Direct And Indirect Restorations Health And Social Care Essay

Today with the of all time spread outing scope of renewing stuffs the tooth doctor needs to be cognizant of how long these Restorations are likely to last and the possible grounds for failure. This will maximize length of service of Restoration and prevent failure. The tooth doctor must besides hold a cognition of renewing stuffs advantages, disadvantages, indicants and contraindications. All this information will let the tooth doctor to choose the right renewing stuff for specific clinical state of affairss taking to long term clinical endurance of Restorations. Long term endurance of direct and indirect Restorations is dependent on the Restoration non neglecting â€Å" failure occurs when a Restoration reaches a degree of debasement that preludes proper clinical public presentation for either aesthetic or functional grounds of because of inability to forestall new disease † 1 Many factors contribute to the failure of a Restoration these include patient, operator and renewing stuff factors. In this literature reappraisal I will turn to the failure of direct and indirect posterior Restorations due to material factors independent of patient and operator factors such as clinical accomplishment degree of operator, tooth place and cavities rate.PurposesWith respect to different stuffs for direct and indirect posterior Restorations I hope to: -Outline failure rates of direct and indirect buttocks Restorations -Outline manners of failure of direct and indirect buttocks Restorations -Outline briefly some advantages, disadvantages, indicants and contraindications of direct and indirect posterior Restorations. -Outline in some instances the factors that operators should see toreduce failure rates -Compare long term endurance of direct V indirect posterior Restoration failureDirect posterior RestorationsBoth amalgam and rosin complexs are indicated as direct category 1 and 2 posterior RestorationsDirect buttocks amalgamAmalgam is one of the most normally used renewing stuffs worldwide in posterior direct Restoration today. Amalgam does n't bond to tooth construction, contains quicksilver and is non aesthetic, but its low cost, straightforward managing process, rapid application and good path record of clinical public presentation in the past mean it continues to be the most convenient renewing stuff in posterior dentitions. In recent old ages at that place has been a diminution in its popularity due to public wellness concerns over its quicksilver content. Failure of amalgams can be every bit high as 6 % at seven old ages. 1 Failure of amalgam is chiefly due to 1. Secondary cavities 2. Tooth break 3. Gross amalgam break 4. Fringy dislocation Secondary cavities has been found to be the most common cause for amalgam failure accounting for 66 % of all failures in amalgam Restorations at seven years.1 Operative technique is of importance in bar of secondary cavities as taint of the readying by blood and spit, hapless matrix technique and hapless condensation lead to hapless adaptation of Restoration to the pit wall and overhangs which predispose to secondary cavities this can do Restoration failure due to tooth break and fringy breakdown.2 Tooth break can besides do amalgam failure. Amalgam does n't bond to tooth construction and therefore does n't reenforce the tooth, it is simply infinite filler and the tooth itself is weakened. It has been found that the bigger the Restoration including deepness and facial linguistic width the more likely the tooth is to fracture.3The ability of a tooth with an amalgam Restoration to defy break can be increased by fixing the enamel borders at an angle greater or equal to 90 degrees.4 This is because the enamel rods in the occlusal country of enamel are approximately parallel to the long axis of the tooth.5 it should be noted that defects like subsurface clefts formed during pit readying contribute significantly to early Restoration failure.6 It has been found that increased cusp break rates are linked to higher figure of surfaces restored increased patient age.7 Amalgam failure can besides originate as a consequence of gross amalgam break. This has been shown to account for about 33 % amalgam failures in one study.1 Amalgam has a low tensile strength which predisposes it to fracture particularly in load bearing countries. 1 Operator can cut down the opportunity of failure by holding pit readyings of equal deepness ( 2mm ) and by making circular internal line angles.8 Marginal dislocation of amalgam can take to failure. Incorrect cavo-surface angle can bring forth fringy surface dislocation and can take to secondary cavities doing failure. Marginal dislocation besides occurs as a consequence of delayed enlargement of amalgam but the add-on of Zn and big sums cooper to amalgam to increase mechanical belongingss has besides lead to a lessening in fringy break and longer service by the Restoration. 9 It should be noted that fringy dislocation of an amalgam is n't a unequivocal diagnosing of secondary cavities or failure of an amalgam. Surveies have shown that secondary cavities is merely present in about 58 % of amalgams with ditched margins.10Direct posterior Resin CompositesResin complexs are non presently the Restoration of pick for posterior dentitions because they are expensive, extremely technique sensitive, take more clip to topographic point and their clinical path record of clinical public presentation has n't been every bit good as amalgam in the yesteryear. This state of affairs is altering as the public becomes more concerned by aesthetics and the wellness hazards associated with the quicksilver in amalgam. Resin complex is besides deriving popularity in the profession as the adhering systems improve and as the thought of conserving tooth construction becomes more of import. Failure of rosin complexs can be every bit high as 14 % at 7 old ages in posterior teeth.1 Assuming the right type of composite was chosen e.g. intercrossed or conventional. Failure of complexs is chiefly due to 1. Secondary cavities 2. Gross rosin composite break With wear, tooth break and staining causing failure of a little per centum of rosin complexs. Secondary cavities has been found to be the most common cause of rosin composite failure accounting for 88 % of failures at seven years.1 However in another survey secondary cavities was found to be 2nd to tooth break at 6 old ages after which it became the primary ground for failure between 6-17 years.11 The chief ground for this is due to polymerization shrinking on scene of the rosin complex which can run 2.6 to 7.1 % 12 this can organize a fringy spread particularly in dentine where bonding is n't as strong which can take to an immersion bacterium ( microleakage ) which can do secondary cavities. The hazard for secondary cavities besides increases with time11 and with the size of the cavity.1 The operator can cut down polymerisation shrinking and perchance secondary cavities by utilizing the incremental remedy technique. Gross rosin composite break is responsible for high per centum of rosin composite failures accounting for 12 % of failures at 7 years.1 Resin complex is a brickle stuff and hence tensile strength is dependent on surface coating. It is for this ground that we ever look at diametric tensile strength as a mention to fracture opposition. Its diametric tensile strength is low and as a consequence rosin complexs are prone to fracture.13 The break opposition is extremely dependent on filler burden of rosin complex with higher filler lading increasing break resistance14 so it is really of import operator chooses of a rosin complex with a high filler burden. Tooth break does n't account for a important proportion of rosin composite failure this is due to the fact that rosin complexs bond to tooth construction and reenforce it against fracture.15 Wear is merely a factor for failure in bruxers in which instance you likely would n't utilize resin composite if it was traveling to be subjected to high emphasiss. Colour is besides no longer a major issue for failure with one survey describing 94 % of rosin complex with acceptable coloring materials lucifer to adjacent dentitions after 17 years.16 This has besides improved with reduced aminoalkanes in the rosin complexs taking to less yellowing. It should be noted that alot of surveies of rosin complexs included older rosin complexs which dont reflect the current rosin complexs in usage which have improved bonding which will take to reduced failure in future surveies.Indirect buttocks inlays and onlaysIndirect rosin complex, gold and ceramic inlays are indicated as indirect category 1 and 2 posterior Restorations. Indirect rosin complex, gold and ceramic onlays are indicated as indirect category 1 and 2 posterior Restorations affecting one or more cusps.Indirect posterior rosin complex inlays/onlaysIndirect inlays and onlays were developed as an aesthetic option for medium and big posterior Restorations. This was done to get the better of some of the jobs associated with direct posterior Restorations. These Restorations are expensive and clip devouring to put but they have distinguishable advantages over direct posterior Restorations which aim to cut down failure. Such advantages include: 1. They have improved proximal contacts as they are developed outside the oral cavity and even if wrong can be adjusted easy. 2. They have decreased polymerization shrinking as it occurs outside the oral cavity. The lone polymerisation shrinking which occurs in oral cavity is of the double cured resin cement on cementation. This decreases microleakage and increases the strength of these restorations.17 No statistical differences in success rates at 5 old ages was seen between these and direct buttocks restorations.18 With respects to failure of these Restorations, in one study19 the failure rate of indirect rosin composite inlays and onlays was 5 % at 4-6 old ages. Fracture of the tooth or fringy ridge, and secondary cavities are the most common manners of failure, with increased failure being seen with increased Restoration size. Loss of fringy adaptation, coloring material and anatomical signifier were besides seen but did non do Restoration failure. In another study20 a failure rate of 6 % at 1 twelvemonth was seen. Failure was due to secondary cavities and loss of mush verve. Again loss of anatomical signifier and fringy adaptation were seen but did non do failure of Restorations. The operator must guarantee round internal line angles and deepness of 2mm. Depth of less than 2mm can do bulk break of Restoration particularily in onlays.Indirect posterior ceramic inlays/onlaysIndirect ceramic inlays/onlays are extremely aesthetic and biocompatible indirect posterior Restorations. They have the same indicants and advantages as indirect posterior rosin composite inlays/onlays but are more expensive and are seen as less user friendly. There is a really strong bond between the rosin cement and the porelain doing it a better stuff for an onlay than rosin complex. Ceramic Restorations have the potency to have on the opposing dentitions, for this ground the operator should n't utilize them for patients with parafuntion and teeth under high emphasiss. Loss of anatomical signifier is non a job with these Restorations. In one study21 eight out of 50 of the Restorations failed due to fracture at 3 old ages it was found that accommodation to the fitting surface and polished surfaces seemed to predispose to failure. Another 6 twelvemonth study22 found failure rate of 12 % with rosin cement and 26.3 % with gic adhering techniques. Partial break and secondary cavities were the most common grounds for failure. It was besides noted that there was increased ditching in ceramic Restoration which is likely due to differing wear rate between ceramic and tooth. Operator must guarantee equal deepness and unit of ammunition internal line angles. The operator must ever do certain that with ceramic Restorations there is contact merely in maximal intercuspation and non in inframaxillary digressive motions.Indirect posterior gold inlays/onlaysPosterior cast gilded inlays and onlays have an first-class clinical path record. These Restorations have first-class wear opposition, do n't have on the opposing dentition and have high strength. They have the same indicants and contraindications as other inlays and onlays with the exclusion that they can be used in high emphasis countries, for illustration they can be used in bruxers. The disadvantage with this type of Restoration is they are expensive, can do hypersensitivity reactions and they are n't aesthetic. Posterior cast gilded inlays weaken the staying tooth construction and can take to cusp break. The chief manner of failure of these Restorations is secondary cavities and tooth break. One survey showed a failure rate of 14.3 % at 10 old ages with 2 and 3 surface Restorations holding lower failure rates that one surface restorations.24 When making these Restorations, particularily in bruxers, the operator must ne'er put occlusal contact at enamel/gold border, contacts must be in enamel or gold merely.Indirect buttocks CrownsCast gold metal CrownsAll metal Crowns are by and large made in the signifier of full coverage cast gilded Crown. This type of Restoration has been around for over 100 old ages and has a repute for giving the longest service of any dental restoration.25 These Restorations are really strong and biocompatible. The readying of full gold Crown is the most conservative of the full coverage Crowns, and unlike ceramic Crowns they cause no wear of opposing dentitions. Their chief drawback is their high cost and deficiency of aesthetics. These Restorations are used in dentition with extended tooth construction loss, root canal treated dentitions and due to its hig h strength they can be placed in bruxers. The chief cause of failure for these Restorations is wear of the metal and secondary caries.26 These Restoration seldom fail by break and tend to protect tooth construction. Surveies have shown that these Restorations have the longest endurance rates and conversely the lowest failure rates of any dental Restoration. One long term survey showed a failure rate every bit low as 4.6 % 27 while another study28 reported a 32 % failure of these Restorations over 10 old ages. Interestingly this survey reported increased failure of dramatis personae gold Crown in root treated dentitions. The operator must maintain in head opposition and keeping when fixing the tooth for these types of Restorations.All ceramic CrownsAll ceramic Crown usage in posterior dentition is increasing all the clip. This tendency will go on as patient ‘s concern with aesthetics additions and development of improved strength in ceramics continues. These Restorations are extremely aesthetic, less expensive than othe r crown options and biocompatible. Unfortunately all ceramic Crowns have a non conservative tooth readying, have really low tensile strength and cause wear of opposing dentitions and as a consequence should non be used in bruxers or in dentitions which undergo high biting forces as they will necessarily neglect. These Restoration are typically merely used posteriorly teeth with loss of tooth construction or which have been root treated. In both instances they can merely be used where aesthetics are paramount and they wont be subjected to high emphasiss. The failure of Thursdaies Restoration in posterior dentition is the highest for all crown Restorations. Current grounds even suggests that clinicians should n't utilize all ceramic Restorations in molars.29 Failure of these Restorations is due to secondary cavities and break of the crown Restoration. One survey showed a failure rate of 0.8 % .30 Another survey reported a 6 % failure in all ceramic Restorations after 3 years.31 Neither of these surveies are longterm survey and the were set in private pattern with individual tooth doctors transporting out work. Possibly their exceeding clinical accomplishment led to such high consequences because in a long term survey over 10 old ages in general alveolar consonant services the failure rate was 52 % . This was higher that gold or ceramometal by a big fraction.28 Just like dramatis personae metal crowns the failure rate is increased in root treated dentitions.Porcelain fussed to metal CrownsPorcelain fused to metal Crowns are the most co mmon signifier of Crown used in dental medicine. They combine the strength of the dramatis personae metal with the aesthetics of porcelain. Their chief disadvantage is their disbursal and the fact they wear opposing dentitions so they cant be used in bruxers. Their biocompatibility is besides questionable as a little per centum of people can hold hypersensitivy reactions to the metal. It is true to state that porcelain fused to metal hold comparatively long term service.32 When they fail it is normally due to recurrent cavities or break of porcelain from the metal understructure.33 One survey showed failure of 38 % at 10 years.28 The rate of failure is increased with root treated teeth as was seen with the other two types of Crowns.DecisionWhile Is have o

Heart of Darkness Study Guide Essay

Chapter 1 1. The setting of the story begins on the Nellie, a ship. The turn of the tide is significant because it gives the men on board extra time to talk, and Marlow begins telling his story. In addition, symbolically, the turning of the tide conveys a change, and perhaps, foreshadowing of the story. The author spends a lot of time dealing with light because it is the main symbol in the novella. Light and darkness are universal symbols that represent good and evil. Although not explicitly stated, those who have the light are those who are â€Å"civilized†, and those who have the darkness are those who remain â€Å"uncivilized†, particularly the people living in Africa. 2. Marlow appears different from everyone else on the ship because of how the author describes Marlow’s character. Conrad describes Marlow as having â€Å"sunken cheeks†, a â€Å"yellow complexion†, and resembling that of an â€Å"idol†. Marlow seems ill through this description. Sunken cheeks convey a lack of nourishment, as well as exhaustion. The color yellow in literature has two meanings: happiness and sickness. In this context, one may infer the color yellow to symbolize Marlow’s sickness, or corruption, as it correlates to the rest of his description. Lastly, an â€Å"idol† connotes a phantom. Marlow appears to be different from everyone on the ship through his description. The audience is civilized. All of the men have jobs, a lawyer, an accountant, the director, and the outside narrator. The story also explains how Marlow remained the only one out of the men to still follow the sea. He also portrays how he did not â€Å"represent his class.† This suggests that Marlow may not be as â€Å"civilized† as the other men. As Marlow begins to tell his story, the narrator explains how Marlow is about to embark on another â€Å"inconclusive† experience. The word inconclusive suggests not fully answering doubts and questions. In addition, Marlow begins to remark the â€Å"weakness of many tellers of tales who seem so often unaware of what their audience would best like to hear.† This conveys how Marlow hopes to interest, or intrigue, his audience. Marlow feels inclined to share his story so that his audience better understands him. 3. The Roman reacted to England, a dark place, by â€Å"civilizing† it, or conquering its territory. At that time, England looked like the â€Å"very end of the world.† It possessed â€Å"sand banks, marshes,  forests, savages.† The story conveys how there was little to eat for a civilized man and only the Thames water for drink. England was a dark place at that time because it was uncivilized. 4. According to Marlow, what redeems the conquest of the Earth is the idea only; the idea that men will unselfishly sacrifice themselves for. Marlow explains how conquering land, and the land’s people, really is not a pretty thing. I think Marlow breaks off because it is a sensitive subject for him to discuss, and maybe only something he truly understands. 5. Marlow keeps comparing the river to a serpent. The comparison is interesting because a serpent symbolizes evil, corruption, and temptation. Similar to the story of Adam and Eve, a snake, or the river in this case, tempts the protagonist. 6. Aside from knitting, the two women in the office appear to be secretaries, or receptionists, for the doctor. Both women appear to symbolize fate; they are the fates who spin, measure, or cute the thread of life. This symbol is an allusion to Greek mythology. As Marlow is progressing toward his journey to Africa, it is in the Company’s office that he meets these two women. 7. Fresleven went insane because he had spent so much time in the jungle. After attempting to stab the village chief, Fresleven was killed. The conflict began with an argument over a couple of hens, which cost him, his life. The village became abandoned because the natives became superstitious; they were all very afraid to kill a white man. 8. Marlow’s Aunt calls Marlow an â€Å"emissary of light† because she believes that during his journey to Africa, Marlow is going to bring knowledge and civilization to the â€Å"savages.† This reflects the imperialism during that time period. 9. The man-of-war is a lifeless forested stretch of coast. Once they reach the Congo River, Marlow boards another ship to journey further upriver. The man-of-war portends the lifelessness of many coasts in Africa; most parts of the place appear corrupt and dreary. 10. Marlow describes the Company’s station as a â€Å"Grove of Death†, in which among the trees there are dying natives and recurring dynamite blasts. I think the natives allowed themselves to be bullied by the white men because they felt inferior. During this time, imperialism was popular and the belief that a white man was better than a black man was common. I also do not think natives had the proper technology, means, or knowledge to necessarily stand up to a group of white men either. 11. The accountant is described as an elegant white man with a clean and  well-mannered appearance. The accountant is described as a â€Å"miracle† because he represents the Company, or how the Company wishes to be seen. The accountant is devoted to the Company. The station manager is described as an average man. The manager’s supreme gift is his ability to never get sick. Marlow does not like the station manager because he is jealous of Kurtz, and also because Marlow describes him as â€Å"originating nothing.† This suggests how the manager lacks innovation and is devoted to keeping up with appearances, although he has nothing to offer. The manager comments about how ‘men should only come out here if they don’t have anything inside.’ This conveys that in order to succeed in the ivory trade business and survive in Africa, one must be ruthless. 12. The brick maker appears to be idle as Marlow remarks on how there â€Å"wasn’t a fragment of a brick anywhere in the station.† The brick maker is waiting for his opportunity to move up the ladder within the company. 13. Kurtz’ painting is of a blindfolded woman carrying a lighted torch, in which her face is appears deceived by shadows. I suppose the painting reflects the men traveling to Africa, blindfolded, to civilize the natives, who represent the light. The woman is blindfolded as the European men are blinded by their negative influence on the natives. The shadows suggest darkness, which suggests corruption. 14. The manager and brick maker are upset at Kurtz’ pre-eminence because they are envious at his success. This conveys the competition, desperation, and corruption during this time period to do whatever it takes to be successful, powerful, and rich. For these European men, money was power and that was their desire. Marlow lies to the brick maker by playing along to further understand his motives. In addition, Marlow allows the brick maker to think he has an influence in Europe to gain information about Kurtz. 15. Marlow was unable to get the rivets from the Company. This suggests how the enterprise is allowing loose policies and for things to follow apart; this conveys a lack of professionalism. The manager does not want the rivets to make it out because he wants his Eldorado Exploring Expedition to follow through. 16. The Eldorado Exploring Expedition suggests an expedition in search for gold during this time. Although there was no gold in Africa, ivory was very valuable. This expedition was led by the manager’s uncle. Its purpose is to find ivory and exploit African resources. Chapter 2 1. The manager survives because he cannot get sick. His plan to â€Å"beat Kurtz† is by delaying the trip to the Inner Station, that way hopefully Kurtz’ illness will kill him because he will not receive the proper care in time. 2. The crew of the steamboat was the cannibals. Although savage, the cannibals are much better at controlling their behavior than the pilgrims. The pilgrims appear willing to begin destruction at any cause in order to gain ivory. The definition of â€Å"civilized† seems to belong to those who are able to exercise self-restraint. 3. The drums symbolize the culture that still exists in Africa. The forest appears to be moving throughout the journey, which may be foreshadowing how the natives are moving with the boat to assure that it does not meet Kurtz. 4. â€Å"The earth seemed unearthly† suggests the discomfort Marlow feels along his journey. On a larger scale, this conveys how Africa has become a place lacking of normality and humanity; Marlow expresses how he feels separated from Earth. â€Å"That was the worst of us, the suspicion that they weren’t human,† suggests how corrupt the men were; they appear to show no signs of humanity. 5. Marlow discovers a book about seamanship. The book appears admirable because it is the only bit of reality Marlow has encountered recently. 6. When they wake up, eight miles from the station, the coast has been covered in a thick fog which keeps them stationary. The fog is a white, however, it does not represent light or goodness. The fog suggests how Marlow’s steamer does not know exactly where they are or what lies ahead in their journey; everything appears unclear physically and emotionally. 7. Marlow claims that the natives will not attack because the â€Å"nature of their noise† seems to convey sadness. In addition, Marlow does not understand how there could be an attack with the severe fog. 8. The sounding man is killed first in the attack because he is the first man seen. The river comes to symbolize not only the way in which Marlow begins his journey into himself, but as they venture further up the river, Marlow begins to realize he has more in common with the natives than Europeans. In addition, the river continues to represent the heart of temptation. The helmsman gets killed because he began to freak out, abandoning his position to grab a gun. Marlow drives the natives away by using the steam-whistle. 9. Marlow wanted to meet Kurtz because he had heard such interesting, wild things about him. Kurtz  represents the thrilling and horrifying wildness that Marlow desired. Kurtz abandoned his life in Europe to pursue fortune in Africa. 10. Kurtz head was compared to that of an ivory ball. This suggests how important ivory was to this man; it was the only thing on his mind. Conrad uses a simile, irony, as well as symbolism to convey this. 11. Kurtz paper is about how white men must treat Africans as though the white men are much greater, super natural beings so that they can exert power over them. At the end, the scribble proclaims to exterminate all brutes. 12. The harlequin is the Russian man, Kurtz’ disciple. The harlequin knows a lot about Kurtz, he claims to only listen to Kurtz, and he acts only has information for Marlow. Chapter 3 1. The harlequin is boyish in appearance, and he is young. His brightly patched clothes are similar to the maps in the office Marlow had admired. The harlequin represents youth and adventure. The harlequin is still alive due to Kurtz’ influence. 2. The stakes outside of Kurtz’ compound were human heads. Most were faced in, while a couple was faced outward. They are the heads of â€Å"rebels†. 3. A group of native Africans carry Kurtz on a stretcher. Marlow describes Kurtz as resembling â€Å"an animated image of death carved out of ivory.† This further suggests how Kurtz was willing to die in pursuit of ivory, which symbolizes power. 4. Kurtz brings his guns with him. Since the natives view Kurtz as a deity, they believe that the guns hold great power. Kurtz brings them to further emphasize his power over the natives. 5. The â€Å"wild and gorgeous apparition of a woman† is a native woman, Kurtz’ mistress. Conrad pairs here with being a warrior. 6. Right before Kurtz dies, Marlow recognizes all of Kurtz’ emotions. This relates to Kurtz’ last words â€Å"the horror! The horror!† because perhaps Kurtz realized that the life he was living was actually not worth dying for. Marlow blows out the candle because it is symbolic of Kurtz’ life. 7. â€Å"He had something to say† relates to Kurtz, who always had something to say, while Marlow had nothing to say. Marlow believes that Kurtz last words are a victory because he thinks he realized his negative impact in the world and his corruption at that moment. 8. Back in the city, Marlow discovers that Kurtz had many other talents such as a gift in music and writing. 9. Marlow gives up the idea that the Europeans belong in Africa. He has gone about doing that by no longer choosing to pursue that lifestyle. 10. The Intended is Kurtz’ fiancà ©e. She  is described as being beautiful and often connected with imagery of light and heaven. Marlow’s belief that women live in beautiful worlds, which should not be disturbed, is relevant here as this beautiful woman is not intertwined with Kurtz’ alter lifestyle, his corrupt lifestyle. 11. Kurtz’ Intended claimed to have known him more than anyone else on Earth. However, she did not know the type of lifestyle Kurtz was living. Marlow tells the Intended that Kurtz’ last words were for her name. Marlow claims that â€Å"it would have been too dark† to tell her the truth. I think the Heart of Darkness is when one allows him or herself to live in a false reality, allowing themselves to lie and deceive others for their own benefit.

Analysis of the Possible Effects of the Caste System

However, there are still countries that seem to lag behind because of their internal problems in regards to inequalities. India with regards to its present global profile is seen to be one of the rising economic powers in the world. In spite of its vast supply of labor especially the skilled workers, this country still remain a low-income one and poverty is still a big issue. This said problem is considered a result of its caste system. The Caste system divides people of India into four groups. This system decides for Indian people what they should do for living for their entire life. The Caste system did help the Indian society to be structured and organized. However, the system in the modern days was only an obstacle for India. It is considered as one of the most dehumanizing systems the world. The caste system is making a big gap between the rich and the poor. The extent of and trends in inequalities and poverty in India affects global trends because of its large population size and majority of its population fall under the poverty line. Due to globalization with the mass improvement of transportation and communication, nations are competing against other nations of the entire world. In a modern society, where time and resource are truly valued, the Caste system has held back India by wasting some incredibly talented individuals of lower caste. This system has made the poor suffer most. They were stripped of an opportunity to learn and be employed on bigger companies. This said situation has further led to the marginalization of the already marginalized people. With the growth of India’s gross national product, still the labor force in agriculture remains too high while those in the manufacturing sector are low. There is no doubt that a striking feature of India’s growth performance in the past years has been the growth of the services sector like IT, software and BPO industries. There is no doubt that India has employed millions of people for this industry but as impressive as the figure seems, it is too small if they are seen against the overall size of the country’s labor force. Employment is the service sector still lags behind. Additionally, employment is only concentrated in a few large cities and very few people from the rural and poor area find jobs in this sector because they lack the required skills. In other countries, the service sector tends to gain a larger share of employment. The rising of globalization has made people move from one place to another easily. Also education has also helped people disregard gender and social inequalities. If India would remain strict on recognizing the caste system, it will pose a threat for them in the future. The world is one, and how a nation deals with its immigrants is really important for the future of the nation. Many people now are intolerant to inequalities and discrimination. Therefore, India may be losing investors or possible capitalists just because of the system. The Caste system cannot make India a stable country anymore, since there is no spot in the system for immigrants to India. India should not lose what it was built for and based on. However, they should be really careful. The caste system may give birth to possible social unrest that may dismay or discourage other people to go to their country. This social blindness can be cured only when there is the realization that all people are created equal and have equal intrinsic value and worth. Analysis of the Possible Effects of the Caste System However, there are still countries that seem to lag behind because of their internal problems in regards to inequalities. India with regards to its present global profile is seen to be one of the rising economic powers in the world. In spite of its vast supply of labor especially the skilled workers, this country still remain a low-income one and poverty is still a big issue. This said problem is considered a result of its caste system. The Caste system divides people of India into four groups. This system decides for Indian people what they should do for living for their entire life. The Caste system did help the Indian society to be structured and organized. However, the system in the modern days was only an obstacle for India. It is considered as one of the most dehumanizing systems the world. The caste system is making a big gap between the rich and the poor. The extent of and trends in inequalities and poverty in India affects global trends because of its large population size and majority of its population fall under the poverty line. Due to globalization with the mass improvement of transportation and communication, nations are competing against other nations of the entire world. In a modern society, where time and resource are truly valued, the Caste system has held back India by wasting some incredibly talented individuals of lower caste. This system has made the poor suffer most. They were stripped of an opportunity to learn and be employed on bigger companies. This said situation has further led to the marginalization of the already marginalized people. With the growth of India’s gross national product, still the labor force in agriculture remains too high while those in the manufacturing sector are low. There is no doubt that a striking feature of India’s growth performance in the past years has been the growth of the services sector like IT, software and BPO industries. There is no doubt that India has employed millions of people for this industry but as impressive as the figure seems, it is too small if they are seen against the overall size of the country’s labor force. Employment is the service sector still lags behind. Additionally, employment is only concentrated in a few large cities and very few people from the rural and poor area find jobs in this sector because they lack the required skills. In other countries, the service sector tends to gain a larger share of employment. The rising of globalization has made people move from one place to another easily. Also education has also helped people disregard gender and social inequalities. If India would remain strict on recognizing the caste system, it will pose a threat for them in the future. The world is one, and how a nation deals with its immigrants is really important for the future of the nation. Many people now are intolerant to inequalities and discrimination. Therefore, India may be losing investors or possible capitalists just because of the system. The Caste system cannot make India a stable country anymore, since there is no spot in the system for immigrants to India. India should not lose what it was built for and based on. However, they should be really careful. The caste system may give birth to possible social unrest that may dismay or discourage other people to go to their country. This social blindness can be cured only when there is the realization that all people are created equal and have equal intrinsic value and worth.

Volkswagen in China Research Paper Example | Topics and Well Written Essays - 4000 words

Volkswagen in China - Research Paper Example In order for MNCs to operate effectively and gain a competitive advantage it is important to assess the competitive position and the relationship between success and strategies. In a highly competitive market it is very important for companies to gain a competitive advantage over its competitors. This can be achieved by either cost advantage or offering differentiated product. Hills work suggests that the differentiation strategies in the automobile sector in China can be beneficial because of many reasons like Chinese automobile is an expanding market and is the world’s second largest automobile industry, therefore has a lot of potential for business. Automobile industry in general has a lot of potential for differentiation strategies and gaining market through it which is evident by the lavish expenditure done on the promotion of these cars. (Chen, J., & Yao, S. 2006; Barrow, C. 2009) This paper will focus and discuss Volkswagen’s globalization strategies for internalization, how it formed strategic alliances globally and how it positioned itself for global competitiveness through its formulated strategies and built strategic ventures and alliances. VOLKSWAGEN INTERNATIONAL Volkswagen dates back to 1937, was founded by Ferdinand Porsche who started it as an automobile advisory company. Being unsuccessful in selling his proposed model he collaborated with Nazi Government to setup a factory and produce the cars of his proposed model. In the post World war period, VW made the most selling car of the 1950s the Beetles. It was then that VW gained recognition throughout the world. In 1960s it opened a plant in Mexico which produced cars on new lines and technology and with time strengthens its position all around the world. (Rana et al.2005) Volkswagen started off with its two joint ventures in China. Its first project was a 50% venture with local leading brand Shanghai Automotive Industry Corporation (SAIC). The other venture was another 50% joint venture with First Auto Works (FAW) in 1991. Initially the company struggled to gain market but later in 1990s its brand Santana ruled the market. These joint ventures together occupy almost half of the market shar e in Chinese market and have a 70% annual growth rate. China is Volkswagen’s second largest market in the world after German market. (Chen, J., & Yao, S. 2006; Barrow, C. 2009) Volkswagen since its start in its Shanghai joint venture in 1985 was considered to be one of the leading the carmaker in China and occupied an eminent position in the market. The emerging Chinese automotive market was a threat for Volkswagen dominant market and soon it faced severe competition with companies like Toyota, Suzuki and General Motors in Chinese markets. One of the head of VW China commented in 2005 that suddenly China has become the toughest market. (Thun, E. 2006) Not even foreign, local market players like Cherry and Geely also competed and tried to win the market by aggressive pricing strategies. In a research of 2002 Volkswagen occupied the largest market share in China, the details of top 5 market share holders are given below: Manufacturer Sales (units) Market Share Shanghai Volkswag en 301,095 23.8 FAW-Volkswagen 207,858 16.4 Shanghai GM 110,763 8.8 FAW Toyota 95,433 7.5 Dongfeng Citroen 85,088 6.7 The table shows Volkswagen in combination with both its ventures SVW and FAW-VW have been the leading automobile company in China with largest market share in 2002. (Chen, J., & Yao, S. 2006; Barrow, C. 2009) SVW initially competed with minimal investment in China, it was able to capture high market share in the early days but soon it faced competition by the modern foreign and

Prison Overcrowding Essay Example | Topics and Well Written Essays - 500 words

Prison Overcrowding - Essay Example The penalties for certain types of offenses are now harsher. The lawmakers have also added new offenses to the penal code. This has also led to the rise of prison overcrowding. There are several ways to reduce overcrowding in prisons. A prison expansion model should be put in place by the United States criminal justice department. They should plan to increase the number of beds whenever the population of inmates surpasses the existing capacity. A community corrections model can also help to reduce overcrowding in prisons. The community’s main objective is to reduce crime and recidivism. The community can carry out court-ordered sanctions. It can assist the court in assessing offenders for placement in the community. The community can take part in the rehabilitation of the offenders and ensure the safety of the public. The people in the community could also pull their resources to fund the jails and prisons in order to facilitate rehabilitation of inmates. Also, a system of graduated penalties imposed by courts can provide supervision of the offenders, rehabilitation, restitution of victims and public safety. There are several factors that impact the crime rate and prison population. These include poverty, alcohol and drug abuse, lack of employment opportunities, lack of education among many others. It is the responsibility of other state services to address these issues. However, due to lack of sufficient funds, these other state devices transfer this responsibility to the criminal justice system. The criminal justice system has rolled out a 20-year â€Å"war on drugs† to help reduce the crime rate and the eventuality of prison overcrowding. The aggressive â€Å"tough on crime† approach is a significant driving force in reducing prison overcrowding.  

Using these historical documents does Congress solve problems Or, does Essay

Using these historical documents does Congress solve problems Or, does it create more - Essay Example Though civil servants amounted to only 10% of the total US employees, the number of beneficiaries kept growing with time. This helped the workers in deed. Besides, due to the observation by the congress that short distant travellers paid more than long distance travellers, the Interstate Act of 1887 was institutionalised to fix the problem. According to the congress these unreasonable and unjust charges were seen as constitutional violation and that something had to be done to illegalize discrimination. Politicians, travellers during low seasons, persistent bargainers and so on, were not subject to exemption as before. Native Indians who squatted in America had to be accommodated into the population. Despite the fact the land given to them by the US government was arid/ semi arid and unproductive for farming, the Dawes Act of 1887 gave the Indians a sense of belonging. A major set back of this Act is that some Indians did not want to embrace farming and the ones who did had no starting resources like seeds, irrigation mechanisms. These problems were of small magnitude compared with the original one of lack of land. Another illustration of the role of the congress is the Boulder Canyon Project Act which was constituted to protect and develop the Colorado River Basin. A large dam was constructed to contain floods, generate hydroelectricity, for irrigation and to provide water for domestic uses. This project had great economic impacts to the people. The contribution of the congress to boost the lives of Americans was the Social Security Act which benefited retired workers, the unemployed, and single mothered families. Also public health services, the aged and the disabled directly benefited from the scheme. The list is endless. The Tennessee Valley Authority (TVA) was established. Production of electricity, navigation, flood control, manufacture of

Philip's vs. Matsushita Essay Example | Topics and Well Written Essays - 2000 words

Philip's vs. Matsushita - Essay Example Both brothers and their father worked hard and by 1900, Philips was the third largest light-bulb producer in Europe. Philips concentrated only on light-bulb technology development. Company policy was to scrap old plants and use new machines or factories whenever advances were made in new production technology. It also established hi-tech laboratories for R&D and it developed a tungsten metal filament bulb that was a great commercial success (Bartlett, 2006, p. 1). In 1899, Philips initiated its offshore business and within a decade it expanded its sales network across Japan, Australia, Canada, Brazil, United State and Russia. In 1919, Philips made an agreement with Genera Electric, giving each company the use of the other's patents. In 1918, Philips introduced the electronic vacuum tubes; eight years it lunched its first radios to market, capturing a 20% world market share within a decade; and during the 1930s, Philips began producing X-ray tubes (Bartlett, 2006, p. 2). During World War II Allied and German bombing had targeted and damaged most of Philips’ manufacturing facilities in the Netherlands, the management board decided to build the postwar organization on the strengths of the national organizations (NOs). The independent NOs had a great advantage in being able to sense and respond to the local market demands and differences. These NOs were also free in financial, legal, and administrative matters, and also to built their own technical capabilities and product development.

Summary + analysis Article Example | Topics and Well Written Essays - 500 words

Summary + analysis - Article Example The unique technical features to look out for when identifying a film noir, according to the authors, include the unusual lighting where light and shadow keep opposing, tilted camera angles, and the scene oppositions that are off-center. Film noirs are also characterized by the inversion of customary values and moral ambivalence. The article further notes that, neo-noir, on the other hand, refers to films that followed the noir classic period. Neo-noir also contains noir sensibility and noir themes. They also have similar characteristics to noir such as disorientation, moral ambivalence, pessimism and alienation. Great examples of neo-noir have also been given by the author. These include movies such as Bonnie and Clyde, China Town, Taxi Driver and Body Heat. The author has also described space, time and subjectivity in neo-noir cinema. Different forms of neo-noir time have been described, including past, present and future neo-noir. The author concludes the article by describing the irreconcilable differences of neo-noir. In my personal analysis of the article, the author’s main aim of giving the examples of movies is to demystify the real meaning of film noir and neo-noir. Hollywood film noir is said to have been generated in the early 1940s and the late 1950s. This leaves a lot to be answered because the author has given many examples of movies that were produced as late as 1995 and 1997. Some of these movies should be referred to as neo-noir because they come after the classic noir period. Also, saying that neo-noir films are better at embodying the noir outlook is confusing because noir films had their own unique characteristics and identifying themes. I believe that there should be a clear distinction between noir films and neo-noir films. The investigation of philosophical underpinnings and themes of neo-noir films should also be applied to noir films so as to allow the use of movies to explore and explain traditional philosophical ideas of

Ford and G.M. Lose Grounds to Imports Essay Example | Topics and Well Written Essays - 500 words

Ford and G.M. Lose Grounds to Imports - Essay Example companies, which has resulted in dwindling of the market share of the â€Å"Big Three†, with particular emphasis on the car segment of the auto industry, and forcing the â€Å"Big Three† to respond in an attempt to hold on to the large market share. In spite of such efforts the Japanese auto manufacturer Toyota in October 2004 forged its way into the top three largest auto sellers in the United States of America, displacing Chrysler from this prestigious position. This event has led to the speculation that the structure of the U.S. auto industry is likely to see a change, wherein Japanese auto manufacturers are likely to rub shoulders with the traditional â€Å"Big Three† manufacturers of General Motors, Ford, and Chrysler. (1). The Japanese auto manufacturers have started edging towards and past the three big American auto manufacturers in terms of market share. There are two possible key factors involved in the pull of the American customer towards Japanese auto products. The first is the Japanese auto products are more economical than the American products, which is related to the strategies employed by the Japanese in boosting the productivity of their employees and cutting manufacturing costs. In the current scenario of job insecurity, investment in the purchase of a new vehicle is bound to be conditioned by the worsening economic scenario. The second possible factor is related to the rising costs of petroleum products. Japanese cars are less of gasoline guzzlers in comparison to the American cars, and with rising fuel prices and unstable incomes the Japanese auto products are more attractive to the American customers. This is reflected in the continuing rise in the sales of Japanese auto products in s pite of the response of incentives by the American auto manufacturers. (1). Put in a nutshell, we may take the game theory as an attempt to explain the strategic actions in a competitive environment and the gains and losses that could emanate from these actions

Targeted Organization Summary Essay Example | Topics and Well Written Essays - 250 words

Targeted Organization Summary - Essay Example The company is also dynamic and is expanding scope. It has for example been planning to expand its ventures into the Arctic waters from primary dependence on the Mexican gulf. The company has also been active in ensuring safety in its ventures, a move that contributed to its temporary clearance for the Arctic exploration. Though a number of regulatory measures still face the company over the exploration, there are high chances that a license will be granted. This will even expand the company’s scope for a more explorative work environment (Broder and Krauss, 2012). As a public health expert, I have the potential to design and implement the organization’s strategies towards safety of employees. My potential will therefore help the company in realizing its commitment and policy statements towards employee and environmental safety (Static, 2009). Broder, J. and Krauss, C. (2012). Shell clears major hurdle in its bid for new Arctic drilling. Retrieved from: http://www.nytimes.com/2012/02/18/science/earth/us-tentatively-approves-shell-spill-plan-for-new-arctic-drilling.html?_r=1 Static. (2009). Shell commitment and policy on health, security, safety, the environment and social performance. Retrieved from:

Contract and Procurement Essay Example for Free

Contract and Procurement Essay Contract and procurement are imperative operations that should be done appropriately for the success of an organization. More often than not, people who are in judge of procurement do take these activities less seriously (MOLENAAR, 2007). Due to such concern most institutions have put in place stringent measures that control all the procurement transactions. In addition to that, people should be employed to be responsible for this duty according to the policies of many institutions should be highly trained (MOSEY, 2009). This sudden change that has taken place in many companies and organizations has real improved the output of the department of procurement hence most activities run smoothly as scheduled. The directors of the department of procurement partly determine the success or the failure of a project that is undergoing. Therefore, the managers of projects work very closely with the procurement officers to ensure that everything that is required is provided whenever its need arises. It is significant that, there exists a good relationship between the project managers and the procurement officers (MOSEY, 2009). If that is not the case, then there shall be contradicting ideas that will jeopardize the progress of the project. It is worth noting that, the duties and responsibilities of the procurement officers vary in accordance with the structure of an organization. This shows that, different procurement divisions have got structures which are designed to make management coordination and monitoring. This arrangement is imperative in improvement of the efficiency of the procurement activities. As aforementioned, the project manager should coordinate the transaction in collaboration with procurement manager to acquire all the requirements. The transactions which are carried out to achieve this are done un der the interpretation of the set policies, rules and regulations (BOWER, 2003). The rules and regulations set by the institution to ensure that the activities are carried out in harmony within all the departments that exist in a company. Unlike in the past, procurement process has dynamically changed and incorporated more activities. It only used to involve purchasing of goods and services required, but that is not the case nowadays (MOSEY, 2009). In procurement planning is done first. It determines whether to purchase a given commodity and if it should be bought the way it should be bought and quantity to be supplied. After this, reliable and potential supplies are determined, and contracts made with to supply the goods ordered (MOLENAAR, 2007). Before a contract is signed, thorough scrutiny is done by evaluating the proposals of the shortlisted vendors and interviews conducted to select the one that is unparalleled in offering those services and goods. After that, the one that emerges the best is awarded the contract. Supervision of the supply is done by the procurement office. Procurement process gives support to the internal activities that are done within an organization. The operations served include management, production and marketing services. It supports all the processes, infrastructure and systems required by the projects. In other the dimension, a procurement body that is independent and separate provides all the things required by the project on a transaction basis (BOWER, 2003). In this case, the director of the project gives a list of things which are required and the procurement officer buys and coordinates the goods until they reach at the company to be used. In either organizational structure, the procurement manager is involved in generating and managing the operational transactions and the linkage that exists between all the stakeholders of the project. This relationship that is created by the procurement manager exists in the whole procurement cycle period (MOSEY, 2009). The relationship between procurement professionals and the project management team is significant in that it creates a better environment for cross functional participation of all stakeholders. Moreover, it enables the procurement department to produce the best services to the project (DINSMORE CABANIS-BREWIN, 2011). Therefore, for the procurement office to fit properly in the organization it must be well acquitted with the management strategies of the project. In a project based organization, there are about five general steps of procurement. Foremost, in collaboration with management, the procurement office should determine the requirements of the project. After determining what the requirements, the supplier is selected, who in agreement with project managers and the procurement professionals is given a contract to supply goods and services. The procurement department supervises and conducts routine assessment on the performance of the supplier until the contract ends (DINSMORE CABANIS-BREWIN, 2011). In centralized corporate management, there is an interaction between the principal stakeholders; the corporate purchasing coordination team, the chief executive officer, the chief purchasing officer, the managers of the business units and the purchasers of the business unit (SANKAR RAU, 2006). All of them have well defined roles and responsibilities in the procurement process. Most companies use formal organizational mechanisms like working groups and commodity teams, non-formal mechanisms of networking like employing competent people and initiating development programs, advanced systems of communication and use of complex management strategies (PENFIELD, 2010). In the centralized business unit procurement, the business units operate autonomously despite the fact that they are under one enterprise. The business unit creates a procurement order ships it to another business unit for supplier. Proper accounting records are kept to show the financial transactions between the two business units (SANKAR RAU, 2006). References BOWER, D. (2003). Management of procurement. London, Thomas Telford. DINSMORE, P. C., CABANIS-BREWIN, J. (2011). The AMA handbook of project management. New York, American Management Association MOLENAAR, K. R. (2007). Alternative project delivery, procurement, and contracting methods for highways. Reston, American Society of Civil Engineers. PENFIELD, P. C. (2010). A primer on negotiating corporate purchase contracts. [New York, N.Y.] (222 East 46th Street, New York, NY 10017), Business Expert Press SANKAR, C. S., RAU, K.-H. (2006). Implementation strategies for SAP R/3 in a multinational organization: lessons from a real-world case study. Hershey, Pennsylvania, CyberTech. MOSEY, D. (2009). Early Contractor Involvement in Building Procurement Contracts, Partnering and Project Management. Chichester, John Wiley Sons.

Armageddon & Physics Essay Example for Free

Armageddon Physics Essay In 2007, the September 1st issue of The New Scientist alleges that the film Armageddon is shown by the management training programs of the National Aeronautics and Space Administration (NASA). A 1998 Jerry Bruckheimer-produced disaster thriller directed by Michael Bay in which deep core drillers attempt to avert an asteroid’s collision with the planet Earth, The New Scientist contends that NASA’s screening of a razzle-dazzle blockbuster claiming ground in science, is purely for entertainment purposes. â€Å"†¦the screenings are just a game for NASAs space geeks: who can find the highest number of impossible things in the movie? The record, [†¦] stands at 168. † Regarding the scientific fallaciousness of Armageddon, astronomer Philip Plait has many contentions. Plait notes that the introductory premise of the film, in which an asteroid of the same size which humanity faces was a â€Å"dinosaur killer† that possesses the same destructive capacity of â€Å"10,000 nuclear weapons. † However, he asserts that this is a severe underestimation, for the fictional asteroid would actually release at the very least, eight hundred thousand nuclear weapons, based on conservative estimates. Plait implicitly infers that the writers were going for a dramatic figure, but one whose complete lack of scientific basis leads to a severe underestimate. It is also preposterous for it to be impossible to communicate the drilling experience of an oil rig crew to astronauts or engineers, former engineer turned writer Tom Rogers notes. However, this is how the movie rationalizes the oil rig crew’s participation in Earth’s salvation despite their complete lack of astronautical experience. But even excusing such a premise, Rogers notes that the film stretches credulity when the Mir space station rotates at high velocities to induce artificial gravity. Amazingly enough, it rotates so fast that it can create gravitonic conditions in under half a minute, despite the fact that the Mir station’s mass exceeds a hundred tons. Rogers’ contention in this scenario is that the planetary gravity conditions could not be possibly simulated unless the human’s height is a small percentage of the rotational radius. As such, the astronauts would only experience gravitonic force on both ends of their bodies, which would feel â€Å"disorienting and probably cause [them] to stumble and vomit. † The Jupiter Scientific Organization also asserts that NASA’s plan of inserting a hydrogen bomb eight hundred feet deep into an asteroid that is three hundred miles wide – essentially a Texas-sized asteroid, which is exactly what it is called at one point in the film – does not actually scale very well. The film’s core (all pun intended) premise is actually absurd: attempting to split an asteroid with two pieces by exploding it with a hydrogen from within would be like hypothesizing that a single hydrogen bomb could fracture the state of Texas. It’s â€Å"like a pin-sized hole no deeper than a scratch in a ten-foot rock. † Such a hydrogen bomb â€Å"would roughly be like lighting a match. Can the ignition of such a match split a ten-foot rock? † Rogers also observes that a flaming shuttle crash site contradicts what the astronauts are told earlier about the gravity being about a tenth of that on the planet Earth. Such a low gravity cannot support an atmosphere – which is why they wear space suits in the first place: the asteroid surface does not and could not hold oxygen – yet for some reason, flames burn in the absence of oxygen. Lastly, a successfully halved asteroid would still be disaster, as the gravitonic forces they exert would cause catastrophic tidal changes that would eradicate most of the Earth’s population. â€Å"Sometimes theres just no way to have a happy ending,† Rogers notes. Works Cited â€Å"Feedback. † The New Scientist, Issue 2619. 01 September 2007.Plait, Phil. â€Å"The Astronomy of Armageddon. † Phil Plait’s Bad Astronomy. 08 August 2007. Retrieved June 6, 2008 from: http://www. badastronomy. com/bad/movies/armpitageddon. html â€Å"Movie Review of Armageddon (and Deep Impact) from a Scientific Viewpoint. † Jupiter Scientific Information. July 1998. Retrieved June 6, 2008 from: http://www. jupiterscientific. org/sciinfo/armageddon. html Rogers, Tom. Insultingly Stupid Movie Physics: Hollywood’s Best Mistakes, Goofs and Flat-Out Destructions of the Basic Laws of the Universe. Connecticut: Sourcebooks Hysteria, 2007.

Management of Pain in Trigeminal Neuralgia

Management of Pain in Trigeminal Neuralgia Percutaneous management of pain in Trigeminal Neuralgia under computed tomography guidance Corersponding Author Dr. Mitesh Kumar Main Author Dr. Roy Santosham Co Authors Dr. Bhawna Dev Dr. Deepti Morais Dr. Rupesh Mandava Dr. R. Jeffrey Abstract Trigeminal Neuralgia (TN) is a brief, excruciating and perhaps the most severe pain known to man affecting the hemifacial region. It occurs mainly due to tortuous vessel compressing the trigeminal nerves, though in many cases, the exact etiology and pathogenesis remain undetermined. The first line therapeutic option for patients affected by TN is the medical line of management and patients refractory to the same, are offered various invasive procedures like balloon compression, gamma knife surgery, radiofrequency ablation, etc. In this paper, we present percutaneous management of the pain by injecting neurolytic drugs in the foramen ovale under Computed Tomography (CT) guidance as the new and promising technique of treatment in TN. Keywords Trigeminal Neuralgia, percutaneous management, CT guidance, neurolytic drugs Objective To evaluate the efficacy and safety of Computed Tomography guided percutaneous management of pain in trigeminal neuralgia using neurolytic drugs. Introduction Trigeminal Neuralgia is also known as tic douloureux, a term given to this painful disease by Nicolaus Andre in 1756 [1] . TN is a pain which typically is intense, brief, usually unilateral, recurrent shock like involving the branches of fifth cranial nerve [2]. It can be mainly classified into two types. First being, the classical TN (Type I), which is due to neurovascular compression, the most common vessel causing the same being superior cerebellar artery followed by anterior inferior cerebellar artery [3]. Second type is atypical TN (Type II), secondary to causes like trauma, tumor, multiple sclerosis or herpetic infections. The distinction between these two types is mainly based on clinical symptoms [4, 5] as Type I pain is episodic in nature whereas Type II pain is more constant. TN is often called by many as â€Å"the suicide disease† [6] as the patients who suffer from it would rather take their lives than bear the pain. The initial line of treatment for TN is medical management by drugs like Carbamazepine, Gabapentin, Oxcarbazepine among others. Patients of type I TN may also be advised microvascular decompression. Those patients who do not respond or have contraindications to the above mentioned drugs or experience no change in the intensity of the pain are called Refractory TN [7]. Such patients are advised invasive procedures like trigeminal nerve block neurolytic block, radiofrequency ablation, gamma knife surgery and balloon compression. We describe our experience in percutaneous management of pain by injecting neurolytic drugs in the foramen ovale under CT guidance in six patients, suffering from TN. Method and Materials used Pre procedural work up The pre procedural work up included clinical evaluation and thorough reading of the Magnetic Resonance Imaging (MRI) scans of all the patients to rule out any neurovascular conflict. Any patient with neurovascular conflict was considered an exclusion criterion in our study. These patients were reported taking the drugs for TN for over three months with no improvement in the pain. The pain score evaluation was done using Numeric Rating Scale [8] and Wong-Baker Faces Pain Rating Scale [9] as a baseline evaluating point to be compared to the same scoring system after the procedure. Routine investigations such as coagulation profile, liver function test, renal function test, HIV and HbsAg were done before the procedure. Numeric Rating Scale Patients rate pain on a number scale from 0-10, 0 being a depiction for no pain and 10 being the worst pain imaginable. Wong-Baker Faces Pain Rating Scale The Wong-Baker Faces Pain Rating Scale is a pain scale that was developed by Donna Wong and Connie Baker. The scale shows a series of faces ranging from a happy face at 0 (No Pain) to a crying face at 10 (Worst Pain Possible). The patient must choose the face that best describes how they are feeling. In our study, we use the Wong Bakers scale to assess the patients’ pain before and after the procedure. The neurolytic drugs and materials used in the procedure were 22 G spinal needle for block, 25 G needle for skin infiltration, 2% xylocaine , Iohexol Non ionic contrast medium, 100% alcohol, 1ml syringe and normal saline solution. The patient was put in the supine position with head placed in reverse occipitomental position (chin up and neck extended), turned 30 ° to the opposite side of the block. The foramen ovale was identified under CT guidance and a virtual track was made starting from a point which was 2-3cms lateral to the angle of mouth on the skin to foramen ovale (Figure 1). Once the trajectory of the needle and the foramen ovale was confirmed on CT scan, the skin at the point of entry was infiltrated by 2ml of 2% xylocaine using a 25G needle. Then, a 22G spinal needle was inserted at the same point and aimed in the direction of planned trajectory towards the foramen ovale (Figure 2). To prevent the needle from entering the oral cavity, a finger from inside the mouth can be used to guide the same [10]. Though, we did not apply this in any of our patients. Following this, negative aspiration was attempted to check for Cerebro Spinal Fluid (CSF) or blood aspirate. If the aspirate contained CSF or blood then the needle had to be readjusted. Then 0.5ml of mixture made from 1ml of iohexol and 2ml of 2% xylocaine was injected into the target site in order to check the spread of injectant and exact needle tip position. Once the tip of the needle touches the mandibular nerve root, the patient might complain of the exact similar pain which he/she has been suffering, thus confirming the accurate needle tip location. This injectant acts as a diagnostic block if the trigeminal ganglion is the pain generator with xylocaine providing anesthesia prior to alcohol injection. A mixture containing 3ml of 100% alcohol, 1ml of iohexol and 1 ml of saline was made. Of this 1ml of the mixture was injected into the foramen ovale (Figure 3 and 4). Post procedure check scan was performed to rule out any complication. Result Exact position of the needle tip in the foramen ovale was seen in all the six patients thus achieving 100% technical success. All these patients achieved a significant level of relief with an average pain score of two immediately after the procedure. Twenty four hours after the procedure, they rated their reduction of pain at an average pain score of one. Four out of the six patients ie Patient No. 1, 2, 4 and 6 were completely relieved of their pain with one year follow up without taking any medication. In Patient No. 3, the procedure was abandoned as during the diagnostic block, the injectant was seen tracking into CSF cistern and fourth ventricle. Patient No. 5 reported with a similar pain of TN within three months with a pain score of five, little less than the pre-procedure pain score of six. The pain was more severe in the pterygopalatine segment, hence a pterygopalatine block was carried out and the patient had a pain score of one twenty four hours after the procedure. Hence, the initial trigeminal neurolysis was partially successful in this patient. No post procedural complication was seen in any of our patients. Discussion The trigeminal nerve arises from the lateral pons at its superior to mid portion. It travels forward in posterior fossa and merges with the trigeminal ganglion in the Meckels cave. The trigeminal ganglion is located lateral to the cavernous sinus. It gives three divisions ophthalmic (V1) segment which emerges from superior orbital fissure, maxillary (V2) from foramen rotundum and mandibular (V3) from foramen ovale. The trigeminal nerve provides sensation for the face, mouth and supplies the muscles of mastication. TN mostly involves maxillary division and mandibular division of trigeminal nerve though it may also involve the ophthalmic division as well. The reported annual incidence rate of TN is about 4.5 per 100,000 persons [11] but the actual figures may be even much higher because of diagnostic challenges associated with the disease. TN is more common in females than males with a ratio of 3:2 and is usually seen after 50 years of age [11]. Trigeminal nerve block is an upcoming treatment in TN patients who are refractory to medical line of management. It relieves the pain and also reduces the side effects of drugs which are used for the treatment. Earlier studies were mainly done using x-ray or fluoroscopic guidance which had its own limitations in terms of image quality and two dimensional views. In contrast to this, CT scan provides excellent and direct visualization of foramen ovale leading to correct placement of needle [12] and thus scoring over fluoroscopy. This reduces the chances of injecting neurolytic agents at improper locations and thereby reduces the side effects. In our cases, initial check CT scan was done by injecting 1ml of iohexol to determine whether the needle is in exact location. This doubly ensured us about the location as well as the spread of injectant. This was different from previous studies done using fluoroscopy where a diagnostic block using xylocaine had to be given in order to confirm the location of the needle tip. We used a mixture of 3ml of 100% alcohol, 1ml of iohexol and 1ml of saline for trigeminal neurolysis however, Han et al stated that trigeminal nerve block with high concentration of lidocaine (10%) is capable of achieving an intermediate period of pain relief, particularly in patients with lower pain and shorter duration of pain prior to the procedure [13]. Alcohol spreads easily and should be used cautiously. The other agents which can be used but were not used in our study are phenol and glycerol. The side effects that may follow the procedure are numbness and hypoesthesia in the entire trigeminal nerve distribution. There can be abolition of corneal reflexes which can produce exposure keratitis and dryness of eyes. Improper injection of alcohol into CSF space can lead to arachnoiditis/ meningitis. CASE 1, 2, 4 and 6 These patients were suffering from trigeminal neuralgia with pain score ranging from six to eight before the procedure. All these patients have been taking carbamazepine for more than three months with no relief from pain. MRI showed no neurovascular conflict. These patients had a significant relief of pain with pain score at three months and twelve months being zero. None of these patients had to take oral medicines after the procedures. Fig 1: Site marked for needle Fig 2: Tip of the needle in foramen insertion ovale Fig 3: Dispersion of injectant in Fig 4: 3D reconstruction showing the foramen ovale needle tip in foramen ovale. Case 3 This eighty year old male came with complains of left sided trigeminal neuralgia. He had been taking carbamazepine for four months with no change in pain intensity. The procedure had to be abandoned as after injecting the diagnostic block, the injectant was seen tracking into the CSF cistern in the cerebello pontine angle and fourth ventricle (Figure 5). Fig 5: CT scan showing needle tip in the left foramen ovale Case 5 This forty seven year old female came with complains of right sided trigeminal neuralgia. She had been taking carbamazepine for three months without any relief in pain. MRI scans showed no neurovascular conflict. The procedure was successful with pain score of one immediately after and at twenty four hours after the procedure (Figure 6). However, this patient came back within three months of the procedure complaining of pain, which was more in the pterygopalatine segment. A pterygopalatine block was done with resultant pain score of one at twenty four hours after the procedure and two at nine months of the procedure. Hence, this patient showed partial response to trigeminal neurolysis carried out initially. Fig 6: CT scan showing the tip of the needle in right foramen ovale. Conclusion Percutaneous injection of alcohol, iohexol and saline mixture at the verge of foramen ovale under CT guidance is an effective and promising method to relieve pain in patients of TN refractory to medical line of management. This technique is inexpensive, cost effective and a relatively painless procedure. Being a minimally invasive technique, the chances of any infection and other post operative complications are less. Since our study involved only six patients, this technique needs to be further evaluated on a large sample size to substantiate the result of this procedure. Having said the above, we would like to emphasize that our initial experience of this procedure was quite impressing. Abbreviations TN Trigeminal Neuralgia CT Computed Tomography CSF Cerebro Spinal Fluid MRI – Magnetic Resonance Imaging References Andre ´ N. Traite ´ sur les maladies de l’ure`thre. Paris: Delaguette, 1756 Merskey H, Bogduk N. Classification of chronic pain: descriptions of chronic pain syndromes and definitions of pain terms. Seattle: IASP Press; 1994. P. 59-71 Jannetta PJ. Microvascular decompression of the trigeminal nerve for tic doloreux. In: Youmans ed. Neurological surgery 4th edn. WB Saunders Co. Philadelphia. 1996: 3404-15 Cruccu G, Gronseth G, Alksne J, et al. AAN-EFNS guidelines on trigeminal neuralgia management. Eur J Neurol. 2008; 15 (10): 1013-28 Gronseth G, Cruccu G, Alksne J, et al. Practice parameter: the diagnostic evaluation and treatment of trigeminal neuralgia (an evidence based review): Report of the Quality Standards Subcommittee of the American Academy of Neurology and the European Federation of Neurological Societies. Neurology. 2008; 71 (15): 1183-90 Michael D. Chan, Edward G. Shaw, Stephen B. Tatter. Radiosurgical Management of Trigeminal Neuralgia. In: editor Pollock Bruce, Intracranial Stereotactic Radiosurgery, an Issue of Neurosurgery Clinics. Elseiver Health Sciences. 2013. pp. 613-621 Cruccu G, Truini A. Refractory Trigeminal Neuralgia. Non-surgical treatment options. CNS Drugs. 2013 Feb;27(2):91-6. doi: 10.1007/s40263-012-0023-0. Hartrick CT, Kovan JP, Shapiro S (December 2003). The numeric rating scale for clinical pain measurement: a ratio measure? Pain Pract 3 (4): 310–6. doi:10.1111/j.1530-7085.2003.03034.x. PMID 17166126. Wong-Baker FACES Pain Rating Scale Foundation: Retrieved 6 December 2009. Michael J. Cousins In: trigeminal nerve block. Cousins and Bridenbaughs Neural Blockade in Clinical Anesthesia and Pain Medicine. Lippincott Williams Wilkins, 29-Mar-2012, 410 Allan B. Wolfson, Gregory W. Hendey, Louis J. Ling, Carlo L. Rosen, Jeffrey J. Schaider, Ghazala Q. Sharieff. In: Bell’s palsy and trigeminal neuralgia. Harwood-Nuss Clinical Practice of Emergency Medicine. Lippincott Williams Wilkins. June 23, 2009, 786 Và ­ctor Whizar-Lugo MD, Francisco Anzorena-Vallarino MD, Roberto Cisneros-Corral MD, Ricardo Valdez-Jeres MD, Rogelio Hernà ¡ndez-Velazco DDS. Use of Computed Tomography Guide for Trigeminal Alcohol Neurolysis. Anestesia en Mexico: Volume 20 No. 1 (January-April 2008) Han KR, Kim C, Chae YJ, Kim DW. Efficacy and safety of high concentration lidocaine for trigeminal nerve block in patients with trigeminal neuralgia. Int J Clin Pract. 2008 Feb;62 (2):248-54. Epub 2007 Nov 23.

The Magyars :: essays research papers fc

The Magyars   Ã‚  Ã‚  Ã‚  Ã‚  The Medieval Period in European History saw several waves of â€Å"barbarians† which helped shape the face of European society. The nomadic tribes of people that lived a migratory life, while other groups were founding civilizations with permanent living centers, are today referred to as barbarians. Two great empires, the Chinese and the Roman, ruled on the extreme edges of the enormous Eurasian continent and were separated by vast distances.1 The people that existed between the two empires and roamed the large wasteland were called â€Å"barbarians.†2 They did not have a permanent living center and therefore raided settled towns and cities for food and riches. Because of there roaming ways and raiding tactics, barbarians were feared and hated in the Medieval World. The word â€Å"barbarian† is presently associated with being backwards, uneducated, or indecent; in one word, uncivilized. These wandering people lived in family orientated groups called clans, which combined together to form a tribe. Tribes depended on one another for protection. Among these barbarian groups where a traveling people known as the Magyars. The Magyars had a major impact on the Carpathian Basin in Central Eastern Europe, and directly affected the picture of the European landscape that we have today.   Ã‚  Ã‚  Ã‚  Ã‚  The magyars are a mysterious peoples whose origins and connections are highly debated among scholars and historians. The first place to begin when searching for origins, is the language. The Magyar language is a branch of the Finno-Ugrian family of languages, most nearly related to Finnish, although supplemented by numerous Turkic words.3 The language is very unique and their is no other like it in the world. Popular 2 belief places the origin of the people themselves somewhere in the Orient. The Old Magyar Fatherland was probably situated in the ancient Orient, which we call the Near-East, and played an important role in Mesopotamian lands.4 Linguistic evidence places the Magyars among the ancient Egyptians. Contemporary records speak of a Makari Queen5 from the XXth dynasty; between 1080-940 BC6 Egyptian Kings of the XIXth dynasty forced the Magyars out of Africa for good. From their the people dispersed, moved around the European landmass, including Hungary, and mixed with other peoples.7 Much of the Finno-Ugrian peoples mainly dispersed in the widespread region on the west side of the Ural Mountains.8 It was in this region that the Magyars were exposed to the Turks. Their language was enriched with Turkic elements while maintaining its basic Finno-Ugric characteristics. It is difficult to pinpoint the exact location of the Magyars during this period because of their nomadic ways.   Ã‚  Ã‚  Ã‚  Ã‚  By the end of the 5th century the Magyars had begun their southward migration The Magyars :: essays research papers fc The Magyars   Ã‚  Ã‚  Ã‚  Ã‚  The Medieval Period in European History saw several waves of â€Å"barbarians† which helped shape the face of European society. The nomadic tribes of people that lived a migratory life, while other groups were founding civilizations with permanent living centers, are today referred to as barbarians. Two great empires, the Chinese and the Roman, ruled on the extreme edges of the enormous Eurasian continent and were separated by vast distances.1 The people that existed between the two empires and roamed the large wasteland were called â€Å"barbarians.†2 They did not have a permanent living center and therefore raided settled towns and cities for food and riches. Because of there roaming ways and raiding tactics, barbarians were feared and hated in the Medieval World. The word â€Å"barbarian† is presently associated with being backwards, uneducated, or indecent; in one word, uncivilized. These wandering people lived in family orientated groups called clans, which combined together to form a tribe. Tribes depended on one another for protection. Among these barbarian groups where a traveling people known as the Magyars. The Magyars had a major impact on the Carpathian Basin in Central Eastern Europe, and directly affected the picture of the European landscape that we have today.   Ã‚  Ã‚  Ã‚  Ã‚  The magyars are a mysterious peoples whose origins and connections are highly debated among scholars and historians. The first place to begin when searching for origins, is the language. The Magyar language is a branch of the Finno-Ugrian family of languages, most nearly related to Finnish, although supplemented by numerous Turkic words.3 The language is very unique and their is no other like it in the world. Popular 2 belief places the origin of the people themselves somewhere in the Orient. The Old Magyar Fatherland was probably situated in the ancient Orient, which we call the Near-East, and played an important role in Mesopotamian lands.4 Linguistic evidence places the Magyars among the ancient Egyptians. Contemporary records speak of a Makari Queen5 from the XXth dynasty; between 1080-940 BC6 Egyptian Kings of the XIXth dynasty forced the Magyars out of Africa for good. From their the people dispersed, moved around the European landmass, including Hungary, and mixed with other peoples.7 Much of the Finno-Ugrian peoples mainly dispersed in the widespread region on the west side of the Ural Mountains.8 It was in this region that the Magyars were exposed to the Turks. Their language was enriched with Turkic elements while maintaining its basic Finno-Ugric characteristics. It is difficult to pinpoint the exact location of the Magyars during this period because of their nomadic ways.   Ã‚  Ã‚  Ã‚  Ã‚  By the end of the 5th century the Magyars had begun their southward migration

Investigation into the kinetics of the reaction between peroxodisulphate(VI) ions and iodide ions :: essays research papers

PLAN Introduction: After having built up knowledge about the kinetics of reactions I decided to do an investigation in this area. I was initially introduced to this particular reaction1 in EP6.4 and then in AA2.1. I was interested in using this reaction as a means of potentially supporting and quantifying some of the theories that I have studied along with also perhaps extending on them. Aim: Using a clock reaction I shall: †¢Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Investigate the effect of concentration for each reactant and use the results to find the rate equation for this particular reaction. †¢Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Investigate the effect of temperature on the rate and use the results to find the activation enthalpy for this particular reaction. Background detail The Reaction:2 The reaction I am studying is often referred to as an ‘iodine clock reaction.’ A clock reaction is where the time taken to form a definite, small amount of a product at the beginning of a reaction is recorded to work out the rate. This reaction involves the oxidation of iodide ions to iodine molecules which are soluble in water and are visible as a pale brown clear solution. The formation of the iodine can easily be detected because all other species in the reaction mixture are colourless. The addition of starch to the reaction mixture further enhances the colour change by forming a dark blue-black complex with the iodine. The overall ionic equation is: (the spectator ions K+ have been left out to see the electron transfer clearly) S2O82- (aq) + 2I- (aq)  2SO42- (aq) + I2 (aq) The initial rate of the reaction can be measured by measuring the time it takes to produce a fixed small amount of iodine in the reaction as mentioned above. This can be done by adding thiosulphate ions into the reaction system which instantaneously revert the iodine molecules to iodide ions. When the amount of thiosulphate ions run out, iodine is produced and there is a sudden colour change. A sudden colour change makes the time required for the iodine to be produced very obvious. This reaction is shown in the equation: 2S2O32- (aq) + I2 (aq)  S4O62- (aq) + 2I- (aq) The total amount of iodine produced in the reaction mixture can be calculated by the equivalent amount of thiosulphate added to the reaction mixture. This way the rate can be measured in concentration of iodine produced per unit time rather than just as a reciprocal of time. This is important because it enables me to work out the rate constant, k, in the rate equation which I will discuss later.

growaw Metamorphosis of Edna Pontellier in Kate Chopins The Awakening :: Chopin Awakening Essays

The Metamorphosis of Edna Pontellier in The Awakening The Awakening, written by Kate Chopin, tells the story of a woman, Edna Pontellier, who transforms herself from an obedient housewife to a person who is alive with strength of character and emotions which she no longer has to repress. This metamorphosis is shaped by her surroundings. Just as her behavior is more shocking and horrifying because of her position in society, it is that very position which causes her to feel restrained and makes her yearn to rebel. Adele Ratignolle is Edna's close friend and confidante, but the two women are nothing alike. Adele is the perfect housewife and mother; she is the epitome of what a Creole woman and mother ought to be. She lives her life for her children, always being sure that they are properly cared for, clothed, and educated. Unlike Adele whose life is fulfilled through loving and caring for her children, Edna is "fond of her children in an uneven, impulsive way" (Chopin, p. 18). They are not enough to justify her life. Adele could not understand how Edna could say that she "would never sacrifice herself for her children, or for anyone" (Chopin, p. 47). Edna's being is taking on a new importance in her life. She is starting to realize just how important it is to be true to herself. She has never done that before. She went along with the way things were supposed to be, holding her socials and tending to her house until she became aware that she needs more from her life. Edna's marriage to Leonce is safe, but there is no passion or excitement. "She grew fond of her husband, realizing with some unaccountable satisfaction that no trace of passion or excessive and fictitious warmth colored her affection, thereby threatening its dissolution" (Chopin, p. 18). While this lack of emotion is enough to satisfy Edna for the majority of her marriage, after she begins to allow her true self to come forth, she feels trapped and seeks a way to escape. She realizes that she needs intrigue and flavor in her marriage, especially, in her life. Leonce cannot understand that she does not fit the mold of the typical Creole woman. Her lifestyle is suffocating her. The person whom Edna truly admires is Mademoiselle Reiz, who is a brilliant pianist.

Bat Case Report

Executive Summary BAT is a technology that sells financial software to individuals and organizations. BAT’s success had attracted a number of competitors. BAT differentiated itself by committing to free tech support for the life of the product. BAT started its call center operations in 1987 with 6 technicians which grew to over a 100 technicians by 2002. However, the call center has been under pressure in terms of long waiting times for customers. Such poor service was beginning to take its toll on the company’s reputation.We recommend that BAT should implement the Fast Track proposal in order to improve customer service and the company’s bottom line. We understand that free technical support is BAT’s value proposition and central to its business model, but we will show with our analysis why this is the best approach to follow. Qualitatively, 1. BAT will still maintain free support with Fast Track. Fast track will only create market segmentation. Customers on top of the market pyramid who are readily willing to pay can be tapped. . Fast Track will convert the call center from a cost center into a profit center. With the revenue being generated out of Fast Track calls, BAT can staff the call center with more technicians to improve service levels for standard callers. Current Situation BOP Team 1 is consists of 8 customer service technicians and the arrival rate of customers is 22. 5 customers/hour. The average time to deal with one customer is 18. 2 minutes. Therefore, the service rate capacity per technician is 3. 2967 customers/hour.After running the Steady-State, Infinite Capacity Queues model, the average waiting time of customers is 0. 14979 hour, which equals to about 9 minutes and there will be in average 3. 37 customers waiting in the queue. Please refer to Appendix 1 for details. Since the arrival rate and the service capacity rate cannot be shortened, increasing number of technician is the only way to shorten the average wai ting time down to less than 1 minute. We ran the model again by adding more technicians one by one, and we found that the average waiting time decrease down to about half minutes at 11 technicians.Please refer to Appendix 2 for details. Fast Track We considered different staffing plans and ran Queuing Macro for average wait time. We considered adding servers and keeping one queue, and other scenarios with dedicated Fast Track Servers. We ran Queuing Macro under five different staffing scenarios: (Please note that we have dedicated Fast track servers in Scenarios 4 and 5) Scenario No| No of Standard Servers| No of Fast Track Servers| 1| 8| 0| 2| 9| 0| 3| 10| 0| 4| 7| 1| 5| 7| 3| The following results were observed:Refer to Appendix 3 for spreadsheet calculations. As observed in the data, Scenario 2 and 3 succeed in keeping Average waiting for track customers to less than 1 minute. Scenario 2 uses less number of resources. Scenario 2 (9 technicians) is the best staffing level, without dedicated servers for Fast Track. Economics of Fast Track We’ve now established that Scenario 2 and 3 keep average wait time to less than 1 minute to help meet the Fast Track Guarantee. In Scenario2, The average server utilization is 75%, which is an adequate level.The additional yearly net revenue that can be obtained ranges from $54,325 to $376,300 depending if 10% or 40% of customers become Fast Track customers. In Scenario 3, The average server utilization is 68%, which is not as good as in the previous scenario. The additional yearly net revenue that can be obtained is also less attractive, ranging from $1,325 to $323,300. Also considering a scenario where we keep 11 technicians, The average server utilization decreases to 62%. The additional net revenue/loss that can be obtained per year is now not so attractive, ranging from a net loss of 51,675 to a net revenue of $270,300. Scenario 2 (9 Servers) offers the best revenue opportunities. Free Service for Fast customers waiting over 1 minute. We did some simulations to see what happens if BAT offers Fast Track service, charging $2 / minute, but giving the service for free if the customer waits over 1 minute. According to the â€Å"Queuing† macro, with 1 additional server there is a 30. 7% chance that any given customer (whether Fast Track or Standard) will wait more than 1 minute.Considering that 10% of these customers are Fast Track individuals, we obtain an arrival rate of 30. 7% * 10% * 22. 5 customers/hr = 0. 69 customers / hr. On the other hand, considering that 40% of customers are Fast Track individuals, we obtain an arrival rate of 30. 7% * 40% * 22. 5 customers/hr = 2. 7 customers / hr This means that, on average, the number of Fast Track customers who will wait over 1 minute ranges from 0. 69 / hr to 2. 7 / hr. In other words, roughly anywhere from 1 to 3 Fast Track customers per hour will be waived from the Fast Track fee.As seen on Appendix â€Å"xxxxx† (Table 4), this rep resents a loss of annual revenue ranging between $2,197 and $8,786. However, despite declines in revenue, this fee-waiver option will surely improve customer’s experience and customer loyalty. Therefore, we recommend Scenario 2 (hiring 1 additional server) in order to implement Fast Track, charging $2 / minute and including the fee-waiver option if waiting time exceeds 1 minute. Service Contracts vs Pay per call There are several aspects to consider when deciding if BAT should offer service contracts or just pay-per-call.Firstly, offering charged technician support goes against BAT’s original value proposition, however, pay-per-call maintained free service option. Also, pay-per-call could differentiate itself from the industry norm. It is easier for customers to accept. BAT has been offering free technician service to support its product since the founding of the company. Free technician support is part of BAT’s value proposition to customers. While charging pay -per-call service is already deviating from BAT’s core value, following the industry norm to offer service contracts could negatively impact the value proposition of BAT.Secondly, offer service contracts require higher investment caused by increased volume of customer calls. With pay-per-call service, customer will only call technician support when they are encountering problems that are urgent and customer can not only solve by themselves in a timely fashion. And since the call is charged on the minute basis, customers are more likely to keep the call short. Whereas, with service contracts, customers could call technician support with any question, and tend to stay on the line longer that they actually need to.There will be an increase of number of phone calls if BAT decides to offer service contracts. The increase of number of phone calls and prolonged time for each phone call will require BAT to invest heavily in terms of human resource and training. Overall, in terms of e conomic value and flexibility in operation, the Pay-per-call option is more preferable than service contracts. Pay-per-call requires less investment in human resource and training, also it has the flexibility to not charge customer, if their waiting time exceeds 1 minute.

Reality of School Violence in US

On January 18, 1993, Scott Pennington, a seventeen year-old student from Kentucky, shot and killed his eastside Carter High groom t distributivelyer Deanna McDavid and janitor Marvin Hicks, and then held his twenty- two classmates at gunpoint for or so fifteen minutes. On September 15, 1995, Daniel Watson, eighteen, was supercharged with sensationness count of kidnapping, two counts of nefarious possession of a weapon on civilize property, and fifteen counts of first stop endangerment after holding a associate degree student at gunpoint at his high accept.Watson had been in a involution before enlighten, and then went home and returned with two handguns. In November of 1996, Drew Golden, 11, and Mitchell Johnson, 13, opened wake on their fellow students and teachers in J one(a)sboro, Arkansas, cleaning four students and an English teacher. Is this what should be incident in Americas schools? Should students create to be to a greater extent concerned with their safe ty, sort of than obtaining a severe education? Incidences convertible to the ones just described occur both(prenominal) year in school systems across the country.According to the National Center for training Statistics, fifty-seven percent of public elemental and momentary school principals report that one or more incidents of crime/ wildness occurred in their schools during the 1996-1997 school year. The center similarly account that ten percent of each public schools experienced one or more serious violent crimes (defined as murder, rape, or other type of knowledgeable battery, suicide, physical attack or economic consumption with a weapon, or robbery) during the 1996-1997 school year. animal(prenominal) attacks or fights led the list of reported crimes in public schools, with about 190,000 reported incidences in 1996-1997.Schools should be places where the objective is to dig students the skills and knowledge to help them with their prospective they should non be havens for violent acts. Something obviously needfully to be done to decrease and hopefully one day eliminate craze in Americas school systems. There have been numerous proposals repair to help the conundrum, but there dummy up has not been a significant progress in the problem nationwide. Several new-fashioned reports-one by the American Psychological fellowship and another by the National instruction Association-show a dramatic increase in the incidence of school emphasis.It is going to possess a team exertion by the authorities, communities and the schools to help tailor hysteria in Americas school systems. The politics has attempted to address the issue of school rage. In 1994, President Bill Clinton sign(a) the Gun-Free School Act, mandating a one-year riddance for students who bring weapons to school. The Act similarly promoted the zippo tolerance for weapons policies of some states and school di nonindulgents. Currently, the federal official judicatur e and most states also make funds available for barroom activities by anti-crime and education legislation.This year, money was allotted in the federal budget for the hiring of more teachers in the schools. Although the government has rate some effort into helping the schools, is it enough? The problem of hysteria of schools is often overlooked by the government and instead more emphasis is put on political scandals, foreign policy, and welf are. It seems unjust for the students who idolize going to school each day that the government concentrates more on the private relations of the president and the precondition of people from other countries, than on the future of its own citizens.The government needs to pass on more money for the improvement of schools, both externally and internally. This money needs to be put toward the hiring of more teachers, violence prevention programs in the schools, and improvements on the school buildings. The government also should be monitorin g the schools physical exertion of the zero tolerance policies, making certain(a) that they are strictly enforced in every school across the country. The second ingredient to solving the problem of violence in schools is community initiatives.An alpha one is providing an assortment of out-of-school programs to students. It is primary(prenominal) that these programs withstand youth constructively engaged when their families are unavailable, and provide them with attention from care adults and good role models. They also need to move on teamwork, mention, and positive personal relationships. These programs keep kids outdoor(a) from negative influences on the street and in the media. Helping youth find employment in the community is another important way for communities to help build the self-esteem and sense of responsibility among adolescents.Having a blood also helps youth appreciate how important staying in school is to their future travel plans. The most important eleme nt to the answer of violence in schools is the improvement ring the actual schools. The first key is to reduce violence through personalization. Overcrowded schools and classes hurt both the educators efforts to know their students and students efforts to know one another. The provide from this is often misunderstanding, frustration, and increasingly, violence. Smaller classes can enable schools to become communities in which students know and cheer one another as individuals.They would also allow educators to form steady caring relationships with the students most likely to start or suffer from physical and psychological violence. School violence frequently results from conflicts that are unsuitably managed and therefore intensify. Conflict resolution programs should be offered in schools to both students and educators to give them skills to efficaciously and constructively handle the controversies that naturally turn in learning environments. Schools should also promote the d evelopment of good display case.The missing mo in violence prevention programs is book of facts development though the skills of empathy and self-discipline, write character education experts Diane G. Berreth and Sheldon Berman. Without these skills, we run the risk of schools comme il faut locked-down and oppressive institutions built around fear rather than responsiveness. Teachers also play an immanent role in dealing with school violence. Studies have shown that children consistently admire and respect those teachers that are strict in background knowledge high standards for behavior and academic performance, and who turn up a personal interest in their students.It is also important that teachers follow strict enrols of conduct throughout the whole school. This code of conduct should be shared with the students, and should not be altered by the teachers. Students should never have the feeling that they might be able to get away with something, because a teacher rarely en forces the rules. It is with longing that teachers reckon the days when disruptive behavior in school meant running in the halls, throwing spitballs and clout ponytails. Today, the disruptive behavior is much more frightening.It takes the shape of brutal beatings, stabbings, and shootings. young violence disrupts schools and is taking its toll on students, teachers, parents, and communities. Youth violence is threatening the entire social organisation of public education. The issue of school violence needs to be attended to quickly. This problem cannot be solved by the efforts of one force, but rather it exit take the teamwork of the government, communities, and the schools to help reduce the violence. If policies such as the ones described are not implemented, students will continue going to school in fear.