Medical Tourism in Goa Essay Example for Free

Medical Tourism in Goa Essay Medical Tourism in Goa Tina D’costa TYBBA MES college of Arts, Commerce Management studies Medical Tourism The seven wonders of the world are all too well known. However one can’t help but marvel at other developments, that have developed magnificently over the years. These unsung heroes are the ones that carry Indias legacy forward. India in a developing country, but we do not wish to limit ourselves to the meaning of the word that entails ‘developing’. If one takes a look at the Medical facilities offered here in India, they would be amazed at the state of the art facilities and quality of service one receives, that complies to international standards. Particularly if you are an NRI, tourist or foreigner, you can be sure of receiving unprecedented attention. The common man too can now find solutions of world-class healthcare with very affordable price tags. Health care and tourism seems quite an odd couple, but with the growing needs in the health-care industry coupled with the idea of a holiday after, is irresistible and people are looking towards India both for allopathic and ayurvedic treatments. The idea of medical tourism never crossed the Goan mind until the seting up of the Apollo Victor Hospital at Margao which is the first super specialty, multi-specialty, tertiary care hospital in the state. With the advent of this hospital, Goa suddenly woke up to this new concept, which caters to people coming in either for planned treatments or for unplanned treatments. Medical tourism is a recent phenomenon in Goa. Many world class medical hospitals like Apollo and Vivus have been started in Goa, which provide world class facilities at a fraction of the corresponding cost abroad. Foreigners from many developed countries prefer to come to Goa for a variety of treatment ranging from dental surgery, hearing problems, knee replacements to even heart surgery. This is a market where Goa has potential for further development and the government should take steps to see that this market can be sustained and increased medical tourism can be promoted in the future. India’s smallest state, Goa, has earned a negative reputation for its drug culture, rave parties, and nude beaches. However, the Ministry of Tourism  is trying to reverse this image through its active promotion of medical tourism. The Ministry is making laudable efforts to showcase the state’s potential, especially in offering  medical vacations  for  tourists who continue to find  affordable  health  care  insurance  a rarity back in their respective  countries. Considering the thousands of  tourists  who flock to Goa annually for its beautiful scenery and its rich architectural heritage, the  medical  tourism industry  here is projected to record impressive growth. Tourism is Goas primary industry. It handles 13% of all foreign tourist arrivals in India. Goa has two main tourist seasons: winter and summer. In the winter time, tourists from abroad (mainly Europe) come to Goa to enjoy the splendid climate. In the summertime (which, in Goa, is the rainy season), tourists from across India come to spend the holidays. Tourism is generally focused on the coastal areas of Goa, with decreased tourist activity inland. Goas tourism contributes to 16% of Indias total foreign exchange earnings. In 2009-10 there were more than 2. 5 million tourists reported to have visited Goa, both domestic and foreign and total revenue earned for the fiscal year 2009-10 from tourism is Rs. 5000 crore as against Rs. 4000 crore in the previous year. A major upcoming concept attracting a lot of tourists to Goa is the rise of Medical Tourism in Goa. Dentists in Goa claim that tourists save over 70% on their dental treatment if done here in Goa. Hence they are now offering holiday packages which include expensive dental treatments too. The Booming Medical Tourism. The concept of medical tourism is not a new one. The first recorded instance of medial tourism dates back thousands of years to when Greek pilgrims traveled from all over the Mediterranean to the small territory in the Saronic Gulf called Epidauria. This territory was the sanctuary of the healing god Asklepios. Epidauria became the original travel destination for medical tourism. Spa towns may be considered an early form of medical tourism. Factors that have led to the recent increase in popularity of medical travel include the high cost of health care or wait times for procedures in industrialized nations, the ease and affordability of international travel, and improvements in technology and standards of care in many countries of the world. Medical tourists can come from anywhere in the world, including Europe, the UK, West Asia, Asia, US and Canada. This is because of their large populations, comparatively high wealth, the high expense of health care or lack of health care options locally, and increasingly high expectations of their populations with respect to health care. Health tourism provides have developed as intermediaries to unite potential medical tourists with provider hospitals and other organizations. It has been started that â€Å"medical tourism is promoted much more heavily in the United Kingdom than in the United States†. A large draw to medical travel is convenience and speed. Countries that operate public health-care systems are often so taxed that it can take considerable time to get non urgent medical care. The time spent waiting for a procedure such as a hip replacement can be a year or more in Britain and Canada; however, in Singapore, Hong Kong, Thailand, Cuba, Colombia, Philippines or India, a patient could feasible have an operation the day after their arrival. Additionally, patients are finding that insurance either does not cover orthopedic surgery (such as knee/hip replacement) or imposes unreasonable restriction on the choice of the facility, surgeon, or prosthetics to be used. Medical tourism for knee/hip replacements has emerged as one of the more widely accepted procedures because of the lower cost and minimal difficulties associated with the traveling to/from the surgery. Medical tourists may seek essential health care services such as cancer treatment and brain and transplant surgery as well as complementary or ‘elective’ services such as aesthetic treatments (cosmetic surgery). Ayurveda Treatment Ayurveda which is form of medical treatment originated from India has gained a lot of prominence in European world for health benefits. Ayurveda means life and Veda signifies knowledge. Therefore by its definition Ayurveda lifts itself beyond the realms of diseases and treatments. It treats life as a single composite phenomenon. After Kerala now Goa is one of Indias best destination for combining Tourism with Ayurveda Treatment. A Goan  Medical  Vacation India is known worldwide for the quality of cardiac procedures and joint replacement surgeries. Tourists from all over the world come down to Goa to take in the sights as well as to benefit from Medical amenities available. Goa is uniquely positioned to develop its health tourism sector. Affordable  Health  Care  Insurance is  a Problem for Goan Locals. While  tourists  rave about the  medical  tourism  facilities  that Goa offers, Goan locals are feeling the pinch due to the escalating  prices  of  medical  treatments. There is now a clamor for an improved  health care  system in the state. The average Joe on the street can afford neither the exorbitant rates of the specialty  hospitals  nor basic  health care insurance. Adding to this dilemma is the lack of  available clinical  services  in remote areas plus the high  prices  of  medication  for  senior  citizens Medical tourism has come to be a new branch of tourism so formed in recent times. The following are some reasons why one visits Goa for Medical tourism: 1. Variety and abundance of available medical skills Goa is very well prepared to service foreigners when it comes to health care. Most Goan doctors speak perfect English, a majority of them are also schooled or trained abroad. While India in general has an universal healthcare system ( meaning that most drugs or procedures are free for the local population) there is also a healthy competition between governmental and privately run hospitals and healthcare institutions for servicing the more wealthy locals with lifestyle procedures (like cosmetic surgery) or visiting foreign tourists (who want to save a dime or two compared to their home countries). If you look around in the tourist belt , you can find plenty of private healthcare providers. Especially the north-western coastal region (Candolim, Calangute and Baga) one can find dental clinics spread all along the coastal belt. In this mentioned area alone I can easily count 30-40 dentists, while larger hospitals mainly only have outlets here, with their main operations to be found in the larger cities like Mapusa, Panaji or even Margao in the south. Major hospitals to consider are for instance the Vrundavan Hospital in Mapusa, Manipal Hospital in Dona Paula, Vintage Hospital in Panaji, Apollo Victor Hospital (very new and a bit more expensive) and NUSI Hospital in/near Margao. Some of the medical services ffered here are: General Medicine and Cardiology, Orthopedic Surgery, Pediatrics, Trauma and Critical care, Cardiovascular and Thoracic Surgery, Endoscopic and Laproscopic Surgery, Gastroenterology and Oncosurgery, Neuro surgery, Cosmetic Surgery, ENT, Urology, Nephrology, Dermatology, Ophthalmology, Dental, Medical Genetics and Counseling, Respiratory Medicine, Physiot herapy, Dietetics, Alternative and Ayurvedic Medicine. Vaccinations too, can be had in almost every hospital. 2. Quality of Surgery, medical personnel and other amenities This one is a bit hard to describe and has to be seen to be believed. Hospitals here in Goa for sure don’t look very special from the outside. Once inside, and you are in a complete different world. The hygiene in every hospital is generally good. Sometimes you really have to wonder, how they can maintain a hospital so clean in an area that looks like a rubbish dump from the outside. Welcome to India! Here especially, looks can be deceiving. Operational devices, x-ray machines, dental equipment and other instruments are of high standard, although not quite on par with Singapore or European ,machines (except the dentists maybe). But you can expect modern facilities and up to date staff and nurses in spotless uniforms. So for general healthcare services and minor surgeries I wouldn’t be afraid to go under the knife here, as most established procedures didn’t change much over the last couple of years. 3. Short Queues or waiting Times Generally, most dentists and hospitals in Goa have very short waiting times, completely different to healthcare providers in Europe or other developed countries, where you sometimes have to make appointments weeks in advance. As a foreigner you can enjoy a very individual and prompt reception. Dentists usually will arrange appointments only 2-3 days away, convenient enough to get a procedure done during a 2-week holiday. The same applies for consultations without appointments with specialists. As a paying customer you usually don’t have to wait long in crowded waiting areas. The few times we had to visit a doctor it was all between 10-15 minutes of waiting times. You also don’t have the feeling that the doctors are very pushy and want to have you out within 5 minutes of their time. A checkup is done very thorough and in an individual manner. The stuff is generally friendly and genuinely interested in your well-being. 4. Low Costs of Generic and Branded Medicine Most medicines can be bought here without prescriptions either right in your local pharmacy or ordered by them if not in stock. Goa is dotted with thousands of pharmacies at every corner. Again the tourist areas from Candolim to Baga have the highest density of pharmacies, while I found Mapusa further to the north-east the best stocked. The best thing: prices for medicines are fixed! So you don’t have to haggle like with everything else in India. Prices are printed on the boxes of medicines and that’s exactly what you pay Another specialty: some branded items are sold here already as generics, even though in most other countries you still can only buy the branded (more expensive) product. One example, a modern tacrolimus-based skin ointment is anywhere else in Asia only available as the branded version (Protopic) and will cost you anything from 300. 000 Rupiah in Indonesia, around 1. 200 Baht in Phuket, 2. 150 Peso in the Philippines to 80-100 SGD in Singapore. No genericsavailable. Buy the real thing or forget it. Not here in India: A generic version (Tacroz Forte) costs a mere Rs 320 for 10g. That is only 20% of the price in Indonesia or Thailand, 15% of the price in the Philippines or 10% of a similar product in Singapore. Isn’t that amazing? Talk about globalization and how you can exploit it for yourself! I found that true for other specific medicines as well. Here are just a few examples for other more common products: Band Aid wash proof: Rs 20 for 10 pieces Immodium: Rs 20 for 10 capsules Paracetamol 500: Rs 14 for 10 capsules Vitamin B complex: Rs 15 for 10 capsules Topical Antibiotic Spray: Rs 195 (40g) Antibiotic Skin Cream: Rs 50 (10g) Broad Spectrum Antibiotic: Rs 50 for 10 capsules Now I just wish, they would be able to send all those cheap medicines abroad to my next travel destinations! 5. Low Consultation and Doctor fees As with everything else in India, one can compare prices and get an impression of the doctor for their surgery first, before committing to a procedure. Luckily the initial costs are very low (for dental procedures, the first checkup is generally free of charge, while for other consultations the fees are quite low, see below). Costs for surgery is generally only a small percentage to health care costs if done in Europe, Australia or the US. I was in Singapore once and was in awe over their low health care costs compared to India. There, major plastic surgeries were nearly dirt cheap. For minor surgeries however, you could save even more, considering getting it done here in India. One example: a friend from Singapore visited us here in Goa, to get a cyst removed on her wrist. While the same surgery would have cost between SGD 1. 200-1. 600, the same procedure was only around SGD 300-400 here in Goa. All with similar quality, aftercare and all costs included. That is only 25% of the cost compared with Singapore I had some dental work done here in Goa, fillings and tooth cleaning, all done very professionally and on short notice. As mentioned above, to consult a specialist, you don’t have to pay a fortune here. From my own and my friend’s experience and what other friends and relatives abroad told me, here are some examples of consultation fees: Dentist: First Consultation – free of charge General Practitioner: Rs 100-250 per Visit Dermatology: Rs 100-200 per Visit Orthopedist: Rs 250 per Visit For minor surgery, like the above mentioned cyst removal, here are some example prices: Orthopedic Surgeon Charges: Rs 5,000 per surgery Anesthetic Charges : Rs 1,500 per surgery Operation Theater Charges: Rs 2,300 per surgery Hospital bed per day: Rs 1,000-2,000 for common ward, depending on hospital Hospital bed per day: Rs 4,000-7,000 for private room, depending on hospital Here are some dental examples: Glass Ionomer Filling: Rs 960 Composite Resin Filling: Rs 1,600 Porcelain to Metal Crown: Rs 7,200- 10,500 Stellon/Fibre Glass/Travelon Dentures: Rs 12,000-24,000 Metal/Invisible Braces: Rs 24,000-44,000 Conclusion: Goa is an interesting location for getting your health propped up and getting those long postponed surgeries done. You have modern facilities, short waiting times and very affordable prices for procedures, hospital services and medicines. Over that you will probably recover much faster, with a holiday in an exotic location added as a bonus. These days with the global financial crisis upon us, prices for flights and package deals to Goa are as low as they can get. So many people are flocking to Goa now, to benefit from the low costs the most. Some people even try to strike a deal with their health insurance provider, either to cover parts of their costs or acknowledging an otherwise not possible surgery. As with everything in India , one has to be aware of some pitfalls too : while medicine prices are generally fixed, this can’t be said about the services and hospital procedures. But there is a good competition, so one can comfortably look around, ask and compare prices before committing to anything. In short, there is a broad variety of options to choose from here. One can talk to different doctors and if in doubt, stick with a larger and well-known hospital instead of a small private clinic. With the facilities Goa can offer, it could be easily converted into a centre of excellence for Medical Tourism. Add to it, the flavour of Goan hospitality, medical tourism could be made very attractive. We therefore have an excellent opportunity to market health care in Goa, especially to the Britishers who consist of 60 per cent of the total tourists arriving in Goa.

Business Model of Nike Essay Example for Free

Business Model of Nike Essay Introduction Nike Inc. was founded in 1962 by Bill Bowerman and Phil Knight as a partnership under the name, Blue Ribbon Sports. Nike’s main products are sports shoes, sportswear, sports goods. In this paper, we will talk about ‘The Challenge of Entrepreneurship’ ‘Competitive Business Model’ ‘Solid Strategic Plan’ ‘Feasibility Analysis’ and ‘Business Plan’. All of these topics are very important when we study the ‘EOE and SBM’, and in each topic have more than one point. We got ‘The Benefits of Entrepreneurship’ ‘Competition’ of ‘The Challenge of Entrepreneurship ’; ‘Core Competencies’ ‘Innovations’ ‘Sustainable Competitive Advantage’ ‘Key Success Factor’ of ‘CBM’; ‘Vision and Mission’ ‘Objectives and Goals’ ‘SWOT’ ‘Competitor’ ‘Business strategy’ of ‘Solid Strategic Plan’; ‘Industry and Market Feasibility’ ‘Product or Service Feasibility’ ‘Financial Feasibility’ and ‘5Forces Model’ of ‘Feasibility Analysis’. Now, we are going to show you the detail. The Challenge of Entrepreneurship The Benefits of Entrepreneurship Surveys show that owners of small businesses believe they work harder, earn more money, and are more satisfied than if they worked for someone else. (Via Dr. Josà © A. Torres Essentials of Entrepreneurship and Small Business Management Powerpoint) Opportunity to Create Your Own Destiny. Nike, originally known as Blue Ribbon Sports (BRS), was founded by University of Oregon track athlete Philip Knight and his coach Bill Bowerman in January 1964. The company initially operated as a distributor for Japanese shoe maker Onitsuka Tiger(now ASICS), making most sales at track meets out of Knights automobile. According to Otis Davis, a student athlete whom Bower man coached at the University of Oregon, who later went on to win two gold medals at the 1960 Summer Olympics, Bower man made the first pair of Nike shoes for him, contradicting a claim that they were made for Phil Knight. Says Davis, I told Tom Brokaw that I was the first. I dont care what all the billionaires say. Bill Bower man ma de the first pair of shoes for me. People dont believe me. In fact, I didnt like the way they felt on my feet. There was no support and they were too tight. But I saw Bower man make  them from the waffle iron, and they were mine. (Via HTTP://en.Wikipedia.org/wiki/Nike,_Inc.) Opportunity to Make a Difference. In 1979, Nike Air cushion technology Air, by the inventor of the m. Frank Rudy patented, first applied on the Tailwind running shoes, the gas film in running shoes soles for the protection of the cushion. And Nike has created many print and television advertisements with Wieden+ Kennedy, Wieden+ Kennedy remains Nikes primary ad agency. It was agency co-founder Dan Wieden who coined the now-famous slogan Just Do It for a 1988 Nike ad campaign, which was chosen by Advertising Age as one of the top five ad slogans of the 20th century and enshrined in the Smithsonian Institution. Walt Stack was featured in Nikes first Just Do It advertisement, which debuted on July 1, 1988. Wieden credits the inspiration for the slogan to Lets do it, the last words spoken by Gary Gilmore before he was executed. Throughout the 1980s, Nike expanded its product line to encompass many sports and regions throughout the world.[16] In 1990, Nike moved into its eight-building Wo rld Headquarters campus in Beaverton, Oregon. (Via HTTP://en.Wikipedia.org/wiki/Nike,_Inc.) Opportunity to Real Improve profits. In 2005, Nike Air Jordan 20 generations. Nike Free series, also in protecting the foot, like barefoot training is provided for the wearer. Nike as of May 31, total annual profits had 13.7 billion dollars, a 12% growth in the past fiscal year. On December 19, 2013, Nike Incs quarterly profit rose as a result of global orders for merchandise for delivery by April increased 13 percent. Future orders of shoes or clothes for delivery between December and April, rose to $10.4 billion. Nike shares (NKE) rose 0.6 percent to $78.75 in extended trading. (Via HTTP://en.Wikipedia.org/wiki/Nike,_Inc.) Opportunity to Contribute to Society and Be Recognized for Your Efforts. NIKE Charity Organization, is a Non-Governmental Organization Headquartered in PORT HARCOURT RIVERS STATE, NIGERIA. It is autonomous and submissive to the laws of the Federal Republic of Nigeria. They are determined to achieve our dreams and purpose of giving hope to the less privilege and to discharge our duties as members of non-profit organization in accordance to our core  values at National, State and Local Government levels. We are prepared to harness, strengthen and efficiently direct our efforts as much as we are out to join hands with other organizations, and individuals in the fight against the Girl Child Abuse. (Via HTTP://saccharinity.com/about_us.php) Competition NIKE is a consumer products company and the relative popularity of various sports and fitness activities and changing design trends affect the demand for our products. The athletic footwear, apparel, and equipment industry is highly competitive in the United States and on a worldwide basis. We compete internationally with a significant number of athletic and leisure footwear companies, athletic and leisure apparel companies, sports equipment companies, and large companies having diversified lines of athletic and leisure footwear, apparel, and equipment. We also compete with other companies for the production capacity of independent manufacturers that produce our products and for import quota capacity. Our competitors’ product offerings, technologies, marketing expenditures (including expenditures for advertising and endorsements), pricing, costs of production, and customer service are areas of intense competition. This, in addition to rapid changes in technology and consumer preferences in the markets for athletic and leisure footwear and apparel, and athletic equipment, constitute significant risk factors in our operations. If we do not adequately and timely anticipate and respond to our competitors, our costs may increase or the consumer demand for our products may decline significantly. (Via Nike-2013-form-10K) Designing a Competitive Business Model Core Competencies Nike’s quality , technology and brand is famous . Nike’s Air cushion technology is almost using in every basketball shoes ,it’s good for athlete’s foot . the Nike having its own core competence due to organizations own skills and core competence it has taken a competitive advantage and now is taking a large market share. The core competence of Nike is to specialize in athletes foot wear and other sports items. As we know every organization has its R D department .The R D department of Nike is playing a vital role because of its innovations in foot wear how the  consumers can feel comfort by wearing their shoes and the quality thats the most important factor to be given in shoes and they have different categories of shoes which is running shoes nick shocks, Jordan, and other types that is targeting different type of consumers having different perceptions. But most important thing of Nike is they dont make shoes they design and then give their design to the production companies in Korea and china or Vietnam. Due to which they are more specialized in their innovation and in this way they have made their core competence in making innovative design of athlete shoes. Innovations Nike believe his research and development efforts are a key factor in nis success .NIKE strives to produce products that help to reduce injury , enhance athletic performance and maximize comfort success . (Via Nike 2013 Annual Report) Nike also find many expert in chemistry, exercise physiology, engineering, industrial design, sustainability and related fields ask they advices to fixed Nike’s shoes and clothing . Nike’s air cushion shock absorption technology is famous in the basketball shoes area .Nike’s Brand shoes like LBJ , Kobe and KD has many color and types . Sustainable Competitive Advantage External Analysis : Nike’s brand awareness is famous all over the world ,everyone buying shoes first chose is Nike . Nike sponsored the top athletes and gained valuable coverage. , like Jordan , LeBron James , .From the Nike’s 2013 annual report will find that Nike growing up every years . Nike has many competitors , like Adidas , Puma , Reebok and so on , but Nike’s market share is more than any other . Internal Analysis :As we know ,Nike’s product is quality , Nike’s has own RD center to creative new technology ,like air cushion shock absorber technology ,environmental technology and so on .It’s basic technology to Nike’s product .Nike always find many creative thing to put in Nike’s product ,like knitting technology in his shoes .That’s awesome . Nike has employed creative marketing and advertisement platforms in building brand awareness and equity of its diversified products. For instance, the company uses Tiger Woods a skilled golfer to build its line of golf products. It further employs professionals in various departments that include distribution, marketing, finance,  product management, research and design, information technology, and product development so as to sensitize the market of its diversified products Nike also operates an internship program every summer lasting for three months giving students an insight on the diverse brands. Other avenues Nike accomplishes diversification strategy is through mergers, joint ventures, takeovers, and acquisitions. The company also has an RD unit called the innovation kitchen located in the main parent company in Oregon, to enable it to continue producing unique products such as the cushioning system in shoes. Key Success Factor Jordan Brand : Jordan brand is a big part of the Nike. Jordan’s shoes is popular in all over the world .Jordan shoes occupy the USA 10.8% market share in 2009 .Jordan shoes sales almost two times of Adidas . (Via :http://sports.sina.com.cn/k/2009-09-12/16084584096.shtml)So Jordan brand is a key success factors of Nike .) Jordan brand is popular in young people , every young people want a Jordan’s shoes it’s beautiful and comfortable .Especially Jordan’s air cushion technology , using in every basketball shoes . Technology :In addition to Nike’s own staff of specialists in the areas of biomechanics ,chemistry , exercise physiology, engineering , industrial design, sustainability ,and related fields , we also utilize research committees and advisory boards made up of athletes , coaches, trainers , equipment managers , orthopedists , Podiatrists , and other experts who consult with us and review designs , Materials , concepts for product and manufactur ing process improvements and compliance with product safety regulations around the world . (Nike Annual Report ) Advertisement : Advertisements play a significant role in the athletic apparel industry, as consumers rely on catalogues and online advertisements . Nike has many endorsers ,like Jordan ,James ,Durant and so on. These guys bring many customers .Nike has online store ,you can buy many things in this store ,before new product star sales ,you’ll get an e-mail about this product .Nike’s advertisement not only online but also in everywhere .It’s very amazing! Adidas :Adidas is a very famous company ,it’s very popular in world too .But in these years, Adidas’s market in decrease very fast .Because Adidas’s endorsers did not famous than Nike’s endorses .Adidas’s endorses including Yao Ming ,A.I ,D.Rose and so on .But they hurt or retied .Adidas’s  quality and technology is also well known .But Adidas lost because the endorses . New Balance :New Balance (I will call New Balance as NB for short ) is known as a most comfortable shoes .They has many new technology ,such as BIOSHIELD ,ABZORB EX ,REVAX ,ENCAP ,and so on .And NB is popular in young people ,you will find many youn g people wear NB in the street .IT’s a huge market to NB. Building a Solid Strategic Plan It’s a significant part of a successful business. It keeps the company to where they oriented, to meet their mission, goals and objectives, and lead it on the right way. A Strategy plan is to build a competitive advantage. It involved Vision and Mission Statement, also Objectives and Goals, SWOT Analysis, Competition Analysis and Formulate Strategies. We are going to find out what does Nike different from others, why it is unique, and what it has that others don’t. I am about to use Five Forces Model to analyze the competitive advantages for Nike. Vision, Mission, Goal and Objective Nike’s vision is â€Å"To bring inspiration and innovation to every athlete in the world.† The legendary University of Oregon track and field coach, and Nike co-founder, Bill Bowerman said, â€Å"If you have a body, you are an athlete.†. It’s their mission. (Via http://help-en-us.nike.com/app/answers/detail/a_id/113/p/3897) Their goal is to become and keep the number one sportswear brand all over the world. Their objective is keep down the manufacturing cost and keep their price down then they can occupied the market in some less developed countries who can become the economically dependent in the industry. (Via http://wiki.answers.com/Q/What_are_the_objectives_of_Nike_company) SWOT Analysis. Strengths As one of the ‘Fortune 500’ company, Nike has numerous strengths. It is positioned at being the number one sportswear brand globally, it Offers their products worldwide, it has a very strong marketing campaign that increases brand familiarity, and it has no factories, it uses OEM (Original Equipment Manufacturer) to get the work done. It has contracts with above 700 shops globally in about 45 different countries. it also has offices in these different countries. It has chains of retail stores like  Niketown so that it can sell there. Its famous Swoosh is instantly recognizable, and Phil Knight even has it tattooed on his ankle. Weaknesses The organization does have a diversified range of sports products. However, the income of the business is still heavily dependent upon its share of the footwear market. This may leave it vulnerable if for any reason its market share erodes. The retail sector is very price sensitive. Nike does have its own retailer in Nike To wn. However, most of its income is derived from selling into retailers. Retailers tend to offer a very similar experience to the consumer. Can you tell one sports retailer from another? So margins tend to get squeezed as retailers try to pass some of the low price competition pressure onto Nike. Opportunities Product development offers Nike many opportunities. The brand is fiercely defended by its owners whom truly believe that Nike is not a fashion brand. However, like it or not, consumers that wear Nike product do not always buy it to participate in sport. Some would argue that in youth culture especially, Nike is a fashion brand. This creates its own opportunities, since product could become unfashionable before it wears out i.e. consumers need to replace shoes. There is also the opportunity to develop products such as sport wear, sunglasses and jewelry. Such high value items do tend to have associated with them, high profits. The business could also be developed internationally, building upon its strong global brand recognition. There are many markets that have the disposable income to spend on high value sports goods. For example, emerging markets such as China and India have a new richer generation of consumers. There are also global marketing events that can be utilized to support the brand such as the World Cup (soccer) and The Olympics. Threats Nike is exposed to the international nature of trade. It buys and sells in different currencies and so costs and margins are not stable over long periods of time. Such an exposure could mean that Nike may be manufacturing and/or selling at a loss. This is an issue that faces all global brands. The market for sports shoes and garments is very competitive. The model developed by Phil Knight in his Stamford Business School days (high value branded product manufactured at a low cost) is now commonly used and to an extent is no longer a basis for sustainable competitive advantage. Competitors are developing alternative brands to take away Nikes market share. As discussed above in weaknesses, the retail sector is becoming price competitive. This  ultimately means that consumers are shopping around for a better deal. So if one store charges a price for a pair of sports shoes, the consumer could go to the store along the street to compare prices for the exactly the same item, and buy the cheaper of the two. Such consumer price sensitivity is a potential external threat to Nike. (Via Nike 2013 Annual Report, http://www.quality-assurance-solutions.com/swot-analysis-nike.html, http://www.ukessays.com/essays/marketing/account-management-provides-special-treatment-in-marketing-administration-marketing-essay.php http://www.marketingteacher.com/swot/nike-swot.html) Analyze the Competition. Nike has some competitive Direct competitors- Adidas, New Balance and Li Ning. They offer the product that Nike does, and all of these companies have different key success factors. Adidas, is the most competitor od Nike with do doubt, they compete with Nike for No.1 sportswear branding for over 40 years But in these years, Adidas’s market in decrease very fast .Because Adidas’s endorsers did not famous than Nike’s endorses .Adidas’s endorses including Yao Ming ,A.I ,Derrick Rose and so on .But they hurt or retied .Adidas’s quality and technology is also well known .But Adidas lost because the endorses; New Balance is known as a most comfortable shoes .They has many new technology ,such as BIOSHIELD ,ABZORB EX ,REVAX ,ENCAP ,and so on .And New Balance is popular in young people ,you will find many young people wear New Balance in the street . IT’s a huge market to New Balance; Some Significant competitors like Under Armour and Skechers, they offer similar products like apparel or footwear, they compete with Nike in some fields. Some Indirect competitors like The North Face or Columbia, both of them are the most of the famous outdoor brand, they offer windbreaker or accessories that Nike does. They have impacts to Nike in some mutual markets. Conclusion: Nike does perfectly in quality and endorsement, they almost signed all significant players and teams all over the world. Adidas has no most strength but all factors are averaged. New Balance does best in technology, it can makes sneakers more comfortable. (New Balance has never signed any endorsers since it founded, so its score is little bit lower) Cost leadership. Nike uses Business Simulation Strategy. It has no factories, it uses OEM (Original Equipment Manufacturer) to get the work done, and it doesn’t has stores mostly. It offers products to Franchised retailers, and let them sell the products. It saved money from factories and rent, so its overhead is low. No shop, no labors,. quantity of materials, low too. If a supplier increases costs, Nike can easily change a new one with lower cost, Nike can do this because of its ability. Nike definitely has low cost access to factors of production. The enormity of Nike in respect to their suppliers gives them a huge advantage in production negotiations. Due to their high volumes for products, the cut-throat low cost nature of selecting a manufacturer, and coupled with the fact that Nikes suppliers depend so heavily on them for their own success that they have little to no bargaining room toward raising prices, allows Nike to continuously enjoy low costs of production. Nikes hardware and software technology implementations of using the not only using the best materials but creating them in a vertical fashion and housing an innovation culture from the top down, allow Nike a first move advantage into cost savings. However most of these advances only bring definite savings for a short time due to competitive parity within the industry, their creative nature definitely does benefit over the long run. Nike reduced costs by cutting some of its endorsements. Company research suggested the endorsement by the Italian soccer team, was not achieving the desired result. Michael Jordan, LeBron James, Kobe Bryant and a few other endorsers were retained while some other like Italian soccer team, were eliminated, to saving over $100 million. Nike does incredible in cost control. (Nike 2013 Annual Report) Differentiation. Differentiation strategy by Nike is used to gain market share advantage in the broad foot ware market. Aside from foot wear, the company boasts of products such as clothing, equipment, and even accessories. The strategy is achieved by producing consumer goods and services that customers perceive to be of high quality or have added unique features. This has been achieved by the company innovating state of the art athletic shoes that are publicized through dramatic â€Å"guerrilla† marketing. Marketing of the different products is designed to coerce customers that Nike’s shoes are not only superior but also a high fashion statement which is a necessary part of a lifestyle based  on athletic or sporting interests. The company has also differentiated itself by using highflyers that are best used in distinguishing sporting disciplines hence enabling the company reach its target market, for instance, the Brazilian national soccer team or even Michael Jordan. Also, Nike is different from others in their Ads. They show not only their technology but also leading endorsers like Michael Jordan, LeBron James, Kobe Bryant and Cristiano Ronaldo in their Ads of new products. At the same time, their Ads are also very creative and with imagination, make people who watched them unforgettable. (Via Nike 2013 Annual Report) Focus.

Lifestyle Changes For Diabetes Health And Social Care Essay

Lifestyle Changes For Diabetes Health And Social Care Essay Diabetes mellitus is a heterogeneous group of disorders, all characterized by increased plasma glucose. In the majority of patients with diabetes, the etiology of the disease is not understood. Expert panels have recommended one set of criteria for diagnosis and another set for classification . The criteria serve two purposes. One is to secure optimal treatment of the patient. The other is to support research aimed at understanding the aetiology and pathogenesis of diabetes syndromes Diabetes mellitus type 2 or type 2 diabetes (formerly called non-insulin-dependent diabetes mellitus (NIDDM), or adult-onset diabetes) is a disorder characterized by high blood glucose in the context of insulin resistance and relative insulin deficiency.(Robbins et al ,2004) More than 220 million people worldwide have diabetes. In 2005, an estimated 1.1 million people died from diabetes.Almost 80% of diabetes deaths occur in low- and middle-income countries. Almost half of diabetes deaths occur in people under the age of 70 years; 55% of diabetes deaths are in women. WHO projects that diabetes death will double between 2005 and 2030.Healthy diet, regular physical activity, maintaining a normal body weight and avoiding tobacco use can prevent or delay the onset of diabetes.(WHO,2009) Many types of diabetes are recognized (Tierney.L.M et al,2002) the principal three are: Type  1: Failure to produce insulin by body mechanism resulting in diabetes. It is estimated that 5-10% of Americans who are diagnosed with diabetes have type  1 diabetes. Currently patients with type  1 diabetes take insulin injections. Type  2: Results from insulin resistance, a condition in which cells fail to use insulin properly, may be combined with absolute insulin deficiency. Majority of patients world over who are diagnosed with diabetes have type  2 diabetes. Gestational diabetes: Pregnant women who previously never had diabetes before but who have sudden increase in blood sugar (glucose) levels during pregnancy mainly due to change in their diet are said to have gestational diabetes. Gestational diabetes affects about 4% of all pregnant women. It may precede development of type  2 (or rarely type 1) Diabetes mellitus . Type 1 Diabetes Diabetes is a long-term (chronic) condition caused by the increase in level of glucose (sugar) in the blood. It is also known as diabetes mellitus. In the UK, diabetes is seen in around 2.3 million people, and its estimated that there are more than half a million more people who have the condition but are not aware of it. Normally a hormone called insulin regulates the blood sugar level, which is produced by the pancreas (a gland behind the stomach). When food is digested and enters the bloodstream, insulin moves any glucose out of the blood and into cells, where it is broken down to produce energy. However, in those with diabetes, the body has higher level of glucose as it is stored and is unable to break down glucose into energy because there is either not enough insulin to breakdown glucose and store it as energy or because the insulin produced is not enough or does not work as required. Gestational diabetes is caused by excess weight, obesity and Insulin Resistance are a condition that develops in the third trimester of pregnancy and affects 4-5 % of all pregnant women in the U.S. That is around 135,000 cases each year. With Gestational Diabetes, the insulin production by pancreas is normal but it doesnt lower the mothers blood sugar levels. The symptoms are only detectable by laboratory testing. Pregnant women can test their blood glucose level by urine dip stick test with each pre-natal visit. This test may show glucose in the urine, which is sign and will require health care provider to carry out further examinations for the presence of Gestational Diabetes, also known as Gestational Diabetes Mellitus http://weight.insulitelabs.com/Gestational-Diabetes.php There are two types of diabetes type 1 and type 2. Type 1 diabetes occurs when the body produces no insulin. It is often referred to as insulin-dependent diabetes. It is also sometimes known as juvenile diabetes, or early-onset diabetes, because it usually develops before the age of 40, often in the teenage years. Type 1 diabetes is far less common than type 2 diabetes, which occurs when there is too little insulin produced by the body to work, or when the cells in the body do not react properly to insulin. People with type 1 diabetes make up only 5-15% of all people with diabetes. type 1 diabetes, will need insulin injections for life as well as blood glucose levels stay balanced by eating a healthy diet and carrying out regular blood tests http://www.nhs.uk/conditions/diabetes/Pages/Introduction.aspx The  main symptoms of diabetes  are: feeling very thirsty(polyphagia) producing excessive amounts of urine(polyurea) tiredness and lethargy weight loss muscle wasting (loss of muscle bulk). Symptoms of type 1 diabetes can develop quickly, over weeks or even days. Other symptoms  are:   itchiness around the vagina or penis or getting thrush regularly, blurred vision (caused by the lens of your eye becoming very dry),   muscle cramps, constipation skin infections. Hypoglycaemia (low blood glucose) If a patient has diabetes, their blood glucose levels can become very low. This is known as hypoglycaemia (or a hypo), and happens because insulin produced by the body is more and has reduced the level of in the bloodstream. In most cases, hypoglycaemia occurs if there is overdose of insulin, although it can also happen if you skip a meal, exercise very vigorously or drink alcohol on an empty stomach. Symptoms of a hypo include: feeling shaky and irritable, sweating tingling lips feeling weak hunger nausea A hypoglycaemia can be brought under control simply by eating or drinking something with sugar in it . If a hypoglycaemia is not brought under control it can lead to confusion, slurred speech and unconsciousness. If this occurs there will be a need to have an emergency injection of a hormone called glucagon. This hormone will raise the level of glucose in your blood as it suppress the effect of insulin. Hyperglycaemia (high blood glucose) As diabetes occurs as a result of your body being unable to produce any, or enough, insulin to regulate your blood glucose level, your blood glucose levels may become very high. This happens because there is no insulin to breakdown glucose from the bloodstream and into the cells to produce energy. Blood glucose levels become too high, it lead to   hyperglycaemia. The symptoms are similar to the main symptoms of diabetes, but they may come on suddenly and severely. They include: extreme thirst a dry mouth blurred vision drowsiness a frequent need to pass urine. If left untreated, hyperglycaemia can lead to complications such as diabetic ketoacidosis, which can eventually cause unconsciousness and even death. Diabetic ketoacidosis occurs when your body begins to break down fats for energy instead of glucose, leading to a build-up of acids in your blood urgent medical attention if diabetes develop in the body and this are the general signs and symptoms seen in case of diabetes a loss of appetite, nausea or vomiting (feeling or being sick), a high temperature, stomach pain or severe abdominal pain a fruity smell on your breath, which may smell like pear drops or nail varnish. http://www.nhs.uk/Conditions/Diabetes/Pages/Symptoms.aspx The McKeown thesis and its Impact: The McKeown thesis attempted to reason the phenomenal growth in population of the from late 18th century to the present day .McKeowns thesis can be summarized as a steep growth in population was primarily due to decline in mortality form infectious diseases and the change in economic conditions due to industrial revolution ,which lead to improvement in rising of living standards and brought a gradual change in nutritional status that improved the human bodys resistance towards various diseases. The development in medical fields achieved by modern science did not make a significant contribution towards the population growth and was largely due to economic forces and changes in living and social conditions. This lead to McKeown reclassifying various fatal diseases recorded by General record office (GRO).McKeown classification was generally of three types (1)Infectious diseases spread through air -Respiratory tuberculosis, Pneumonia, Bronchitis (2) Infectious diseases spread through water or food Cholera, Diarrhoea, Typhoid (3) All other diseases contagious and degenerative When a population develops it is important that the individuals are in a position to fight diseases and problems that can arise from them, this depends on the resources that they have. These resources could be knowledge, social setup, power, money. Those people who have access to resources have advantage and can gain health benefits from the public health system from those who are not in position to direct access to public health system. Resources are important in two different ways first , they can develop the individuals behaviour towards health by helping them access and make choices and whether they could afford them all helping towards health enhancing behaviours and Second, resources are shaped across a broad range of contexts such as communities, neighbourhoods, social network , occupation and the risk as well as protecting factors .Housing for poor people would always be associated with pollution, noise, indifferent social conditions . Access to broad range of problems lie wi th socio economic condition of the individual like knowledge of best doctors and ideal treatment of medical problems and the freedom in making choices .The reason for social condition always being important is resources shape the access to health relevant circumstances . The social condition has been responsible for determining the quality of life and plays an important role as health determinant. (Link.B.G and Phelan.J.C 2003) Mckeown was the former chairman of World health organizations advisory group on health research strategy concludes that the average life expectancy had improved by 23 years in first half of century and medical therapy was responsible for only for few years of it. Meckeown believed that most this decrease was due to identification of bacilli which causes respiratory tuberculosis was not done till year 1882 and effective pharmacotherapy was not available till year 1947. Between 1700 and 1915, the mortality rate in England declined from 27.9 deaths per thousand living to 14.4 and average life expectancy at birth Increased from 37.1 (in 1701) to 53.5 (in 1910-12). These figures reflect a major Improvement in the life-chances of the British population over the course of the Period, and therefore it is hardly surprising that the McKeown thesis, which attempts to account for the decline of mortality and the modern rise of population, has played a big role in economic, social and medical history as well as history of epidemiology and population studies In the years following the publication of McKeown thesis it is argued that its unlikely the dietary standards would have improved during the second half of 18th century as the value of wages was falling as there were apparent contradictions between real wages and mortality. (Wrigley and Schofield, 1981). McKeown argued that there was no means to fight air borne diseases in 18th century and the reduction in deaths was more likely due to improved human body resistance towards these diseases. Illich was not content in criticizing modern medicines for to improve life expectancy , he proposed that medical interventions were in fact responsible for increasing the mortality rate by using ineffective and hazardous medical therapies which at times not tested or researched properly .Illich stated that chronic usages of drugs lead to numerous side-effects , infections acquired from hospitals , poorly performed surgeries as well as false positives and false negative tests from medical tests. McKeown was aware that higher rate in fertility was responsible for increase in population rather than reduced mortality rate but dismissed it on grounds that higher birth rate means higher infant mortality as well due to the high risk parity of mothers so would not account for such a high rate of population growth. McKeown pointed out that mortality rates for most of the infectious diseases reduced considerably before any effective medical measure was in place. McKeown concluded that public health measure such as sewage disposal system, public waste disposal, and supply of clean and potable water and pasteurization of milk was important only from year1870, so the reason behind the decline mortality rate before this was according to McKeown due to improvement in living standards .Improvement in nutrition due to increase in agriculture productivity was also responsible for the increase in resistance to airborne infectious diseases such as Tuberculosis.(Grundy,2005). Prestons article c oncluded that the increase in life expectancy all over the world between 1930s and 160s could not be totally attributed to increase in living standards and suggested that advances in medical care and public health did make significant contribution towards decline in mortality. Prestons did make an effort to prove McKeown thesis wrong but had little influence on conventional belief and the theory of improved standard of living became conventional wisdom for that present time. (Mackenbach J P,2006) It has recently been shown that McKeowns interpretations of his very own epidemiological data is flawed in many respects, firstly smallpox and diphtheria are two diseases that have been eradicated totally all over the world by vaccinations which is a preventive health measure .Positively the only three diseases to be eradicated before great world war was- cholera , typhoid and smallpox all these are attributed to public health measures and not nutrition .When all this data is analysed it goes to show that public health measures taken played the most decisive role in reduction of mortality . Furthermore since McKeowns work was published two significant forms of new evidence has appeared which slams the nutrition/living standard theory by McKeown. The first half of the century, the period which is under review suggests that as when the wages across sectors started improving, the reduction in mortality rate showed a slight decline from previous years and if wage increase meant better nu trition these was not seen in children .The growing cities and towns where the wage improvement were seen showed a trend of areas which had highest mortality rate and children were poorly developed (R.Woods and J.Woodward.1984).Although the points raised here are relevant they skew the main issue here which is that growth in income is not necessarily same all over the world and can vary considerably from developed countries to developing and underdeveloped countries .There are no patterns in cross-sectional associations between the income of a nation and progress in developing health standards as well as life expectancy of their population. Prestons analysis underestimated the effects of economic development and its relation with reduction in mortality rate, that the relationship between the economic development and the developments in medical field are crude conceptualization between the two. McKeowns study can be explained by relevance of the question that underlines them. This concerns the importance of medical interventions, social, economic, political measures which affects the health status and health inequalities. Study suggest that measures need to be taken to improve health inequality and medical interventions and social changes has to be taken as complimenting rather than opposing each other . Interventions Type 1 diabetes is approached by primary, secondary, and tertiary intervention Primary intervention includes treatment of all individuals with diabetes. The possibility of using autoantigens new medium to combat diabetes as a vaccination is currently being explored not only in animal experiments but also in human tests. The selection of children on the basis of HLA type is being used to treat newborns with either oral or nasal insulin. Animal experiments have shown that treatment of spontaneously diabetic nonobese diabetic mice with GAD as a peptide, protein, or expressed in potatoes reduced diabetes. Vaccinations studies done both children and adults remain a future possibility to test determine whether type 1 diabetes can be prevented. (Lernmark.A.1999) Secondary intervention involves screening for genetic, autoantibody, and other possible markers at birth, in school children, or in adults . Individuals classified with type 2 diabetes but positive for islet autoantibodies (representing slow-onset type 1 diabetes, latent autoimmune diabetes in the adult, or type 1.5 diabetes) are also being tested to determine whether they are suitable for immune intervention to preserve their ß-cell function. Recent studies in Japan suggested that early insulin treatment preserves ß-cell function. Several intervention trials are pending, including the use of subcutaneous or oral insulin in the Diabetes Prevention Trial for Type 1 Diabetes, milk formula or nasal insulin in Finland, aerosol insulin in Melbourne, or nicotinamide in the European Nicotinamide Diabetes Intervention Trial. In the next few years studies would find out the extent of such intervention trials preserve ß-cell function in subjects at risk for type 1 diabetes.(Lernmark.A .1999) Tertiary intervention involves the treatment of patients diagnosed with type 1 diabetes very recently. Previous studies have demonstrated that treatment plans with satisfactory results are not present such as immunosuppression with cyclosporin and other agents has not been able to stop the pathogenetic process in new-onset patients. A future innovative treatment is planned so that it represents an antigen-specific immune intervention. Animal experiments have demonstrated that in case of early diagnosis or in patients with early onset the timely administration of antigen or insulin, at the time of clinical onset may slow the disease process.(Lernmark.A.1999) Being active is referred to as physical activity (exercise) and is defined as the act of expending energy. It is generally categorized into two different types aerobic (requiring oxygen to maintain muscular effort) or anaerobic (not requiring oxygen to maintain muscular effort). The term exercise is used as a general label for being active and physical activity as well as exercise. Major challenges to decision making about exercise include how to develop and implement an efficient and effective exercise regimen, how to modify it to an individual patients motivation level knowing his mindset and barriers so that exercise will be initiated and maintained, and how to select, measure, and achieve specific, desired outcomes. Given these decision-making challenges Exercise interventions aimed at achieving these outcomes usually vary by type, intensity, duration and frequency. As with any type of self-care behaviors, barriers to exercise vary and are individual to particular patients depend ing on their health status as well as mindset. Among potential considerations for barriers has to be devised for individual patients type of exercise and duration, intensity, and frequency may need to be tailored to severity of progression of diabetes since complications such as neuropathy and retinopathy may affect the exercise capabilities of a diabetes patient. In addition, patients may consider availability of time, among many other factors such as age, job profile, social status and other medical complications, as posing a substantial barrier to integrating regular exercise or physical activity into normal daily lifestyle. Each of these poses challenges to the initiation and maintenance which is the more difficult part of exercise for patients and therefore to the measurement, monitoring, and management of exercise intervention outcomes for providers. Exercise is one of the most important features to both type 1 and type 2 diabetes patients. For type 2 diabetes patients, engagi ng in regular exercise may improve glycemic control and reduce the risk of vascular complications, increase insulin sensitivity, reduce stress and stave off depression and contribute to control of lipids and blood pressure, thereby reducing the risk of cardiovascular disease, the leading cause of death in diabetes patients. Type  2 diabetes is determined primarily by lifestyle related factors and hereditary factors. Lifestyle A number of lifestyle factors are known to be important to the development of type  2 diabtetes. In one study, those who had high levels of physical activity, a healthy diet, did not smoke, and consumed alcohol in moderation had an 82% lower rate of diabetes. When a normal weight was included the rate was 89% lower. In this study a healthy diet was defined as one high in fiber, with a high polyunsaturated to saturated fat ratio, and a lower mean glycemic index. (Mozaffarian.D.et al 2009) Obesity has been found to contribute to approximately 55% type  2 diabetes, and decreasing consumption of saturated fats and trans fatty acids while replacing them with unsaturated fats may decrease the risk.(Saad.F.2009) increased rate of childhood obesity in between the 1960s and 2000s is beleived to have lead to the increase in type  2 diabetes in children and adolescents. (Rosenbloom.A. et al.2003) Environmental toxins may contribute to recent increases in the rate of type  2 diabetes. A positive correlation has been found between the concentration in the urine of bisphenol A, a constituent of some plastics, and the incidence of type  2 diabetes. (Lang.A.2008) Medical conditions Subclinical Cushings syndrome (cortisol excess) may be associated with DM type 28The percentage of subclinical Cushings syndrome in the diabetic population is about 9%.Diabetic patients with a pituitary microadenoma can improve insulin sensitivity by removal of these microadenomas. (Taniguchi T.2008) Hypogonadism is often associated with cortisol excess, and testosterone deficiency is also associated with diabetes mellitus type 2, even if the exact mechanism by which testosterone improve insulin resistance is still not known. (Farrell JB,2008) Genetics Both type  1 and type  2 diabetes are partly inherited. Type  1 diabetes may be triggered by certain infections, with some evidence pointing at Coxsackie B4 virus. There is a genetic element in individual susceptibility to some of these triggers which has been traced to particular HLA genotypes (i.e., the genetic self identifiers relied upon by the immune system). However, even in those who have inherited the susceptibility, type  1 diabetes mellitus seems to require an environmental trigger. There is a stronger inheritance pattern for type  2 diabetes. Those with first-degree relatives with type  2 have a much higher risk of developing type  2, increasing with the number of those relatives. Gene expression promoted by a diet of fat and glucose as well as high levels of inflammation related cytokines found in the obese results in cells that produce fewer and smaller mitochondria than is normal, and are thus prone to insulin resistance. COMPLICATIONS of Diabetes Early complications- Diabetic ketoacidosis is a medical emergency, because it can cause coma and death. Hospitalization, usually in an intensive care unit, is necessary. Large amounts of fluids are given intravenously along with electrolytes, such as sodium, potassium, chloride, and phosphate, to replace those fluids and electrolytes lost through excessive urination. Insulin is generally given intravenously so that it works quickly and the dose can be adjusted frequently. Blood levels of sugar, ketones, and electrolytes are measured every few hours. Doctors also measure the bloods acid level. Sometimes, additional treatments are needed to correct a high acid level. However, controlling the levels of sugar in the blood and replacing electrolytes usually allow the body to restore the normal acid-base balance.( Robbins and Cotran,2007) Late Complication of Diabetes Mellitus: Macro-vascular complications as: Atherosclerosis with MI, CVA, peripheral vascular disease Micro-vascular complications as: Diabetic Retinopathy Diabetic retinopathy refers to progressive pathologic alterations in the retinal microvasculature. In type 2 diabetes, though the incidence of blindness is lower, higher disease prevalence results in an even larger number of patients affected with severe visual loss. Diabetic Neuropathy Diabetic neuropathy (DN) is a common and troublesome complication of diabetes mellitus, leading to great morbidity and mortality and resulting in a huge economic burden for care of the patient with diabetes mellitus. It is the most common form of neuropathy in the developed countries of the world, accounts for more hospitalizations than all the other diabetic complications combined, and is responsible for 50% to 75% of nontraumatic amputations and patients have serious co-morbid conditions, especially heart, eye, and peripheral vascular diseases. Diabetic neuropathy is a heterogeneous disorder that encompasses a wide range of abnormalities affecting proximal and distal peripheral sensory and motor nerves as well as the autonomic nervous system. The major morbidity associated with somatic neuropathy is foot ulceration, the precursor of gangrene and limb loss. (Robbins and Cotran,2007) Research on diabetes The features of Type 1 diabetes in humans as well as mice in labororatory environment is significantly dependent on an relation between the environmental factors and genetic feature of humans as well as the study animal. Studies by Giulietti.A.et al(2004) al point towards vitamin D as being one of the environmental factors that can modulate the incidence of diabetes. This study further shows that in mice that developing Type 1 diabetes are generally at higher risk due to its genetics as well as vitamin D deficiency which leads to features seen in early part of life leading to a more aggressive form of the disease causing earlier onset, and a higher final incidence of the disease. This model of subtle vitamin D deficiency in early life, with only a marginal vitamin D deficiency in blood, but no effect on calcium concentration in serum or bone calcium content. This is most probably the reflection of the vitamin D status in many infants and small children as this model has temporary and limited vitamin D deficiency, even in areas with high exposure to sunlight, since infants always are shielded from UV B exposure or direct exposure of sunlight. The application of vitamin D supplement is advised in many countries it is far from strictly controlled and many times, these supplements are omitted or administered irregularly or not paid enough importance to keep tab on their supply and demand. The higher incidence of Type 1 diabetes in the past two decades may be seen due the nutritional rickets which has never been completely eradicated in many countries and may be reappearing in may industrialize countries (Giulietti.A.et al, 2004). It was found that the risks for diabetes in African-Americans, Hispanics, and Native Americans are approximately 2, 2.5, and 5 times greater, respectively, than in Caucasians being the least. Various national and ethnic populations within the U.S. to the total U.S. population were analyzed to find possible risk factors for the development of type 2 diabetes this was done by number of cross-sectional studies and prospective studies . Studies of the prevalence of type 2 diabetes in Mexican Americans and non-Hispanic whites in San Antonio showed that there is an inverse relationship between prevalence of diabetes generally and their current socioeconomic status. The cultural effects lead to an increased incidence of obesity in these populations which may also be related to their diet and physical activities, which may lead to insulin resistance. Genetic factors may also be a contributing factor. (Haffener.S.M 1998) There are no high quality data on the research about the long lasting effectiveness of the dietary treatment of type 2 diabetes, however the data available indicate that the adoption of exercise which is a change in lifestyle appears to improve glycated haemoglobin at six and twelve months in people with type 2 diabetes. There is an urgent need for more well-designed studies which will analyse the wide range of interventions, at various points during follow-up (Moore.H. et al 2004) Weight loss improves glycemic control with magnitude of improvement related to both magnitude of weight and characteristics of patient , the amount of weight loss required to reduce blood glucose is large, even modest weight loss produces glycemic control .The most important issue is how to improve weight loss especially long term weight loss, in type 2 diabetic patient .Dietary modification is most important direction in weight loss program (Hertzel.C.et al) Implications for developing world Type I diabetes is the only major organ-specific autoimmune disorder not to show a strong female bias. The overall sex ratio is roughly equal in children diagnosed under the age of 15 but while populations with the highest incidence all show male excess, the lowest risk populations studied, mostly of non-European origin, characteristically show a female bias. In contrast, male excess is a consistent finding in populations of European origin aged 15-40 years, with an approximate 3:2 male:female ratio. This ratio has remained constant in young adults over two or three generations in some populations. Further, fathers with Type I diabetes are more likely than affected mothers to transmit the condition to their offspring. Women of childbearing age are therefore less likely to develop Type I diabetes, and should this occur are less likely to transmit it to their offspring. Type II diabetes showed a pronounced female excess in the first half of the last century but is now equally prevale nt among men and women in most populations, with some evidence of male preponderance in early middle age. Men seem more susceptible than women to the consequences of indolence and obesity, possibly due to differences in insulin sensitivity and regional fat deposition. Women are, however, more likely to transmit Type II diabetes to their offspring. Understanding these experiments of nature might suggest ways of influencing the early course of both forms of the disease.(Gale.E.A.M. et al 2001) It is recognized that there will be substantially increased costs of widely applying the recommendations of study in the U.S on the Diabetes control and complications trial (DCCT). There will also need to be additional efforts to ensure professional education, so that health practitioners are implement this recommendations through the trial are able to effectively and safely implement the therapy employed in the DCCT. It is hoped that the benefits of trial are long term healthier; more productive lives with fewer complications will offset the costs of tight control. The cost-benefit ratio for intensive therapy in diabetes in this trial is in a range similar to other accepted treatments in the U.S that are

FDR and Winston Churchill Essay -- essays research papers fc

Between the years of 1939 and 1945 the world was sent spiralling in a mess of corruption, violence and uncertainty. Allied powers were faced with the unparalleled task of protecting the world from tyranny. In terms of political power, this weight was bestowed upon the shoulders of two memorable individuals. By and large Winston Churchill and Franklin D. Roosevelt can be labelled as beacons of democracy and leaders of the free world in their time. Winston Churchill, the son of Lord Randolph Churchill, became an officer in the 4th cavalry in 1894. Between 1895 and 1899 he served in Cuba, India and South Africa as a reporter. Churchill entered politics in 1900 and held many government posts until he was appointed First Lord of the Admiralty prior to World War One. Due to logistical and tactical failures during wartime, Churchill was somewhat discredited and lost his naval post. In the inter war period, Churchill remained politically active and made his way up the ranks to become chancellor of the exchequer in Stanley Baldwin’s Conservative government. When World War Two broke out, Prime Minister Neville Chamberlain appointed him to his old post as First Lord of the Admiralty. When Chamberlain was forced to resign, Churchill became Prime Minister. He served throughout the war as Britain’s supreme leader until he was defeated in a 1946 general election. Churchill once again became prime minister from 1951 until his r esignation in 1955. In 1953, he was knighted and received the Nobel Prize in Literature. Franklin D. Roosevelt was a lawyer educated at Harvard and Columbia University School of Law. His political career started when he was elected to the New York State senate in 1910. He was appointed Assistant Secretary of the Navy, a position he held from 1913 to 1920. As a Democrat, Roosevelt ran as vice presidential nominee along side James M. Cox, an election that was lost to the republican candidates Warren Harding and Calvin Coolidge. While vacationing on Campobello Island, N.B., Roosevelt was stricken with polio and became paralysed from the waste down. However, he eventually recovered partial use of his legs. In 1928 and 1930, Roosevelt was elected governor of New York. At the height of the great depression, in 1932, Franklin D. Roosevelt became the 32nd president of the United States. He went to work immediately utilising government resources to combat ... ...d weaknesses as every individual does, but were, without a doubt, very successful leaders in their time. Churchill and Roosevelt were truly beacons of democracy and leaders of the free world. Bibliography Alacritude, LLC. Encyclopedia.com. 24 Feb. 2003 < http://www.encyclopedia.com/>. Churchill Center, The. Sir Winston Churchill Homepage. 5 Mar. 2003 < http://www.winstonchurchill.org/>. Gardener, Brian. Churchill in his Time. London: Methuen & Co Ltd., 1968. Gilbert, Martin. Churchill’s Political Philosophy. London: Oxford University Press, 1981. Goff, Richard, et al. The Twentieth Century, A brief Global History. New York: McGraw-Hill Company, 2002. Jablonsky, David. Churchill: The Great Game and Total War. Portland: International Specialized Book Services, Inc., 1991. Kimball, Warren F. The Juggler: Franklin Roosevelt as Wartime Statesmen. New Jersey: Princeton University Press, 1991. Ludwig, Emil. Roosevelt: A Study in Fortune and Power. New York: The Haddon Craftsmen, Inc., 1937. White, Graham J. FDR and the Press. Chicago: The University of Chicago Press, 1979. White House, The. The White House Home Page. Mar. 9 2003 .

Symbols and Symbolism in Edgar Allan Poes The Masque of the Red Death

   "The Red Death had long devastated the country. No pestilence had ever been so fatal or so hideous. Blood was its Avatar and it seal - the redness and the horror of blood..." - Edgar Allan Poe (Regarding the plague of the Red Death) The plague Edgar Allan Poe spoke of in his short story The Masque of the Red Death was one of complete and utter misery that defaced whomever it struck. While this pestilence was surging throughout the country mentioned in the story, a man by the name of Prince Prospero decided to attempt to cheat death out of its cold and icy grip. He along with a group of the most elite of the time closed themselves in one of the Prince's abbeys to try to wait out the death that lurked everywhere outside the castle walls. Several months after their escape from civilization, Prospero held a masked ball for his friends, when to their utter horror, death made its way in and killed all of the masqueraders. Through this short story, Poe depicts the underlying theme that death is inevitable, and trying to escape it is one of the most futile actions one can do. By reading this piece, the reader gains a lot of insight into the way Poe's mind worked, and the events in his life that inspired him to write in the way that he did. Pieces Poe wrote, such as "The Masque of the Red Death," show the intertwined nature Poe's stories took with his real life situation. The most profound characteristic surrounding "The Masque of the Red Death" is the symbolism Poe incorporates into even the simplest of elements. Symbolism runs rampant throughout the story, and, to the unaware reader, these gems of Poe's character may be overlooked. The peculiar characteristic about the symbolism Poe depicts is that al... ...jority did not understand the amount of suffering that went into each and every word. Works Cited Bloom, Harold, et al. The Tales of Poe. New York: Chelsea House, 1987. Broussard, Louis. The Measure of Poe. University Of Oklahoma Press: Norman, 1969. Burduck, Michael. Grim Phantasms: Fear in Poe's Short Fiction. New York: Garland, 1992. Dudley, David. "Dead or Alive: The Booby-Trapped Narrator of Poe's 'Masque of the Red Death.'" Studies in Short Fiction. Newberry College, vol. 30 Spring 1993. 169-174. Halliburton, David. Edgar Allan Poe: A Phenomenological View. Princeton University Press, 2015. Kesterson, David et al. Critics on Poe. Florida: University of Miami Press, 1973. Womack, Martha. "The Masque of the Red Death." Publisher: Christoffer Nilsson, 1997. Web. 4 June 2015. http://www.poedecoder.com/essays/masque/

Bioterrorism and Science: The Censorship of Scientific Journals Will Do More Harm than Good :: Essays Papers

Bioterrorism and Science: The Censorship of Scientific Journals Will Do More Harm than Good Science is based on the open communication of research and information. Scientists often build on the work and results that their colleagues have published in scientific journals. This process of incremental development prevents scientists from â€Å"reinventing the wheel† before continuing forward with original research. It stands, therefore, that the publication and distribution of research is necessary for future research to be productive. However, the dissemination of research has an adverse side effect in the current world. Scientific journals not only inform scientists about recent developments in their field of research, they also inform terrorists. It is possible for terrorists to use the same information found in scientific journals, intended for the benefit of the scientific community, to harm other people. The September 11th attacks force journal editors and reviewers to consider whether censorship is necessary to prevent further, more severe, terrorist attac ks. I believe, however, that broad censorship of scientific journals will hurt our own efforts at biodefense and health care more than it will hinder terrorists looking to make biological agents. In order to understand the current anxiety over bioterrorism we must look at the history of terrorism, both biological and conventional. Bioterrorism was a worry of American scientists and policy makers long before the attacks on September 11th. It has been estimated that, during the Cold War, the Soviet Union employed as many as 60,000 people in a biowarfare research program ([Anonymous] 2000). Ex-Soviet biowarfare researchers have reported the development of a strain of plague resistant to 16 different antibiotics by the Biopreparat, a clandestine network of research facilities located in Russia and Kazakhstan (Dennis 2001). It is certain that the US government was aware of the Soviet interest in biowarfare and thus also had biowarfare and defense programs. It wasn’t until Iraq used chemical weapons against the Kurds that we thought a modern state would actually employ chemical or biological weapons. Then, in 1995, the Japanese cult Aum Shinrikyo released sarin gas on a subway, killing 12 ([Anonymous] 2001), and demonstrated that there was need for real concern about chemical and biological terrorism. In addition to the September 11th attacks, the American public was also subjected to anthrax attacks during the final months of 2001. As the first biological attacks on US soil in more than a decade, these emphasized that bioterrorism is still around and that the United States is still unprepared for a large-scale biological attack ([Anonymous] 2000).

Online Education Essay

Education is an important part of people’s lives; it will either make them or break them in the future depending on the careers they choose. Education is greatly diverse today in comparison to the 1950s because of advancements in teaching and other great inventions that provide easier techniques of teaching. One major issue that has been raised is distant learning courses and online education. Distant learning could be any format from VHS videos, DVDs, or internet courses online. Online education has been legal since 1993 and is a new way of teaching students of all ages. Online education has been gaining popularity through out the years because of the ease of the internet. The internet has made it easier for people to stay connected and has provided people with unlimited resources on the World Wide Web. Many educators have mixed feelings about online educating because there are so many pros and cons to the issue. Mary Kassop, author of â€Å"Ten Ways Online Education Matches, or Surpasses, Face-to-Face Learning,† writes, â€Å"Can students learn as much and as well online as they do in F2F courses? Not only is the answer to these questions a resounding ? yes, ‘ but there are many ways that online courses may actually surpass traditional F2F classes in quality and rigor†(357). Kassop is a pro advocate of online education and she is correct on the issue because it can provide a good education to many people. Online courses provide a good teaching environment where the individual is on his or her own all in the comfort of their room. The convenience of online courses provide busy individuals a chance to get the equal amount of education as a student going to class and all that is needed to get started is a computer with internet access. One computer can open the gates to a whole new world of learning and excitement. To stimulate the experience there are many classes offered online by city and university colleges. Long Beach City College has a few to offer such as Psychology and Sociology which are equal to or even better then face to face classes. One example of a class that is better online rather than face to face is Sociology because they let the students observe human communication at public spaces without the teacher being there. The work that is done in the classes is also expected from someone who signs up for an online class. The online class materials are the same as the normal classes themselves, but the books used can be ordered from book stores online. Discussion on issues is done in chat rooms and forums where everybody writes their views on the issue. This is an advantage for foreigners who can not speak proper English correctly. Live video and sound can also be done with special equipment for a real time conversation with instructors and peers. Other features on the online courses are the learning aides that can be used while taking the course. Certain programs can be made such as flash cards and games which can increase the learning experience of the student. These learning aides can be done on the student’s time and does not require the teacher to be there. Time for a face to face class is very difficult if a person works 40 hours a week but an online course can put an ease on the time restriction because the person does the work at their own pace and time. It is also easier to sign up for an online class than a class at a college. Message boards are in use if the students need to leave a question or a comment about the subject their on. They also save time by not traveling to the college and trying to find a parking space. Rural areas where students have to travel a great distance to get to class can save time and money by doing online classes. For example, a child of a farmer can help the family out in the morning with the farming chores then go to an online class later on. Rural kids may also take additional educational classes online that their school does not provide. Children in the movie industry may also take online courses to keep up with their studies while on the road filming movies. Hillary Duff takes online course while she films. As the price of education continues to rise, the rate of students applying for online educational classes will continue to get greater. The price for a unit at Long Beach City College is $26 and the price per unit will continue to rise as long as there is a deficit in California’s budget. Online courses provide a cheaper alternative for schools that have a problem with their budget and actual classroom space. Teachers can also record themselves and the student can download the film if they miss the session. This gives a student the chance to catch up on a class session if he missed out on that day. In 2002, 12 of the 55 National Geographic Bees were homeschoolers meaning that courses than at home can provide a great teaching environment. Students do not have to put up with bad influences from regular schooling and help build their own identity without social pressures that traditional schooling may have. Some students may also earn their high school degree faster then their peers. While the pros are stated some cons are also involved with online classes such as the there is no real person to person interaction with an instructor. No face to face communication means there is no personal attention from an instructor. Some may also feel the accreditation from an online school is not the same as a real university classroom. Students do not get to feel the real situations of a traditional classroom or university causing them to be isolated or anti-social. There is no support from an instructor like a real class and everything is usually done by the student. Everything depends on his or her ability to understand the material and be ready for term papers and test. Some knowledge of computers is necessary if the student wants to be able to stay in the class as being computer illiterate is a big issue determining if the person will pass or fail because most of the work is done online. Many low-income students might be affected by the computer issue because desktops and laptops are expensive and many may not be able to afford such luxuries. Another problem is if a person always needs an extra push or reminder that a up coming report or test is coming because there is no instructor there to provide the push and it is all up to the student remind themselves. However, the cons stated above can also work to help the student become more responsive. The person to person interaction is not really needed because when they graduate some individuals will become office workers and they usually work in a cubical providing the same atmosphere that the online class provides. Also by the students doing everything by themselves in an online class they become more independent, teaching them that there is not always a person there to guide them in a problem, just like in life. As for the issue of the computer cost that some students can not afford they can use public resources to access the internet such as the library and so on. There are also loans, grants, and other forms of financial help they can get to provide them with the tools they need to get started in an online  class and with the computer training they must learn in an online class it can provide a leg up in the competitive job market. Online education could be the tool of the future to provide the young and the old with schooling and instruction. It provides a cheaper way of teaching while still giving the student the material necessary for the class. Students learn responsibility through online education and will give them a reason to work hard during the class. All in all online classes will help provide many students with the education they require.