative to provide a solution to this problem. After research and discussions with senior doctors visiting the camp, I proposed to use a puff tonometer to check IOP of all patients undergoing surgery. This method doesnt require extraordinary skill to use, hence it is effective in a busy camp. This proposal was accepted by the supervisors. It had been a great success with surgical cancellations dropping by more than 95%. I received a letter of thanks. Making such a difference in patient care makes me proud. PAPER 2 Describe how you realised that you wanted to become an Ophthalmologist? [Edit] My inspiration for becoming an ophthalmologist stemmed from working in DARUL-HIKMAT DARUL-SHIFA, a charity eye hospital in Pakistan, which I have attended biannually since my first year in medical school. There I observed how a small procedure brings a remarkable improvement in the quality of a patients life. Out of interest, I undertook 2 ophthalmology electives and I was privileged in observing practice on an incredible elective at MOORFIELDS EYE HOSPITAL. It was a great experience and further motivated me to become ophthalmologist. Achieving a Distinction in Ophthalmology during my MBBS, I joined Rawalians Research Forum during my final year in medical school, where I published two research papers. Since then I have been actively involved in audits and clinical studies. I have presented 14 papers in international and national conferences. In addition, I have several published articles in many journals. Most notably during the Haematology, I was involved in ‘randomized control trials. As a Foundation year doctor, I regularly attended eye clinics and theatres in my free time. I did a week of a TASTER SESSION and managed to arrange a SPECIAL MODULE in ophthalmology during GP rotation. I have excellent hand to eye coordination and dexterity. I am competent in Objective Subjective Refraction. In my recent job I have done 53 Phacoemulsifications,6 Squint Surgeries, 23 IV injections, and 64 argon YAG laser procedures. The combination of medicine and surgery, the variety of cerebral and fine motor skills necessary has drawn me to the specialty. It is the only specialty that has satisfied me at the highest level. Sight for many is the most valued of senses and to be in a position to improve and restore eyesight, and prevent eye disease gives me great pleasure. I am dedicated, hardworking, and energetic person. In addition, I have passed RCO exams and my experience in ENT, neurosurgery, diabetics and oncology will make me a great candidate. What do you think are the main issues in solving global blindness by 2020? [Edit] Approximately 314 million people worldwide live with low vision and blindness. 90% of these blind people live in low-income countries. 80% of blindness is avoidable. Without effective, major intervention, the number of blind people worldwide has been projected to increase to 76 million by 2020. The major causes of blindness in the world are cataract (50%), refractive errors (15-30%), Trachoma, Onchocerciasis, Glaucoma, Diabetic Retinopathy, Age Related macular degeneration. According to WHO, restorations of sight and blindness prevention strategies are among the most cost-effective and gratifying interventions in health care. In 1999, WHO launched VISION 2020 The Right to Sight. It is a joint programme of the World Health Organization (WHO) and the International Agency for the Prevention of Blindness (IAPB) with an international membership of NGOs, professional associations, eye care institutions and corporations. It aims for control of avoidable blindness by 2020; to achieve the aim the following issues need to be addressed. HR development: adequate and purposeful training of all eye care personnel is a key factor. Apart from ophthalmologists, the ophthalmic nurse, ophthalmic medical assistants and especially refractionsists should be recruited and trained appropriately. Infrastructure Equipments development: facilities should be equipped according to the tasks. Local entrerpreaunership should be encouraged to participate to reduce cost and enhance sustainability. Awareness Education of local community: community participation is vital and this can be achieved by creating awareness in the public about the diseases and the facilities available to treat and prevent them. Funding: regular and new funding sources should be explored. Outside medicine, what personal attributes make you a good candidate for a career in Ophthalmology? [Edit] I possess combination of qualities through which I have not only achieved over and above the required competencies mentioned in the RCOphth curriculum for ST1 and F2 but also a good working relationship with the colleagues to prove as a good and successful ophthalmologist. I maintain good rapport with patients. During my foundation training, I had experience of caring for terminally ill patients, breaking bad news and discussing the patients care and resuscitation status with their family, which I was able to do in an empathetic and sensitive manner. I am actively involved in audits, and publications to maintain good medical practice alongside the tough demands of clinical work. This requires refinement of my time management and organizational skills. I believe in sharing the skills and experiences, which I do by not only involving myself in teaching but also in charity and voluntary work. I possess qualities of a good team leader and an effective team player, which I have gained thr ough my clinical and non-clinical experiences. I prioritize work and this helps me in coping when working under pressure. I am making most of the opportunities to gain experience and refine my personal skills and will do my best to become a good ophthalmologist. Injuries in Sports and Exercise | Case Studies Injuries in Sports and Exercise | Case Studies PDG. Understanding Injury in Sport and Exercise Settings Self-Selected Case Studies Introduction In this case study we shall consider three athletes who are superficially similar and have presented with injuries as a result of their sport. The athletes will be referred to as Mr.A, Mr. B and Mr. C. Each is in their twenties and are club standard runners. Mr.A fell during a training run and sustained an inversion injury to his left ankle. Mr. B presented with a pre-patella bursitis of his right knee and Mr. C could not compete because of severe metatarsalgia. Mechanism and pathophysiology of injury If we consider the aetiology and mechanisms of each injury we can see that although they are largely sports related and, to a degree sports specific, each is fundamentally different in terms of presentation, cause, treatment and outcome. Let us consider Mr. A. who fell during training. He was a modest club runner who ran sporadically for personal enjoyment. He sustained an acute inversion injury which resulted in a partial tear of the lateral malleolar ligament. This ligament effectively joins the Tibia to the talus and calcareous and is largely responsible for the lateral stability of the joint. (Clemente C D 1975). There was immediate pain and subcutaneous swelling and, although he could weight bear immediately after the injury, Mr.A could only walk with great pain. Lateral distortion of the joint was extremely painful. The fundamental aetiology of the injury was a sudden inversion stress to the ankle which was greater than the ligament could withstand and this resulted in rupture of some of the collagen fibres of the lateral ligament together with the underlying joint capsule. This allowed substantial bleeding to track into the surrounding tissues which, together with both extravasation of synovial fluid and accum ulation of tissue oedema, led to the clinically apparent swelling over the lateral malleolus. Mr. B, by contrast, was a fiercely competitive sub-elite runner who noticed his injury developing more slowly over a period of about ten days. He was preparing for a race and had increased his running schedule both in intensity and distance covered. Initially he was aware of a discomfort in the anterior aspect of his knee which felt superficial. This was apparent at the end of his training sessions and persisted for a few hours while travelling home. As the training sessions intensified, the pain grew more persistent until it occurred throughout his running session. Although it was a nuisance, it was not severe. By the end of ten days it had become very severe to the point that there was demonstrable swelling over the lower pole of the patella which was tender to the touch and constantly painful. The mechanism of this injury is typical of the overuse injury seen with overtraining. It is believed to arise initially from micro tears within the body of the patella ligament which become inflamed and the constant stresses involved with training do not let the injury heal sufficiently and the inflammation becomes accumulative to the point that histology would show inflammatory changes occurring throughout the ligament and this, in turn, causes friction on the surrounding structures. (Hewett T E et al. 1999) This is manifest as a constant progressively painful swelling localised in the region of the patella ligament and is aggravated by movement of the knee joint. It is tender to the touch and limits exercise. Mr. C was a club runner of modest ability, but with an over optimistic appreciation of his own ability, who trained with the elite runners at the club. He frequently complained of minor injuries that were blamed for his particular lack of performance in races. On this occasion he presented with pains in his forefoot over the metatarsal heads which was very specific and occurred when the toes were flexed but not when they were extended (an unphysiological finding). He could run, but complained bitterly of forefoot pain after the race and could be seen hobbling off the track and around the changing rooms after the race. Examination of his foot was completely unremarkable and no consistent physical abnormality could be found. It was noticeable that Mr. C vociferously blamed this problem for his inability to perform well. No physical diagnosis was made but the aetiology of his complaint was thought to be a psychosomatic manifestation of his anxiety relating to his inability to beat the b etter runners at the club. This equated to a mechanism of cognitive distortion and denial together with a compensatory conversion symptom complex to rationalise his poor performance. (Patel D R et al. 2000) In short we see three competitive runners with common presentations of injury, but three very different mechanisms of pathophysiology and aetiology. Each will require a different approach to treatment and will follow a very different illness trajectory. Psychology of sports injury There are a number of different theoretical concepts (with differing degrees of security of evidence base) that can be usefully employed in describing sporting motivation and are therefore relevant to the incidence of sporting injury. (Wigfield A et al. 2000) The literature on these subjects is very extensive and beyond the scope of this essay to consider in any degree of detail. Reversal theory (Apter M J 2001) is commonly utilised in this regard and can describe relationships between the personality characteristics and motivational stimuli. Paratelic dominant athletes commonly enter the paratelic motivational state and are typically arousal seekers and engage in high risk and highly competitive sports (viz Mr. B )(Cogan N A et al. 1998) Mr.A, by contrast is the typical telic dominant athlete who tend to be arousal avoiders, who plan and consider their training carefully and prefer low intensity experiences. (Kerr J H et al. 1999) Let us start this consideration of the psychology of sports injury with an assessment of Mr. C who presents with a primarily psychological complaint Mr. C has an overtly psychosomatic presentation. This can be conveniently described in terms of reversal theory (Apter M J 2001). and the paratelic concept (Murgatroyd S et al. 1978). There are aspects of the metamotivational states described in the theory which are relevant to Mr. C’s perception of his motives for continued participation in running even when he was clearly failing to achieve his set targets. If appears that Mr. C has developed a variation of a paratelic protective framework with somatic constructs. He needs the high arousal gratification of the paratelic dominant athlete by lining up on the starting line with the elite athletes, but has developed his idiosyncratic phenomenological frame as a coping mechanism which allows him a sensation of safety from his perception of failure with a series of somatic excuses for his failure to perform. (Kerr J H 2001) One psychological technique that has been demonstrated to work in this type of case is a form of cognitive behaviour therapy which allows a realisation of the implications of an action to be re-evaluated by the client. (Fowler D et al. 1995) This was combined with a strategy of the setting of â€Å"step-by-step† short term goals. This effectively allowed the client to consider his need to unrealistically compare himself with the elite athletes and to allow him to achieve progressive attainable targets, thereby recognising and capitalising on achievement rather than ruminating on poor past performance comparisons with other (better) athletes. (Pain M et al. 2004). The idea is that by setting and achieving some short term goals, the client can focus on the present, make small progressive steps, and recognise new achievements, instead of ruminating on past performance level. (Hall H K et al. 2001). Complicity by the clinician in agreeing that his symptoms may actually be physical can be completely counterproductive in this type of case (see on) Injury management The object of management of any injury is clearly to maximise the degree of recovery possible and to limit and residual disability that may occur as a result of the injury. In broad terms we can consider the immediate (first aid) treatment and the subsequent longer term management as separate issues. (Hergenroeder A C 2003) In the case of Mr.A’s acute injury the essential elements of treatment (once the diagnosis has been confidently made) should be to prevent further tissue damage and bleeding by immobilisation of the joint (splinting), prompt cooling to reduce the tissue reaction to the injury, analgesia to relieve the pain (but with the caveat that pain relief should not be an indication to stress the joint) and pressure to minimise blood and tissue fluid accumulation. The longer term considerations should be that weight bearing should be kept to a minimum for about 7-10 days. Mobilisation should then begin in a graded fashion over about four to six weeks. Running on flat surfaces could realistically begin (possibly with an ankle support) after that time. Mobilisation (both active and passive) is necessary to ensure that the fibroblastic activity of the ligament repair mechanism does not restrict movement of the joint to the degree that the long term restriction of movement becomes a problem. (Orchard J 2003) Mr.A would be well advised to avoid running on uneven surfaces for a period of many months and to undertake a course of physiotherapy involving modalities such as wobble board training to improve his proprioceptive capabilities. (Lephart S M et al. 1997) Because of the injury, Mr.A should always regard himself as more prone to get a recurrence if he were to have another fall. Mr. B should be treated in a distinctly different way. There is no â€Å"acute† first aid treatment as such, as the critical factor here is to recognise that the injury is the result of overuse of a joint. Rest, or in some cases simply a reduction in the training schedule, is often all that is needed to allow the condition to resolve. (Krivickas L S 1997) There is some evidence to suggest that the use of NSAIAs may help to reduce the inflammatory reaction and thereby increase the speed of recovery but their use must be undertaken with caution because of the propensity of runners to consider that the analgesic properties of the NSAIA group can be equated with evidence of suppression of the pathophysiology of the lesion, and therefore they can start to increase their training schedule thinking that the inflammation has settled because the knee is pain free. (Nickander R et al. 2005) Some clinicians would recommend the use of steroid injections in the paratendon tissues. It has to be noted that this is contentious because of the risk of tendon damage if the steroid is injected into the wrong area. Mr. C requires no immediate physical treatment. Indeed on an intuitive basis, physical treatment could be considered counterproductive as it could be viewed as reinforcing his aberrant adaptive and compensatory mechanisms by colluding in the physical nature of his pathology. By entrenching his position, the clinician could be actually aggravating the problem. Once confidently diagnosed, Mr. C should be promptly referred to a competent sports psychologist for treatment along the lines that we have outlined above. Lecture to club The first serious examination of sports injuries as a specific entity was carried out by William Haddon in 1962 (Haddon W et al. 1962). The growth in interest since then has been exponential. In terms of general observation about sports related injuries we can observe that it is generally accepted that one of the common predictive factors for an injury is a history of previous injury. (Watson A W 2001) ( Lee A J et al. 2001) Various studies have reported increased odds ranging from 1.6 to 9.4. (Chalmers D J 2002). In order to accommodate this information it is clearly important to know the other risk factors involved The practical problem is that in order to assemble a coherent evidence base on this issue it is vital to have well designed and robust trials to consider. In short, there are very few of these. (Parkkari J et al. 2001). A critical analysis of the literature on the subject reveals that there is a surprising paucity of evidence for any significant preventative measure for sports injury. Part of the reason for this is that if there is anecdotal evidence that a procedure reduces the risk of injury then it is likely that a substantial proportion of participants will already be using it. This makes double blind trials almost impossible. Van Mechelen ran a trial of the prophylactic value of warming up and down only to find that over 90% of participants were using the technique already. (van Mechelen et al. 1993) It is clearly of dubious ethical possibility, quite apart from a practical possibility to get a control group of athletes not to warm up just to see if they are more likely to get injured. The management of sports injuries is therefore largely a combination of intuition based on anatomical and physiological principles, guided by experience and validated by what scientific evidence base there is on the subject. The three case studies presented above have all occurred in similar status club runners for completely different reasons. This therefore exemplifies the need to undertake a holistic assessment of each case in order to be in a position to make a confident and accurate diagnosis. One should note that there are occasions when the injury or the pathology is blindingly obvious, but it is more common to have to undertake further investigations in order to firmly establish the diagnosis. Mr.A might require X-Rays to exclude a chip fracture of his lateral malleolus. Mr. B might require some blood tests to exclude a connective tissue disorder and Mr. C may need further assessment in order to be confident that there is no genuine physical pathology. References Apter M J. (2001). Motivational styles in everyday life: a guide to reversal theory.  Washington: American Psychological Association, 2001. Chalmers D J (2002). Injury prevention in sport: not yet part of the game? Inj. Prev., Dec 2002 ; 8 : 22 25. Clemente C D. (19750. Anatomy: A Regional Atlas of the Human Body.  Philadelphia, PA: Lea Febiger; 1975 (Figure 180). Cogan N A, Brown R I F. (1998). Metamotivational dominance, states and injuries in risk and safe sports. Pers Individ Dif 1998 ;10 :789–800. Fowler D, P A Garety, L Kuipers (1995). Cognitive Behaviour Therapy for Psychosis: Theory and Practice. London : Wiley 1995 Haddon W, Ellison A E, Carroll R E. (1962). Skiing injuries: epidemiologic study.  Public Health Rep 1962 ; 77 : 973–85. Hall H K, Kerr A W. 92001). Goal-setting in sport and physical education: tracing empirical development and establishing conceptual direction. In: Roberts GC, ed. Advances in motivation in sport and exercise. Campaign, IL: Human Kinetics, 2001 : 183–233. Hergenroeder A C (2003) Prevention and treatment of sports injuries. Clin Sports Med 2003 Hewett T E , T N Lindenfeld, J V Riccobene, F R Noyes (1999). The effect of neuromuscular training on the incidence of Knee injuries in Female athletes. The American Journal of Sports Medicine, 1999 Kerr J H, Svebak S. (1999). Motivational aspects of preference for and participation in risk and safe sports. Pers Individ Dif 1999 ; 27 : 503–18 Kerr J H. (2001). Counselling athletes: applying reversal theory. London: Routledge, 2001. Krivickas L S (1997) Anatomical factors associated with overuse sports injuries  Sports Med, 1997 Vol 5, no 3 Lee A J, Garraway W M, Arneil D W. (2001). Influence of preseason training, fitness, and existing injury on subsequent rugby injury. Br J Sports Med 2001 ; 35 : 412–17 Lephart S M, D M Pincivero, J L Giraldo, F H Fu (1997) The role of proprioception in the management and rehabilitation of athletic injuries,  American Journal of Sports Medicine, 1997 Vol 3 Pg 55-59 Murgatroyd S, Rushton C, Apter M J. (1978). The development of the telic dominance scale. J Pers Assess 1978 ;42 : 519–28. Nickander R, FG McMahon, AS Ridolfo (2005). Anti-inflammatory agents,  Annual Review of Pharmacology and Toxicology Vol. 19 : 469-490 Orchard J, T M Best (2002) The management of muscle strain injuries: an early return versus the risks of recurrance. Clin J Sport Med, 2002 vol 3 pg 26-30 Pain M and J H Kerr (2004). Extreme risk taker who wants to continue taking part in high risk sports after serious injury. Br. J. Sports Med., Jun 2004 ; 38 : 337 339. Parkkari J, Kujala U M, Kannus P. (2001). Is it possible to prevent sports injuries? Review of controlled clinical trials and recommendations for future work.  Sports Med 2001 ; 31 : 985–95. Patel D R , E F Luckstead (2000). Sport participation, risk taking and health risk behaviours. Adolesc Med, 2000 Vol 312 pg 22-30 Stevenson M R , Peter Hamer, Caroline F Finch, Bruce Elliot, and Marcie-jo Kresnow (2000). Sport, age, and sex specific incidence of sports injuries in Western Australia. Br. J. Sports Med., Jun 2000 ; 34 : 188 194. van Mechelen W, Hlobil H, Kemper H C G, et al. (1993). Prevention of running injuries by warm-up, cool-down, and stretching exercises. Am J Sports Med 1993 ; 21 : 711–19 Watson A W. (2001). Sports injuries related to flexibility, posture, acceleration, clinical defects, and previous injury, in high-level players of contact sports. Int J Sports Med 2001 ; 22 : 222–5 Wigfield A, JS Eccles (2000). Expectancy -value theory of achievement motivation. Contemporary Educational Psychology, 2000 ############################################################## PDG

The Debate of Human Cloning Essay -- Cloning Clones Science Genetics E

Missing Appendix The Debate of Human Cloning Human cloning has become a hot topic for debate. As we progressed one step closer to successfully cloning and developing a human being, legislators and the general public have become more concerned about the ethical and moral implications of this procedure. The federal government has been unsuccessful in reaching an agreement as to what policy to pass and enact. Thus, any current legislation on human cloning has been developed and enforced by individual states. The state of California is one of the few states in the United States that has a policy on human cloning. Human cloning is banned in the state of California. Because current policy does not allow for any human cloning to take place, many research projects have come to a standstill. Scientists have still been able to carry out certain cloning procedures that may not be viewed as ethical by the general public as a result of loopholes in current legislation. It is recommended that the current policy in place be revised to eliminate these loopholes and rewritten to permit human cloning to take place to generate the tissue and cells needed for therapeutic development and research to take place. The ban on human cloning should only apply when the procedure is used for reproductive purposes because current research has shown that it is not safe to use in humans at this time(Appendix A.1). With proper restrictions and guidelines in place, society stands to gain many benefits through permitting human cloning for the purpose of research. DRAFT April 17, 1999 M E M O R A N D U M TO: California State Legislators and Governor Gray Davis DATE: April 17, 1999 SUBJECT: Recommendation that the state of California continues its ban on human cloning but revise the current policy to permit human cloning for research. BACKGROUND On July 5, 1996, researchers in Scotland made history when they announced the birth of Dolly, the world’s first successful cloning of a sheep (Appendix A.1). The world was shocked. The ability to reproduce human beings without sexual reproduction was no longer only an idea to be explored in sci-fi movies and books. After over forty years of research and development, human cloning is quickly becoming a reality. The basic technique used to clone humans and animals, somatic-cell nuclear transfer, involves the insertion of DNA from a soma... ...MA. 1997;278: 13-14. 11) http://www.leginfo.ca.gov/calaw.html 12) Wise, Jacqui. â€Å"Bills on Human Cloning Are Full of Loopholes.† British Medical Journal. 1998;316: 573. 13) http://www.usfca.edu/cloning/ 14) http://www.humancloning.org/ 15) Mayor, Susan. â€Å"UK Authorities Recommend Human Cloning for Therapeutic Research.† British Medical Journal. 1998;317: 1613. 16) Furrow, Barry, et al. Health Law: Cases, Materials and Problems. St. Paul: West Group, 1997, p.894. 17) Bower, Hilary. â€Å"Public Consultation on Human Cloning Launched.† British Medical Journal. 1998;316: 411. 18) http://www.seattletimes.com/health-science/html98/clon_012098.html 19) Benatar, D. â€Å"Cloning and Ethics.† QJM. 1998;91: 165-166. 20) Josefson, Deborah. â€Å"US Scientist Plans Human Cloning Clinic.† British Medical Journal. 1998;316: 167. 21) Furrow, Barry, et al. Health Law: Cases, Materials and Problems. St. Paul: West Group, 1997, p. 415. 22) Furrow, Barry, et al. Health Law: Cases, Materials and Problems. St. Paul: West Group, 1997, p. 248. 23) http://www.ebglaw.com/newsstand/cloning.html 24) Furrow, Barry, et al. Health Law: Cases, Materials and Problems. St. Paul: West Group, 1997, p.435. The Debate of Human Cloning Essay -- Cloning Clones Science Genetics E Missing Appendix The Debate of Human Cloning Human cloning has become a hot topic for debate. As we progressed one step closer to successfully cloning and developing a human being, legislators and the general public have become more concerned about the ethical and moral implications of this procedure. The federal government has been unsuccessful in reaching an agreement as to what policy to pass and enact. Thus, any current legislation on human cloning has been developed and enforced by individual states. The state of California is one of the few states in the United States that has a policy on human cloning. Human cloning is banned in the state of California. Because current policy does not allow for any human cloning to take place, many research projects have come to a standstill. Scientists have still been able to carry out certain cloning procedures that may not be viewed as ethical by the general public as a result of loopholes in current legislation. It is recommended that the current policy in place be revised to eliminate these loopholes and rewritten to permit human cloning to take place to generate the tissue and cells needed for therapeutic development and research to take place. The ban on human cloning should only apply when the procedure is used for reproductive purposes because current research has shown that it is not safe to use in humans at this time(Appendix A.1). With proper restrictions and guidelines in place, society stands to gain many benefits through permitting human cloning for the purpose of research. DRAFT April 17, 1999 M E M O R A N D U M TO: California State Legislators and Governor Gray Davis DATE: April 17, 1999 SUBJECT: Recommendation that the state of California continues its ban on human cloning but revise the current policy to permit human cloning for research. BACKGROUND On July 5, 1996, researchers in Scotland made history when they announced the birth of Dolly, the world’s first successful cloning of a sheep (Appendix A.1). The world was shocked. The ability to reproduce human beings without sexual reproduction was no longer only an idea to be explored in sci-fi movies and books. After over forty years of research and development, human cloning is quickly becoming a reality. The basic technique used to clone humans and animals, somatic-cell nuclear transfer, involves the insertion of DNA from a soma... ...MA. 1997;278: 13-14. 11) http://www.leginfo.ca.gov/calaw.html 12) Wise, Jacqui. â€Å"Bills on Human Cloning Are Full of Loopholes.† British Medical Journal. 1998;316: 573. 13) http://www.usfca.edu/cloning/ 14) http://www.humancloning.org/ 15) Mayor, Susan. â€Å"UK Authorities Recommend Human Cloning for Therapeutic Research.† British Medical Journal. 1998;317: 1613. 16) Furrow, Barry, et al. Health Law: Cases, Materials and Problems. St. Paul: West Group, 1997, p.894. 17) Bower, Hilary. â€Å"Public Consultation on Human Cloning Launched.† British Medical Journal. 1998;316: 411. 18) http://www.seattletimes.com/health-science/html98/clon_012098.html 19) Benatar, D. â€Å"Cloning and Ethics.† QJM. 1998;91: 165-166. 20) Josefson, Deborah. â€Å"US Scientist Plans Human Cloning Clinic.† British Medical Journal. 1998;316: 167. 21) Furrow, Barry, et al. Health Law: Cases, Materials and Problems. St. Paul: West Group, 1997, p. 415. 22) Furrow, Barry, et al. Health Law: Cases, Materials and Problems. St. Paul: West Group, 1997, p. 248. 23) http://www.ebglaw.com/newsstand/cloning.html 24) Furrow, Barry, et al. Health Law: Cases, Materials and Problems. St. Paul: West Group, 1997, p.435. The Debate of Human Cloning Essay -- Cloning Clones Science Genetics E Missing Appendix The Debate of Human Cloning Human cloning has become a hot topic for debate. As we progressed one step closer to successfully cloning and developing a human being, legislators and the general public have become more concerned about the ethical and moral implications of this procedure. The federal government has been unsuccessful in reaching an agreement as to what policy to pass and enact. Thus, any current legislation on human cloning has been developed and enforced by individual states. The state of California is one of the few states in the United States that has a policy on human cloning. Human cloning is banned in the state of California. Because current policy does not allow for any human cloning to take place, many research projects have come to a standstill. Scientists have still been able to carry out certain cloning procedures that may not be viewed as ethical by the general public as a result of loopholes in current legislation. It is recommended that the current policy in place be revised to eliminate these loopholes and rewritten to permit human cloning to take place to generate the tissue and cells needed for therapeutic development and research to take place. The ban on human cloning should only apply when the procedure is used for reproductive purposes because current research has shown that it is not safe to use in humans at this time(Appendix A.1). With proper restrictions and guidelines in place, society stands to gain many benefits through permitting human cloning for the purpose of research. DRAFT April 17, 1999 M E M O R A N D U M TO: California State Legislators and Governor Gray Davis DATE: April 17, 1999 SUBJECT: Recommendation that the state of California continues its ban on human cloning but revise the current policy to permit human cloning for research. BACKGROUND On July 5, 1996, researchers in Scotland made history when they announced the birth of Dolly, the world’s first successful cloning of a sheep (Appendix A.1). The world was shocked. The ability to reproduce human beings without sexual reproduction was no longer only an idea to be explored in sci-fi movies and books. After over forty years of research and development, human cloning is quickly becoming a reality. The basic technique used to clone humans and animals, somatic-cell nuclear transfer, involves the insertion of DNA from a soma... ...MA. 1997;278: 13-14. 11) http://www.leginfo.ca.gov/calaw.html 12) Wise, Jacqui. â€Å"Bills on Human Cloning Are Full of Loopholes.† British Medical Journal. 1998;316: 573. 13) http://www.usfca.edu/cloning/ 14) http://www.humancloning.org/ 15) Mayor, Susan. â€Å"UK Authorities Recommend Human Cloning for Therapeutic Research.† British Medical Journal. 1998;317: 1613. 16) Furrow, Barry, et al. Health Law: Cases, Materials and Problems. St. Paul: West Group, 1997, p.894. 17) Bower, Hilary. â€Å"Public Consultation on Human Cloning Launched.† British Medical Journal. 1998;316: 411. 18) http://www.seattletimes.com/health-science/html98/clon_012098.html 19) Benatar, D. â€Å"Cloning and Ethics.† QJM. 1998;91: 165-166. 20) Josefson, Deborah. â€Å"US Scientist Plans Human Cloning Clinic.† British Medical Journal. 1998;316: 167. 21) Furrow, Barry, et al. Health Law: Cases, Materials and Problems. St. Paul: West Group, 1997, p. 415. 22) Furrow, Barry, et al. Health Law: Cases, Materials and Problems. St. Paul: West Group, 1997, p. 248. 23) http://www.ebglaw.com/newsstand/cloning.html 24) Furrow, Barry, et al. Health Law: Cases, Materials and Problems. St. Paul: West Group, 1997, p.435.