Pico Paper

Are kidney patients who received a radical nephrectomy at a higher risk of impaired renal function and cardiac related death compared to those who received a partial nephrectomy? Kiara Wilson Nursing 3163 Dr. Linda Upchurch November 12, 2012 Background Are kidney patients who received a partial nephrectomy at a lower risk of impaired renal function and cardiac related death compared to those who received a radical nephrectomy? When a patient is diagnosed with kidney damage, a surgical nephrectomy is often performed. Kidney damage may be caused by blocked blood vessels, kidney stones, masses, infection, and/or kidney cancer.With this procedure the kidney damage may be treated and also prevent further damage. A partial nephrectomy is a surgical procedure to remove a portion of the kidney. Partial nephrectomies are normally done laparoscopically with hand assistance or with robot assistance. A radical nephrectomy involves removing the kidney and the adrenal glands. A radical nephrectomy may be done laparoscopically or by open abdominal surgery. My patient was diagnosed with damage of the left kidney. Blood tests were performed and the patient was found to have a toxic WBC granulation. This toxic granulation led infection, inflammation and sepsis.An abdominal and pelvic CT scan found a 7. 8 x 5. 6 x 6. 2 cm, solid, enhancing left lower pole renal mass and parasitic vessels in the infected area. A hand assisted partial laparoscopic nephrectomy was performed. They removed the lower portion of her left kidney. The kidney was to be tested for malignancy. The concern with my patient is that she has a past medical history of hypertension, anemia, and deep vein thrombosis. She is at an increased risk of further cardiac and renal complications. I believe these factors influenced the doctors’ decision to perform a partial nephrectomy instead of taking the radical approach.To find research on this kidney condition, I accessed the Galileo database. I searched for infor mation on ways to treat renal masses and kidney cancer. I found multiple articles about laparoscopic and radical (open) nephrectomies. I found many articles that discussed the differences between the two and the affects they have on patients who receive them. I found an interesting study called â€Å"Partial Nephrectomy Is Associated with Improved Overall Survival Compared to Radical Nephrectomy in Patients with Unanticipated Benign Renal Tumours. I found it interesting because it was relevant to the health issues that were being addressed with my patient. There millions kidney patients who undergo these procedures each year. I wanted to discover which procedure provided the best outcome for my patient and others with similar kidney problems. Purpose According to this study, â€Å"a partial nephrectomy has been associated with improved overall survival in patients with localized renal masses compared to those who received a radical nephrectomy† (Weight, 2010).The purpose of this study is to test the overall survival rate of patients who had unanticipated renal masses. Another objective of this study is to also study the effect of these procedures on cardiac specific survival rates and other causes of death related to decreased kidney function. Hypothesis The hypothesis for this study are that the use of partial nephrectomies would be first line of treatment compared to radical nephrectomies in that partial nephrectomies provide better protection of renal function. Decreased renal function will lead to a low survival rate.Patients who undergo radical nephrectomies will have higher rate of cardiac related deaths Design A seven year, nonrandomized study was conducted using 499 participants. Of these 499 particiapants, 111 patients had received a radical nephrectomy while 388 patients received a partial nephrectomy. The choice of which surgery to do was left of the surgeon and the patient’s preferences. They took into consideration the mass size, th e appearance, the patient’s current health, life expectancy and the comfort of the surgeon in making their decisions.The patient’s comorbidities were assessed using the Charlson-Romano Comorbidity Index. Each patient’s vital signs were acquired using the Social Security Death Index. Anyone without a Social Security Number was excluded. The cause of death information from the patients’ medical records was reviewed. From there the participants were further categorized by the condition that caused the death. Cardiac deaths ranged from death related to ischemic heart disease, CHF, ischemic stroke, myocardial infarction, ischemic stroke, and peripheral vascular disease.Renal deaths were broken down into death related to renal failure, renal insufficiency, or nephritic syndrome. All other possible causes of death were group together. Perioperative, postoperative data and renal function tests were collected before and after the procedures. Preoperative data was used to create the propensity model that was utilized in a multivariate model of survival. They measured the overall survival rate of the participants and cardiac specific survival rates. Findings Radical nephrectomies are greatly associated with an increased risk of death from any cause.Patients with unanticipated benign tumors that were treated with RN were more likely to die from any related health problem than those treated with PN. Participants who received a radical nephrectomy were more likely to be older, with high comorbidity scores, and larger tumors. Those with smaller masses and tumors were more likely to have a partial nephrectomy. Radical nephrectomies are associated with an increased risk of death by 2 folds from any cause. The risk of cardiovascular death was substantially higher in those with decreasing post-operative renal function.Decreased kidney function was related to an increase in cardiovascular death and death from any other cause in overall majority patient s. Sixteen participants died of cardiac related deaths. Renal preservation was increased in the group that had the partial nephrectomy with majority of the patients having an eGFR above 60 %. Radical nephrectomy participants only had an eGFR of 30 % or lower. The higher eGFR is associated with an increase chance of survival in PN patients. Discussion Previous studies indicate that postoperative impaired renal function plays a role in the overall survival of patients with renal masses.The data concluded that no matter which surgery was performed there would be a decrease in kidney function. However, those patients who received a PN had a remarkable lower decrease in renal function. It can be stated that patients have decreased function are at an increased risk of cardiac related death and death by other causes. For many of those who don’t die from cardiac related death it can be concluded that other conditions that cause death are worsened by renal insufficiency. This study wa s relevant to the PICO question I asked.This study answered my question and provided the information necessary to make it a valid question. I believe the limitations to this study are that the researchers did not randomize their study. They picked which participants they thought would influence their study. The strengths of this article are that is discusses the importance of preserving renal function when performing a nephrectomy. It also provides evidence that patients should be educated on the risks of death and further complications associated with their procedures. It could allow for better planning and managing of the care for these patients.Implications As a nurse it would be my responsibility to knowledgeable about procedures such as these and how they will affect my patient. It would be my job to educate the patients on what to expect from this surgery and what it means for their health. I could also use this information to better assess patients before and after these proc edures. This research provides material that could be used to better treat and prevent life threatening conditions that could arise after surgery. References Landman, D. (2006). Open Partial Nephrectomy.Retrieved November 9, 2012, from Kidney Cancer Institute: www. kidneycancerinstitute. com/open-partial-nephrec. html Landman, D. (2006). Open Radical Nephrectomy. Retrieved November 9, 2012, from Kidney Cancer Institute: www. kidneycancerinstitute. com/open-radical-nephrec. html Weight, C. J. , & Leiser, G. (2010, April 29). Partial Nephrectomy Is Associated with Improved Overall Survival. EUROPEAN UROLOGY, 58, 293-298. Evaluation (to be completed by instructor)| Possible Points| Actual Points| Introduction of clinical problemComments:| 20| | Purpose/Aim of the study/articleComments:| 10| |Theoretical framework of the study/articleComments:| n/a| | Hypotheses/QuestionsComments:| 5| | DesignComments:| 5| | FindingsComments:| 10| | DiscussionComments:| 25| | ImplicationsComments:| 20| | ReferencesComments:| 5| | Grade| 100/100| /100| PICO Paper Grading Rubric (submit, along with PICO OAT form, with your paper) Student Name: _Kiara Wilson______________Date: November 12, 2012_____________ Are kidney patients who received a radical nephrectomy at a higher risk of impaired renal function and cardiac related death compared to those who received a partial nephrectomy?

The Art of Ballet

The art of ballet started out as a fun dance for the wealthy and throughout history, has evolved into an elegant, world wide form of structured expression. From its beginnings in European cultures to its now widespread and diverse variations, ballet shows no signs of slowing down in popularity any time soon. Early ballet was influenced by the social dancing of its day, ballroom dancing. This art was born when the ancient Greek and Roman renaissance of the fifteenth and sixteenth centuries took place, reviving an interest in all things human and the arts.The word â€Å"ballet† derives from the Italian word â€Å"balla,† meaning dance. In the Italian city-states of the fifteenth century, many â€Å"balli† meaning â€Å"dances† were held. The ballis involved specific steps that our generation would classify as ballroom steps. Ballet got much recognition when Louis XIV ascended to the throne of France. He came from an arts school where he studied the arts of f encing, music, and dance. His passion for dance was very serious. So serious in fact, that he established the Academic Royale de Danse in 1661, employing 13 ballet instructors.Another well –known founder of ballet is Jean-Georgeos Noverre, also known as the â€Å"Shakespeare of Dance†. He argued for a new, more expressive form of ballet. He created ballet d’action, meaning ballet with out instruments. The Romantic Period played a very important role in the development of women in ballet. This period began in the early eighteen-hundreds. The milestones accomplished within this time period included large female background dancers to accompany the prima ballerina, the lightening of female costumes, and women dancing en pointe.Dancing en pointe, turn out, and the basic five ballet positions exemplify ballet, and are now standard for all ballerinas. The next step on the road to modern ballet is the formation of classical ballet. While the first production of the ball et known as La Sylphide took place in Paris and most famous ballerinas of the day were still coming from Italy, the second half of the nineteenth century saw the axis of the ballet world shift from Western Europe to Russia. However, a Frenchman was responsible for this shift.Marius Petita created five of ballet’s greatest classics in the late nineteenth century: Don Quixote, La Bayadere, The Sleeping Beauty, Swan Lake, and The Nutcracker, as well as restaging Giselle and La Coppelia. All of these classics share common similarities marking them as the trademarks of what is now regarded as the classical repertoire. They generally begin with group dances and evolved into complex stories between two or three main characters. The grand pas de deux, meaning big step for two, commonly begins with an adagio (slow, lyrical dance) between a male and a female dancer.The dance includes high extensions of the woman’s legs, multiple pirouettes, and big leaps forming a long straight line with the female’s legs in the air. Following the adagio is the allegro. This portion is merely a solo showcase of the male dancer’s ability and strength across the stage. An allegro for a ballerina features softer, yet intricate footwork and pirouettes. Finally, we have the coda, or finale, which reunites the dancers in an exuberant flourish. During that time period, three schools of classical ballet emerged.The French school is the oldest of the three. Known for its grace and elegance rather than its technical virtuosity, the French school was nevertheless held in high regard. The Italian school was known for its dexterity, difficulty of its steps, high leaps, and multiple turns. Lastly there was the Russian school. The Russian school was basically a hybrid of the prior schools. This school was held in high esteem due to its combination of serene elegance, breathtaking choreography, and the most complete and well-developed technique in all of ballet.The Russian b allet school slowly led the movement of ballet throughout the world and is responsible for how far ballet has grown. While Petipa’s traditional romantic style still held sway over Europe and Russia, Isadora Duncan, a freethinking American brought a completely new aesthetic to the stage. She believed in a more â€Å"anit-ballet† view of dance. She believed ballet was elitist and superficial. Duncan started a form of dance that was quite the opposite of what ballet was known for. This style of dance would be natural, free, and unbounded by rules.Duncan took her dancing on the road, touring through Europe and Russia alone, barefoot, and dressed in long tunics. The traditional aspect of her performance was the music she danced to, which was mostly Mendelssohn, Beethoven, and Chopin. She had many enemies, but with every enemy she gained, there were hundreds who thought her dramatic expression was lively and wquite enjoyable. Through the next few years, modern dancers began to fuse ballet with their own expressive movements. Also, ballet choreographers began incorporating modern techniques into their dances.As time moved forward, so did the swift evolution of ballet. Cultures took the basics and made it their own and by the late 1970’s , many classical ballet companies started incorporating modern steps into its repertoire and hiring modern choreographers to construct distinctive works on its own dancers. It is evident that as the world changes and its people continue to gain knowledge about their surroundings, the art of ballet will continue to spark interest and develop creativity in many people aspiring to gain the technique of the craft.

Barack Obama Speech Analysis Essay

In the compelling Inauguration speech of Barack Obama, the first African-American President, a large range of language and oratory techniques are utilized to convey his message to an audience of over a million Americans. The speech was delivered on the traditional inauguration date of the 20th January 2009, on the steps of the Lincoln Memorial where, 45 years earlier, Martin Luther King Jr. delivered his iconic ‘I Have a Dream’ speech. During Obama’s speech, he uses a range of oratory devices to present himself as credible, the techniques include; the proficient use of tone and performance aspects, extensive use of biblical references, allusion to history, and an important underlying theme. These techniques help to convey his strong message of hope and reapplying the good old American values of honesty, courage, tolerance and loyalty. On the 20th January 2009, democrat Barack Hussain Obama became the first African-American to take the presidential oath for America . He delivered his inauguration speech to an audience of over a million Americans, and at a time when the world’s economy had taken a downturn and America had a controversial presence in the Middle East. Americas history had been darkened by its racism and history of slavery and so the significance of this event was amplified as it showed a new acceptance and a positive step in American Civil Rights. Obama also delivered his inauguration speech on the steps of the Lincoln memorial where, 45 years earlier, Martin Luther King delivered his iconic ‘I Have a Dream’ speech. Congressman James Clyburn, the highest ranking African-American congressman of that time said about the event, â€Å"Today is about the validation of the dream Dr. King initiated 45 years ago on the steps of the Lincoln Memorial†, this shows the significance of the event, and put pressure on Obama to put on a show of strength. In Barack Obama’s Inauguration speech, it soon becomes obviou s that he is a seasoned orator who has a natural ability to persuade the audience’s emotions. His use of tone and pitch, amplified by his presentation, has a convincing effect on his delivery. In his opening sentences he says â€Å"I stand here today humbled by the task before us, grateful for the trust you’ve bestowed, mindful of the sacrifices bourne by our ancestors.† In hearing this, the listener is struck by his humbleness and sense of humility. The tone urges caution which  contrasts with the celebratory mood of the audience. His choice to use words like humbled, grateful and mindful along with his natural charisma and charm, causes the audience to respect him and listen to what he has to say. To increase the desired effect of his speech on the audience, Obama repetidly uses an allusion to history, this also helps to strengthen the audiences confidence in him. His statement â€Å"all are equal, all are free, and all deserve a chance to pursue their full measure of happiness† is a clever twist on the Declaration of Independence, a founding document of America and something all Americans can relate to. He uses a patriotic appeal and asks for a â€Å"†¦return to these truths†, a return to the old and true American traits of â€Å"honesty and hard work, courage and fair play, tolerance and curiosity, loyalty and patrionism†. The appeal effectively utilizes pathos, coupled with with allusion and historic references, to pursuade his audience to believe in him. During the delivery of his speech, Obama repeatidly alludes to biblical references, which acts not only as a useful language technique, but also shows a link to his background and heritage. In saying â€Å"the time has come to set aside childish things† (1 Corinthains 13:11), Obama exploits the ethos appeal and cleverly alludes to the refence, as his audience is not all christain and he did not want to offend them. This is yet more proof of his natural oratory ability and it also reflects on his African-American background, in which biblical references and hymns were used and widely known. These effects combined with the seamless delivery proves his incredible speaking ability and his charisma and charmwhich has helped him in his American dream, from being raised by a single mother, to becoming the first African-American president. Obama’s inauguration speech includes the interesting theme of ‘Drawing strength from out heroic past’. There are many references to history that Obama then applies to the current time. He took office at a troublesome time when the economic downturn was occurring and people were growing weary of the war on terror, so Obama cleverly addresses these issues with references to returning to the ideals of founding fathers, which raises a note of patrionism and brings the audience together. To help portray his theme, Obama includes extensive use of personal pronouns, for example â€Å"We the people have remained faithful to the ideals of our forebearers, and true to our founding documents†, he commends the audience for rem aining faithful to past ideals while using the  personal pronoun ‘we’, which deepens their confidence inhim and continues to draw the audience and speaker together. The speech effectively serves its purpose and addresses the issues of the day, while being strengthened with the use of personal pronouns, which has a constructive effect on the audience in view of getting the audience to believe in Obama, and accept what he is saying. The effectiveness of Barack Obama’s inauguration speech is complimented by his compelling use of oratory devices and techniques, including; the convincing effect of his tone and pitch, amplified by the presentation, the combined effect of allusion and historic references in making his appeals, an extensive use of biblical references which represents his heritage – and which are thoughtfully alluded to, as well as an underlying theme which helps Obama to elaborate on his message and address the issues of the day. These techniques are the cornerstone to gaining acceptance from the audience and persuading them to believe in what he is saying, and he also uses his charisma and charm in conjunction. The result is, a critically acclaimed speech which the NYTimes states as â€Å"Reveling in a moment of national significance† where Obama puts on a positive show of strength, rises to the occasion, and establishes himself as the 44th President of the United States of America.

Credit risk management of CDSs, case from AIG Essay

Credit risk management of CDSs, case from AIG - Essay Example In regard to the bailout, AIG was presented with access to a $85 billion credit facility. In exchange, the United States government was presented with warrants for a 79.9% equity stake in AIG and the power to expel dividend payments to shareholders. AIG’s misfortunes started in a unit known as AIG Financial Products, which traded in credit default swap (CDS). A CDS acts as a safeguard against a default on assets that are connected to corporate debt and mortgage securities. The losses to AIG’s portfolio of CDSs were prompted by the disintegration of the subprime mortgage1 market. A groundbreaking amount of defaults by subprime borrowers with adjustable rate mortgages initiated the current catastrophe in the global financial markets in 2008. Most of these began in 2005 and 2006 when lenders remarkably loosened up on underwriting standards. Figure 4.2: Subprime mortgage originations Source: Bradford (2008) ‘The Subprime Mortgage Meltdown, the Global CreditCrisis and the D&O Market.’ Advisen : Productivity&insight for insurance professionals. The assumption was that homeowners would refinance prior to the monthly payments being readjusted, but decreasing real estate prices made it inaccessible for the majority of subprime borrowers who had hardly any or no equity in their houses to refinance. As they were incapable of paying the increased monthly payments, many borrowers had no choice but to default. Defaults in U.S. mortgages rose beyond record levels in the second quarter of 2007, and the fallout rapidly expanded all through the financial markets. The subprime mortgage debacle immediately brought forth the worldwide credit crisis. AIG is one of the financial institutions with credit default swaps business that was also affected during these circumstances. From then on, many CDSs were sold as insurance to cover those exotic financial instruments that created and spread the subprime housing crisis. As those mortgage-backed securities2 and collateralized debt obligations3 became more or less valueless, abruptly that reputedly low risk event saw an actual bond default occurring on a daily basis. AIG sold CDSs were no longer taking in free cash. It had to pay out a large amount of money. The crisis at AIG is a â€Å"question of liquidity, not of capital†, according to ROB Schimek, EVP and CFO of AIG Property Casualty Group. Despite the fact that there have been a small amount of losses paid under the CDSs, contract provisions demand of AIG to post collateral in cash if the value of the assets underlying a CDS declines. At the parent level, AIG has approximately $80 billion in shareholder equity, though the majority of that is secured in the company’s insurance operations and cannot be converted to meet the collateral calls of the financial products unit. Since it did not have enough cash to meet the collateral demands, the company faced a liquidity crisis and bankruptcy protection. 4.3 What AIG actual did leaded the company go down 4.3.1 The undoing of AIG liquidity crisis AIG reported â€Å"an unrealized market valuation loss of $11.5 billion on [the] super senior credit default swap (CDS) portfolio† held by its subsidiary, AIG Financial Products in the annual report for 2007. The definition of CDSs was discussed in chapter 2.2. This initiated a drastic downfall and ended AIG’

According to the question answer the question Essay

According to the question answer the question - Essay Example ducation makes it inappropriate to some people while Foster is of the belief that the current system of education has been able to enable to get students to have a good interpretation of their experiences. The walking journeys of Cheryl strayed in wild and Andrew Forstaffle in the â€Å"this American life† radio episode† hit the road† have some things in common. For instance, in both cases there are people who are compelled by the experiences that they are going through in life to go far places from wherever they were at first. Andrew Forsthoefel decides to go on a journey of over four thousand miles on foot after losing his job. He takes people he meets on the way with him. On the other hand, Cheryl strayed move to many cities in the process of trying to find a new life after the divorce with her former husband. The difference between the two cases is that Cheryl strayed was in search for a new life while Andrew Forsthoefel’s did not seek a new life. The views that Cheryl Strayed and Robert Bly give about the term being wild can be a little bit morally misleading. This is because they all advocate for some behaviours that are simply inappropriate morally. For instance, when someone looks at the kind of lifestyle that Cheryl Strayed leads in the name of being wild such as sleeping with strangers someone can clearly see the immoral part of it. Robert Bly, basically advocates for masculinity where female people are treated with less regard or respects. The two views can basically be said to be misleading in their description of being wild. Looking at the poem by Edward Hirsch someone can easily notice the importance that he gives to the emotional parts of human existence (Addonizio and Laux 242). This can be seen in the line where he asserts on the importance of people believing in their hearts. This can be seen in the first line. The poets urge people to believe in having better lives, even at times when they are going through the hardest parts of their

Journal Coursework Example | Topics and Well Written Essays - 500 words

Journal - Coursework Example Revolutionizing the communication industry has completely changed the way that humans across the world interact with each other. We have developed from the point where paper messages would have to be carried, sometimes taking weeks to reach the recipient, to being able to communicate halfway across the world instantly. This has given humanity a huge advantage. It allows for globalization of the economy, collaboration for scientific and other research as well as strategic movements of large military forces or just the simple hello to a relative that lives far away (Parker, 2005). The implementation of technology has had a great impact on society as a whole. Human behavior has been influenced by communications technology. Society has developed based on efficiency and a fast paced environment due to the fact that information is now readily available via networks, internet, etc. As a result, our generation lives in one where everything is expected quickly. Compared to about thirty years ago, the efficiency of industry and business has increased as well as learning in institutions due to the implementation of better and faster computers and internet (FitzGerald, & Dennis, 2009).

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Nokia - Case Study Example Nokia’s biggest strength is the reputed brand name and the acceptance of Nokia products in over 150 countries. Nokia products are custom made for each country and region considering the economic and cultural situations. Moreover Nokia products are easy to use and a wide range of telecommunication products are available from Nokia to cater the needs of all the segments of people in the world. Being the number one mobile manufacturer in the world, the resale value of the Nokia products are best in the industry. The major weakness of Nokia is the price of their product. Compared to other mobile manufacturers, Nokia products are expensive. Nokia is not offering much promotions and sales discounts to the customers compared to others. Moreover, after sales services of Nokia seems to be not adequate. Globalization and liberalization has offered Nokia lot of opportunities worldwide. The heavily populated and rapidly developing countries like India and China offer great opportunities for Nokia products. In developing countries like India the standard of living has increased a lot and people started to use expensive items and Nokia can easily capitalize on that (Scribd) The major threats for Nokia is from the competitors like, Motorola, Sony Erikson, LG, Samsung etc. Apple has recently introduced a touch screen phone which was new in that category. Even though Nokia has introduced some substitutes for countering the Apple threat, it was not successful enough to beat the Apple challenge. Recently Nokia has experience a major problem in India when some of the Nokia batteries started to burst. Nokia forced to replace all the batteries of a particular series in India which actually damaged the reputation of Nokia in India. Nokia unveiled plans to launch a slew of services for mobile users, starting later this year in Europe and Asia. The scheme

Mini proposal JUST (SAMPLING& METHOD OF DATA COLLECTION) Essay

Mini proposal JUST (SAMPLING& METHOD OF DATA COLLECTION) - Essay Example The selected sample will be subdivided into three different groups which will be used in conducting the research. A combination of various sampling techniques will be utilised in seeking to ensure the researchers get the most representative and balanced sample. This will be critical in ensuring that the findings of the research can be generalised to other groups of individuals. The sampling methods will include the ones discussed below. This approach is commonly utilised in seeking to ensure inclusion of individuals with specific qualities that are being analysed by the researcher. The fundamental reason for utilising purposeful sampling in this research is to provide an in-depth understanding of the perceptions that teenagers have regarding their body image following involvement in sport and physical activity (Suri, 2011). Purposeful sampling techniques will be utilised in seeking to ensure that the researcher gets only the individuals who fit into the specified research sample. This will be based on the women’s capability to participate in sport and other related physical activities. The research will involve different groups of samples in seeking to present the different elements that have been defined within the research. This will involve the establishment of a sample and then selecting a few individuals from the sample to become the research participants. The samples will be stratified according to the specification for the different groups of participants involved in the research. This will ensure that the small sample size becomes representative of a population upon which they can be generalised. The research seeks to collect qualitative data which will be utilised in establishing the perceptions of the teenage girls regarding their image after participating in sport and physical activities. The data collection process will involve conducting interviews with the selected population

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Volunteer report - Essay Example I made sure that the activities were adequate so that they did not feel exhausted at the end of the workout. I assisted them in the form of groups and visited the place thrice a week i.e. Monday, Wednesday and Friday. My tenure ended on April 10, 2014. The only difficulty which I had to face was communicating with the people as two of the group members had listening problem. It is true that elderly people are like new babies who require a lot of attention and care. I allocated sufficient time and efforts during the whole volunteer period so that I could provide them a marvelous experience of their life. There were about six people in my group and I had to make sure that I address the demands of each person appropriately. One person spoke at such a low volume that I had to listen to her talk with complete attention. I even made sure that I gave time to each individual so that they could share their feelings and thoughts effectively. I even asked them open ended questions to have clarity about their requests so that their queries were resolved. I even did physiotherapy of a person on his request as his legs were hurting and I asked him to guide me so that I could perform the exercise effectively. I definitely feel that the helping skills have to be used according to the situation and they should be in alignment with the instance so that the desired results are attained. I believe that my clients were contended with my behavior and they appreciated my efforts. One of the clients even mentioned that she feels relaxed after talking to me. Also, other person was satisfied with my helping actions as he stated that I have the ability of proactively responding to other individual’s requests efficiently. Despite all these points, I think that I have to develop an understanding about people’s psychology so that I can assess their demands from the body language and assist them in resolving their

The Learning and Growth Perspective Essay Example | Topics and Well Written Essays - 750 words

The Learning and Growth Perspective - Essay Example This has been the principal reason why she turned to the learning and growth perspective of Futura (Gumbus and Johnson, 2003). The use of this balanced scorecard makes Futura have the ability maintain talented people and to attract them in the local market place. Analysis At Futura Company, it tries to create an environment and set goals that will help improve employee performance, as well as being able to provide a safe, challenging and enjoyable environment and be able to recruit individuals that have interests of the company at hand. Futura measures turnover and according to Gumbus & Johnson (2003), the turnover of the company has gone down by 33% from 1998. She says that the improvement is because of a work-life initiative that is done with an aim of a corporate culture that is based on performance and commitment of employees. She further states, to achieve this, it is fundamental to provide a healthy and a balanced workplace and be able to treat employees as an individual. The m easures the company uses to evaluate growth and learning include surveys such as; employee friendly initiatives at Futura, where employees are approached by Futura each year, and they are given a form to fill up a list of benefits and what they think is beneficial to them. For example, some of the benefits are, medical benefits and spouse scholarships. Another measure is that of birthday review; this normally applies every month, and it is an interview of HR with the employee. According to Gumbus and Johnson (2003), they are asked questions that are aimed at finding out how happy the employees may be at work, as well as some of the problems they encounter. They are also asked where they get information on the company, as well as how they think the company can improve its communication. Futura also uses leadership survey, where employees are questioned on how they can help the manger improve his management and leadership skills. This in turn, will increase the effectiveness of the em ployees and promote a two-way communication between the manger and employee. Futura has also certification and training matrix as a measure, which has provided a guide to compensation and able to monitor the employee future career improvement with the company. It has also encouraged employees to see clearly and be able to improve on their future performance at Futura. Other measures include; customer service, here the company is determined to provide exceptional customer service through hiring people with interest in company goals and able to retain those that have an excellent customer service. This dimension measures customer satisfaction and complaints, on-time delivery and return material rate (Gumbus and Johnson, 2003). To be able to achieve this Johnson management conducts meeting every month. Other measures include internal operations and financial and also flexibility of the balanced scorecard. Futura was encouraged to introduce a tool that would improve the cost of informat ion on each customer and this tool have been used by sales force, to manage net-gross, margin levels and be able to analyze each customer. Futura may use internal operations to predict the ability of the job to be successful and be able to measure continually, and because employees’ skills change so should the balanced scorecard (Gumbus and Johnson, 2003). Conclusion The measures implemented by Futura do capture the full

Multi-national operation and risk management of Debenhams plc Essay

Multi-national operation and risk management of Debenhams plc - Essay Example It is in light of this that Debenhams has been brought under the spotlight for a through market analysis on how the company presents itself on the international market and seeks to better its financial performance through the engagement of various forms of globalisation strategies. Whiles initiating globalisation strategies, it is also admitted that there are risks that can easily prevent the company from growing to the level it desires. Risks management strategies within the company are therefore scrutinised to balance the discussion. Company Description Not only is Debenhams listed on the London Stock Exchange but it is also a member of the FTSE 250 index (Davidson, 2010). Currently, the company emphasises on UK, Ireland and Denmark as its major market destinations. This notwithstanding, there are number of international franchise that operate under the name of the company. As of 2012, the total number of UK, Denmark and Ireland based locations for the company were 172 and those op erating as international franchise were 68 stores across 25 countries (Alter, McLaughlin & Melniker, 2008). The company is currently engaged in retail chain departmental stores, which means that it is not a manufacturer of the products that it sells out to customers. In effect, the company does not source raw materials but depend on suppliers who deal directly with the manufacturers of the various products that the company displays on its shelves. The operational industry of the company mainly focuses on the sale of electrical and electronic products, clothes, accessories, cosmetics, gifts, toys, shoes and home furniture. The operating income with which the company went into the 2012 annual market was ?158.3 million, out which ?2,229.8 million was produced as revenue and ?125.3 million as net income (Kingdon, 2013). The operations of the company in all its local and international stores are run by a powerful 29,000 employee base that undertake all forms of duties ranging from manage rial positions to cleaning (Kloha, Weissert & Kleine, 2005). Financial Performance and Globalisation Strategies Gross transaction value Since 2008, Debenhams has focused its strength on competitive global marketing on two larger market segments, which are UK and International market segments. Together, these two form the group market for the company. To measure its profitability ratio, there is a lot of emphasis on the gross transaction value that the company creates, as this value represents the unadulterated quantum of revenue accrued by the company over given period of time (Groves, Godsey & Shulman, 2012). From the table below, it would be noted that there has been a steady rise in the physical quantum of gross transaction value for both UK and international markets. However, these increases have not come at an even interval of growth as the figure shows that there are years that the percentage rise goes down even though they do not represent negative growth trends. What is more , the margin of percentage growth has always only been minimal, indicating that the company

Luxury Car Market in India Essay Example for Free

Luxury Car Market in India Essay The Luxury goods industry is a very wide industry comprising of products from watches, jewellery, perfumes, expensive wines to yachts, expensive pens, and clothes. Goods for which demand increases more proportionally as compared to income, are known as ‘Luxury goods’, in contrast to a necessity goods, for which demand increases less proportionally to income. Some luxurious goods are bought due to the tag implied of a status symbol, such goods tend to signify the purchasing power of those who buy them. These goods are not always better in quality or appearance than their less expensive substitutes. The main purpose of purchasing these goods is to display the wealth of their owners. The industry is said to be highly cyclical and the driving force behind the growth of this industry is wealth worldwide, while the economic growth and conditions of various regions affect this industry. Jewellery has been part of the Indian civilization since ancient history. They were in fashion since ancient civilizations as Harappa and Mohanjodaro. Made out of almost any material, jewelry is basically adorned to highlight nearly any body part. Be it the traditional jewelry or the latest ones which are increasingly in demand, i. e. the costume imitation jewelery. There is no dearth when it comes to accentuating the beauty with varied imaginative stunningly designed jewelry items. This report has focused on luxury product categories jewellery. The report provides an overview on the size of the market, importance of luxury goods, target market, problems faced and the various driving factors as well as the latest trends. The major global luxury market players have been profiled. STATEMENT OF RESEARCH QUESTION? The Indian gems and jewellery sector is also largely unorganized at present. There are more than 15,000 players across the country in the gold processing industry, of which only about 80 players have a turnover of over $4. 15 million. I want to evaluate the problems faced by the jewellery sector and come up with measures to help make the sector more organized. ?The rise of the middle class population in India is estimated to be around 120-150 million. Keeping this in mind I want to potray the market potential of luxury goods in India. ?India as a Manufacturing Hub for Global Luxury Brands. I want to study and evaluate methods adopted by major countries and conclude the possibility of India being the manufacturing hub for global luxury brands. THEORETICAL RATIONAL The advent of foreign luxury brands is in a way an indicator of the promising India growth story. Looking to reap early mover advantages, these brands have set up shop in our country. The Indian luxury market, currently in its growth stage needs to address key concerns like the lack of adequate retail infrastructure and limited availability of trained workforce for the trade if it wishes to promote luxury retail in the country. The world today is looking at India, and the products coming out of it. Our skills pool speaks of the highest level of craftsmanship and creativity as it has evolved and been refined by many generations that carry on the trade. India is also well poised to be an outsourcing destination for foreign luxury brands. The obvious benefits that India has to offer such as low labour costs, superiority of fabrics and customization, gives it an advantage over other mass producing countries. To achieve the objective of promoting indigenous brands and positioning India as a future manufacturing hub for luxury goods, consolidation in the industry is imperative. The need of the hour is for the industry players to create a sophisticated business model supported by financial and legal footings, and for the government to develop the requisite infrastructure. Indias luxury sector has gained significant speed. It has the potential and resources, to outshine other developing economies. Thus the route is chalked out and the objective is known. If the road can be cleared of challenges and impediments, luxury retailing in India will have a smooth drive ahead. THE EXPECTED IMPLICATIONS OF THE RESEARCH PROJECT FOR ORGANIZATIONS My research on luxury goods and jewellery is innovative because it brings together analysis of national discourses about Indian market with a study of the practices and choices of the Indian government and the luxury goods and jewellery sector. I believe this research can be helpful to the nation, development agencies, and indigenous organizations. I am particularly committed to sharing the results of my analysis with the Jewellers Association in India and hope that my work will not just be an extraction of truths, but will give them information with which they can help make the sector more organized. PRELIMINARY LITERATURE REVIEW Attempting to break into markets overseas is generally more challenging than trying to expand into new domestic markets. Globalization is the process of social, political, economic, cultural and technological integration among countries around the world. (Hodgetts / Luthans / Doh, 2006:pg. 7). Evidence of growth is seen by increased levels of trade, capital flows and migrations; a lot of changes in the environment have taken place. India is the world’s second most populous country; it has traditionally had more than its share of political and economic problems. The per capita GDP remains low, but the recent environmental trends have boosted thus helping to bolster a large middle and upper- class market for goods in the luxury and jwellery industry. The industry is dominated by family jewellers, who constitute nearly 96% of the market. Organised players such as Tata with its Tanishq brand, have, however, been growing steadily carving a 4% market share. As India’s jewellery market matures, it is expected to get more organised and the share of family jewellers is expected to decline. There are more than 6,000 players in domestic diamond processing industry. The average gestation period for setting up a diamond cutting and polishing unit is 15 months. The low gestation period, coupled with low capital cost allows easy entry into the sector. This has led to the industry being largely characterised by a large number of small scale players. However, just as in the case of jewellery, the share of the organised sector has increased significantly in recent years due to an increase in demand for better and finer quality of finished goods. India Gems and Jewellery Industry – Highlights Jewellery market size – $13 billion Diamond jewellery – $1. 2 billion Gold jewellery market growth year on year – 15% Diamond jewellery market growth – 27% (By bharatbook. com Dated: Jul 24, 2008). According to market reports, around 6- 7 million Indians can afford to buy luxury goods but hesitate to do so since they are unfamiliar with brands and products. With a growing millionaire base in India, the luxury market is growing annually at around 35% CAGR (The Economic Times: August 10, 2008) If India keeps the last three years average growth at 9%, the income levels of consumers is expected to almost triple by 2025. By 2025, it is estimated that India will become the fifth largest consumer market, rising from 12th largest today. High disposable income and a largely young population will drive consumption patterns upwards. With a huge youth populace below 25 years and having a 17% share of the world working population, India presents a huge market for brands across the spectrum. It is estimated that 52% of luxury customers are in the age bracket of 25-34years old. By 2033, the active age group 25-45 years is expected to be around one third of the population. With the average age of potential luxury consumers decreasing, the country is a goldmine waiting to be tapped. Given the core strengths of the manufacturing sector, India can well become a manufacturing hub for global luxury brands. Already brands like Louis Vuitton and Frette are looking at India as a manufacturing base for their products, but there are others who simply source their requirements from India. It is estimated that the manufacturing of luxury items in India can grow to US $500 million13. This manufacturing capability if harnessed properly can propel India as one of the leading destinations for manufacture. The cost advantages, particularly in labour intensive sectors like leather and accessories add to the advantage of the country. Luxury in India To be successful in India, it is both necessary to gauge the financial potential as well as the mindset of the Indian luxury consumer. This will help in bringing forth the right product offerings to the Indian consumer as well as targeting them better. Qualitative Insights 1. According to a study by American Express, ‘Inside the Affluent Space’, the mindset of the Indian consumer is a desire to prove that â€Å"I’ve Made It†. This can be related to the luxury categorization which is based on the fact that luxury is seen as a reward, both for achievements in life as well as showcasing these achievements to others. 2. The Luxury Marketing Council Worldwide has established a chapter in India, with the aim of promoting luxury in India. Their task will also be to build synergy between various luxury brands interested in India by way of sharing of consumer insights as well as best practices. 3. Even the Asian region is not uniform in its preference for luxury in terms of need fulfilment. Therefore, it becomes important to delineate the needs of the Indian consumer from the other Asian regions to target them better. This agenda gains importance because many Indians look at acquiring luxury from places such as Hong Kong, Tokya, China etc. Eg. It is interesting to note that Singapore consumers are more of connoisseurs compared to Hong Kong consumers who want Talk-Value from their luxury goods. 4. Hindustan Times has been at the forefront of driving the luxury revolution in India by organizing two Indian Luxury Conferences in the last 4 years. To add to it, it also brings out a monthly supplement of luxury goods available in India, thereby creating awareness for the luxury brands. Quantitative Insights. 1. As far as quantitative estimates are concerned, there will be 135,000 millionaires (in US dollar terms) in India by 2009. 2. The affluent market is set to grow at a rate of 13% in India, and by 2009, there will be approximately 1. 1 million affluents here. 3. The wealth potential of India’s affluents was to the tune of US$ 203 billion as of 2005. HYPOTHESES Keeping my literature review in mind my hypotheses would contain: Aim †¢The aim of this research is to study the different entry strategies and analyse which strategy is the most appropriate for luxury goods and jewellery in India. Objectives †¢Develop a case study on Indias luxury goods and jewellery industry and its progress to date and to seek secondary information that relates to entry strategies in the luxury goods and jewellery business. †¢Study the luxury goods and jewellery industry environment and Indias modifications. DATA SOURCES AND THE JUSTIFICATION FOR THE CHOICE Secondary Data Source The secondary data source would be documentary data: books, electronic media, and articles published in journals and newspapers which would help to answer the research question. Primary Data Source. To validate the finding of the research, interviews will be taken from the people who are in the jewelry and luxury goods industry. Semi structured interviews will help in putting across our research question and also listening on the topic area which interest the interviewee. Questionnaires data under this would help me to evaluate the general perceptions. Sample Size of primary Data Large qualitative methodology will be adopted for primary data collection. A survey conducted by e-mail questionnaire. A sample size of a few questions will be analyzed and interpreted with an approval from the supervisor. Method of Data Collection The literature search will aim to be comprehensive, but restricted access to primary literature. The collection of primary data will be based on a survey; the number would be restricted due to the restrictions of time to complete the project and resources to support it. I intend to collect data from luxury goods and jewellry industrialists who include manufacturers, exporters, traders, agents, lecturers, and students through questionnaire. Surveys and questionnaires will be administered on paper, in different formats. All may take place in person, or by mail, over the phone or via Internet/ Email. Data Analysis Both qualitative and quantitative techniques will be used in this research. The data obtained from the questionnaire will be analysed using quantitative technique. An interview and data which is collect from secondary source will be analysed qualitatively.. Interview data will be transcribed and then analysed qualitatively. Here, qualitative research would be used explore and understand peoples beliefs, experiences and attitudes. And quantitative research would be all the numerical data which would be from the surveys and questionnaires. RESEARCH DESIGN Dissertation Time Plan. MonthActivity December 3rd/4th weekStart thinking about the research ideas and data collection January1st/ 2nd weekLiterature searching and define objectives. January 3rd/4th weekLiterature searching/ writing. Submission of proposal Febuary1st/2nd weekDrafting of literature review/ working on Research Methodology/Conduction Interviews/ Meeting the tutor and taking a feedback February3rd/4th weekChecking literature review/ Analysis of the data collected and linking theories to the case study. July 1st/2nd weekMeeting tutor and check for final revision. July 4th weekSubmission of final draft. METHODOLOGY TO BE EMPLOYED The research for this dissertation would be done using multi-methods this is because different methods can be used for different purposes in this study. The research would have an inductive approach as I would collect data from companies and bring out responses to the research questions. The time horizon would be cross- sectional because this study is of particular trend, and not longitudinal analysis as they are made on observations over a period of time. The data collected would be by multi-methods i. e. qualitative and quantitative. These methods would be used to study the changes in environments. There would be secondary data to analyze the changes within the context of the organization. Details of any ethical considerations and steps taken to meet potential ethical concerns. Luxury goods should not be confused with the moral legitimation of their consumption. Especially if you are yourself a merchant who profits from the trade in luxury goods. Spending money on luxury goods, does good to the poor by inducing them to exert the industry, rather than keeping them idle. Hence creating employment for the poor. This kind of justification takes the issue of motivation for granted, that is, it assumes that people desire to consume luxury goods with a good conscience, thus keeping money in circulation. The following steps can be taken to meet potential ethical concerns: †¢Raising awareness of the code with subsidiarys. †¢Evaluation of the ethical monitoring programme. †¢Further monitoring of additional high risk suppliers from whom the company sources goods †¢ †¢Respect the use of banned substances/chemicals and provide an â€Å"alert service† to the retailers. References Books †¢ Charles W. L. Hill (2003), International Business †¢ Financial Times Management (1999), Mastering Global Business. †¢ George S. Yip (1992), Total Global Strategy. †¢ Gill, J. and Johnson, P. (1997) Research Methods for Managers (2nd edition), London, Paul Chapman. †¢ Harold chee, Rod Harris (1998), Global Market Strategy. †¢ Helen Deresky (2006), International Management, 5th edition: Managing across borders and cultures. †¢Hodgetts, Luthars, Doh (2006), International Mangement: culture, strategy and behaviour(6th edition), America, Mc-Graw-Hill/Irwin. †¢Isobel Doole, Robin Lowe (2004), International Marketing Strategy: analysis development and implementation. †¢GEMSTONES By Ronald F. Balazik †¢Fortune Magazine, 2007 †¢Mintel International Group, 2006 Websites †¢AmCham Shangai, http://www. amchamshanghai. org/AmchamPortal/MCMS/Presentation/Publication/Insig ht/InsightDetail. aspx? Guid=%7BFCCD3DCF-18BB-4705-9C8D-C677B764ACE1%7D †¢The Economist, August 2007 http://www. economist. com/business/displaystory. cfm? story_id=9005244 †¢Seeking Alpha http://seekingalpha. com/article/15478-growth-in-chinas-luxury-goods-market-to-be-fueled-by-2nd-tier-cities †¢http://www. just-style. com/store/product. aspx? ID=53193 †¢http://www. robbreport.com/News/Press-Releases/Robb-Report-Launches-Robb-Report-Global. asp †¢The Economist, August 2007 http://www. economist. com/business/displaystory. cfm? story_id=9005244 †¢International Herald Tribune, 2005 http://www. iht. com/articles/2005/12/04/opinion/rbuy. php †¢Forbes, 2005 http://www. forbes. com/2005/06/22/luxury-wealth-trends-cx_sr_0622luxury. html †¢Wikipedia http://en. wikipedia. org/wiki/Luxury_good †¢Harvard Business School, http://hbswk. hbs. edu/item/4321. html †¢Miami Herald 2007, http://www. miamiherald. com/business/story/271242. html †¢Boston Consulting Group, http://retailindustry.about. com/od/seg_luxury/a/bl_bcg071304_2. htm †¢International Herald Tribune, 2007 http://www. iht. com/articles/2007/01/15/bloomberg/sxlux. php †¢Alf Nucifora, http://www. nucifora. com †¢HNWIs Behaviors and Portfolios Globalize, 2006, Merrill Lynch-Capgemini †¢Harvard Business School, http://hbswk. hbs. edu/item/4321. html †¢The Economist, August 2007 http://www. economist. com/business/displaystory. cfm? story_id=9005244 .†¢The Economist, August 2007 http://www. economist. com/business/displaystory. cfm? story_id=9005244 †¢Cosmetics Design Europe, 2006 http://www. cosmeticsdesign-europe.com/news/ng. asp? id=65405-luxury-goods-experiences †¢Boston Consulting Group http://retailindustry. about. com/od/seg_luxury/a/bl_bcg071304_2. htm †¢WWD. The Magazine, The Luxury Institute http://www. luxuryinstitute. com/about/news. html †¢Forbes, 2005 http://www. forbes. com/2005/06/22/luxury-wealth-trends-cx_sr_0622luxury. html †¢Wikipedia, http://en. wikipedia. org/wiki/Concierge_medicine †¢Forbes, 2005 http://www. forbes. com/2005/06/22/luxury-wealth-trends-cx_sr_0622luxury. html †¢WWD The Magazine, The Luxury Institute http://www. luxuryinstitute. com/about/news. html †¢The Economist, August 2007. http://www. economist. com/business/displaystory. cfm? story_id=9005244 †¢US Chamber of Commerce, January 24, 2007 http://www. asiapacificms. com/articles/korea_counterfeits/ †¢http://www. iltm. net/en-gb/press/pressreleases680. cfm nation master. com Articles †¢Luxury goods market in India keep its cool 10 Aug 2008, †¢The Kirk Report Problems With Luxury Goods -TUESDAY, OCTOBER 23,2007 †¢Market for luxury goods: THE CASE OF THE COMIT? COLBERT By Giacalone, Joseph A Publication: Southern Business Review Date: Fall 2006 2006 †¢Why The Luxury Market Continues To Roar by Alf Nucifora.

Effect Of Music And Noise On Working Memory Psychology Essay

Effect Of Music And Noise On Working Memory Psychology Essay Memory is an integral part of everyday life. It is required for simple tasks, such as keeping a phone number in mind before dialling it, or for more complex tasks such as learning a mathematical formula to apply to a sum. Memory is based on three basic processes. It can be defined as the process by which individuals encode, store and retrieve information (Feldman, 2004). Encoding is the receiving of sensory information and transforming it into some form which can be stored. Storing is the process of putting the information into memory. Retrieval is the process of gaining access to the stored information (Morgan, King, Weisz Schopler, 2008). The interaction of these three processes is required for the proper functioning of memory. Memory failure, that is forgetting, can occur when information has not been properly encoded and stored and therefore, there can be no retrieval (Baddeley, Eysenck and Anderson, 2009). The working of memory cannot be reduced to just a single explanation. It is composed of various interrelated systems. In 1968, the Atkinson-Shiffrin Model of Memory was proposed. It stated a three stage model of memory. Information, which was recorded by an individuals sensory system, enters sensory memory which holds the information momentarily. The information then moves to short-term memory, where it is stored for 15 to 25 seconds. And finally, the information moves to long-term memory where it is relatively permanent. The amount and kind of rehearsal of the information determines whether the information will move from short-term memory to long-term memory, or not (Feldman, 2004). Stimulation of extremely brief duration is stored in sensory memory. This is the first kind of information presented by the environment to individuals. The term sensory memory denotes different types of memory (Feldman, 2004). In the early 1960s, scientists at Bell Laboratories in USA analysed the fleeting visual memory system, which later came to be known as iconic memory. It is the brief storage of visual information. The auditory counterpart or auditory sensory memory is echoic memory (Baddeley, Eysenck and Anderson, 2009). Iconic memory is said to last for less than a second while echoic memory lasts for two to three seconds. Sensory memory can store information for a very brief time only. If the information does not pass to short-term memory, then it is lost forever. Information that is stored transiently in sensory memory is not meaningful as it is only a representation of raw sensory stimuli. For long-term retention the information is passed on to short-term memory which is the next stage of memory (Feldman, 2004). Short-term memory is the performance on particular types of task involving the simple retention of small amounts of information which is tested either immediately or after a short delay. Short-term memory forms a part of working memory. There are various methods of testing short-term memory. One of the classical methods is the digit span test which requires remembering digits for a short period of time. Specific amounts of information can be held in short-term memory. George A. Miller, one of the founders of cognitive psychology, in 1956, suggested that memory capacity is limited by the number of chunks of information. A chunk is a meaningful group of stimuli that can be stored as a unit of short-term memory (Baddeley, Eysenck and Anderson, 2009). For the transfer of information to long-term memory from short-term memory, rehearsal is required. It is the repetition of information that has entered short-term memory. If elaborative rehearsal is used, the information is more likely to get transferred to long-term memory; otherwise it may only remain stored in short-term memory. Elaborative rehearsal is the strategic organization of information (Feldman, 2004). In the late 1960s, the idea of short-term memory being a unitary system was discarded and new theories emerged. These explained short-term memory as involving a number of systems interacting with each other. One such model is of verbal short-term memory. It is the concept of phonological loop. The phonological loop features a part in the multi-component working memory model proposed by Baddeley and Hitch in 1974. The phonological loop is composed of two parts, a short-term store and an articulatory rehearsal process. This store has a limited capacity. The items are stored as memory traces and decay within a few seconds. But, these traces can be retrieved by sub vocal rehearsal. A prominent feature of the short-term store is the phonological similarity effect. This is a tendency for immediate serial recall of verbal material to be reduced when the items are similar in sound. Therefore, remembering a series of dissimilar words is easier than remembering a list of words that are phonologically similar. But, this effect does not appear when the lists are lengthened and if there are several learning trials involved. It is also seen that there is a tendency for verbal memory span to decrease when longer words are used. This is the word length effect. Another factor which disrupts verbal short-term memory is the irrelevant sound effect. It was found that music interfered with digit recall. Vocal music was more disruptive that instrumental music. The retention of serial order can be disrupted by irrelevant stimuli provided they fluctuate over time. Another concept of short-term memory is the visuo-spatial short-term memory. The visual and spatial components have been proposed as a part of the visuo-spatial sketchpad which is a component of working memory. It is a counterpart of the phonological loop (Baddeley, Eysenck and Anderson, 2009). After the 1960s, short-term memory has transformed into the concept of working memory. According to this, information is not only retained for a short period of time, but can also be manipulated and can be involved in higher order processing activities such as comprehension, problem-solving and reasoning (Levin, Thurman and Kiepert, 2010). In 1974, Baddeley and Hitch drew two main observations from studying the effect of an irrelevant memory load on verbal reasoning. The first was that an irrelevant short-term memory task interfered with cognitive tasks. This was consistent with the idea of a common working memory system that combines temporary information storage with ongoing mental operations. Secondly, the concept of working memory went beyond that of short-term memory. It included an additional resource which was not shared with short-term memory (Graham J. Hitch). Working memory refers to the ability to coordinate mental operations with transiently stored information during cognitive activities (Graham J. Hitch). It is a system for temporary maintenance and manipulation of information that is helpful in performing complex tasks (Baddeley, Eysenck Anderson, 2009). An example of the usage of working memory is complex mental arithmetic where the task is broken down into several stages. The various stages have to be coordinated and the early stages generate transient information that has to be maintained for use in the later stages (Graham J. Hitch). Working memory and cognitive abilities are related to each other. Working memory affects cognitive tasks and, in turn, cognitive abilities are required for the understanding and manipulation of working memory. The Baddeley-Hitch Model of Working Memory, which was proposed in 1974, is highly influential and attempts to give a clear understanding of working memory. According to this model, working memory has three components: the phonological loop, the visuo-spatial sketchpad and the central executive. The phonological loop is specialized in holding sequences of acoustic items. The visuo-spatial sketchpad performs a similar function for visually and spatially encoded items. This entire system is controlled by the central executive which is an attentionally limited system that selects and manipulates material in the subsystems (Baddeley, Eysenck Anderson, 2009). A few factors affecting phonological memory are the phonemic similarity of items as well as the word length of the items. Memory spans vary with the length of the items. They are higher for shorter items than for longer items. But, these effects did not appear when the items were presented visually. Spoken stimuli accesses the articulatory loop automatically whereas visual inputs have to be verbally recoded, a control process that involves subvocalization. The phonological loop also explained why the presence of background speech disrupts short-term memory for visually presented verbal stimuli. According to Baddeley, irrelevant noise was easier to ignore than irrelevant speech which suggested that unattended speech enters the phonological store whereas non speech sounds do not. Working memory is thought to be under the control of the central executive. It is responsible for the coordination of mental activities in working memory as well as supervision of phonological loop and visuo-spatial sketchpad and the interaction with long-term memory (Graham J. Hitch). In 2000, Baddeley proposed a fourth component of the working memory model which would explain its interaction with long-term memory. It was called the episodic buffer and was assumed to be a storage system which could hold about four chunks of information in a multidimensional code. It acts as a link between the various components of working memory, and connecting the components with input from long-term memory. It has been studied that music has a favourable effect on working memory. Classical music such as Mozarts Sonata for two pianos in D Major, K.448 and Vivaldis Four Seasons: Spring are said to have an especially beneficial effect, by improving cognitive performance of individuals (Copley, May). In 1993, Rauscher et al claimed that after listening to Mozarts sonata for 2 pianos (K.448) for ten minutes, subjects showed better spatial reasoning skills than after listening to relaxation instructions or silence (Jenkins, 2001). This came to be known as the Mozart Effect. Rauscher et al stated that the participants IQ increased by 8 to 9 points over the two other conditions- relaxation and silence (Smith, Waters and Jones, 2010). The Vivaldi Effect was observed in a study when it was found out that those who listened to Vivaldi while exercising increased their scores of verbal fluency tests after their workouts compared to those who exercised without music (Roberts, June). Background noise is any sound that distracts or interferes with an individuals focus of attention. Background noise is said to disrupt the concentration of an individual. It can affect a persons ability to think clearly and retain information and can impair learning and memory (Andrews, January). Noise can include road traffic, people talking in the background, etc. Working memory is an important component as everyday cognitive tasks rely on it. It is integral in the development of language and reading. The study aims to explore the influence of music (classical) and background noise on working memory, which is responsible for enabling complex cognitive activities. The Mozart Effect has been observed to have a beneficial effect on visuospatial performance. This study aims to see if it can be extended to the performance of working memory as well. The study will also observe whether conditions of silence and music will elicit a better performance of working memory than the condition of background noise and the condition of background noise and music. The objectives of this study are to find out if music has a positive effect on working memory and if noise has a detrimental effect on working memory. In addition, the study aims to compare the effects of silence and music on working memory as well as to find out if background noise and music will have a detrimental effect on working memory. The hypotheses of the study are that music will have a positive effect on working memory, noise will have a detrimental effect on working memory, silence will have a better result on the performance of working memory than music and background noise and music will have a detrimental effect on working memory. Chapter Two Review of Literature Various studies have been conducted which show the positive and detrimental effects of music and noise on working memory. The following research articles look at studies which have been conducted which express the relationships between music, noise and working memory. The Effects of Background Music and Noise on Working Memory was conducted by Amanda Eiras and Kaycee McNeil. It examines how verbal working memory was affected by background music and noise. The study was conducted on 14 participants between the ages of 18 to 30 years. The participants were made to recall a list of 30 words in 30 seconds under four conditions: in silence, in music, in noise and in music and noise. It was found that the presence of music was not statistically significant F(1,11) The Effect of Background Music and Noise on the Cognitive Test Performance of Introverts and Extraverts was conducted by Stacey Dobbs, Adrian Furnham and Alistair McClelland. This study examines whether background noise is as distracting as music and the effect it has on introverts and extroverts while they do cognitively complex tasks. 118 female school children between the ages of 11 to 18 years were the participants of the study. The participants were made to complete 3 tasks- RPM, Wonderlic Personnel Test and Verbal Reasoning Test Byron, 2006 under 3 conditions: noise condition, music condition and silence condition. The results showed that in RPM, the performance in silence was significantly better than in the presence of music and the performance in music was significantly better than in the presence of noise. In the Wonderlic Personality Test, the performance in silence and music was significantly better than in the presence of noise. The performance in the presence of silence was not significantly different from performance in the presence of music. In the test of verbal reasoning the performance in silence was significantly better than with music and just failed to be significantly better than with noise. There was no significant difference between performance under music and noise conditions. Recall of Words Heard in Noise was conducted by Anders Kjellberg, Robert Ljung and David Hallman. This study examines if recall of words and recognition of sentences, when orally presented, were affected by the presence of background noise. 32 participants between the ages of 18 to 34 years were chosen. The participants were required to complete two memory tasks: recall of words and recognition of sentences under two conditions- with background noise and without background noise. The results show that the number of words correctly recalled were significantly lower in the noisy condition (mean= 8.50 and 11.03 for noise and control condition respectively.) In the recognition of sentences task there was no significant differences between the conditions. Does music enhance cognitive performance in healthy older adults? was conducted by Nicola Mammarella, Beth Fairfield, and Cesare Cornoldi. This study examines whether music can enhance cognitive performance. 24 participants between the ages of 73 to 86 years of age were chosen. The participants were required to do two tests: a forward version of digit spans and word fluency test under three conditions: music, no music and white noise. The results for digit span show that the music condition showed a significant advantage over the white noise condition and the non-music condition. There was no difference between the white noise condition and the non-music condition. The results for the phonemic fluency show that there is a significant advantage of music over white noise and non-music conditions. And the difference between white noise and non-music conditions were not significant. Listening to the Vivaldi excerpt led subjects to show a significant increase in phonological working memor y capacity and phonemic fluency. Acoustical Barriers in Classrooms: The Impact of Noise on Performance in the Classroom was conducted by Julie E. Dockrell and Bridget M. Shield. The study examines the effect of classroom noise on the performance of primary school children. 158 children were chosen as participants for the study. Their mean age was 8 years and 6 months. The participants were given four tests to complete: an aptitude test, verbal tests which included reading and spelling, non-verbal tests and an arithmetic test under three different class noise conditions: base (normal classroom condition when children are working quietly and no one is talking), babble (noise consisting of childrens babble) and babble with environmental noise. The results showed that verbal task performance is worst in babble and best in base condition. In the non-verbal tests, the performance is best in the babble and environment noise condition. The study, The Effect of Background Music and Background Noise on the Task Performance of Introverts and Extraverts was conducted by Gianna Cassidy and Raymond A. R. Macdonald. This study examines the effects of music with high arousal potential and negative affect, music with low arousal potential and positive affect and everyday noise on the cognitive performance of introverts and extraverts. The sample size was 40. It included 20 university student, 10 adolescents and 10 non-studying/working adults. The materials used were music with lyrics and background noise (which was everyday general sound, classroom working sounds, traffic and conversation including laughter). The participants had to complete 5 cognitive tasks. They were the Stroop Neuropsychological Screening Test, a delayed recall task from the Rivermead Behavioural Memory Test (version A, item 6 A), a free recall task which had 20 six letter words, a distractive task which was a numerical task and the delayed recall task. The participants completed the five tasks in one of the four background sound conditions: positive low arousal music which was relaxing, negative high arousal music which was aggressive, background noise and silence. Performance on all the tasks was poorer while listening to background sound (which includes music and noise) compared to completing the tasks in silence. Listening to high arousal music was significantly more detrimental to task performance than listening to low arousal music across all tasks. Background noise and high arousal music significantly reduced performance across all tasks compared to the silence condition. High arousal music was more detrimental to task performance the Stroop task. The Effects of Acute Background Noise on Recognition Tasks was conducted by Daniel Diegard. 23 students were chosen as the participants for the study and the mean age was 22 years. The materials used were random white noise, encoding items, a distracter task which was a mental arithmetic task and a working memory capacity test which required the participants to complete an arithmetic test and alternating between equations and memorizing word sequences. The results showed that there was no significant difference between the four noise conditions effects on the participants recognition score. There was a significant within-subject effect on the participants response times, dependant on the presence of noise during the recognition part [F(1,21)=5.60, p=0.028] and also a between-subject ffect for the two experimental groups [F(1,21)=8.57, p=0.008]. Background white noise had no significant effect on the participants learning capacity. It was seen that the interaction effect of the experi mental group and encoding noise did approach significance. The results of this study are shown to be inconsistent with most previous studies conducted. Effects of Prior Exposure to Office Noise and Music on Aspects of Working Memory was conducted by Andrew Smith, Beth Waters and Hywel Jones. The participants of this study were 36 undergraduate students between the ages of 18 to 25 years. This study was further divided into two studies. The first examined whether habituation occurred to office noise and how long it takes for habituation. The second study was an attempt to replicate the Mozart Effect which represents an improvement in spatial reasoning following listening to Mozart. In the first experiment, a mental arithmetic task was given to the participants. After the first mental arithmetic task, a habituation period to office noise was presented for five minutes. There were three conditions which were used. The first was continuous noise condition which was heard throughout the presentation of all the mental arithmetic tasks and the habituation periods. The second was the noise control condition in which the participants heard n oise during the mental arithmetic task but not during the intervening habituation period. The final condition was the quiet condition in which no noise was presented during the mental arithmetic task. The habituation phase was for 20 minutes in total placed between the arithmetic tasks. The results showed that there was a significant effect of noise condition [F(2,33)=8.3, p In the second experiment 24 undergraduate students were chosen to be the participants. Their mean age was 22 years. The participants had to complete spatial ability tasks in three conditions: after listening to Mozarts piano sonata, after positive mood induction and after sitting in silence. The results showed that the participants had higher scores on the test in the Mozart condition than in the other 2 conditions. Music Listening While You Learn: No Influence of Background Music on Verbal Learning was conducted by Lutz Jancke and Pascale Sandmann. This study examined the influence of listening to background music on verbal learning performance. The sample size of this study was 75 and the participants were randomly assigned to five groups. The participants had to learn the presented verbal material with and without background music. Each group of participants was exposed to one of five different background stimuli: in-tune fast, in-tune slow, out-of-tune fast, out-of-tune slow and noise. This study did not find any consistent or consequential influence of background music on verbal learning. There was neither an enhancement nor a decrease in verbal learning performance during the presentation of the background sound conditions. The Relative and Perceived Impact of Irrelevant Speech, Vocal Music and Non-Vocal Music on Working Memory was a study conducted by Thomas R. Alley and Marcie E. Greene. The sample size of this study was 60. The study examined the effects of vocal music, equivalent instrumental music and irrelevant speech on working memory to understand how music affects performance and the degree of impairment. The participants completed a digit span task in the presence of irrelevant speech, vocal music, instrumental versions of the vocal music and silence. The results of this study showed that speech and vocal music hindered performance. The performance in instrumental music was better than that of vocal music but was not significantly different from speech or silence. Chapter Three Methodology The aim of this research will be to study the effects of music and background noise on working memory. Research Design A quantitative study will be carried out and experimental research design will be used. The study will involve a group of individuals who will be made to recall lists of words under four different conditions- silence, background noise, music and music and background noise. Hypotheses Music will have no effect on working memory. Noise will have no effect on working memory. Silence will have no effect on working memory. Background noise and music will have no effect on working memory. Sampling Sample size consisting of 40 individuals including males and females in the age range of 19 to 23 years. The sampling method to be used will be convenience sampling. The study is an experimental and quantitative research as variables will be measured and analysed using statistical techniques. Ethical Consideration Informed consent will be given to the participants before the experiment is conducted to ensure that their participation is voluntary. Confidentiality of identity of the participants will be guaranteed. The participants will be allowed to leave the experiment when they want. Tools Used 16 list of 20 words each Mozarts Sonata for 2 pianos in D, K.448 Vivaldi- Spring Clip of background noise on a busy street Data Analysis The Analysis of Variance or ANOVA will be used as there are more than two variables which will be taken into consideration as well as the interaction between the two. Operational Definitions Working Memory- Working memory is the ability to temporarily store words while performing other cognitive tasks. Music- Music can be defined as the vocal and instrumental sound to produce form, harmony and expression. Noise- Noise is defined as unwanted sound. In this study, noise is that which is not important to the main focus of attention.

Ocular Manifestations in Hansen’s Disease

Ocular Manifestations in Hansen’s Disease Christina Samuel1, Sundararajan D2 1Postgraduate, 2HOD. Department Of Ophthalmology, Meenakshi Medical College, Kanchipuram, Tamil Nadu, India ABSTRACT Background: Leprosy or Hansen’s disease is a chronic mildly contagious granulomatous disease of tropical and subtropical regions caused by the rod shaped bacillus, Mycobacterium leprae. It affects the skin, peripheral nerves in hands and feet, mucous membrane of nose, throat and eyes. When left untreated it is capable of producing various deformities and disfigurements. Aim: To study the ocular involvement in patients with Leprosy under the parameters of age group, sex type and duration of leprosy. To study the different ocular manifestations and identify the potentially sight threatening lesions and provide early management. Methods: A prospective study of 50 cases diagnosed with Hansen’s disease were included. Detailed history and thorough clinical examination done. Potentially sight threatening lesions were managed conservatively or surgically. Results: Out of 50 cases of Leprosy, 58% had ocular involvement and majority were of the age group 21-40years. Ocular involv ement was predominantly seen in Lepromatous type with 35% having ocular lesions. The most common ocular manifestation observed was superciliary madarosis(48%). Potentially sight threatening lesions accounted for 72.4% of which lagophthalmos was common. No cases of blindness seen. Conclusion: Visual impairment is preventable in Leprosy if detected early. The risk of ocular complications increases with the duration of the disease, despite being treated with systemic anti-leprosy drugs. Keywords: Leprosy (Hansen’s disease), lepromatous, tuberculoid, slit skin smear, ocular involvement INTRODUCTION Leprosy or Hansen’s disease is a chronic infectious disease caused by an intracellular rod shaped acid fast bacilli Mycobacterium leprae which affects the skin, nasal mucosa, peripheral nerves and the anterior segment of the eye.1 Mycobacterium laprae was discovered by a Norwegian physician G.Armauer Hansen in the year 1874.1 The most ancient writings of ‘’SUSHRUTA SAMHITA’’ compiled in 600BC refers to leprosy as Vat Rakta or Vat Shonita and Kushtha2,3. Leprosy occurs in all ages and both sexes. Male: Female ratio is 2:14. Leprosy bacilli has a predilection for neural tissue and their target is Schwann cell. The fate and type of leprosy depends on the resistance and immunity of the affected individual5 ( Jopling, Mc Douglass 1996). There are 11million cases throughout the world and about 1/3rd have ocular manifestations.6 Prevalence of blindness due to leprosy is 4.7% of the population in India.7,8 Various studies shows ocular involvement in Leprosy patients. The frequency and types of involvement depends on the duration and form of the disease.2,9 Ocular lesions are common in lepromatous type of leprosy and presents with lepromatous nodules, conjunctivitis, keratitis, pannus, scleritis and uveitis. Lesions are rare in Tuberculoid type of leprosy and are secondary to the involvement of branches of facial nerve which presents with paralytic lagophthalmos, exposure keratitis and neurotrophic keratitis. Acute iridocyclitis and scleritis are seen in type 2 lepra reaction occurring in lepromatous leprosy.6 Blindness has been reported in 7% of patients secondary to lagophthalmos, uveitis, exposure keratitis and cataract8. Proper attention and early detection can prevent potentially sight threatening lesions. MATERIALS AND METHOD The present study was carried out in the out patient Department. of Ophthalmology and In patient department of Dermatology at Meenakshi Medical College and Hospital, Kanchipuram from March 2012-May 2014. In this study a total of 50 patients were taken, 38 males and 12 females of the age group 20years and above . Prior to the study an informed consent form from the patients and ethical clearance was obtained from the Institutional Ethics Committee. Inclusion Criteria: All diagnosed cases of leprosy. Old and new cases, both genders and age group of 20 years and above. Exclusion Criteria: Non compliant patients, Patients with pre existing ocular disorders due to other causes than leprosy. Type of study: A cross sectional descriptive study for a period of 14 months. Procedure: Relevant details of both ocular and systemic history, including details of lepra reaction and clinical examination of patients was recorded on a proforma. A detailed slit lamp examination of the anterior segment of eye was done. Visual Acuity recorded with help of Snellen’s chart10. Corneal sensation was checked with a wisp of cotton. IOP was recorded with help of Schiotz tonometer10. Fundus examination with 78D and IDO done. Lab investigations like haemogram, ESR, Urine routine and RBS done. Slit skin smear and skin biopsy from the ear lobe was performed by the Dermatologist and report obtained as positive for M.leprae (Ziehl Neelsen technique)11. Patients were started on systemic anti leprosy drugs(multi drug therapy) and treatment for lepra reactions. Patients with ocular manifestations were treated accordingly to their need of Lubricant eye drops, topical antibiotic with steroid drops, eye ointments, frequent blinking exercises, physiotherapy, lid taping at nigh t time and spectacle correction. RESULTS: In this study of 50 patients with leprosy, majority belonged to the age group of 21-40years (46%). 76% were males and 24% were females. Out of 50 cases, 30% were tuberculoid type, 22% lepromatous type and 48% borderline type. Out of 50 cases 58% had ocular involvement in which 45% were within the age group 21-40years. Out of the 29 cases with ocular involvement 72% were males. 35%with ocular manifestations were of lepromatous type of leprosy. 41.4% gave a positive history of lepra reaction. The ocular involvement was directly proportional to the duration of leprosy. 55% had leprosy more than 5 years. Superciliary madarosis (48%) was the most common ocular manifestation. The potentially sight threatening lesions were Lagophthalmos(35%), seen more in lepromatous type(14%). 28% had corneal hypoesthesia, 21% with exposure keratitis, 17% had corneal opacity, anterior uveitis and conjunctivitis each accounted for 7%. It was interesting to note that 60% of patients with lagophthalm os had exposure keratitis. DISCUSSION: The involvement of eyes in leprosy is due to infiltration of the tissues by the bacilli and damage to the nerves12. In this study 58% of the patients had ocular involvement. This can be compared to other studies of Wani.S.et al 2005 which showed 69% of ocular involvement, Gnanadoss A S et al 1986 showed 59.2% 13. Studies conducted by Shields shows 33% of potentially sight threatening lesions which included keratitis, iritis, lagophthalmos and secondary glaucoma14. In our study the potentially sight threatening lesions were lagophthalmos, exposure keratitis, uveitis, corneal hypoesthesia and corneal opacity which accounted nearly for 72.4%. Majority of the patients in our study were of the age group 21-40 years and male predominance was seen in both for, affected eyes with leprosy(76%) and ocular involvement (72%). This can be compared with the study by Wani.S et al (82.6%)12 which also showed predominance for men. This study further shows that ocular manifestation were se en more in lepromatous leprosy (75.36%) followed by borderline(14.49%) and tuberculoid leprosy(10.14%)12. In our study conducted, ocular involvement was 35% in lepramotous, 31% in borderline and 17% in tuberculoid type. The reason being that M.leprea has a favourable environment in the anterior segment of the eye and the bacilli is found more in lepromatous type of leprosy. Madarosis was the commonest ocular manifestation in our study which was about 48% when compared with Shield’s 1974(54%)14 and Acharaya B P (59.2%)15 and Wani.S. et al (72.46%)12. Lagophthalmos accounts for 35% in our study when compared to Wani.S et al (28.98%)12 , Acharaya B P (34.3%)15 , Lamba et al 1983 (13%)16 , Shields 1974 (29%)14 and Weerekon 1972 (27%)17. Lagophthalmos is commonly associated with lepra reaction in the face and damage to the facial nerve and also depends in patients with lepromatous leprosy(14%) which is similar to the observation by Wani.S et al (18.84%)12. In this study corneal in volvement was seen in 66% of the patients, corneal hypoesthesia 28%, exposure keratitis 21% and corneal opacity in 17%. In the study conducted by Wani.S et al corneal involvement (36.23%)12 . Radhakrishnan N et al observed that the major cause of blindness in leprosy was exposure keratitis due to lagophthalmos(23%) and leucoma (25%)18. Cataractous changes in lens was seen in 17% of the patients, but it was not a complication due to leprosy or MDT but merely due to senile lens changes in the older age group of the patients in our study. This is also supported by the study from Gnanadoss A S et al13. Iris pearls seen in anterior uveitis are said to be the pathognomic of leprosy19,20. But in our study uveitis was observed only in 7% of the patients when compared to Wani S et al12 which showed 31.88%. This probably is due to the small sample size of our study and also the duration of leprosy not being more than 10 years for all patients ,because uveitis is seen mostly in chronic cases o f leprosy. This is supported by various studies like Lamba 1983 16(14%), Hornblass 197321 (16%) and Gnanadoss A S et al 198613 (5.6%). In this study all patients with ocular manifestations were either treated formerly(58.6%) or presently (41.4%) with systemic anti leprosy drugs. Courtright et al suggested that ocular pathology will still occur in MDT treated leprosy patients22. Thus treatment does not prevent the occurrence of ocular lesions12. Moreover once the patient is on treatment the ocular reaction is seen more in the first 6-12 months due to reactions23. The progressive leprosy related lesions are the result of chronic nerve damage. CONCLUSION: The risk of ocular lesions increases with the duration of disease, lepra reaction and facial patches in this reaction. Screening of all patients affected with leprosy can help in identifying the potentially sight threatening lesions which can be treated earlier. Visual impairment if detected early is preventable. The Multi Drug therapy for leprosy has improved the outcome of the affected with leprosy but does not retard the development of ocular complication. LIMITATIONS: Owing to the small sample size in this study many other ocular manifestations could not be assessed. A relationship between uveitis, Complicated cataract and leprosy can be suggested if the patients presents with a longer duration of leprosy more than 10 years, as in this study we had only 4 patients in that category. ACKNOWLEDGEMENT It is with the sense of accomplishment and deep gratitude that we dedicate the work to all those who have been instrumental in its completion. We are greatly thankful to the RMO, Meenakshi Medical College Hospital and Research Institute, Kanchipuram. To our Associate Professors, Assistant Professors, Colleagues and Staffs of the Department of Ophthalmology and Dermatology for their timely help, support and constant guidance in our work. REFERENCE 1.Lewallen, Paul Courtright. An overwiew of ocular leprosy after two decades of multidrug therapy. International Ophthalmology Clinics world blindness. Sept2004, vol47(3):87-99. 2. Dharmendra. History of spread and decline of leprosy. Leprosy.Vol I, Bombay: Kothari Medical Publishing House,197;7-21. 3. Rastogi N, Rastogi RC. Leprosy in ancient India. Int J Lepr 1984;52:541-3. 4. Park K. Epidemiology of Communicable Diseases. Park’s Textbook of Preventive and Social Medicine. 17thedn., Jabalapur: M/S Banarsidas Bhanot Publishers, 2002; 242-253. 5. The disease In: Handbook of Leprosy, 5th edn., Delhi CBS Publishers and distribution; 1996;10-53. 6. Sihota. Tandon disease of uveal tract. Chapter 17.Parsons’ Diseases of the Eye,20th Edition. New Delhi. Elsivier 2007;239-72. 7. Thompson Allardice et al, Patterns of ocular morbidity and blindness in leprosy: Leprosy review vol 77(2) June 2006. 8. Ffytche TJ. Residual sight threatening lesions in leprosy patient completing Multidrug therapy and Sulphone monotherapy, Lepr. Rev, 1991;62: 35-43. 9. Mark J. Mannis Mascai, Arthur. Leprosy, chapter 62. Eye and skin disease, Lippincott- Raven publishers, 1996;543-50. 10. Orthoptists and Prescribing in NSW, VIC and SA. The Royal Australian and New Zealand College of Ophthalmologists. Retrieved 29 July 2010. 11. PVS Prasad. Microbiology. In: all about leprosy. 1st edn. Jaypee brothers publishers,2005.pg 4-11. 12. Junaid S. Wani, Saiba Rashid M.S. Ocular manifestations in leprosy- A clinical study; JK- Practitioner 2005; 12(1): 14-17. 13. Gnanadoss AS, Rajendran N. Ocular lesions in Hansen’s (leprosy). IJO 1986;34:19-23. 14.Jerry A Shields; George O; Waring; AJO,1974,77;880-890. 15. Acharaya B P. Ocular involvement in Leprosy- A study in mining areas of India. IJO 1978; 26:21-4. 16. Lamba PA; Arthanariswaran: Leprosy India 1983,55;490. 17. Lloyd Weerekon: BJO. 1972,56;106. 18. Radhakrishnan N, Albert S. Blindness due to leprosy. IJO 1980;28:19-21. 19. Ffytche. T.J., 1981, Trans. Ophthal. Soc. U.K. 101:325. 20. Hogeweg, M. Leiker, 1983, Brit J Dermat.109:477. 21. Albert Hornblass: AJO.1973,75;478. 22. Courtright. P., Lu Fang Hu. Multi drug therapy and eye diseases in leprosy. A cross sectional study in People’s Republic of China. Int . J. Epidemiol. 1994;23(4):835-42. 23. Dr. Margreet Hogeweg, Prevention of Blindness due to Leprosy. ICEH, http://www.iceh.org.uk.

Embryonic Stem Cell Research Provides Revolutionary and Life-saving Bre

"Stem cell research is the key to developing cures for degenerative conditions like Parkinson's and motor neuron disease from which I and many others suffer. The fact that the cells may come from embryos is not an objection, because the embryos are going to die anyway." -- Stephen Hawking The phrase â€Å"stem cell† calls to mind images of controversy: Pro-life picketers outside abortion and in-vitro fertilization clinics, patients with chronic disabilities waiting on a cure, scientists in a lab experimenting with a petri dish. These cells offer unimaginable opportunities for regenerative medicine because they can retain the ability to differentiate. Stem cells are classified as either adult or embryonic. Embryonic stem cells can reproduce any cell in the body, whereas adult stem cells can only produce somatic cells within their own tissue type. Somatic simply means a cell that is not directly involved in sexual reproduction. What makes research into stem cells exciting is that they can provide a means to regenerate cells in a way that humans cannot accomplish on their own. Spinal cord tissue can be regenerated in paraplegics, giving a new lease on life to war veterans. Mental diseases associated with age such as dementia, Alzheimer’s, and Parkin son's, can be cured. Even entire organs can be reconstructed and implanted into patients that desperately need them, such as in the case of Claudia Castillo, who received a bronchus coated with her own cells. Why then is such a cutting-edge and promising field subject to so much controversy? Because one of the primary sources for stem cells is blastocysts, undeveloped microscopic human offspring only 200 cells large. Generally the opponents of stem cell research are also pro-... ...db0-932e-4bfd-b9ab- 1a874c41df1a %40sessionmgr111&vid=1&hid=110&bdata=JnNpdGU9ZWhvc3QtbGl2ZQ %3d%3d#db=ulh&AN=J0E381453909605>. Obama, Barack. "Finding a Middle Ground." Vital Speeches of the Day 75.7 (2009): 316-319. Academic Search Complete. EBSCO. Web. 5 Aug. 2014. . Scott, Christopher Thomas. Stem Cell Now: from the Experiment That Shook the World to the New Politics of Life. New York: Pi, 2006. Print. Thompson, Tanya. "World first as woman gets organ made from stem cells." news.scotsman.com. Johnston Press Digital Publishing, 18 Nov. 2008. Web. 3 Oct. 2014. . Stephen Hawking Quote Web. 3 Oct. 2014. http://www.brainyquote.com/quotes/keywords/stem_cell_research.html#iM2R1JXFolmB71yF.99