Organizational Change Plan Essay

Falls are a common cause of morbidity and the leading cause of nonfatal injuries and trauma-related hospitalizations in the United States (Center for Disease Control and Prevention, 2012). Falls can occur in home and as well as in any health care facility. In hospitals, falls consistently make up the largest single category of reported incidents, with most falls occurring as a result of medication related issues, toileting, and hospital environment conditions. With falls accounting for the leading cause of injuries in hospital, it is imperative that environment safety and fall prevention is addressed in facilities. This change plan will include the need for implementation of a fall risk assessment and fall precautions, barriers to change, factors influencing change and the readiness for change as well as resources available to support change. These changes will be implementing with the help of using, Kurt Lewin’s Change Plan Theory. Need for the Proposed Change A fall is defined as an event which there is a downward displacement of a patient’s body from a standing, sitting, or lying position that may result in injury (St Peter’s Hospital, 2012). St. Peter’s Hospital in Albany, New York, is one of the major acute care hospitals committed to promotion of patient safety. Acute care hospitals show that fall rates range from 1.3 to 8.9 falls/1,000 patient days and that higher rates occur in units that focus on eldercare, surgical, neurology and rehabilitation (â€Å"National Quality Measures Clearinghouse†, 2013). Due to the high number of patient falls and increased risk factors in the hospital it is imperative to have fall assessments and fall prevention standardized throughout the hospital. Patients’ will be provided an optimal safe environment during care based on the Environment Safety and Fall Prevention Policy and Procedure. Fall  prevention strategies are to be executed per standard of care and indivi dualized based on patient assessment within the patient plan of care. Certain patients are considered to be at a greater risk for falls. Factors such as patients who are 85 years old or older, osteoporosis, anticoagulants treatment, bleeding disorders and patients post-operative. Every patient who is admitted into the hospital is placed on universal fall precautions and nurses will further assess patients based on the Hendrich II Assessment Tool and Get-Up-and-Go Assessment. Patients are also reassessed every shift, with change in condition, after a transfer, and after a fall. The Hendrich II Fall Risk Model is used to assess a hospitalized patient’s risk of falling. Designed to be administered quickly, it focuses on eight independent risk factors: confusion, disorientation, and impulsivity, symptomatic depression, altered elimination, dizziness or vertigo, male sex, administration of antiepileptic (or changes in dosage or cessation), administration of benzodiazepines, and poor performance in rising from a seated position in the Get-Up-and-Go Assessment (Hendrich, MSN, RN, FAAN, 2007). Along with universal fall precautions, Hendrich assessment and Get-Up-and-Go Assessment, staff members should be monitoring their environment on an ongoing basis for situations that may lead to a fall, such as tubing and equipment posing as a tripping hazard. Staff members must be proactive with assisting patients with unsteady gait, need for assistive devise and patients with weakness to ensure safety. Once a patient is scored a fall risk, the nurse will initiates a fall prevention program and activate fall risk in patient’s plan of care. A yellow arm band is placed on the patient, special skid resistant slipper socks are provider to the patient and fall precaution sign is placed outside patient’s door and over the bed to ensure all staff members are aware of fall risk. Providing education on preventing falls to both family and patient, placing patients closer to the nurses’ station, providing bed alarms, sitters and hourly rounding are other measures to avoid falls. Patients who score five or greater are considered to be risk for falls and fall interventions will be initiated. Another safety measure important to prevention of falls is to include fall risks in all shift to shift reports. Barriers to Change St. Peter’s Hospital is an large organization specializing in Cardiac,  Hepatobiliary, Bariatric, Gastrointestinal and Orthopedic Surgeries. Being such a diverse large organization inconsistency throughout the hospital shows to be the major barrier to change. Other barriers are lack of employee involvement, lack of financial resources and poor communication. To overcome such barriers, an awareness of the need for an effectiveness of fall risk assessment and fall prevention program is essential. Employees, patient’s, and family members need to be aware of fall risks, fall precautions and the fall prevention program. Factors Influencing Change Increasing patient satisfaction and at the same time preventing and reducing the amount of falls on a daily basis is the key factor. Patient satisfaction is ultimately the driving force behind the changes in the hospital. If patients are not satisfied with care, they will go to another provider and thus the hospital will lose money. In order for St. Peter’s Hospital to remain ranked in the top 10 hospitals, they must ensure all patients are pleased and safe with their care. One way to make certain that the hospital patient safety increases is by implementing changes throughout the hospital to standardized the fall risk assessments and fall prevention program. In order to be successful with this change, regulatory changes will be necessary to be made in accordance with fall prevention. St. Peter’s Hospital is committed to patient’s safety and ensures all patients are provided with an optimal safe environment during care. Training is required for all employees to guarantee compliance and full understand of the fall prevention program. Evaluation of the program is another regulatory change that is necessary for the success of the program. Monitoring on a regular basis is required to determine effectiveness of program and deciding if changes should be made or modified. Factors Influencing Readiness for Change When organizational readiness for change is high, organizational members are more likely to initiate change, exert greater effort, exhibit greater persistence, and display more cooperative behavior (Weiner, 2009). Readiness requires both the capability to make change as well as the motivation to make the change. Readiness is contingent on several different factors throughout the hospital. Several factors for implementing the falls  risk assessment and fall prevention program is the high rate of falls throughout the hospital. Readiness is also determined by the financial stand point of the hospital. The hospital must be willing and able to devote extra funds to pay for increased amount of employee training and education. Theoretical Change Model: Kurt Lewin’s Change Theory Utilizing Kurt Lewin’s Change Theory can assist St. Peter’s Hospital to make the change, minimize disruption and assure that the change is adopted permanently. Lewin’s three step model of change are as follows: Unfreezing, Changing and Refreezing. Unfreezing is the readiness for change. During this phase St. Peter’s Hospital will prepare the hospital staff for the implementation of the falls risk assessment and falls prevention program. In order to prepare the hospital staff of the need for change, they must first provide information and research regarding the program and the benefits. Once unfreezing is complete, St. Peter’s Hospital would transition into the second phase known as, Change. Change is the actual implementation of the proposed change. In order to implement these changes, training will be provided and required for all employees to guarantee compliance and full understand of the fall prevention program. Evaluation and monitoring of the program will also be conducted during this phase to ensure compliance as well as understanding. Actually making the falls risk assessment and falls prevention program a permanent entity to the nursing assessment is the final stage of refreezing. During this stage, St. Peter’s Hospital will continue to offer education and support throughout the hospital to standardized the fall risk assessment and falls program. Recourses Available for Change It would be virtually nearly impossible to implement an successful change without having the necessary resources. In order to implement such a plan as the fall risk and fall prevention program, St. Peter’s Hospital must have a team of educated employees throughout the many disciplines and be able to train the remainder of the hospital with the new proposed changes. Education would be in the form of class room demonstrations, on the unit in-services in addition to hospital based website education. Finances is another major resource that is required for the change plan. Without the  proper means, the hospital is not able to pay the employees and implementation would not be in effect. Conclusion Patient education needs to be incorporated into the admission process and continue throughout the hospitalization stay. Education provides the patient with the knowledge of the importance of safety and what part he or she contributes in their care as well as risk factor identified. Fall prevention programs are designed to determine fall risk and prevention strategies while collaborating with the patient’s health care. Informing both the patient and the family will bring an understanding and mindfulness to fall prevention. Falls are devastating to both the patient and the hospital considering a single fall may result in a downward spiral of reduced mobility with a loss of function and further risk of falls. Along with proper education, fall risk assessments are vital to the fall prevention process. These fall risk assessment are implemented hospital wide and are conducted every shift, change in status, during transfers to different units and at discharge (St. Peter’s Hospital, 2012). Compliance and consistency reduces falls and the overall cost of falls throughout the hospital improving the care. References Center for Disease Control and Prevention. (2012). Falls Among Older Adults: An Overview. Retrieved from August 23, 2014, from http://www.cdc.gov/homeandrecreationalsafety/falls/adultfalls.html Currie, D.N. Sc, M.S.N., R.N., Leanne. (n.d. ). Fall and Prevention. Retrieved August 23, 2014, from http://ncbi.nlm.gov Hendrich, MSN, RN, FAAN, Ann. (2007, November). How to Try This† Predicting Falls. AJN, 107(11), 50 National Quality Measures Clearinghouse. (2013). Retrieved August 23, 2014, from http://www.qualitymeasures.ahrq.gov/content.aspx?id=36944 Environmental Safety and Fall Prevention. (2012). Retrieved August 23, 2014, from http://www.sphcs.org/environmentalsafetyandfallprevention.org Weiner, B. J. (2009, October). A Theory of Organizational Readiness for Change . Implementation Science, 4(67)

Green Marketing Plan †Nandos Essay

The purpose of this plan is to analyse the environmental efforts of the Nando’s Carnegie branch, and to develop strategies that propels them a step closer towards a more eco-friendly and sustainable future. Nando’s was established in 1987 in Johannesburg, South Africa. It has approximately 300 stores in Australia since the brand arrived here in 1990. Nando’s has already taken action to be more environmentally responsible, with better packaging designs and partnering with organizations that are tackling the world’s social problems. The sources of information for this  marketing plan include websites, articles and the management at the Carnegie branch of Nando’s. Since some data is unavailable to us (e.g. the annual costs of the business), certain assumptions will have to be made. Nando’s already has a clear focus on reducing its packaging, but energy and water usage have not been addressed as effectively. To reduce their usage of energy, they will have to consider their lighting, and the equipment that is used in the kitchen. Solar panels will also be installed to reduce their electricity use. Water usage will also be reduced by switching to more effi cient equipment in the kitchen and toilets. By employing the strategies that have been outlined, Nando’s will be able to target their triple bottom line by reducing cost, lightening their carbon footprint and consequently improving the lives of the people. Situation Analysis Nando’s Background Nando’s is not the common type of fast food joint, but is more of a casual dining place. Nando’s first began trading in 1987, in Johannesburg, South Africa. It arrived in Australia in 1990, with its first store opening in Perth. Since then, its popularity has grown in every state in Australia, with new stores opening all the time. There are approximately 300 stores operating nationally, with plans to expand further. Nando’s is famous for its unique Peri-Peri marinade that is used for all the chicken items on the menu (Nandos, 2012). This green marketing plan is for Nando’s Carnegie and how they can incorporate sustainability into their operations. Nando’s Environmental strategies Nandos does not advertise their sustainability efforts much, but protecting the environment and â€Å"doing the right thing† has always been a part of their business strategy. They are already raising awareness for an organisation called â€Å"United Against Malaria†, which is a charity that raises awareness of malaria, and aims to put an end to it (Mumbrella, 2012). Nando’s Carnegie has been selling â€Å"United Against Malaria† bracelets to raise funds for the charity. All Nando’s restaurants also use recyclable packaging for their products (they signed the Australian Packaging Covenant in 2010, which means they must adhere to their guidelines). They have also begun selling water bottles which use 35% less plastic than the previous bottles that were used. Recycle logos and information are also printed onto the packaging to educate consumers (Nandos, 2010). Nando’s also makes use of recycling services, which are available at every branch, including Carnegie. Nando’s have implemented a system of having its suppliers of oil provide oil to each store in large quantities so as to reduce the amount of trips that they need to make. This system also reduces the use of steel drums for containing the oil. Spent oil is then sent to recyclers to produce biodiesel, which Nando’s then uses to run its trucks (Nandos, 2010). Analysis of environmental performance Even though Nando’s does undertake all of the above- mentioned activities in their business processes, they are still not realizing their full potential in terms of sustainability. Even though Nando’s does try to buy recycled products, they do not have an explicit policy that states that they should buy recycled. Nando’s also does not have a policy to encourage their overseas suppliers to improve design to reduce the environmental impact of their packaging (Nandos, 2010). Just by implementing these guidelines, Nando’s could improve their environmental performance substantially. However, Nando’s does print environmental logos on all its primary and secondary packaging to encourage recycling throughout its value chain all the way to consumers. Nando’s also discourages consumers to take away the food, and this helps to reduce the use of extra packaging. All Nando’s restaurants have a relaxed atmosphere and a â€Å"homely† feel that urges consumers to eat there rather than take the food home (Nandos, 2012) The fast-food chain also uses renewable resources i.e. sugar cane material, for most of its packaging. Also, they try to make sure that the packaging is made using no small parts so littering is minimized (Nandos, 2010). A few inefficient business methods that are specific to the Carnegie branch include the washing of dishes and the use of disposable gloves. The bulky dishwasher is used even when there are just a few dishes, which results in wastage of water. Also, workers use disposable gloves which are not made of  renewable resources, and are replaced quite often due to overuse. Evidently, Nando’s has integrated sustainability into its organizational plans. However, with a more concentrated focus on the environment, Nando’s will be able to reduce their impact further, and could position themselves as the industry standard in terms of environmental impact. Current marketing strategies Nando’s main message in its advertising campaigns is the fact that they use fresh chicken that is flame-grilled, not fried. They use this as a point of differentiation to gain an advantage over other fast-food chains, like McDonald’s or KFC (Baker, 2010). With its creative and occasionally controversial marketing campaigns and catchy taglines such as â€Å"Portugasm†, Nando’s targets an educated, younger demographic market. The organization has successfully used social media to connect with their customers, and its website to communicate any new plans, or to inform the public of any events taking place at Nando’s.  Nando’s also uses its store design to complete the brand experience for customers. Wooden tables, soft,fluid lighting and posters showing the history of its unique flavours convey an image of relaxation and a natural, friendly appeal to the brand (Nandos, 2012). Even though the target market may be a young demographic, consumers of all ages and backgrounds visit Nando’s, presumably because of its uniquely cooked chicken. Industry analysis The Australian fast food industry has flourished in the last decade, with industry revenue rising by 4.3% to reach $16,007,400,000 per annum. There were approximately 36,730 fast food establishments in Australia in 2010 (RAPS, 2011). With such a large number of fast food organisations, they definitely have a significant impact on the Australian environment and could make a massive difference if they incorporated sustainability into their business practices. The current macro-environment factors will further examine the current situation and trends in the fast food industry. Political factors – All businesses involved in the production and sale of domestic food products must abide by the guidelines set in the â€Å"Food Standards Australia and New Zealand† (RAPS, 2011). This ensures that all businesses follow at least the minimum requirements for sustainability. – The introduction of the carbon tax has resulted in prices of products like fruits, vegetables, bread and meat will rise (Sebo, 2012), this means all fast food chains including Nando’s will have to raise their prices. Social factors – Consumers nowadays place more importance on preservation of the environment and healthy eating, so businesses must ensure they must deal with these issues (Price & Lawson, 1992) – Fast food continues to be seen as unhealthy and pollutants of the environment (Price & Lawson, 1992). – Fast food businesses are also perceived as litterers by a majority of consumers (Price & Lawson, 1992). Technological factors – A new kind of method of utilizing solar power, referred to as solar thermal, means that power can be stored for a longer period of time as the technology does not rely on direct sunlight (Sorly, n.d.) – Advances in packaging designs so they use less material mean that costs for companies are decreased and they decrease their environmental impact (Joy, 2011). – Progress in the development of water efficient fittings result in reduced water usage for all businesses. Natural factors – Water is a major factor influencing all businesses in Australia, as Australia is the driest inhabited continent in the world (White, 2009). – Growing population means more demand for food, which places more pressure on the sources of fast food businesses (White, 2009). – Depleting sources of fossil fuels, which are the main source of energy in Australia, will result in increased energy prices (White, 2009). Customer analysis There has been a significant increase of fast food consumption in Australia, with traffic to fast food joints increasing by roughly 7% in 2010 (Markey & Watson, 2011). People of all walks of life come to Nando’s, but a majority of them consist of younger people. Majority of consumers who purchase fast food do so for convenience (TheTelegraph, 2007). Therefore, they probably do not consider environmental factors in their purchase decision. However, with the green consumer group growing within Australia, opportunities for going green for businesses are becoming more appealing. In Australia, there are certain trends that define consumers today. Consumers can be divided into certain groups. These include the Value Consumer, the Busy Consumer and the Green Consumer to name a few (ACRS, 2010) The Value Consumer These are consumers who spend their money more wisely, and mostly consider only what they need. This is mainly a consequence of the Global Financial Crisis as consumers have become more cautious in their spending habits. This can be evidenced by the fact that consumer spending in Australia has been decreasing steadily, and this trend looks set to continue (Schwarten, 2012). These customers then force businesses to create value, so as to attract them to their brand. The Busy Consumer These are consumers who are becoming increasingly time-poor and convenience has a major effect on their purchase decisions. They place more emphasis on â€Å"speed, simplicity and convenience† (ACRS, 2010). Time is very valuable to them, so fast food is the ideal choice for these types of consumers. The Green Consumer This has become a growing niche in the market, and identifies those consumers who are more concerned about the environment than other people. They are willing to spend more for products if they know it will help to conserve the environment. They will actively seek out green products or even organic products, and they take into account the environmental practices of the  business before choosing to purchase. This consumer market is continuously growing, with an estimated buying power of US$500 billion in 2007 globally (ACRS, 2010). In Australia, consumers spent around AU$12 billion on environmentally-friendly goods in 2009, and the market reached AU$21 billion by 2010. Australians attitude towards environmental issues Australians are undoubtedly concerned about the environment, but the high costs of going green are stopping them from being very eco-friendly. This is confirmed by the fact that 100% of Gen Y and 91% of Gen X believe in the effects of climate change, according to McCrindle Research (n.d.). However, 65% do not want to pay more than 10% for green products, while only 10% are willing to pay any price. Consumers also feel that environmentally friendly products should cost less than other  products so as to encourage people to buy them (McCrindle, n.d.) Consumers nowadays expect business to be transparent with their activities and to be accountable at every level of business (Davis, 2007). Organizations are also expected to provide accurate information regarding the environmental impact of their products, and to minimize the impact through the use of innovative designs and manufacturing techniques (Savita, 2011). This means a restaurant like Nando’s is expected to provide the information about their environmental impact to customers, and do all they can to protect the environment, and provide safe products to customers. The purpose of this marketing plan is to target the growing Green Consumer market, and to inform the Value Customer of the high level of environmentally friendly business practices taking place at Nando’s Carnegie so as to give them another reason to eat there. Competitor analysis Direct competitors of Nando’s Carnegie include Grill’d, McDonalds, KFC,  Subway and other various dining restaurants due to their geographic proximity to the Nando’s branch. McDonald’s Strengths 1. Participate in the  government’s Energies  Efficiencies  Opportunities Program. 2. Engage in countrywide water saving  programs. 3. McDonald’s has full  control over its supply  chain, which allows it to  incorporate sustainability  into its operations easily. 4. Conduct extensive  research into reducing  the impact of their  packaging, and are a  member of the Australian  Packaging Covenant.  (McDonalds, 2012) Weaknesses 1. The strategies they are undertaking have  not changed their greedy, corporate brand  image (Barriaux, M. 2007) 2. McDonald’s does have a slight perception  of going green in the minds of consumers, but  its actual green performance is much lower  (Streeter, 2011) 3. McDonald’s customers alone produce 6.35  kgs of trash during peak hour. 4. McDonalds, due to its large size, is  susceptible to being sued by individuals or  organisations that see any weakness in their  sustainability efforts e.g. the 1986 court case  (Archives, 2007) 5. Damage the environment extensively from  their production techniques  (EthicalFootprint,2010) Strategies 1. Litter Control program helps  keep the restaurant grounds clean. 2. Restaurant includes rain water  tanks, dual flush toilets and water  restrictors on taps. 3. Use scorecard method for  sustainability targets for its  suppliers to make sure the goals  are being met throughout the  supply chain. 4. Use recyclable material for  packaging, and continuous  research is put into finding new  ways to reduce packaging material.  (McDonalds, 2012) KFC Strengths Weaknesses Strategies 1. Benefit from alliance  with Carbon Trust, as  they provide them with  ideas of green  technologies. 2. Yum! Brands, (KFC’s  parent company) are  always looking for new  ways for environment  sustainability (Yum!  Brands, 2010). KFC  benefits from this as  they have access to all of  the green technologies  that Yum! Brands  develops. 1. KFC has been linked with deforestation  activities in several parts of the world  (Halladay, 2012). 2. KFC has experienced problems with animal  rights groups, hygiene problems at certain  restaurants, and poor working conditions for  workers. This has had an adverse effect on  their brand image. 1. Switched to recyclable material  for packaging in 2009  (EnvironmentalLeader, 2009). 2. All wrappers for chips, burgers,  and cups are put through a dual  waste stream bin, which is then  sorted and sent out to recycle  (KFC, 2012). 3. Dual flush system and waterless  urinals in the restaurant help to  conserve water. 4. Increased insulation for floor,  walls, and ceiling (KFC, 2012) Subway Strengths Weaknesses Strategies 1. Work with  International Purchasing  Companies Ltd to  generate ideas for  environment  sustainability (Subway,  2012). 2. Subways brand motto,  Ã¢â‚¬Å"Eat Fresh†Ã‚  complements its  sustainability goals  (Fitzgerald, Brown &  Stewart, 2009). 3. Member of the  Australian Packaging  Covenant, which  provides Subway with  clear goals for reducing  environmental impact  (Subway, 2012) 1. Subway received some bad press for an  incident involving animal cruelty, which may  have damaged their brand image in the minds  of a few consumers (Reale, 2011) 1. Switched to more energy saving  lighting and low flow water  faucets. 2. Furniture and cleaning materials  are made from more sustainable  materials. 3. Majority of the paper packaging  used is completely recyclable.  (Subway, 2012) – Grill’d is also a competitor of the Nandos Carnegie branch. They have a brand image that promotes healthy living and their supply consists of only fresh ingredients. Their Local Matters initiative, which is used to support local charities, is a fundamental part of their corporate social responsibility program (Grilld, 2012) Internal analysis Human Resources The management at Nando’s Carnegie has had experience with Nando’s for quite some time, so they know how to implement any new operations into the business effectively. Also, this Carnegie branch is family-owned so they would be enthusiastic about any positive innovations or advancements. Marketing capabilities Nando’s uses several mediums to reach its consumers. It uses social media such as its own Facebook page and Twitter account. They also re-designed their website to give it a more informal, fun look. Nando’s also advertises in-store with a variety of posters and brochures. Nando’s also utilises TV advertising but not as intensely as the other fast food franchises. Nando’s is known for its somewhat cheeky advertising, and this has improved brand awareness since it first moved to Australia (Squidoo,n.d). Financial Resources Average revenue daily for the Nando’s Carnegie branch is approximately $2,200. So average annual revenue is approximately $791,720. Objectives To incorporate sustainability into Nando’s accounting framework, the Triple Bottom Line will be used. This means that objectives will be formed so as to address business, society and environmental factors. The TBL framework considers people, planet and profit at the core of the business. Objective 1: Reduce overall environmental impact by intensifying focus on water usage, energy usage and packaging material. By doing this, Nando’s Carnegie will aim to achieve a 50% reduction in costs. Objective 2: Increase awareness of Nando’s Carnegie’s environmental efforts by 50% among consumers by December 2014. Green Marketing Strategy Objective 1: Reduce overall environmental impact by intensifying focus on water usage, energy usage and packaging material. By doing this, Nando’s Carnegie will aim to achieve a 50% reduction in costs. Strategy Reduce water usage by 50% by December 2014. Strategy Reduce energy use by 50% by December 2014. Actions 1. Replace existing  dish washer with  dishwasher that has 4  Star Water Efficiency rating. 2. Ensure all employees  use the dishwasher only  for a full load. 3. Install time flow taps  and dual flush toilets. Actions 1. Replace fryer with  energy-efficient fryer  that has earned the  ENERGY STAR. 2. Install ENERGY  STAR convection oven. 3. Add strip curtains and  automatic door closers  to the walk-in  refrigerator to keep  inside temperature low. 4. Install CFL bulbs in  every part of the  restaurant. 5. Install demand based  exhaust control. This  regulates the exhaust fan  speed in the kitchen to  meet ventilation needs. 6. Install energy  efficient Reverse Cycle  Air Conditioner. 7. Install 7 solar panels  on roof of building. Cost $3000- $6000. Time flow taps- $300 each Dual flush toilets- $500 Cost $950- electric $4,400- gas $1,800- electric $ 3,400- gas $5 per bulb. (Times approximately 25 bulbs for the restaurant = $125) $1500 – $2000 $3000- $4000 Through the implementation of these strategies, Nando’s will be able to reduce their overall operating cost. The investment in green technology might have a high initial investment, but will definitely be profitable in the future. For example: – Energy-efficient fryers can save up to $100 for electricity or $470 for gas annually. ENERGY STAR electric ovens can save up to $190 annually CFL bulbs can reduce energy consumption by 75% Cutting down on idle time for the combination oven can save up to $800 annually. By turning down the central cooling by 3 F, air conditioning costs can be reduced by 12-15 percent. The solar panels could help save up to $400 in electricity costs. (Energy Star, 2012) Clearly, these cost savings are quite significant, and a 50% reduction in costs is therefore perfectly realistic. Strategy 4: Nando’s is already committed to eco-friendly packaging practices, as they follow the strict guidelines under the Australian Packaging Covenant. However, Nando’s does not currently work with third-party organizations to improve design and recycling of packaging, they must begin doing so in order to benefit from specialist knowledge that those firms (e.g. The Cardboard Pallet Company) have acquired. Objective 2: Increase awareness by 50% of Nando’s Carnegie’s environmental efforts among consumers by December 2014. Strategy Actions Increase communication efforts  of eco-friendly changes taking  place through a range of  mediums and creative tactics. 1. Change in-store poster design  to a green theme to emphasize  the changes taking place. N/A Cost 2. Advertise in local â€Å"Caulfield  Glen Eira Leader† newspaper  and â€Å"The Daily Green† website  about the restaurant’s green  efforts. 3. Use outdoor banners to  advertise sustainability practices. 4. Distribute brochures inside  store to raise awareness of the  shift to sustainability at  Nando’s. $500 (approximately) $300 ($150 for each banner) $2000 Other strategies that Nando’s could undertake involve: Using their food waste and turn it into compost to use it to grow plants. They could do this by having their own compost recycling operation or send their food waste to a compost facility. Encouraging more eat-ins by providing facts about the environmental impact of packaging to consumers. Using the strategies listed, Nando’s will be able to affect its Triple Bottom Line positively. Through the implementation of the strategies, they will be able to minimise their environmental impact, reduce their costs significantly and improve the store environment for the people who visit the store (i.e. through improved design and having more decorative plants in the store). The achievement of these objectives will show Nando’s devotion to sustainability. References Archives (2007, April 11). McDonalds, Environmental McNasty? Retrieved 27 September, 2012 from http://theconcordian.com/ Baker, R. (2010, June 30). Nandos has lipsmackin’ giveaway plan. Marketing Week. Retrieved from http://www.marketingweek.co.uk/nandos-has-lipsmackin-giveawayplan/3015217.art icle Barriaux, M. (2007, July 05). McDonalds goes green, but not all customers are lovin’ it. The Guardian. Retrieved from http://www.guardian.co.uk/ Davis, P. (2007, November 13). Is your company naughty or nice? Consumers want to know before buying. Retrieved September 27, 2012 from http://www.marketingexperiments.com/blog/ Energy Star (2012). Energy Star Guide For Restaurants. Retrieved from http://www.energystar.gov/ia/partners/publications/pubdocs/restaurants_guide.pdf?04bb-ca54 Environmental Leader (2009, January 28). KFC Switches to Earth-Friendly Packaging. Retrieved September 28, 2012 from http://www.environmentalleader.com/ Ethical Footprint (2010, May 14). Unethical companies: McDonalds. Retrieved 27 September, 2012 from http://ethicalfootprint.wordpress.com/ Fitzgerald, T., Brown T. & Stewart E. (2009, April 01). Cover Story: Subway’s Journey to Green. Retrieved September 28, 2012 from http://www.chainalytics.com/wpcontent/uploads/2011/03/2009-04-Subways-Journey-to-Green.pdf Grilld (2012). Retrieved from http://www.grilld.com.au/ Halladay, J. (2012, June 25). Kentucky Fried Chicken Destroying the Rainforests. Retrieved 28 September, 2012 from http://www.the-platform.org.uk/2012/06/25/kentucky-friedchicken-destroying-the-rainforests/ Joy. (2011). 50+ Eco-friendly & Recyclable Packaging Inspiration. Retrieved from http://jayce-o.blogspot.com.au/ KFC (2012). Markey A. & Watson C. (2011, May 27). News.com.au. Retrieved from http://www.news.com.au/ McCrindleResearch (n.d.). Australians on Climate Change: Attitudes and Behaviours. Retrieved from http://mccrindle.com.au/ResearchSummaries/Australians-on-ClimateChange-Attitudes-and-Behaviours.pdf McDonalds (2012). Retrieved from http://mcdonalds.com.au/ Mumbrella. (2010, June 07). Nando’s launches single with Disco Montego in lead up to World Cup. Retrieved September 25, 2012 from http://mumbrella.com.au/nandos-launchessingle-with-disco-montego-in-lead-up-to-world-cup-27672 Nandos. (2010). Action Plan: Implementing the Sustainable Packaging Guidelines 2010-2015 (Australian Packaging Covenant). Retrieved September 25, 2012 from http://www.nandos.com.au/sites/default/files/nandos-australia-apc-action-plan.pdf Nandos. (2012). Retrieved September 24, 2012 from http://www.nandos.com.au/aboutus/nandos-australia Price, S. & Lawson, J. (1992). Nutritional and Environmental Issues in Fast Food. Nutrition and Food Science. 92(2), 4-10. Reale, R. (2011, July 15). Nike and Subway, like NFL, Support Animal Cruelty and Torture. Retrieved September 28, 2012 from http://realetybytes.com/ Retail and personal services training council (2011, n.d). Fast Food Environmental Scan 2011. Retrieved from http://rapstc.com.au/wp-content/uploads/2011/12/Fast-Food-EnvironmentalScan-2011.pdf Savita, H. (2011). EMERGING ISSUES IN CORPORATE SOCIAL RESPONSIBILITY: ISO GUIDANCE ON SOCIAL RESPONSIBILITY TOWARD CONSUMERS: IMPLICATIONS FOR MARKETERS. AMA Summer Educators’ Conference Proceedings. 22, 109-116. Schwarten, E. (2012, September 20). Consumer Spending falls again, Commonwealth Bank of Australia says. Retrieved September 26, 2012 from http://www.news.com.au/ Sebo, T. (2012, July 03). Carbon Tax: The Great Unknown. Gouldburn Post. Retrieved from http://www.goulburnpost.com.au/ Sorly, P. (n.d). The Top 5 Green Technology Breakthroughs. Retrieved September 25, 2012 from http://greenopolis.com/ Squidoo (n.d.) Nando’s Franchise. Retrieved from http://www.squidoo.com/nandos-franchise Streeter, A. (2011, August 10). â€Å"Best† Green Brands List Implies That Greenwash Works. Retrieved September

Pilgrims Progress Short Form Essay

MAIN CHARACTERS (a clear, concise description of each): Christian is the main character, he has a simple personality. He represents just one aspect of the human experience: the search for religious truth. He is his faith (hence the name) his motivation, the search for salvation in the celestial city, is the one aspect that clearly defines him. Apollyon is the antagonist, he has a physical irregularity that displays his evil. Apollyon is a hybrid being, part dragon, bear, human, and fish, the air associated with his wings, the fire linked with dragons and the earth that bears live on. These combination convey his immense power, suggesting that he draws power from all parts of the universe, his nature is complex, the exact opposite of Christians extreme simplicity. MINOR CHARACTERS (a clear, concise description of each): Evangelist- the messenger carrying the gospel, or the word of Christ, to Christian he spurs Christian on his journey to the celestial city. Obstinate- a neighbor of Christian in the city of destruction who refuses to accompany him. Pliable- A neighbor if Christians who accompanies him for a while. After falling though the slough of Despond , Pliable is discouraging and returns home, only to be mocked by the townsfolk. Help- Fellow pilgrim who helps pull Christian from the Slough of Despond. Worldly Wiseman- A reasonable and practical man whom Christian encounters early in his journey Worldly Wiseman tries unsuccessfully to urge Christian to give up his religious foolishness and live a content secular life. Formalist- A traveler whom Christian meets along the wall of Salvation. With his hypocrisy, Formalist sneaks over the wall, instead of following the straight and narrow as Christian did. Hypocrisy- Formalist’s travel companion Discretion- One of the four mistresses of the Palace Beautiful. Discretion takes Christian and feeds him. Piety- one of the four mistresses of the palace Beautiful. Piety asks Christian about his journey so far. Prudence- One of the four mistresses of the Palace Beautiful. Prudence tries to understand Christian’s purpose in traveling to Mount Zion Charity- One of the four mistresses of the palace Beautiful. Charity asks Christian why he did not bring his family, which causes him to weep. The Interpreter- Spiritual guide who shelters Christian. The Interpreter instructs Christian in the art of reading religious meanings hidden in everyday objects and events, which he houses in his Significant Rooms. Shining Ones- Three celestial creatures who clothe Christian with the new garments and give him the certificate. The Shining Ones act as guardians throughout Christians journey. Faithful-Fellow pilgrim from Christian’s hometown who reports on the city they both left behind. Faithful loyally accompanies Christian until he is executed in the town of Vanity for the crime of disrespecting local Satan- worshiping religion. Talkative- Fellow pilgrim who travel alongside Christian and faithful for a while. Talkative is spurned by Christian and faithful for a while. Talkative is spurned by Christian for valuing spiritual words over religious deeds. Mr. By-ends- A user of religion for personal ends and social profit. Mr. By-ends accompanies Christian briefly after Christian escapes from vanity. Hopeful-Pilgrim who replaces Faithful as Christian’s travel companion and confidant after leaving Vanity, all the way to Celestial city. Hopeful saves Christian’s life in the river before the gates to mount Zion Giant Despair- Master of the doubting castle. Giant Despair imprisons Hopeful and Christian for trespassing on his domain and is later killed by Great-Heart and Christian’s sons. Diffidence- Giant Despair’s wife. She encourages the harsh punishment of Hopeful and Christians in the Doubting Castle. Demas- Gentlemanly figure who tries to entice Christian and Hopeful with silver and dreams of wealth. Temporary- A would-be pilgrim whom Christian speaks of in a cautionary way, warning of Temporary’s backsliding before his spiritual progress was complete. MAIN SETTING(S) (a clear, concise description of each): There is no main setting; the novel occurs in a variety of places. ONE PARAGRAPH PLOT OUTLINE: Faith, Hope, Mercy, Envy, Ignorance, Guilt: These are not abstract concepts, but the names of vividly imagined, sharply draw human characters encountered by Christian, the hero of The Pilgrim’s Progress. In Christians search for salvation, each step along the way becomes a dramatic rendering of an inner state of the human psyche. As Christian journeys from â€Å"The wilderness of this world† to the glory of the Celestial City, he confronts a seemingly endless array of temptations, threats, and dangers, including the nearly irresistible allure of material splendor at Vanity Fair; the crushing psychological burden of depression and despair in the Slough of Despond ; and the fear and uncertainty that eats away at faith in the Doubting Castle. TWO OR THREE SYMBOLS (explain references and importance): City of Destruction- the city represents the entire world as it is, with all of its sins, corruptions, and sorrows, no one living there can have any hope of salvation. Interpreter- a character symbolizing the Holy Spirit. ONE OR TWO SENTENCES ON DOMINANT THEMES (State the theme correctly, e.g, â€Å"Love is blind.† NOT â€Å"the theme is about love.† What about it? BS. See Lit Book, p1187): The path to spiritual salvation is one full of many obstacles. STYLE ANALYSIS- CITE EXAMPLES AND ANALYZE THE EFFECT: The Style Analysis portion of your short form must be ONE Page. Use bullet points-NOT narrative format- like ur Novel Notes Single Spaced- but otherwise MLA format one inch margins N E Tabs s/b 1.5† Use Bullet Points – NOT narrative format ELABORATE on the Effect! Use your TOOLBOX and HandOuts DICTION: SYNTAX: FIGURATIVE LANGUAGE: FOUR SHORT (memorable QUOTATIONS TYPICAL OF THE WORK – include speaker and occasion. 1. â€Å"quote† – â€Å"Here is a burdened sinner. I come from the City of Destruction, but am going to Mount Zion, that I may be delivered from Wrath to come; I would therefore, sir, since I am informed that by this gate is the Way thither, know if you are willing to let me in?† Speaker – Christian Occasion – Christian introduces himself to the gatekeeper Goodwill, so that he can get through the gate and continue on his journey to salvation. 2. â€Å"quote† – â€Å"By this I perceive thou art one of my subjects; for all that country is mine, and I am the prince and God of it. How is it then that thou hast run away from thy king?† Speaker- Apollyon Occasion – Apollyon tries to kidnap Christian and thwart his journey. 3. â€Å"quote.† –   You will use this Short Form to write your analysis essay.

Social Responsibility and the Community Research Paper

Social Responsibility and the Community - Research Paper Example Notably, corporate social responsibility promotes the reputation of the company and creates a competitive advantage. In the modern world, organizations are under pressure to practice corporate social responsibility while still making profits. Indeed, it has become an expectation for all organizations to be ethically and socially responsible for the benefit of the organization and the society (ISO, 2010). This paper will research and write an analysis of Starbucks social actions in the community. Analysis Starbucks Coffee Company is the leading coffee retailer, roaster, and brand of specialty coffee in the world. Starbucks originated from Seattle, USA, but today it operates in over 60 countries with more than 18,000 stores. Starbucks specializes in premium and sell salads, books, gifts, warm and cold beverages, and other accessories. Due to its wide market network, high quality of its products, and the wide range of products, Starbucks commands a significant market presence where it h as the largest customer base in the coffee other blend- drinks industry. As a result, it interacts with many societies and therefore influences their lives. Therefore, there is need for a corporate social responsibility strategy to guide the operations of Starbucks Coffee Company all over the world. ... Indeed, it is clear from the organization’s website that Starbucks adopted various corporate social responsibility strategies with a view of achieving its mission statement. Specifically, the corporate social responsibility strategies adopted by Starbucks includes the 2000 partnership with Conservation International aimed at creating ethical coffee-sourcing guidelines (Bruhn-Hansen, 2012) and the formulation of the Starbucks Foundation. Moreover, Starbucks seeks to be accountable to all Starbucks stakeholders and making social investments in origin countries as well as minimizing their environmental impact. Additionally, the organization participates in the Global Month of Service. There are various pros and cons to the application of the respective corporate social responsibility strategies adopted by Starbucks Coffee Company. For example, the 2000 partnership with Conservation International aimed at creating ethical coffee-sourcing guidelines derives notable pros and cons. I n this strategy, Starbucks boosts the lives of farmers by purchasing at outright prices, signing long-term contracts, and buying directly from farms and cooperatives (Starbucks Corporation, 2013). This equally ensures sustainable supply of high-quality coffee to the organization. Moreover, through the Ecologic Enterprise Ventures and the CI Foundation, Starbucks avails credit facilities to farmers (Starbucks, 2001). Nevertheless, an outright price and long-term contracts hinders the farmer from enjoying better prices from other companies in the near future. More so, there is a risk to the repayment of the loans given to the farmers. On the other hand, the partnership allows Starbucks to give financial incentives and rewards to coffee suppliers who conserve the environmental and demonstrate

Mask Movie Review Example | Topics and Well Written Essays - 1750 words

Mask - Movie Review Example The disease is extremely rare and thought to occur in about every 1 in 22 million children. Rocky lived in Los Angeles in 1979 with his mom, Rusty, who is a free spirit and cheerfully irresponsible woman who hangs around with a motorcyclists. Rusty wanted to give her son a completely normal life despite of her disabilities and very soon her boyfriends also start to help her in taking care of her son. Rocky had a hobby of collecting baseball cards and he also saved money to travel Europe with his friend Ben on motorcycle. When trying to get Rocky admission in a new school, Rusty was persuasively refused and advised by the principle to get Rocky admitted in a special school that can help him in a better way. But Rusty was determined to get her son a normal child’s life and schooling so she insisted and very soon Rocky was allowed admission in school because of his excellence in old school. Early in his new school, Rocky’s classmate used to stare at him with amazement due to deformity, and asked him to take his mask off. But Rocky won their hearts by his witty and clever sense of humor. Rocky’s grades were among the best students of the school and very soon he started giving tuitions to his fellow students at $3. The principle who first tried to disown him also appreciated the hard work and intelligences of Rocky who was progressing very well. The principal then offered him a job as a counselor on the summer camp for blind junior students. T first Rocky was not sure what to do but he accepted the job later. Rocky’s mother used to leave him and stay away for several hours with her motorcycle gang. She was depressed most of the times but she tried to keep herself positive and away from all fears & worries by using drugs and alcohol. Rocky hated it so he tried to break her bad habit. At times during the movie Rocky is also seen upset when for example he realizes that because of his facial deformity he couldn’t ever enjoy the pleasur e of having girlfriend. During his camp side job, Rocky meet a very beautiful girl names Diana. She was blind since birth and could not see, but feels his deformity. Rocky and Diana spent time together and falling in love. Rocky taught her the meaning of descried words like pillowy, cloudy, red and blue colors. It became apparent that Diana’s parent were not pleased by Rocky’s presence so they were being overprotective of their daughter and tried to keep Rocky away from her. Diana was then sent to a boarding school to finish her one semester. Diana and Rocky promised to stay true to each other. One night when Rusty threw up a party to cheer Rocky up, he went to sleep early claiming that he has a bad headache. In the morning Rusty discovered that he had died in his sleep. She mourned and was very upset. As Rocky is buried, one of Rusty’s friend arranges the set of baseball cards on his tombstone. Theory The analysis of Rocky’s development throughout the mo vie and how his disability and deformity retarded his psychosocial and psychological development can be well understood by relating it to the following theories: Erickson’s psychosocial theory Freud’s psychoanalytic theory Piaget’s cognitive developmental theory 1. Freud’s Psychoanalytic Theory Freud proposed theories that signified the importance of events and experiences during childhood and focused on mental disorders rather than normal functioning. According to Freud theory of child development, a person’

Vegetarian is healthy Research Paper Example | Topics and Well Written Essays - 1250 words

Vegetarian is healthy - Research Paper Example What are the advantages of becoming a vegetarian? What are the health risks associated with being a vegetarian? An Overview of a Vegetarian lifestyle In the world of today, the diet of vegetarians has become common all over the world, with a number of people throughout the world preferring to become vegetarians. Most people are of the argument that embracing a vegetarian diet can be regarded as essential for a healthy life. Organizations that agitate for the rights of animals discourage people from eating meat, chicken or fish. The diet of vegetarians mainly contains fruits, vegetables, as well as whole grains. Vegetarians argue that what they take can be considered as the best combination of a healthy diet. However, there are counter arguments that seem to discredit vegetarian meals, arguing that these meals are not complete. It has been argued that, despite the nutritional benefits of a vegetarian diet, the meals taken by vegetarians cannot fulfill all the body’s nutritional requirements (Maurer 1-10). Categories of Vegetarians There are various categories of vegetarians, which include semi-vegetarian, lacto-vegetarian, pesci-vegetarian, and ovo-vegetarian. A semi-vegetarian refers to a vegetarian who eats meat, but only meat from chicken and fish. A lacto-vegetarian encompasses a vegetarian who may eat dairy products; however, he or she does not eat eggs. Most of these vegetarians are found in the Hindu religion who takes dairy products, but for religious reasons avoid eggs; a pesci-vegetarian eats fish only. The category of ovo-vegetarians includes people who eat eggs but tend to avoid dairy products, as well as meat (Brown 1-144). Body Arguments for being Vegetarians There are several benefits that accrue when a person becomes a vegetarian as compared to a person who eats meat, poultry, and fish. These benefits consist of the advantages of becoming a vegetarian. One of the arguments that support a vegetarian lifestyle emanates from the fact that a v egetarian diet is rich in fiber, Vitamin C and folate. The diet of vegetarians includes nuts, grains, seeds, fruits, cereals, vegetables and beans. Components such as fruits and vegetables provide minerals and vitamins that play an essential role for enhancing a healthy body. Seeds and beans act as reliable sources of proteins. Vegetables have phytochemicals, which play an essential role in preventing a person from contracting some chronic illnesses. Moreover, green leafy vegetables can be regarded as a credible source of antioxidants. Beneficial enzymes, natural sugars, as well as trace elements, can be derived from fruits and vegetables that vegetarians eat (Brown 1-144). Another benefit that a person can derive when he, or she is a vegetarian is that they take few chemicals by engaging in a vegetarian lifestyle. Those people who take animal products eat as much as the chemicals that the animals eat. Every bite of either pork hotdog or beef contains several pesticides that cause c ancer. Beef and dairy products are also known to be the primary source of contamination that results from nuclear radiation. Animal fat contains industrial pollutants, pesticides, and sex hormones that have effects of estrogen and can cause breast cancer. Vegetarians are free from these contaminants that can accumulate in human fat and reach higher levels than food, thus causing breast cancer. Thus, a vegetarian life

The effects of the 2008 financial crisis on the investment in the Gulf Essay

The effects of the 2008 financial crisis on the investment in the Gulf area especially on Qatar - Essay Example The high unemployment rate and the collapse of the financial institutions cumulatively limited the potential of individuals and corporations to invest. The Gulf Area experienced a period of oil-boom during the period between 2003 and 2008, a time when the economy grew by double figures. Qatar was a major distributor of oil in the world and the rising demand underpinned the increase in its sales during this period. The impact of this is that there was reduced unemployment, rise in economic class and the growth of the gross domestic product (Khamis, Senhadji, Hasan, & International Monetary Fund, 2010). On the other hand, the economic development resulted to increase in the public confidence and hence increased borrowing from monetary banks. The public’s incentive to invest and take advantage of the growing business opportunities led to the increase of loans from both public and private sector. As a result, the year 2007 marked the peak of economic debts in financial institutions. During this period also, the international monetary funds and the World Bank encouraged financial institutions to provide low interest loans for the local people to inspire investment (Siddiqi, 2013). The negative impact of this is that the potential to invest became much higher than the available business opportunities, leading to business failure. The global recession affected the world at large and this resulted to an adjustment of the world economic situation. The reduction in the value of local currencies resulted in the decline of the purchasing power. The impact that this had is that there was reduced economic exchange in the international business market. Qatar experienced a period of reduced demand for oil from western countries, which resulted to reduction into its national income. Consequently, the country experienced retarded economic growth, and the GDP

Should Americans have free universal health care Research Paper

Should Americans have free universal health care - Research Paper Example However, the health insurance project does not give an impression of achieving its intended purpose of providing quality health security. In the contemporary American society, health security seems to be confined to a given section of the local populace. I am a loyal retiree and an inhabitant of the United States of America. No member of my entire family is currently entitled to health insurance coverage. My health insurance coverage was, unfortunately, withdrawn when I lost my job. Nonetheless, I do admit that even when I enjoyed the privileges that come with full-time job, I never benefited from the scheme as to my expectations. Consequently, my quest for valuable health care services coerced me into conducting a research on the proposed free Universal Health Care; its legitimacy and suitability to the ordinary American population. The research paper is a detailed, analytical editorial based on a number of past research studies. INTRODUCTION The universal health care, also known as the social health protection, is a system which provides quality health coverage and financial shield to all citizens of a given country. Its key goal is to provide a significant package of financial and medical promotions to all members of the state’s populace. ... Today, scores of debates and arguments have developed in America pertaining to whether or not the Universal health coverage is morally justified. The so called Obama Care was established and approved in 2010 as an idea of the Institute of Medicine. Its principal concern is to ensure that all Americans have affordable health coverage by 2014. The Americans’ take on the current health care system Most American citizens sympathize with the fact that the present-day American healthcare system is skewed toward the concern of corporate bodies rather than independent individuals and small scale business units. The contemporary American health insurance policy employs a scheme known as pooling in which employers attached to large corporations insure their employees with health care insurances, subject to contract. However, there is usually a wide disparity between the sick and healthy as a majority of the insured employees live healthily. As a matter of facts, the said discrepancy cov ers the expenses of the sick resulting to sound premiums for the companies’ employees. Conversely, this approach is only appropriate for companies with the substantial number of employees thus creating hurdles for undersized businesses. Miniature business units find sheer intricacy in covering their employees. This is attributed to the high ratio of the hill to the healthy resulting in sky-scraping premiums. In contrast, such establishments often fail to afford the premiums hence opt out of upholding the health coverage system for their employees. As a result, most American employees in the small business sector tend to believe that the proposed free Universal health coverage will be a better deal if well implemented.

Create a dialogue between two people. Describe and critique two Essay

Create a dialogue between two people. Describe and critique two perspectives on morality - Essay Example I believe in utilitarian ethics and I would like to discuss it with you and maybe learn about your moral basis.† Steve was delighted by the topic and replied, â€Å"I have also noted our differences and attributed it to diversity. Discussing our moral values would be important to our interpersonal relationship and will improve our perspective on our environments. I believe in deontology ethics. Could you please tell me about your ethical perspective?† David: â€Å"Utilitarian ethical perspective is based on the concept maximum good to a majority of members of the society (Brooks and Dunn 183). It informs judgment on a act, whether of commission or of omission, based on effects on members of the society and therefore means that morality of an act is determined after members of the society have interacted with the act and its effects, both positive and negative have been observed. The act is then said to be unethical if realized bad effects on members of the society are m ore significant than benefits from the act. It is however considered moral if greater benefits can be derived from it and this identifies two perspectives to determining ethics in an act, the extent of effects on people and the number of people that the act affect. Utilitarianism also relates to decisions whose implementation has effects on people. Rule utilitarianism explains this by offering rules that can lead to maximum good in a society. A decision to restrict a person’s right to smoke in a public place is for example moral under utilitarian ethics because while it may infringe the smoker’s need and may be cause distress, it will be beneficial to many other people I the immediate environment through ensuring clean air and protecting the people’s lives (Kanniyakonil 65- 66).† David: â€Å"I should have been keen to note that your judgments are based on consequentialism. My ethical perspective, deontology, is however a rule based perspective to moral j udgment. The perspective associates morality with duty that is expected of people in a society and is based on social rules. It is different from your ethical perspective because it disregards consequences of an act or a decision. An act that is consistent with established rules is for example considered ethical despite its negative consequence to members of the society and an act that contradicts existing rules and obligations is considered immoral irrespective of the net benefit that in which it results. considering your example of smoking in a public place and suppose that a the society allows people to smoke in public places, then the act of smoking is considered moral regardless of the air pollution and its associated effects on people’s health (Basford and Slevin 214, Showler 21)† David: â€Å"Reliance on rules for judging decisions and actions has the benefits in fair judgment and this is contrary to the scope of your utilitarian approach that also appear to be subjective. One of my concerns with utilitarian approach to ethics is the lack of a suitable measure for benefits and harm of an act. There is no standard measure and this compromises reliability and fairness because some people may be more sensitive than others are while some may exaggerate consequences. It is also difficult to identify population segments that have been affected by an act or a decis

Grand Canyon Crash of 1956 Essay Example | Topics and Well Written Essays - 1500 words

Grand Canyon Crash of 1956 - Essay Example The agency was established to run a broad Air Traffic Control (ATC) system and to certify aircraft designs, airline training programs and maintenance. The Air Traffic Control (ATC) system is responsible for managing air traffic. It is run by the FAA with a twofold purpose: to maintain a safe separation of aircrafts flying over the US and to make aircraft traffic to move as efficiently as possible. The ATC is actually a good place in the airline industry to appreciate its systems-like structure. The ATC organizes all the flights in the country (therefore, implementing a centralized architecture for the industry) and was created based on the idea of a broad and nation-wide system of scheduled flights, which did not existed before. The ATC comprises four types of facilities: airport towers, terminal radars, en route centers and flight service stations. Airport towers look after planes while they taxi to and from runways and during take-off and landing. Terminal radars monitor flights during the climb and the descent phases of the flight. There are 236 of them in the US. The en route centers keep track of aircrafts while they are en route during the high-altitude cruise phase of the flights. Finally, flight service stations are information centers for pilots flying in and out of small cities and rural areas. A keyA key facility in overseeing the entire ATC system is the FAA's Air Traffic Control System Command Center (ATCSCC), located in Herndon, VA. It looks for situations that might create bottlenecks and setups up management plans to control the traffic into and out the troubled sectors. The goal of such a plan is to keep traffic at the trouble spots manageable for the controllers. The importance of the ATCSCC becomes clear when one acknowledges that, on average, there are 900 daily flight delays of 15 minutes or more, which cost to the airlines and customers around $5 Billion USD a year. However, the ATC model is a centralized system architecture that many argue will not be able to cope with the saturation of the airspace and the increase in traffic delays that are expected to take place in the near future. The big challenge for the industry is the design and implementation of a distributed air-flight management system that could increase the throughput of the aviation system keeping the safety levels unchanged. This approach is called Free Flight and is currently being researched by the FAA and the aviation community. Free Flight is expected to improve significantly the efficiency of the National Airspace System. With Free Flight, pilots operating under Instrument Flight rules (IFR) will be able to select the aircraft's course, speed, and altitude in real time. Today, pilots define a flight plan with the ATC, prior to take-off and have to follow the route specified in that plan. Any deviation from that route must be pre-approved by ATC. With Free Flight, pilots will be able to change route, speed and altitude to achieve the desired results, notifying the ATC. Pilot's flexibility will mainly be restricted only to ensure separation and to prevent unauthorized entry into special use airspace. The Free Flight concept is based on two airspace zones, protected and alert, the sizes of which are based on the aircraft's speed, performance characteristics, and communications, navigation, and surveillance equipment. The protected zone, the one closest to the

Reading the Text of the Photograph Essay Example | Topics and Well Written Essays - 750 words

Reading the Text of the Photograph - Essay Example The mother’s eyes are directed outside the window where she could be looking at something which caught her attention – or could just be lost in her thoughts. They both appear to be pensive as both their lips are curved downwards. Both are wearing white which glow as the sun shines on them. Two throw pillows neatly covered by a weaved pattern appear beside the mother, with one pillow directly providing cushion to her back. To their back, at the upper left portion of the photograph appears a top thin table containing picture frames which are about nine in number. There are bigger frames, numbering three, which are mounted on the wall above the thin table. Most of the background is obscured in contrast to the bright light focused on the mother and child. It is possible that this picture is taken either late morning (almost near noontime) – or immediately after lunch. The photographer could possibly be a member of the family – the father, or brother, or even a sister who wanted to capture the lazy, reposed mood of the members. It is possible that mother and child did not expect their photos to be taken, as they remain sober and melancholy. This photograph is taken inside an auditorium where two prominently seated men are close to the photographer. A total of seven men are clearly seen in this photo – all smiling. These men could be batch mates or members of an all male organization; maybe a fraternity or a professional civic organization. It is eminent that these men are viewing someone, possible a colleague or a person with great humor. There were not viewing a film as their eyes were not focused on a movie screen – but rather on someone directly in front of them. They could possibly be listening to a guest speaker or a batch mate talking about his previous experiences. The man on the right front seat was holding a snack (possible filled with peanuts) and he was seated in a slouching position

Negative Influence of Social Media Essay Example for Free

Negative Influence of Social Media Essay Today, Mass Media is notoriously known to project a negative influence on teens and society. It manipulates several aspects of our lives including, but not limited to, the choices we make about our overall physical appearance, how we perceive beauty, healthy decisions we make regarding drug and alcohol use, engaging in premarital sex, and our peer and social interactions. We emulate what the media portrays as acceptable and desirable, though it goes against the norms and values put forth from society. As we mature, our goals and values seem to change as we break from the traditional values and connect with those portrayed as cool and current, through the media and pop culture. During adolescence, one often struggles with choosing between what is right from wrong and the media often accentuates the lives of celebrities. Young children are known to emulate their role models, unconscious of the consequences that may result in their actions. The media has been proven to be detrimental to the health and lifestyle of the youth. The media has a strong impact on the appearance satisfaction of today’s youth. Young women are constantly comparing their bodies to the ones seen advertised on television commercials. Around 10 million females and 1 million males in the United States are suffering from eating disorders such as anorexia, bulimia, etc. After seeing these beautiful and flawless models on billboards and advertisements, many women are disturbed with their personal body images. This is known to be a main contributor to eating disorders around the world. Thus, the media has the effect to change ones mental set up. Beauty and Body Image in the Media† is an article that explains the negative affect the media has on young women and how they view themselves. Images of female bodies are seen in films, TV, magazines, ads, etc. These models are engraving the perfect body image into the minds’ of the youth. Women’s magazines are full of ads influencing women that if they lose weight they’ll have it all. Researchers have observed that these images of thin and airbrushed models are associated with depression, loss of self-esteem, and the development of harmful eating habits. It’s been suggested that almost half of all preadolescent girls are dissatisfied with their appearances and either diet or think about dieting. Further, 50 to 70 percent of average weight girls feel that they’re overweight and 90 percent of women are frustrated with their body images. These advertisements are not only advertising their products, but they’re also selling an entire way of life. The media promotes tan, fit, and outward physical perfection in men and women. It is not only middle-aged adults who seek cosmetic surgery to alter their appearance. Today, children also undergo cosmetic procedures. In fact, in 2005 it was reported that children under the age of 18 underwent approximately 333,000 cosmetic procedures. Some included liposuction, breast augmentation, otoplasties (ear pinnings), and rhinoplasties (nose jobs). Teenagers of both genders are trying to acquire a perfect figure rather than living a healthy lifestyle and appreciating themselves for who they truly are. The media also has a reputation for promoting unhealthy choices, such as unprotected premarital sex and drug and alcohol use. The media is sending the wrong message to young adults that taking part in these activities is okay. The article, â€Å"The Media’s Influence Undermines America’s Morals†, by Tim LaHaye contains numerous examples of how the media is detrimental to the future of the United States. AIM, Accuracy In Media, and PMRC, Parents Music Resource Center, are organizations that support government regulation of the media. They believe that the media is destroying our culture and altering our values. Moviemakers, producers, and journalists are provoking sexual immorality in our society by explicitly exposing and promoting sexual relationships. The media is even found glamorizing teen pregnancies in the MTV series, 16 and Pregnant and Teen Mom. LaHaye states that, â€Å"the media’s power is seen in its degrading influence not only on the nation’s morals, but on†¦ virtually every area of life. † Music also plays a huge role in influencing teens toward becoming sexually active and provocative. â€Å"Rock Music Has a Negative Effect on the Youth†, by Rob Lamp is another article which states that rock music is somewhat accountable for the increase in teenage pregnancies. A counselor for pregnant teenagers believes that young girls are emulating celebrities. They are buying their albums and dressing like them. Today, 30 percent of all women loose their virginity before age sixteen. Violence sexuality has also become popular in music videos and song lyrics. Rap lyrics are being criticized by child advocate groups such as the American Academy of Pediatrics, for imparting the wrong message to the youth about sex and drugs. Misogamy is a derogatory or hateful comment geared towards girls and women and a lot of rap artists tend to include misogamy in their lyrics. The  APA has determined that today’s youth actually spends more time listening to and reading to the lyrics via the Internet to their favorite music than they do watching television. This council urges parents to be vigilant when it comes to knowing what their children are listening to. Lamp also states the kind of electronic music played at raves has been associated with the use of drugs and alcohol. † The Robert Wood Johnson foundation backed a report titled â€Å"Substance Abuse: The Nations Number One Health Problem†, which shows juveniles are starting to use drugs and alcohol between the ages of 12 and 13. In fact, by eighth grade 52 percent of adolescents have used alcohol and 20 percent have used marijuana. This figure jumps to 80 percent use of alcohol and 49 percent use of marijuana by the 12th grade. A research conducted in 1997 showed that in the 200 most popular movie rentals, alcohol appears almost 93 percent of the time and illicit drugs appeared roughly 25 percent of the time. Further, of the 1,000 most popular songs, 27 percent were shown to include alcohol or drug references. These numbers have surely risen since 1997. In addition to music videos and song lyrics promoting premarital sex and drug/alcohol use, this form of media is also seen promoting violent behavior among adolescent teens. Robert Lamp also believes that â€Å"heavy metal and rap have been associated with reckless behavior and below-average academic performance†¦ heavy metal and rock music have also been associated with an increasing risk of suicide, depression, delinquency risk behavior, smoking, and conduct problems† (Neale 1). In recent years, lyrics are becoming more vulgar and inappropriate. The violence heard in rock music instigates adolescents to commit violent crimes. In Northport NY, a seventeen-year-old boy was slaughtered; the names of Ozzy Osbourne and his former band members were spray painted at the crime scene, along with many satanic symbols. Doctor Guttman, a Professor of Psychiatry at Northwestern University states that, â€Å"Rock has so often been involved in these things (violence, teen suicide, etc. ) many of us in psychiatry have had to take it more seriously. † 45 percent of about 1,200 rock music videos supervised were viewed as explicitly violent. Video games and movies also play a prominent role in promoting violence among youth. The article â€Å"Most Teens Play Violent Video Games†, by Ben Berkowitz and published in the Washington Post, states that â€Å"70 percent of American teenage boys have played the violent, but popular â€Å"Grand Theft Auto† video game, and they are more likely to have been in a fight than those who have not played. † It is clear that the violence depicted through these games are mimicked by youth who have difficulty distinguishing between fantasy and what is appropriate and acceptable in a realistic environment. Tim LaHaye gives a real life example of how the media affects certain people. In San Diego, a High School honor student watched An ABC horror movie on the life of Lizzy Borden, an infamous axe murderer in the 1890’s. After viewing this film, he decided to murder his mother, father, and sister. These examples illustrate how juvenile violence is promoted through music, video games, and movies. We live in a society that depends greatly on the media to impart information, allow for communication, and provide entertainment on a regular basis throughout our daily lives. It is vital that we are attentive and vigilant in deciding what our youth should be allowed to view and listen to, as we know there is a direct connection between what one consumes and what one in turn values, how one behaves and how one interacts in society. Too much exposure to the negative aspects of the media can be detrimental to one’s mental, emotional and physical health. The media influences how we perceive beauty, the healthful decisions we make, and how we interact socially. The negative media is harmfully transforming our ethical values of life and our outlook on society.

Tibialis Anterior Tendon Reconstructed With Plate and Screw

Tibialis Anterior Tendon Reconstructed With Plate and Screw Traumatic Ruptures On The Insertion Of The Tibialis Anterior Tendon Reconstructed With Plate And Screw Fixation Technique And Anterolateral Thigh Flap Running title: tibialis anterior tendon reconstructed with plate and screw fixation technique Haijun Mao M.D., Guangyue Xu M.D. Institution:Orthopedics, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China Abstract Objective: Traumatic ruptures of the tibialis anterior tendon are rare but can cause substantial functional deficiencies. This study aimed to evaluate the effectiveness of the reconstruction of traumatic ruptures on the insertion of the tibialis anterior tendon using plate and screw fixation technique and anterolateral thigh (ANTEROLATERAL THIGH) flaps. Methods: Eight consecutive patients with a traumatic rupture of anterior tibialis tendon on the insertion were managed from February 2008 to February 2012. The insertion was reconstructed with plate and screw fixation technique, and the tissue defects were repaired with ANTEROLATERAL THIGH free flaps. Results: All flaps survived without any complications. The average preoperative and postoperative American Orthopedic Foot and Ankle Society ankle-hind foot scores of the patients were 51 and 94.7.Good ankle dorsiflexion strength against strong resistance was observed in eight ankles postoperatively, and a substantial improvement in strength was noted compared with the preoperative examination. Conclusion: Repairing a ruptured insertion of the tibialis anterior tendon using plate and screw fixation technique and ANTEROLATERAL THIGH flaps was a reliable technique and yielded satisfactory results. Level of Evidence: Level V, retrospective case series. Key words: tibialis anterior tendon; plate and screw fixation technique;rupture Introduction Ruptures of the tibialis anterior tendon, either traumatic or atraumatic, are uncommon. Traumatic ruptures are caused by an acute trauma accompanied with osseous or soft-tissue injuries in addition to pain and weakness in dorsiflexion of the ankle[1,2]. Tibialis anterior tendon is important in ankle dorsiflexion3. Ruptures of this tendon can cause functional deficiencies. A localized pseudotumor is usually present at the anteromedial aspect of the ankle, corresponding to the retracted, ruptured tendon end. Physical examination may include loss of the contour of the tibialis anterior tendon over the ankle and the use of the extensor hallucis longus and extensor digitorum communis to dorsiflex the ankle[2]. Traumatic ruptures are usually accompanied with associated injuries. Traumatic ruptures of the tibialis anterior tendon that occur in the avascular lesion within 2cm to 3cm of the insertion make an end-to-end suture impossible because bone reattachment is necessary[1,3–6]. These ruptures are caused by accidents and result in tissue defects. Consequently, island or free flaps may be required during the repair of the tibialis anterior tendon. Clear guidelines about the treatment of these injuries are currently unavailable. Reconstruction of this tendon to restore ankle dorsiflexion and inversion includes end-to-end repair, tendon transfer, or allograft augmentation[4,7–10]. The present study describes a surgical technique using plate and screw fixation with anterolateral thigh (ANTEROLATERAL THIGH) flaps to reconstruct traumatic ruptures of the tibialis anterior tendon. Patients and Methods Eightconsecutive patients with a traumatic rupture of anterior tibialis tendon on the insertion were managed from February 2008 to February 2012. These patients comprised six males and two females with an average age of 32(range,24-46) years. Five and three ruptures involved the right and left legs, respectively. This study defines traumatic rupture as a rupture that occurred because of direct blunt trauma (e.g., accident) to the tendon accompanied by osseous or soft-tissue injuries. These blunt traumatic cases were accompanied by tissue defects, which were reconstructed with ANTEROLATERAL THIGH free flaps. Early repair (3weeks after the rupture or less) was performed for all the traumatic cases, and the average time from rupture to surgery was 1.8(range: 3days to 3weeks) weeks. Rupture of tibialis anterior tendon was diagnosed based on history and physical examination. All patients had functional complaints, includingweakness in dorsiflexion or unsteady gait, limping, and increased fatigue with walking. Physical examination included a pseudotumor at the anterior part of the ankle, loss of the normal contour of the tendon, and weak dorsiflexion of the ankle accompanied by hyperextension of all toes. Magnetic resonance imaging was performed to assess the retraction of the tendon and confirm the diagnosis. All patients were available for follow-up. A retrospective review was conducted on medical records, final patient interviews, and physical examinations at an average of 2years and 3months (range: 1year and 3months to 4years) postoperatively of all cases. Postoperative manual strength testing was performed using a 0 to 5 scale (0, no evidence of contractibility; 1 (trace), evidence of muscle contraction with no joint motion; 2 (poor), range of motion with gravity eliminated; 3 (fair), range of motion against gravity; 4 (good), range of motion against some resistance; and 5 (normal), range of motion against strong resistance. 11 The American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score was used for preoperative and postoperative evaluation. This 100-point standard rating system is designed to compare the results of different treatment methods in patients with the same disorder. The anti-hindfoot AOFAS scores evaluate pain (50 points), function (including gait, range o f motion, and strength) (40 points), and alignment (10 points). 12 Surgical Technique All surgical cases were performed under general anesthesia in the affiliated drum tower hospital of nanjing university medical school.A small longitudinal incision was made above the superior extensor retinaculum. The extensor retinaculum was left intact if possible to avoid adhesions of the tendon.The proximal ruptured tendon end typically retracted to the inferior edge of the retinaculum or just beneath it. Debridement was performed for the proximal and distal parts of the tendon.If the tendon could be brought to its insertion, a direct tendon repair was carried out. If the tendon ends could not be approximated or if the tendon could not be apposed onto its insertion site, an interpositional tendon graft, which included plantaris tendon (two cases), extensor digitorum longus tendon (one case), and peroneus tertius tendon (one case), was used to bridge the gap and reinforce repair . An anchor is usually used in most reported literature. However, this study employed plate and screw fixation technique to repair the tibialis anterior tendon to its anatomical insertion. Direct tendon repairs were performed in four cases. The end of the tibialis anterior tendon was placed on its anatomical insertion, and then a mini-plate was pressed on it and screwed. The harvested grafts had smaller diameter than the tibialis anterior. In most patients, this tendon could be doubled, which usually resulted in a graft with a diameter of 5mm to 6mm. The ankle and foot were held in maximal dorsiflexion and maximal supination, respectively, to determine the final length of the tendon graft. One end of the grafted tendon was fixed using plate and screw fixation technique. The tendon should surround one screw to ensure a firm insertion. When the bony attachment was performed, the tendons were sutured to each other with Vicryl using the side-to-side technique. Finally, the tissue defect was repaired with free flaps. In this study, the ANTEROLATERAL THIGH was performed in all cases. Short-leg cast immobilization was used for the first 2weeks to maintain the ankle in 0Â ° of dorsiflexion. Weight bearing in the cast was allowed in the succeeding 2weeks. The duration of cast immobilization was determined in part by the surgeon’s perception of repair quality during surgery. At 6weeks postoperatively, weight bearing and full dorsiflexion were allowed. Plantar flexion was gradually increased. Results All ANTEROLATERAL THIGH flaps survived without any complications, such as necrosis and infection, except for bloated appearance. The average preoperative and postoperative AOFAS Ankle-Hind foot scores of the patients were 51 and 94.7, respectively. Active dorsiflexion was possible after 2weeks to 3weeks. Good ankle dorsiflexion strength against strong resistance was observed in eight ankles postoperatively, and a substantial improvement in strength was noted compared with the preoperative examination. All patients were able to walk without a visible limp. However, one patient had a little residual weakness in dorsiflexion in comparison to the uninjured side. On physical examination they still had5/5 strength. This caused some symptoms of fatigue or pain after prolonged walking. One patient had 4/5 strength result in a little claudication and continued hyperextension of the toes when walking. Because of the small sample size, there was no valid statistical means to compare the results. Complications arose in one patient. She developed a regional pain syndrome. At the final assessment, we considered that the adhesion of the intermediate branch of the superficial peroneal nerve may be the cause of complication. After the operation of releasing nerve, the patient reported no residual pain and walked with a normal gait. All patients were satisfied with the final result and would undergo the procedure again. Case report A 46year-old man suffered from a tissue defect and rupture on the insertion of the tibialis anterior tendon from a motor vehicle accident (Figure 1). His preoperative AOFAS Ankle-Hind foot score and ankle dorsiflexion strength were 53 and 3/5, respectively. One week later, a complete debridement was performed. We used the plate and screw technique to reconstruct the tendon insertion without tendon grafting (Figure 2). The defect was reconstructed with ANTEROLATERAL THIGH free flap. After the operation, a short-leg cast was performed. At 2weeks after the operation, the flap was stable and the wound healed well. At a 14month follow-up, the postoperative result was 95.3 and the ankle dorsiflexion strength was 5/5 (Figures 3 and 4). He was able to walk without a visible limp. Discussion Ruptures of the tibialis anterior tendon are rare but can lead to considerable functional deficiencies. Ouzounian and Anderson[10]reviewed their clinical experience with 12 patients who had tibialis anterior tendon ruptures. Two types of ruptures were identified based on clinical presentation: (1) atraumatic ruptures, which occurred in low-demand older patients who presented late with minimal dysfunction and (2) traumatic ruptures, which occurred in high-demand younger patients who presented earlier with more disabilities. The authors concluded that patients with traumatic ruptures, regardless of the time of presentation, demonstrated better function after operative intervention.13 In our studies, the average age of the patients was 32(range,24-46) years. Therefore, correct diagnosis should be performed as early as possible. Delayed diagnosis is common because of intact ankle dorsiflexion that occurs as a result of secondary function of the extensor hallucis longus and extensor digitorum communis muscles[14-17]. The diagnosis is significantly based on physical examination, accompanying by weakness of ankle dorsiflexion and a palpable defect of the subcutaneous portion of the tendon and a peseudotumor at the anterior part of the ankle. A pseudotumor usually corresponds with the retracted ruptured tendon end, which becomes entrapped at the distal extent of the superior extensor retinaculum. Ankle dorsiflexion is weaker than that in the contralateral extremity. A steppage gait is a characteristic but is not universally present. Conservative treatment with ankle-foot orthoses, bracing, and activity modification is a viable option in inactive patients. However, we speculated that even in cases with a considerable delay, a reconstruction should still be considered regardless of the age of the patients[8]. Several operative techniques have been published. Many reports recommend an end-to-end suture, but most publications report the use of other techniques because of the difficulties of obtaining an adequate suture repair[2,3,18]. In cases where tendon stumps are often retracted and undergo degenerative changes, an end-to-end suture does not provide adequate tensile strength to transmit the forces required for function. For such cases, tendon graft is needed. In recent literature, the interpositional autografts used include plantaris tendon, extensor digitorum longus, extensor hallucis brevis, and Achilles tendon[2,13,19]. We used ANTEROLATERAL THIGH flaps for the soft tissue reconstruction in these patients. The advantages of ANTEROLATERAL THIGH flaps include consistent and reliable anatomy, long pedicle, being far from the ablative site, allowing two-team approach, the feasibility to create multiple skin paddle by recruiting additional perforators, the flexibility to reconstruct composite defect with chimeric flap by recruiting different tissue types based on a single pedicle, and low donor-site morbidity. When a muscle component is required, we preferred to elevate the flap in a chimeric fashion anterolateral thigh hough elevating the flap as a musculocutaneous flap is also a viable option and may decrease the operative time[20]. A suture anchor or a bio-tenodesis screw is often used for the reconstruction of the insertion of the tibialis anterior tendon. However, this study employed the plate and screw fixation technique to reconstruct the insertion because of its several advantages. The screw can fix the tendon to the bone as point, and the plate can fix the tendon as flat. According to the physics formula of pressure(p)=force(f)/square(s), large square results in small pressure when muscle tension is constant. The plate and screw fixation technique may increase the square and decrease the pressure, thereby improving the firmness between the bone and the tendon. Two patients removed the cast a week after the operation. At the last interview, the patients had a manual strength of 5/5 and walked without a visible limp. These results indicate that the technique decreased the duration of cast immobilization compared with previously published reports. However, no valid statistical approach could be performed bec ause of the small sample size. In our future research, we will use a large sample size to validate the results statistically. The applied technique was simple and easy to follow. During our operation, we tested different directions (perpendicular, parallel, or other angles) of the plate to the tendon and the direction of the muscular contraction. We considered that placing the plate perpendicular to the tendon is relatively easy. We speculated that a share force exists between the plate and tendon if the plate is parallel to the tendon. In addition, a cutting action may be produced on the tendon after a long time. Thus, we situated the plate perpendicular to the direction of muscular contraction. This study has few limitations. First, it is retrospective and lacks a control group of nonoperatively managed patients. The results are not representative of all patients with tibialis anterior rupture; this study only included younger patients who were symptomatic. Second, the AOFAS Ankle-Hindfoot score was used as the clinical outcome measurement, which is not a validated instrument. Nevertheless, this study allows comparison of results because AOFAS Ankle-Hindfoot score is also used in other published studies. Conclusion We recommend surgical reconstruction of the traumatic ruptured tibialis anterior tendon using plate and screw fixation technique and ANTEROLATERAL THIGH flaps. This technique allows early mobilization and yields satisfactory results.

Impact Of Globalization On Fashion And Pharmaceutical Industries Economics Essay

Impact Of Globalization On Fashion And Pharmaceutical Industries Economics Essay Globalization is a broad concept and it has been defined in many ways by different authors. According to Freedman(1999 ,p 156) and Woods(2000,p78), globalization means various quantitative and qualitative developments ranging from a dramatic increase in international transactions, especially in finance, to the international and spatial reorganization of production, the global harmonization of tastes and standards, liberalization, deregulation, privatization, the arrival of new information technologies, the global diffusion of information, values, and ideas, massive population transfers, trends towards a universal world culture, the spread of a worldwide preference for democracy, and the erosion of the nation state. Globalization has different dimensions like economic, cultural, political and environmental. It has different impacts on different industries with varying intensities based on these different dimensions. In this essay, the impact of globalization on fashion and pharmaceuti cal industries are examined and compared. This is to examine the differing intensities with which globalization affects these two industries. In the next two sections, the different impacts of globalization on fashion and pharmaceutical industries are discussed separately. In the last section, the impact of globalization on both these industries is compared and conclusions are made. 2. Impact of Globalization on Fashion Industry The most important elements of fashion industry are textile, clothing or apparel and footwear industries. It also includes food, housing, music, automobiles, perfumery and beauty products. According to Davis (1992), one main distinguishing feature of fashion industry is its ability to differentiate between different social classes or otherwise called social differentiation. For example, the most fashionable items are always very expensive and can be purchased by the upper class while the middle class goes for cheaper items. This made it necessary to produce the fashionable items in cheaper price in the fashion industry to achieve the selling target (Graham et al, 2006). Globalization affects fashion industry through the production, distribution and marketing channels. One main impact of globalization is to keep the people informed and updated on each and every new trend in the fashion industry through old and new media like radio, television, newspapers, internet, mobile phones etc. Consequently, now there is a tendency for imitating Western fashion all over the world replacing the traditional clothing in each nation. For example to highlight secularism, a ban has been imposed on women wearing headscarfs in France by considering wearing headscarf as a traditional religious symbol. The government considered wearing headscarf adversely affecting the immigrants to assimilate into the Western culture, which is called cultural assimilation (Huntington, 1997). This cultural assimilation is an important impact of globalization in fashion industry. The updating of new trends in the fashion industry was based on the economies of scale approach. This is intended to obtain new trends in fashion to all markets at appropriate times and at the correct prices for reducing the total production costs. The need for reducing production costs has resulted in the tendency among the developed nations to outsource production to developing nations like China where the production will be cheaper. This has adversely affected the local business in developed nations and violates the economies of scale principle. The local industries got affected badly because of this outsourcing of production and many of them were not able to continue operating consequently. Eg: producing a brand, t-shirt in Western China where no minimum wage regulations are there instead of producing it in Australia for reducing the production cost. In this case, achieving high profit margin in Australia is very difficult compared to that in China (Purdy, 2000). Globalization has changed this phenomenon however by reducing the transportation and communication costs and thereby increasing the accessibility of people to new fashions all over the world. This has also increased the speed of production in fashion compared to the olden days. The modern communication tools like internet forums have enabled the development and spreading of new technological innovations, which has increased the effectiveness of production in all nations. Globalization has thus resulted in more exchange of ideas and information regarding the availability of textile fabrics and production, which has also resulted in a rise in the demand for products. The consequence of all these was the brand names monopolizing the fashion industry and the spread of individualistic attitude instead of post materialistic especially among the middle classes. Base on these global conditions, the trends in fashion industry were to tempt the individuals for self-improvement instead of accepting them as they are. The most visible example of this can be seen from the growing trend of becoming thin models as the ideals of female beauty. This has proved to be anatomically more correct and has several psychological and physiological impacts. However, the negative side is that this has created by the pressure among female models for becoming thin models (Collins, 1997). The merits of globalization in fashion industry can be considered as the shift in the trends among the middle class from buying outsourced products under the influence of post materialistic ideologies to buy more locally produced ones. However, the problem is that the population of middle class is seen to be decreasing compared to the other groups. In addition to these, another impact of globalization was the shift in the production from developing to developed nations to go with the principle of economies of scale mostly under the influence of new and old media all over the world. However, this cannot be considered as a favourable trend especially under the scenario of the present economic crisis (Graham et al, 2006). According to Abarnathy et al (2003), the globalization of textile and clothing industry is not a new one and its history can be traced back to even the twelfth century. According to this study, in the earlier days the globalization was concerned with movement of labour and capital across nations based on comparative factor costs and productivities for labour, capital and other inputs between nations and their impact on product costs, changes in international exchange rates, quotas and tariffs. In the present scenario, the movement of labour and capital is based on some other aspects of distribution in addition to these like lean retailing, product proliferation, onshore and offshore outsourcing. The Multi Fibre Arrangement that has been existing in the textile industry for many years ended in 2005 with the decision of all WTO members to eliminate all quotas on textiles. China after accessing WTO in 2002 became a quota free nation in the WTO in the same year. The overall picture in the fashion industry thus shows that globalization has resulted in falling transportation and communication costs .This has significantly affected the growth of the markets in the industry .The concept of lean retailing has developed combining reduced transportation and communication costs as well as new technical innovations. The main problem however with the lean retailing is that it has enhanced the pricing pressures (Abarnathy et al, 2003). As a part of globalization process, the quotas on textiles also were removed with effect from 2005. 3. Impact of Globalization on Pharmaceutical Industry In the case of pharmaceutical industry, globalization has its effect through the combination of technological and economic dimensions (SickBlog, 2009). The focus of this industry is to research, develop and distribute drugs. Globalization process affects the industry through three major segments namely production, research and development and marketing. In the present era of globalization, it is reported in many studies that big companies in the industry, which were once in their better times, are now in difficult stages mainly due to inefficient Research and Development (RD)(Dufala,2007;Pouw,2008 etc). The established companies are reported to have failed in producing new items into the market mainly due to the rising RD costs. For example, Pfizer, which was the fourth largest multinational pharmaceutical corporation in the world, is now facing very bad time with a 10-year market exclusivity granted to new drugs. Globalization has resulted in enhanced availability of information, which has changed the role of doctors (Dufala, 2007). For example, in the case of patients who have information from internet, the decisions made by doctors are found to be questionable. Thus, the enhanced availability of information has affected the value chain in pharmaceuticals. It has also made the regulatory agencies to be more cautious. Thus, globalization process has affected the marketing by shifting towards patients. As a consequence of globalization, the generic markets are reported to be growing by taking advantage of the market exclusivity of original drugs and producing in low cost places for eg: Ranbaxi and Teva. In addition to these two developments, may small biotechnology companies face problems due to the difficulty in financing the projects in these companies (Dufala, 2007). All the developments as a part of globalization process have resulted in enhancing competition in the industry while it has not increased pressures for restructuring unlike other industries. Contract Research Organizations (CROs) have prominent role because of globalization process (Shuchman, 2007). The globalization has resulted in increased mergers and acquisitions of the CROs. Examples of CRO s are Pharmaceutical Product Development (PPD), Quintiles, Parexel, Kendle and Covance. The CROs are technologically very innovative and makes se of new business concepts. Thus, it can be seen that CROs were the main actors who were able to utilize the benefits of globalization .At the same time big pharmaceutical companies were not able to do so. It is argued that globalization has improved the conditions of developing nations by improving access to medication by joining organizations like World Trade Organization (WTO). This has been enabled through compulsory licensing or by importing cheaper versions of drugs before the expiry of patents (Slick Blog, 2009). On the other hand, it is argued that the Trade Related Aspects of Intellectual Property Rights (TRIPS), which increases the scope, duration and coverage of the industrial patents of the WTO members, has marginalized the traditional knowledge of local people. Moreover, it has been argued that the growth and development of the domestic pharmaceutical companies are adversely affected by TRIPS (Pouw, 2008). However, exceptional cases are the Indian pharmaceutical companies like Ranbaxi and When Cipla, which have obtained significant growth and expanded their operations. It is also argued that globalization has adversely affected the developing nations through some other ways. In spite of the TRIPS having clause that exempts nations suffering from diseases like AIDS from patent observation, nations like America opposed this through international law suits .Thus many developing nations like South Africa were left in a difficult situation (Slick Blog, 2009). Hence, it is argued that TRIPS has supported in establishing the dominance of some big pharmaceutical companies and rising their presence worldwide (Pouw, 2008). The pharmaceutical industry has fond out the solution for this by outsourcing the production and research and development process as a part of the globalization process. These were intended to make them more cost effective in response to their rising costs. However studies have shown that these costs have been overestimated(Sampath,2005) .For example, the average cost of developing a pharmaceutical drug includes the costs of borrowing mone y to finance the RD process and the marketing costs of the product in addition to the costs of RD. This has overestimated the total RD costs. In addition to these, as a part of the globalization process, the big pharmaceutical companies are forced to perform many human trials with their new drugs before releasing them to the market. However, the main problem with this is that most consumers are reported not to be willing to participate in this process. For example, the consumers were not willing to participate in the phase three trial of Macugen, the eye disease drug by Pfizer (Shah, 2006). It is argued that the reforms as a part of the globalization process has resulted in a national ruin by the developing nations through opening of markets and through the loans provided by IMF and World Bank attached with stringent conditions (Harvey, 2005). Globalization has also affected the marketing process in pharmaceutical industry through preventing the direct to consumer marketing in most countries and promoting advertisement through global media. This type of advertisement through global media is reported to have created distorted images of health and diseases (Petryna and Kleinman, 2006).For example, the diseases like AIDS , are picturized as incurable by these advertisements which has resulted in the marginalization of many developing nations. Moreover, most of the advertisements have been related to allergic diseases rather than the real health crises. This has resulted in creating distorted images of many diseases and medicines. Overall, it is reported that the globalization process has increased the profits in pharmaceutical industry through reducing RD and production costs. This has necessitated the need for sustainable capital, which has resulted in the mergers of big pharmaceutical companies. Thus, the big pharmaceutical companies have started monopolizing the industry leaving the developing nations to be exploited for cheap labour and drug testing (Pouw, 2008,). The outsourcing process, which is supposed to offset the rising costs in the industry, is reported to have negative implications as discussed here. The public private partnerships, where the governments and big companies work together for resolving health crises, however are expected to bring many advantages for the developing nations (Bull and McNeill, 2007). 4. Conclusion In this essay, the impact of globalization on two industries the fashion industry and pharmaceutical industry are discussed. In the case of fashion industry, the globalization impacts are through the combination of cultural, technological and economic dimensions. In the case of pharmaceutical industries, the impact is through a combination of cultural and economic dimensions. In the case of both the industries, globalization has resulted in decreasing the transportation and communication costs. Moreover, it enhances the availability of information through the world media. In the case of fashion industry, these have resulted in a shift from using the outsourced products by the middle class to more locally produced items based on the economies of scale principle. This has resulted in shifting labour from developing to developed nations .Though this is intended to make the production in a more cost effective manner, it is not obtained to be favourable in the present economic condition. The impact of globalization has affected the production, distribution and marketing sides of this industry. The increased availability of information had its impact through the cultural dimension of globalization in the case of fashion industry. The positive impacts of globalization in this industry include aspects like enhancing the speed of production, reducing time lag between production and delivery and creating an individualistic approach necessitating the need for self-improvement. At the same time, negative impacts include the shifting of labour from developed to developing nations. In the case of pharmaceutical industry, the focus is on the research and development of drugs in addition to its production. Hence, globalization affects this industry through three channels production, research and development as well as marketing unlike the fashion industry. The reduction in transportation and communication costs had its economic and technological impacts. Though this has helped in reducing the production and RD costs, this had created dominance for the big pharmaceutical corporations. The enhanced availability of information made the public more aware of the adverse effects of drugs and hence made the decisions of doctors in some cases questionable .This can be considered as a positive aspect of globalization in the industry. At the same time, the enhanced communication through worldwide media has created distorted images in the minds of public regarding many diseases and the concept of health itself. Thigh the globalization process has increased the profitability of the industry; this has resulted in the monopoly of multinational giants in the industry. This has adversely affected the domestic pharmaceutical companies with only a very few exceptions. In the case of pharmaceutical industry, globalization process ahs resulted in creating prominent role for third party players like the CROs unlike the fashion industry. Many big companies who were earlier profitable got adversely affected due to the rising production and RD costs. Outsourcing which was fond as a solution to this had many negative cultural and economic effects. However, compared to the fashion industry the effects of outsourcing were not so intense in the pharmaceutical industry, which can be understood from the discussion. In the case of fashion industry, Quotas and tariffs were eliminated on textiles as a part of the decision of WTO members. In the case of pharmaceutical industries, TRIPS agreement was aimed to assist the developing nations by increasing the access to medication for developing nations. At the same time, TRIPS was obtained to leave the developing nations in difficult situation by marginalizing them in many cases. In the case of fashion industry, the globalization process has resulted in increasing competition and restructuring of the industry with a shift of labour from developing to developed nations. However, in the case of pharmaceutical industry, though globalization ahs resulted in enhanced competition, it has not resulted in the restructuring of the entire industry. Rather, it has created the emergence of the third party players, the CROs that made use of new business concepts and technological innovations. The above discussion thus shows that globalization process has affected both the fashion and pharmaceutical industries but through different intensities. The dimensions of globalization through which it affects both the industries are also little bit different. In the case of similar dimensions of globalization also, the intensities of impacts are different for both the industries depending on the nature and structure of both the industries. Globalization affects both the industries through different channels in spite of the similarities. Hence, it can be concluded that industry specific factors play important role in determining the intensity of the impact of globalization on each industry. The discussion above thus shows that industry specific studies are more relevant in examining the impact of globalization. Though globalization has both positive and negative impacts on industry performance, a generalized picture cannot be obtained in this regard. Macro studies may conceal many f actors regarding the impact of globalization as is clear from the discussion above.