CRANBERY SUPPLEMENTS AS PROPHYLACTIC TREATMENT Assignment

CRANBERY SUPPLEMENTS AS PROPHYLACTIC TREATMENT - Assignment Example From the above boundaries it might be foreseen that in the event that cranberry supplements are extremely valuable, at that point the recurrence of urinary tract contamination will diminish, the side effects of UTI like polyuria and hematuria will diminish, the symptomatic outcomes will show ordinary tally (5000-9000 cu mm) of WBC and decreased degrees of C - responsive protein. The further foreseen result will be the decrease in the recurrence of anti-microbials endorsed or there will likewise be a diminished need to raise the measurement and class of an anti-toxin. This implies however contamination may happen yet it doesn't require the mediation with an anti-infection and the inborn resistance of the body can deal with the circumstance. Further diminished need to raise the measurements and class of an anti-microbial likewise involve that odds of anti-toxin opposition would not be high, if cranberry supplements are regulated (Lane and Takhar,2011) (Wang, Fang and Chen, 2012) The convention will be assessed with the assistance of measurable trial of criticalness and in such manner the â€Å"chi square test† will be performed. Above all else delineated arbitrary examining would be done to determine the example sizes and the cutoff points. Seven gatherings will be shaped with the ladies in the age scope of 18 to 67 years. These gatherings are 18-28 years, 29-38 years, 39â€48 years, 49-58 years, 59-multi year, 69-78 years and 79-88 years. Information will be gathered from the urologists who arrange that these ladies are patients of repetitive urinary tract contaminations. Patients underneath or more the predefined age range won't be remembered for the investigation. Further recently analyzed patients of UTI will likewise be excluded from the examination. After determination of tests the patients in each gathering will be isolated as the trial arm and control arm. The patients of the test arm might be directed cranberry supplements and the patients of control arm will get fake treatment. Anyway as the examination will

Catch 22 And A Few Good Men Essays - English-language Films

Lose-lose situation And A Few Good Men Lose-lose situation and A Few Good Men Lose-lose situation is a novel about the Second World War. It is determined to the island of Pianosa, which is off the shoreline of Italy. It is set toward the finish of the war while the Germans are on the run and being pushed out of Italy. The book centers around a bomb gathering, all the more explicitly a unit wherein a bombardier named Yossarian is allocated to. Yossarian is disturbed on the grounds that every one of these individuals he doesnt even know (the Germans) are attempting to execute him. The epic is exceptionally difficult to comprehend as a result of the manner in which it is composed. It is useful in books about the military to have a period date gathering so you recognize what is happening. This book doesnt have that and is so brimming with streak backs and glimmer advances that it made my head turn. It wasnt ineffectively composed however it was hard follow. It has numerous specialized mistakes, for example, having helicopters for search and salvage while helicopters werent utilized in military help until the Korean War. The story is a decent one however portrays military life as a joke nearly. The vast majority of the servicemen in this book had no control and did essentially however they wanted. Yossarian experiences the entire story attempting to escape his group and return home. His concern is the leader of the gathering continues raising the quantity of missions required to fly before the turn home. Each time he draws near the raise the number on him once more. Through everything he attempts every one of these plans to get sent home he acts wiped out and attempts to act insane. At the point when he attempts to acts insane he feels that he has an ideal intend to get sent home since there was a standard that any individual who was insane was unfit to serve in the rigors of battle, yet the standard said they needed to request to be grounded. At the point when he goes to get himself grounded he finds there is a trick. Dilemma says that any individual who requests to be grounded isn't insane on the grounds that perceiving threat is the procedure of a balanced brain and anybody with a normal psyche isn't insane. That is the fundamental story line of the book. A Few Good Men is a film about the preliminary of two Marines for homicide. The primary characters are Lt.j.g. Dan Kaffey and Lt.Cmdr Joanne Galloway. They are the two legal counselors in the Judge Advocate General Corps of the Department of the Navy. They are the resistance lawyers for Lance Corporal Dawson and Private First Class Downey. Dawson and Downey were accused of killing an individual from their crew, Private First Class William Santiago. The explanation that they slaughtered him was in fact a mishap. They were attempting to dimness him when something turned out badly. They were training him because on the grounds that he broke the hierarchy of leadership and went outside his unit for help. In the Marine Corps that isn't right since it makes the Marines in your hierarchy of leadership resemble a lot of dolts. The two Marines, Dawson and Downey were requested by their detachment authority who thusly was arranged by the contingent administrator to train Santiago. The two Marines would not like to give a break for least prison time in light of the fact that the accepted that they don't did anything incorrectly they were following requests and they didn't plan to kill him. The film discusses a code that Marines follow particularly Marines forward sent on tense circumstance. Fundamentally the code said that the unit and the crucial first all different things are auxiliary including solace and individual security. The Marines overcome the preliminary and are discovered blameless in light of the fact that they were just after requests and didn't plan to slaughter Santiago. They were seen as blameworthy of lead unbecoming of a Marine and were despicably released from the Marine Corps. The unit officer Colonel Jessup was set to be court martialed for requesting the Code Red (inception) and Kaffey and Galloway look like saints for discovering reality and correcting the wrongs. At the point when you think about these two works you get yourself

A Beginners Guide to Yoga essays

A Beginners Guide to Yoga expositions Expanding back torment, seething pressure, the beginning of a headache . . .who hasnt encountered a few or these sensations eventually? Finding a remedy for these distresses would deify their pioneer and for all intents and purposes guarantee sainthood. In spite of the fact that not a panacea, yoga is a close to fix just for accomplishing unwinding and internal harmony. Yoga, which implies association or parity (1), goes back farther than 2,500 years prior to the consecrated Hindu religion. The antiquated Rig-Veda (Knowledge of Praise) contains songs made by kavi (soothsayer artists) ready to look past their five detects. The songs detail their delights and bits of knowledge, and structure the premise of antiquated Yoga (2). Fans of Yoga today despite everything look for these euphorias and bits of knowledge, and have different types of Yoga to seek after to assist them with accomplishing them. Much the same as a bloom can have numerous petals that stretch out from one stem, Yoga has numerous sorts that all offer essential things. The four structures follow: 3. Raja Yoga (the study of mental control) 4. Gyana Yoga (the way of information) While these types of Yoga may seem unique, truly they supplement one another. Raja Yoga, the study of mental control, contains three developments, MantraYoga, Kundalini Yoga, and Hatha Yoga (3). These methods of Yoga target control of mental changes and accomplishing the supreme. Hatha Yoga, the most popular among them, looks for a change through physical decontamination and fortifying. The objective of Hatha Yoga is to amplify the consciousness of the body and psyche. Advancing from two Sanskrit words, Hatha truly comprises of two planets: ha, which means sun, and tha, which means moon. These two planets represent the two parts of the body and brain. Hatha Yoga intends to even out these two parts to make a completely working person. Struggle rises, in any case, when one side regularly overwhelms the other yet is never totally freed of its partner. The vast majority have been prepared to favo... <!

Not accepting the Treaty of Versailles - Free Essay Example

The Treaty of Versailles was a treaty attended by all victorious nations of the Great War Except for Russia as they were in the middle of a civil war. It was to sort out what would happen to Germany as they were blamed of starting the Great War. The main contributes Nicknamed The Big Three were French premier Georges Clemenceau of France, British prime minister David Lloyd George of Great Britain, and President Woodrow Wilson of the United States of America. The Treaty also put the blame for starting WW1 on Germany and it therefore had to pay reparations. Original figure was 6,600,000,000 goldmakrs, an very harsh but possible figure; this was reduced by the Dawes Plan and the Young Plan later. One must not forget that Germany enforced even harsher terms on Russia in the treaty of Brest-Litovsk, so the complaints may sound somewhat hypocritic. However, having to accept the blame really angered many Germans, as they saw the war as the result of everyones mistakes. It was probably more the fact of defeat and the revolution in Germany that created underground aggression than the treaty itself that had this effect. Many hardline German nationalists also felt in some sense cheated of their victory over Russia. The dreams of boundless expansion in Eastern Europe lived on. Within Germany particular venom was directed against those who signed the armistice whom Hitler and others routinely called the November criminals. The team that actually tried to negotiate in Paris and Versailles was not vilified to anything like the same extent. The reparations were widely seen as the harshest element of the Treaty of Versailles. For many the restriction of the size of the army to 100,000 men was also very irksome, and this clause of the treaty was never observed. A further cause of intense resentment was two attempts to go beyond the treaty. In 1921 Polish irregulars (with the approval of the Polish government) tried to seize the plebiscite area of Upper Silesi a before the plebiscite was held, and they were kept at bay by various Friekorps and units of the British Army. Then, in 1923, the French and Belgians occupied the The terms of the Treaty of Versailles. The treaty can be divided into a number of sections; territorial, military, financial and general. Territorial The following land was taken away from Germany : Alsace-Lorraine given to France Eupen and Malmedy given to Belgium Northern Schleswig given to Denmark Hultschin given to Czechoslovakia West Prussia, Posen and Upper Silesia given to Poland The Saar Danzig and Memel were put under the control of the League of Nations and the people of these regions would be allowed to vote to stay in Germany or not in a future referendum. The League of Nations also took control of Germanys overseas colonies. Germany had to return to Russia land taken in the Treaty of Brest-Litovsk. reparations it seemed clear to Germany that the Allies wanted nothing else but to bankrupt her. Germany was also forbidden to unite with Austria to form one superstate, in an attempt to keep her economic potential to a minimum. General There are three vital clauses here: 1. Germany had to admit full responsibility for starting the war. This was Clause 231 the infamous War Guilt Clause 2. Germany, as she was responsible for starting the war as stated in clause 230 was, therefore responsible for all the war damage caused by the First World War. Therefore she had to pay reparations the bulk of which would go to France and Belgium to pay for the damage done to the infrastructure of both countries by the war. Quite literally reparations would be used to pay for the damage to be repaired. Payment could be in kind or cash. The figure was not set at Versailles it was to be determined later. The Germans were told to write a blank cheque which the Allies would cash when it suited them. The figure was eventually put at 6,600 million a huge sum of money well beyond Germanys ability to pay 3. A League of Nations was set up to keep world peace. In fact the first 26 clauses of the treaty dealt with the Leagues organisation. The Treaty of Versailles was a treaty attended by all victorious nations of the Great War (Except for Russia as they were in the middle of a civil war It was to sort out what would happen to Germany as they were blamed of starting the Great War. The main contributes Nicknamed The Big Three were French premier Georges Clemenceau of France, British prime minister David Lloyd George of Great Britain and President Woodrow Wilson of the United States of America. The Treaty also put the blame for starting WW1 on Germany and it therefore had to pay reparations. Original figure was 6,600,000,000 goldmakrs an very harsh but possible figure this was reduced by the Dawes Plan and the Young Plan later One must not forget that Germany enforced even harsher terms on Russia in the treaty of Brest-Litovsk, so the complaints may sound somewhat hypocritic. However having to accept the blame really angered many Germans, as they saw the war as the result of everyones mistakes. It was probably more the fact of defeat and the revolution in Germany that created underground aggression than the treaty itself that had this effect. Many hardline German nationalists also felt in some sense cheated of their victory over Russia. The dreams of boundless expansion in Eastern Europe lived on. Within Germany particular venom was directed against those who signed the armistice whom Hitler and others routinely called the November criminals. The team that actually tried to negotiate in Paris and Versailles was not vilified to anything like the same extent. The reparations were widely seen as the harshest element of the Treaty of Versailles. For many, the restriction of the size of the army to 100,000 men was also very irksome and this clause of the treaty was never observed. A further cause of intense resentment was two attempts to go beyond the treaty. In 1921 Polish irregulars (with the approval of the Polish government) tried to seize the plebiscite area of Upper Silesi a before the plebiscite was held, and they were kept at bay by various Friekorps and units of the British Army. Then, in 1923, the French and Belgians occupied the The terms of the Treaty of Versailles. The treaty can be divided into a number of sections territorial military financial and general. Territorial The following land was taken away from Germany : Alsace-Lorraine (given to France Eupen and Malmedy given to Belgium Northern Schleswig given to Denmark Hultschin given to Czechoslovakia West Prussia, Posen and Upper Silesia given to Poland The Saar Danzig and Memel were put under the control of the League of Nations and the people of these regions would be allowed to vote to stay in Germany or not in a future referendum. The League of Nations also took control of Germanys overseas colonies. Germany had to return to Russia land taken in the Treaty of Brest-Litovsk. Some of this land was made into new states Estonia Lithuania and Latvia. An enlarged Poland also received some of this land. Military Germanys army was reduced to 100,000 men the army was not allowed tanks She was not allowed an airforce She was allowed only 6 capital naval ships and no submarines The west of the Rh ineland and 50 kms east of the River Rhine was made into a demilitarised zone No German soldier or weapon was allowed into this zone. The Allies were to keep an army of occupation on the west bank of the Rhine for 15 years. Financial The loss of vital industrial territory would be a. France and Britain threatened to continue the war if they didnt accept, and the German generals told the government that Germany was in no position to fight effectively. This was because they were running out of raw materials food men and ammunition so there was a great chancee losing the war. Not accepting the Treaty of Versailles would have resulted in the war being reopened. Some German politicians were in favour of this for example the Chancellor, Scheidemann, and the Army Minister Noske who resigned rather than accept the treaty. However, the senior German generals said the the army was in no position to resume fighting. The military and many politicians also feared that a resumption of the war would lead to a massive and possibly successful Communist uprising in Germany. France and Britain threatened to continue the war if they didnt accept, and the German generals told the government that Germany was in no position to fight effectively. This was because they were running out of raw materials, food, men and ammunition so there was a great chanceof losing the war. Not accepting the Treaty of Versailles would have resulted in the war being reopened. Some German politicians were in favour of this, for example, the Chancellor, Scheidemann, and the Army Minister, Noske, who resigned rather than accept the treaty. However, the senior German generals said the the army was in no position to resume fighting. The military and many politicians also feared that a resumption of the war would lead to a massive and possibly successful Communist uprising in Germany.

Healthy Food Vs Unhealthy Food - 1043 Words

Healthy food vs unhealthy food, knowing the difference and what it does to our body and why some of the food we eat causes obesity. They both have a similarity, but there is a huge difference in healthy and unhealthy food. The main difference are taste, cost, and health. You will see a difference in the costs, but not a huge difference, but we are still saving money from not eating healthy food. Buying cheaper food and healthy food you will see the quality and quantity. Especially, how it looks, feels, and how much comes with the product. I feel like our rate of obesity is so high because healthy food is more expensive than eating junk food or fast food. When eating healthy there are a good amount of benefits compared to not eating†¦show more content†¦Just about every fast food restaurant offers some kind of healthy alternatives today. Whether it’s grilled chicken sandwiches, wraps, or salads, there is usually something for everyone. One thing to keep in mind is that healthier options generally tend to be a little more expensive. But because it is fast food, you are still going to save money over homemade foods. (2017, July 5). Healthy food quality and quantity. Yes , you are paying more for healthy food and yes, you do get less product from paying their expensive healthy food. When you are buying healthy food they already have them package individually so the food you buy will have just amount of calories you want and just enough of nutrients. Having such good quality from eating healthy food, it will make you fuller faster because of the product they put in the meat, snacks, and drinks. There are a few disadvantages of eating unhealthy cheap food because sometimes the product they make contains too much salt and fat. Which is why sometimes cheap food has bad quality for the price you are getting. Unhealthy foods contain unhealthy product do not get me wrong though, there are some cheap food that does have great quality in their food. You just have to pick out the right stuff for the right prices. There is not a huge price difference in healthy food or unhealthyShow MoreRelatedHealthy Foods Vs. Unhealthy Foods1939 Words   |  8 Pagesshop for healthy foods? Studies prove that the expense of vegetables, fruits and organic products, have caused the obesity levels in the U.S. to increase dramatically. Healthy foods should be cheaper than junk foods because we shouldn t be paying more to live a healthier lifestyle. In our society, healthy choices are sometimes a lot harder to make than unhealthy ones; going to the gym vs. staying home, ordering a salad vs. French fries or buying healthy groceries vs. unhealthy ones. Healthy foodsRead MoreCauses Of Junk Food Essay855 Words   |  4 Pages12 July 2017 The Quick Solution: Junk Food Studies show that a minimum of 1 in 4 people eat junk food every single day (â€Å"11 Facts About American Eating Habits†). It may appear as a small portion, but in reality that is almost one billion, seven hundred fifty million individuals who are consuming processed, fried,and baked foods daily. Even though these foods have no nutritional value and can lead to different health problems, people would rather eat junk food because of its conveniency and its wayRead MoreObesity : A Healthy Lifestyle919 Words   |  4 PagesToo many people are obese. Americans are becoming very lazy and are less motivated to work out or exercise. Americans are also becoming dependent to fast unhealthy food places to eat every day. Americans need to choose a healthy lifestyle vs. an unhealthy lifestyle because being healthy is essential in today’s competitive world. According to Center of Disease Control in 2013 it states that 35.7% of Americans are obese. Obesity is a very harmful disease that can be cured from good nutrition andRead MoreWhy Does America Have An Obesity Problem?1600 Words   |  7 Pagesresponsibility to keep one’s self healthy, but are there ways the government can strive for an overall healthier diet for Americans? Can we change the manipulative ways of Super Markets and persuade them to look past profit? The American government should put in effort to provide a better dietary path for American citizens by working on motivating individuals to make better choices in their diet, pushing Super markets and industries to work together to lower prices of healthier foods, and placing policies andRead MorePROPOSAL TO REDUCE UNHEALTHY EATING HABIT AMONG STUDENTS AT MEMORIAL UNIVERSITY OF NEWFOUNDLAND758 Words   |  4 Pagespurpose of this study is to r educe the unhealthy eating habits among MUN students through investigating the reasons that lead to unhealthy eating habits and showing the harms that are caused by unhealthy diets to make students aware of their food and health choices. Suggestions will be made for students to manage the menu and evaluate balanced nutrition. Historical Background Students at Memorial University are facing great pressure from school and work. A healthy eating habit can help students toRead MoreThe Problem With Today s Adolescent Society1432 Words   |  6 Pagesvery unhealthy lifestyle that if not taken under control, could potentially lead to Type II Diabetes or high cholesterol. Some people believe that the kids’ parents should be leading their children in the right direction but the parents may not have the correct education or understanding for knowing the components of a healthy diet and lifestyle. On the other hand, other believe that childhood obesity comes from fast food and the media offering the consumers a very cheap way to an unhealthy mealRead MoreEssay about Health Benefits of the South Beach Diet823 Words   |  4 Pagesonly healthy foods and in limited amounts, the South Beach diet proves to be an effective and safe path to weight loss. South Beach permits foods which are high in fiber and low in saturated fat such a s whole grain rice, salmon and nuts. The diet does not exclude any particular class of food, fats or carbohydrates for example, but insists that foods high in cholesterol, such as bacon, be avoided. Yet, this is not the only restriction of the diet. South Beach also limits the amount of food consumedRead MoreObesity : The Current State Of Obesity1518 Words   |  7 Pagesa greater than that of other countries who live healthier lifestyles. Living healthy lifestyles is a great goal for a country to look towards achieving, and encouraging these lifestyles can benefit the country as well as the people. There are a lot of benefits for living healthy lifestyles, while there are also many negatives to living an unhealthy lifestyle. Taxing fatty foods would help to encourage buying healthy foods, and it could reduce obesity rates in America. There are a couple of problemsRead MoreThe Speech : Plant Based Diet1065 Words   |  5 Pageshave had a plant-based diet and a diet made up of p rocessed food and meat, and based on my experience and research it is clear that a plant based diet is the better choice. D. Preview main points I will be telling you today how plant-based foods are healthier for you, how it will help improve your mental health, and how eating plant based foods is cheaper. (Transition) Before I get ahead of myself I will tell you how plant-based foods are far healthier for your body than animal products. IIRead MoreThe Current State Of Obesity1526 Words   |  7 Pagesa greater than that of other countries who live healthier lifestyles. Living healthy lifestyles is a great goal for a country to look towards achieving, and encouraging these lifestyles can benefit the country as well as the people. There are a lot of benefits for living healthy lifestyles, while there are also many negatives to living an unhealthy lifestyle. Taxing fatty foods would help to encourage buying healthy foods, and it could reduce obesity rates in America. There are a couple of problems

International Marketing For Potential Foreign Market Essay

LO1: Understanding the concept of international marketing for potential foreign market: To: International Marketing Director From: Adopting the International Marketing Approach Subject: Internationalization of Hilfiger Date: (AC 1.1) Why Hilfiger Have to develop international marketing International marketing is a most renowned concept in today’s globalized world. It is the application of marketing principles in more than one country. Hilfiger should develop international marketing for the following reasons: New revenue potential: New market share will indeed generate more profit. If we are able to successfully introduce our product in other countries then it will help us to grab more revenue potential. Since clothing is one of the basic needs as well as luxury so international marketing is not be too risky for us. (Anon, 1978) Learning a new culture: International marketing is crucial in learning a new culture. If our company go for international marketing then the company will experience and learn the culture of that country which may cost us. Because we may produce some products which may fail but this will help us in long run to go for another market of same nature in a very cost effective way. The experience of our company in dealing with a new culture will increase. (Anon, 1978) Diversifying company Markets: When a company go internationalized then the market is diversified. So it reduces the risk of any slow down or shut down of a specific market due to anyShow MoreRelated4 Phases of International Marketing Involvement664 Words   |  3 Pagesinvolve in international marketing, they have to do study and analysis of market potential in the country they interested to do business so that they can decide the level of involvement they would like to commit. There are 4 phases of international marketing involvement; which are no direct foreign marketing, infrequent foreign marketing, regular foreign market and international marketing. In no direct foreign marketing stage, the company may not actively involve in international marketing. But yetRead MoreDifferent Levels Of Market Involvement And Modes Of Entry Essay1251 Words   |  6 PagesDifferent levels of market involvement and modes of entry. In global marketing, the marketing across the national boundaries lies between the potential complexities of international marketing which precisely defines what is involved in it. On the other hand the orders received from other national boundaries are responded by the independent broker too. The company is also involved in the transaction of selling its products and services to the broker with some efforts put in along with the considerationsRead MoreWhat Are the Specific Characteristics of the International Marketing Activities Designed and Implemented by Small Firms?1266 Words   |  6 PagesInternational Marketing What are the specific characteristics of the international marketing activities designed and implemented by small firms? As defined Robert W. Rowden (Thunderbird International Business Review, March-April 2001), a small firm (with a maximum of 50 employees) is centralized and personalized through management of an owner-manager. This type of organization provides some advantage such as proximity between manager and employees because there is less hierarchy. FurthermoreRead MoreInternational Marketing Ch 1 Essay1693 Words   |  7 PagesChapter 1 The Scope and Challenge of International Marketing Discussion Questions |1. |Define: | | | |International marketing |Foreign uncontrollables | | |Controllable elements |Marketing relativism Read MoreMarket Entry Strategies1002 Words   |  5 PagesIntroduction Market entry strategies refer to modes of accessing a share of clients en masse in a new environment. This paper will give an overview of different market entry options available and their extent of applicability in the Abu Dhabi National Hotels Company’s effort to enter the US market. It will also evaluate Abu Dhabi National Hotels Company by considering indirect market entry options in entering the US market. Market entry strategies Read MoreMarketing Manager For A Small Company1394 Words   |  6 Pages1. You are the marketing manager for a small company located in the United States that manufactures specialized part for high-end ink-jet printers. The company’s largest customer (Hewlett-Packard) has asked your company to supply parts to 10 of its distribution and repair sites around the world. The company has never sold products outside the United States so this represents a significant step for the company. What stage in the global experience learning curve is the company likely entering and whyRead MoreInternational Marketing: Factors to be Considered in Foreign Markets1657 Words   |  7 Pages1.The International marketing is defined as performance of business activities including price, promotions, product and distribution decision and then the task of marketing research is to systematically collect data, process it in to valuable information which is vital for marketing decision. The information of host country on political stability, cultural attributes and geographical characteristic are required for sound for foreign markets. Information on economic general data on level of growthRead MoreEssay on Wal-Mart Analysis1677 Words   |  7 PagesSupercenters and Sam’s Club warehouse stores, the company operates 2,823 units in the United States, 606 units in six foreign countries, and has 7 joint ventures in the Pacific Rim. Ten strategies have been identified that will ensure continued revenue and market share growth via foreign expansion, the foray into new domestic markets (the urban market) and concentration strategies in existing markets by enhancing the one-stop-shopping appeal of the current units. One red flag that the company analysis uncoveredRead MoreInternational Market and Trade Research in Ireland1550 Words   |  7 PagesInternational market and trade research is beyond the capabilities and needs of the small Irish exporter. Discuss. International Marketing and Trade Research follows the very same path as domestic research, only that there are a few more problems that can arise when entering the international market. Customers in international markets may have very different customs, cultures, and expectations from the same company than those in their own mother country. In this case, secondary information mustRead MoreThe Cultural Differences Of International Marketing1255 Words   |  6 PagesHaving examined the notions of Consumer Ethnocentrism and Country-of-origin effects, we can assume that nowadays the job of a marketer has become quite difficult. International Marketing is very challenging since the key to success is hidden behind the ability of a marketer to adapt rapidly to the changes that a multicultural marketplace entails. Today’s managers of global firms must deal with many obstacles in order to ensure the interests of their businesses in other countries (Research Methodology

What Is Globalization free essay sample

What is globalization Shift toward more integrated and interdependent economy. Free trade is a policy in international markets in which governments do not restrict imports or exports. However, most governments still impose some protectionist policies that are intended to support local employment, such as applying tariffs to imports or subsidies to exports. Lower price Some countries Technologies Centralization has revolutionized the transportation business, significantly erring the costs of shipping goods over long distances.Reduce chipping cuts Employment lowering the costs of shipping goods over long distances. Benefits Cost A number of political, economic, and legal factors determine the costs of doing business in a country. With regard to political factors, a company may have to pay off politically powerful entities in a country before the government allows it to do business there.The need to pay what are essentially bribes is greater Risk t rises, demons rat ions, t errors, and violent conflict Thus, a legal risk can be defined as the likelihood that a trading partner will opportunistically break a contract or expropriate property right s. We will write a custom essay sample on What Is Globalization or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page When legal risks in a count rye are high, an into New Zealand cut its corporate tax rate from 30% to 28% last year and eliminated certain deductions, making the cut fiscally neutral. Investors have prospered, with the countrys benchmark stock index, the NZ 50, up 24% over the past 12 months.We determined the Best Countries for Business by grading 141 nations on 11 different factors: property rights, innovation, taxes, technology, corruption, freedom (personal, trade and monetary), red tape, investor protection and stock market performance. Forbes leaned on research and published reports from the following organizations: the Central Intelligence Agency, Freedom House, Heritage Foundation, Property Rights Alliance, Transparency International, World Bank and World Economic Forum. What is globalization free essay sample Globalization, â€Å"refers to processes of international integration arising from the interchange of world views, products, ideas, and other aspects of culture† (Merriam-Webster, 2014). Since the 1980’s the impact of globalization has been on the rise. Western cultures are bringing about new ways of culture while indigenous people are modifying their traditional ways to western civilization. I will be discussing two non-western cultures and the effects of globalization. The two cultures that will be discussed are the Zimbabwean and Japanese cultures (Watson, 2006). McDonald’s began in 1954 in Los Angeles where it was known as just a cheap, clean, burger joint. Ray Kroc who was a salesperson wanted to expand this concept and signed a contract with the owners (Koetse, 2012). In 1971, McDonalds made its way to Japan where it began to introduce western fast food. Some of the challenges that they faced were the menu items, which rice was not offered as part of the menu (Koetse, 2012). We will write a custom essay sample on What is globalization? or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page The taste of the food was not of tradition for the Japanese and was considered a snack rather than a meal. The â€Å"table manners at McDonald’s â€Å"was not of Japanese tradition. At McDonald’s people ate while standing instead of tradition of everyone sitting and eating together with chopsticks and not their hands. Sharing meals in the Japanese culture is a big part of their tradition as it brings a sense of togetherness. Hamburgers, bread and fries are hard items to share among a family (Koetse, 2012). Prior to the start of McDonald’s, Japan’s culture when it came to meals was sitting all together and eating with chopsticks. In addition, having rice served at every meal was considered the main course while meat with meals was not something of tradition (Koetse, 2012) The Japanese used several decorative bowls to eat from instead of just one and made sure to hold them with both hands. The practice of obentos, which are lunches prepared by the mothers for their children to take to school and eat with their peers, was an important tradition of their culture (Watson, 2006). The influence of McDonald’s making its way to Japan was direct by expanding the corporation of a successful business all over the world. Although, the start of McDonalds in Japan lead to some hesitation because it was looked upon as their culture was being changed to an American way it later became a hit (Koetse, 2012). McDonald’s eventually adapted their menu to meet more of the Japanese food traditions such as rice burgers and teriyaki burgers. In addition, for desert, a green tea ice cream was launched for their taste. The seating was adapted so everyone could sit together and enjoy their meal. With the changes McDonalds has made in Japan fast food is now looked at as something trendy, even teenagers go there to study and hangout with their friends. Fast food is becoming a part of everyday life in Japan (Koetse, 2012) The second non-western culture that was impacted by globalization is the Zimbabwean culture in Africa. The changes with the economy and the liberalization of trade have affected this culture drastically (Muyale-Manenji, 1998). Prior to change, women in this culture were known as farmers and civil servants. Many of them had small businesses selling fruit and vegetables that were grown. Even young children would stay out late at night to help. The impact of the globalization of trade has affected their agriculture production by putting in fertilizers and insecticides at reasonable prices (Muyale-Manenji, 1998). The market of produce is now going to businesspersons looking just to make a high profit for themselves and no credit to where it came from. The removal of boundaries has led to cross border trade and job searching which has increased crime and diseases in this African culture (Muyale-Manenji, 1998). Women are becoming prostitutes to make money, which they are, contracting diseases such as AIDS. Rape cases have increased especially with young children because they are out of their parents’ supervision (Muyale-Manenji, 1998). Further, globalization has had a negative impact on the Zimbabwean’s language. They are no longer speaking there traditional language it was replaced with English. The Zimbabwean people that are speaking in English and not their local language are highly looked upon (Ting-Tooney, 1998). The English language is westernizing the Zimbabwean culture and becoming the way of communication. Their local language is almost becoming a foreign language because of how little it is used (Ting-Tooney, 1998). Culture is â€Å"the customary beliefs, social forms, and material traits of a racial, religious, or social group† (Merriam-Webster, 2014). Culture is what makes a group stand out from anyone else. Globalization can have a positive and negative affect on cultures. It allows other cultures to interact with each other and interchange new ideas on ways of life. With the Japanese culture, globalization had a positive affect however, the Zimbabwean culture it affected them in a negative way (Ting-Tooney, 1998).

Postpartum Hemorrhage free essay sample

For these reasons, various authors have suggested that PPH should be diagnosed with any amount of blood loss that threatens the hemodynamic stability of the woman. The diagnosis of PPH is usually reserved for pregnancies that have progressed beyond 20 weeks’ gestation. Deliveries at less than 20 weeks’ gestational age are spontaneous abortions. Bleeding related to spontaneous abortion may have etiologies and management in common with those for PPH. Epidemiology - Frequency United States and industrialized countries The frequency of PPH is related to the management of the third stage of labor. This is the period from the completed delivery of the baby until the completed delivery of the placenta. Data from several sources, including several large randomized trials performed in industrialized countries, indicate that the prevalence rate of PPH of more than 500 mL is approximately 5% when active management is used versus 13% when expectant management is used. We will write a custom essay sample on Postpartum Hemorrhage or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page The prevalence rate of PPH of more than 1000 mL is approximately 1% when active management is used versus 3% when expectant management is used. [7, 8]  See eMedicine article  Management of the Third Stage of Labor. Developing countries The increased frequency of PPH in the developing world is more likely reflected by the rates given above for expectant management because of the lack of widespread availability of medications used in the active management of the third stage. [2]  A number of factors also contribute to much less favorable outcomes of PPH in developing countries. The first is a lack of experienced caregivers who might be able to successfully manage PPH if it occurred. Additionally, the same drugs used for prophylaxis against PPH in active management of the third stage are also the primary agents in the treatment of PPH. Lack of blood transfusion services, anesthetic services, and operating capabilities also plays a role. Finally, the previously mentioned comorbidities are more commonly observed in developing countries and combine to decrease a womans tolerance of blood loss. Etiology PPH has many potential causes, but the most common, by a wide margin, is uterine atony, ie, failure of the uterus to contract and retract following delivery of the baby. PPH in a previous pregnancy is a major risk factor and every effort should be made to determine its severity and cause. In a recent andomized trial in the United States, birthweight, labor induction and augmentation, chorioamnionitis, magnesium sulfate use, and previous PPH were all positively associated with increased risk of PPH. [9] A recently published, large population based study supported these findings with significant risk factors, identified using a multivariable analysis, being: retained placenta (OR 3. 5, 95% CI 2. 1-5. 8), failure to progre ss during the second stage of labor (OR 3. 4, 95% CI 2. 4-4. 7), placenta accreta (OR 3. 3, 95% CI 1. 7-6. 4), lacerations (OR 2. 4, 95% CI 2. 0-2. 8), instrumental delivery (OR 2. 3, 95% CI 1. 6-3. ), large for gestational age (LGA) newborn (OR 1. 9, 95% CI 1. 6-2. 4), hypertensive disorders (OR 1. 7, 95%CI 1. 2-2. 1), induction of labor (OR 1. 4, 95%CI 1. 1-1. 7) and augmentation of labor with oxytocin (OR 1. 4, 95% CI 1. 2-1. 7). [10] PPH is also associated with obesity. In a study by Blomberg, the risk of atonic uterine hemorrhage rapidly increased with increasing BMI; in women with a BMI over 40, the risk was 5. 2% with normal delivery and 13. 6% with instrumental delivery. [11] As a way of remembering the causes of PPH, several sources have suggested using the â€Å"4  T’  s† as a mnemonic: tone, tissue, trauma, and thrombosis. 12] - Tone Uterine atony and failure of contraction and retraction of myometrial muscle fibers can lead to rapid and severe hemorrhag e and hypovolemic shock. Overdistension of the uterus, either absolute or relative, is a major risk factor for atony. Overdistension of the uterus can be caused by multifetal gestation, fetal macrosomia, polyhydramnios, or fetal abnormality (eg, severe hydrocephalus); a uterine structural abnormality; or a failure to deliver the placenta or distension with blood before or after placental delivery. Poor myometrial contraction can result from fatigue due to prolonged labor or rapid forceful labor, especially if stimulated. It can also result from the inhibition of contractions by drugs such as halogenated anesthetic agents, nitrates, nonsteroidal anti-inflammatory drugs, magnesium sulfate, beta-sympathomimetics, and nifedipine. Other causes include placental implantation site in the lower uterine segment, bacterial toxins (eg, chorioamnionitis, endomyometritis, septicemia), hypoxia due to hypoperfusion or Couvelaire uterus in abruptio placentae, and hypothermia ue to massive resuscitation or prolonged uterine exteriorization. Recent data suggest that grand multiparity is not an independent risk factor for PPH. - Tissue Uterine contraction and retraction leads to detachment and expulsion of the placenta. Complete detachment and expulsion of the placenta permits continued retraction and optimal occlusion of blood vessels. Retention of a portion of the placenta is more common if th e placenta has developed with a succenturiate or accessory lobe. Following delivery of the placenta and when minimal bleeding is present, the placenta should be inspected for evidence of fetal vessels coursing to the placental edge and abruptly ending at a tear in the membranes. Such a finding suggests a retained succenturiate lobe. The placenta is more likely to be retained at extreme preterm gestations (especially lt; 24 wk), and significant bleeding can occur. This should be a consideration in all deliveries at very early gestations, whether they are spontaneous or induced. Recent trials suggest that the use of misoprostol for second trimester termination of pregnancy leads to a marked reduction in the rate of retained placenta when compared to techniques using the intrauterine instillation of prostaglandin or hypertonic saline. [13]  One such trial reported rates of retained placenta requiring Damp;C of 3. 4% with oral misoprostol compared to 22. 4% using intra-amniotic prostaglandin (p=0. 002). [14] Failure of complete separation of the placenta occurs in placenta accreta and its variants. In this condition, the placenta has invaded beyond the normal cleavage plane and is abnormally adherent. Significant bleeding from the area where normal attachment (and now detachment) has occurred may mark partial accreta. Complete accreta in which the entire surface of the placenta is abnormally attached, or more severe invasion (placenta increta or percreta), may not initially cause severe bleeding, but it may develop as more aggressive efforts are made to remove the placenta. This condition should be considered possible whenever the placenta is implanted over a previous uterine scar, especially if associated with placenta previa. All patients with placenta previa should be informed of the risk of severe PPH, including the possible need for transfusion and hysterectomy. Finally, retained blood may cause uterine distension and prevent effective contraction. - Trauma Damage to the genital tract may occur spontaneously or through manipulations used to deliver the baby. Cesarean delivery results in twice the average blood loss of vaginal delivery. Incisions in the poorly contractile lower segment heal well but are more reliant on suturing, vasospasm, and clotting for hemostasis. Uterine rupture is most common in patients with previous cesarean delivery scars. Routine transvaginal palpation of such scars is no longer recommended. Any uterus that has undergone a procedure resulting in a total or thick partial disruption of the uterine wall should be considered at risk for rupture in a future pregnancy. This admonition includes fibroidectomy; uteroplasty for congenital abnormality; cornual or cervical ectopic resection; and perforation of the uterus during dilatation, curettage, biopsy, hysteroscopy, laparoscopy, or intrauterine contraceptive device placement. Trauma may occur following very prolonged or vigorous labor, especially if the patient has relative or absolute cephalopelvic disproportion and the uterus has been stimulated with oxytocin or prostaglandins. Using intrauterine pressure monitoring may lessen this risk. Trauma also may occur following extrauterine or intrauterine manipulation of the fetus. The highest risk is probably associated with internal version and extraction of a second twin; however, uterine rupture may also occur secondary to external version. Finally, trauma may result secondary to attempts to remove a retained placenta manually or with instrumentation. The uterus should always be controlled with a hand on the abdomen during any such procedure. An intraumbilical vein saline/oxytocin or saline/misoprostol injection may reduce the need for more invasive removal techniques. [7] Cervical laceration is most commonly associated with forceps delivery, and the cervix should be inspected following all such deliveries. Assisted vaginal delivery (forceps or vacuum) should never be attempted without the cervix being fully dilated. Cervical laceration may occur spontaneously. In these cases, mothers have often been unable to resist bearing down before full cervical dilatation. Rarely, manual exploration or instrumentation of the uterus may result in cervical damage. Very rarely, the cervix is purposefully incised at the 2- and/or 10-o’clock positions to facilitate delivery of an entrapped fetal head during a breech delivery (Duhrssen incision). Vaginal sidewall laceration is also most commonly associated with operative vaginal delivery, but it may occur spontaneously, especially if a fetal hand presents with the head. Lacerations may occur during manipulations to resolve shoulder dystocia. Lacerations often occur in the region overlying the ischial spines. The frequency of sidewall and cervical lacerations has probably decreased in recent years because of the reduction in the use of midpelvic forceps and, especially, midpelvic rotational procedures. Lower vaginal trauma occurs either spontaneously or because of episiotomy. Spontaneous lacerations usually involve the posterior fourchette; however, trauma to the periurethral and clitoral region may occur and can be problematic. Thrombosis In the immediate postpartum period, disorders of the coagulation system and platelets do not usually result in excessive bleeding; this emphasizes the efficiency of uterine contraction and retraction for preventing hemorrhage. [5]  Fibrin deposition over the placental site and clots within supplying vessels play a significant role in the hours and days following delivery, and abnormalities in these areas can lea d to late PPH or exacerbate bleeding from other causes, most notably, trauma. Abnormalities may be preexistent or acquired. Thrombocytopenia may be related to preexisting disease, such as idiopathic thrombocytopenic purpura, or acquired secondary to HELLP syndrome (hemolysis, elevated liver enzymes, and low platelet count), abruptio placentae, disseminated intravascular coagulation (DIC), or sepsis. Rarely, functional abnormalities of platelets may also occur. Most of these are preexisting, although sometimes previously undiagnosed. Preexisting abnormalities of the clotting system, such as familial hypofibrinogenemia and von Willebrand disease, may occur and should be considered. An expert panel recently issued guidelines to aid in the diagnosis and management of women with such conditions. [15]  An underlying bleeding disorder should be considered in a woman with any of the following: menorrhagia since menarche, family history of bleeding disorders, personal history of notable bruising without known injury, bleeding from the oral cavity or GI tract without obvious lesion, or epistaxis of longer than 10 minutes duration (possibly requiring packing or cautery). If a bleeding disorder is suspected, consultation is suggested. Acquired abnormalities are more commonly problematic. DIC related to abruptio placentae, HELLP syndrome, intrauterine fetal demise, amniotic fluid embolism, and sepsis may occur. Fibrinogen levels are markedly elevated during pregnancy, and a fibrinogen level that would be in the reference range in the nonpregnant state should be viewed with suspicion in the aforementioned clinical scenarios. Finally, dilutional coagulopathy may occur following massive PPH and resuscitation with crystalloid and packed red blood cells (PRBCs). Risk factors and associated conditions for PPH are listed above; however, a large number of women experiencing PPH have no risk factors. Different etiologies may have common risk factors, and this is especially true of uterine atony and trauma of the lower genital tract. PPH usually has a single cause, but more than one cause is also possible, most likely following a prolonged labor that ultimately ends in an operative vaginal birth. Prevention High-quality evidence suggests that active management of the third stage of labor reduces the incidence and severity of PPH. 8]  Active management is the combination of (1) uterotonic administration (preferably oxytocin) immediately upon delivery of the baby, (2) early cord clamping and cutting, and (3) gentle cord traction with uterine countertraction when the uterus is well contracted (ie, Brandt-Andrews maneuver). The value of active management in the prevention of PPH cannot be overstated (see  Management of the Third Stage of Labor). The use of active versus expectant management in the third stage was the subject of 5 randomized controlled trials (RCTs) and a Cochrane meta-analysis. 16, 7, 8]  These trials included more than 6000 women, and the findings are summarized in Table 1. Table 1. Benefits of Active Management Versus Expectant Management  (Open Table in a new window) Outcome| Control Rate, %| Relative Risk| 95% CI*| NNT  Ã¢â‚¬  | 95% CI| PPH of 500 mL| 14| 0. 38| 0. 32-0. 46| 12| 10-14| PPH of 1000 mL| 2. 6| 0. 33| 0. 21-0. 51| 55| 42-91| Hemoglobin lt; 9 g/dL| 6. 1| 0. 4| 0. 29-0. 55| 27| 20-40| Blood transfusion| 2. 3| 0. 44| 0. 22-0. 53| 67| 48-111| Therapeutic uterotonics| 17| 0. 2| 0. 17-0. 25| 7| 6-8| *CI: Confidence interval †  NNT: Number needed to treat The findings show a conclusive benefit for active management, with an approximate 60% reduction in the occurrence of PPH greater than or equal to 500 mL and 1000 mL, hemoglobin concentration of less than 9 g/dL at 24-48 hours after del ivery, and the need for blood transfusion. An 80% reduction in the need for therapeutic uterotonic agents was noted. These results were all highly significant as indicated by the 95% confidence interval figures. The results indicate that for every 12 patients receiving active rather than physiological management, one PPH would be prevented. For every 67 patients so treated, one patient would avoid transfusion with blood products. One concern regarding active management is that retained placenta may occur more frequently. This concern is not supported by the trials. This is especially true if oxytocin is used as the uterotonic. [17, 18]  The US RCTs mentioned above compared the use of active management protocols in which the oxytocin was administered either immediately after delivery of the baby or immediately after delivery of the placenta. The authors stated that no statistically significant difference was noted in the PPH rate and that delaying administration until after placental delivery was justified. Noteworthy is the finding that early administration of oxytocin (before placental delivery) did not increase the rate of retained placenta. Additionally, the trial showed trends toward a benefit for early administration of oxytocin, including a 25% reduction in PPH and a 50% reduction in the need for transfusion. [9]  These findings are clearly consistent with the previous RCTs and the early administration of oxytocin with delivery of the baby is strongly recommended. They also stated that administration with delivery of the baby did not increase the rate of retained placenta, but they did not point out that this finding clearly supports early administration. Additionally, the trial showed trends toward a benefit for early administration of oxytocin, including a 25% reduction in PPH and a 50% reduction in the need for transfusion. [9]  These differences may be due to chance, but, given the results of the previous RCTs, the administration of oxytocin with delivery of the baby would seem to be strongly warranted. Following delivery, administering a uterotonic drug that lasts at least 2-3 hours is reasonable. [3]  This could be 10 U of oxytocin in 500 mL of intravenous fluid by continuous drip, 200-250 mcg of ergonovine intramuscularly, or 250 mcg of 15-methyl prostaglandin F2-alpha (carboprost [Hemabate]) intramuscularly. The use of misoprostol and a long-acting oxytocin analogue (carbetocin) is being studied for this use. [19]  It has been suggested that distribution of misoprostol ahead of childbirth in communities where home birth is unavoidable can be an effective approach. However, there is insufficient evidence to support this and there are concerns that the drug might be used for starting labor or terminating pregnancy. [20] The presence of significant antepartum or intrapartum risk factors warrants delivery in maternity units that have readily available resources to deal with massive obstetric hemorrhage. All medical facilities should have protocols for dealing with PPH and obstetric hemorrhage. Pathophysiology Over the course of a pregnancy, maternal blood volume increases by approximately 50% (from 4 L to 6 L). The plasma volume increases somewhat more than the total RBC volume, leading to a fall in the hemoglobin concentration and hematocrit value. The increase in blood volume serves to fulfill the perfusion demands of the low-resistance uteroplacental unit and to provide a reserve for the blood loss that occurs at delivery. [6] At term, the estimated blood flow to the uterus is 500-800 mL/min, which constitutes 10-15% of cardiac output. Most of this flow traverses the low-resistance placental bed. The uterine blood vessels that supply the placental site traverse a weave of myometrial fibers. As these fibers contract following delivery, myometrial retraction occurs. Retraction is the unique characteristic of the uterine muscle to maintain its shortened length following each successive contraction. The blood vessels are compressed and kinked by this crisscross latticework, and, normally, blood flow is quickly occluded. This arrangement of muscle bundles has been referred to as the living ligatures or physiologic sutures of the uterus. [5] Uterine atony is a failure of the uterine myometrial fibers to contract and retract. This is the most important cause of PPH and usually occurs immediately following delivery of the baby, up to 4 hours after the delivery. Trauma to the genital tract (ie, uterus, uterine cervix, vagina, labia, clitoris) in pregnancy results in significantly more bleeding than would occur in the nonpregnant state because of increased blood supply to these tissues. The trauma specifically related to the delivery of the baby, either vaginally in a spontaneous or assisted manner or by cesarean delivery, can also be substantial and can lead to significant disruption of soft tissue and tearing of blood vessels. Presentation Although the presentation of PPH is most often dramatic, bleeding may be slower and seemingly less noteworthy but may still ultimately result in critical loss and shock. This is more likely to be true of bleeding secondary to retained tissue or trauma. Nursing practices for routine care in the postpartum period should include close observation and documentation of maternal vital signs and condition, vaginal blood loss, and uterine tone and size. The uterus should be periodically massaged to express any clots that have accumulated in the uterus or vagina. 21] The usual presentation of PPH is one of heavy vaginal bleeding that can quickly lead to signs and symptoms of hypovolemic shock. This rapid blood loss reflects the combination of high uterine blood flow and the most common cause of PPH, ie, uterine atony. Blood loss is usually visible at the introitus, and this is especially true if the placenta has delivered. If the placenta remains in situ, then a significant amoun t of blood can be retained in the uterus behind a partially separated placenta, the membranes, or both. Even after placental delivery, blood may collect in an atonic uterus. For this reason, the uterine size and tone should be monitored throughout the third stage and in the so-called fourth stage, following delivery of the placenta. This is accomplished by gently palpating the uterine fundus. If the cause of bleeding is not uterine atony, then blood loss may be slower and clinical signs and symptoms of hypovolemia may develop over a longer time frame. Bleeding from trauma may be concealed in the form of hematomas of the retroperitoneum, broad ligament or lower genital tract, or abdominal cavity. The clinical findings in hypovolemia are listed in Table 2. Table 2. Clinical Findings in Obstetric Hemorrhage[22]  (Open Table in a new window) Blood Volume Loss| Blood Pressure (systolic)| Symptoms and Signs| Degree of Shock| 500-1000 mL (10-15%)| Normal| Palpitations, tachycardia, dizziness| Compensated| 1000-1500 mL (15-25%)| Slight fall (80-100 mm Hg)| Weakness, tachycardia, sweating| Mild| 1500-2000 mL (25-35%)| Moderate fall (70-80 mm Hg)| Restlessness, pallor, oliguria| Moderate| 2000-3000 mL (35-50%)| Marked fall (50-70 mm Hg)| Collapse, air hunger, anuria| Severe| Two important facts are worth bearing in mind. The first is that caregivers consistently underestimate visible blood loss by as much as 50%. The volume of any clotted blood represents half of the blood volume required to form the clots. The second is that most women giving birth are healthy and compensate for blood loss very well. This, combined with the fact that the most common birthing position is some variant of semirecumbent with the legs elevated, means that symptoms of hypovolemia may not develop until a large volume of blood has been lost. 23] Rapid recognition and diagnosis of PPH is essential to successful management. Resuscitative measures and the diagnosis and treatment of the underlying cause must occur quickly before sequelae of severe hypovolemia develop. The major factor in the adverse outcomes associated with severe hemorrhage is a delay in initiating appropriate management. Contraindications Other than nonconsent, absence of surgical expertise or allergy to specific agents, the techniques used in the management of PPH have no absolute contraindications. The vast majority of cases (gt;99%) are handled without what would traditionally be considered surgical intervention. In most cases, surgical intervention is a last resort. An exception is those cases in which uterine rupture or genital tract trauma has occurred and surgical repair is clearly indicated. Transfusion of packed RBC and other blood products may be necessary in the management of severe PPH. Some women may refuse such an intervention on personal or religious grounds. The most widely known group that does not accept blood transfusion are Jehovah’s Witnesses. The wishes of the patient must be respected in this matter. Significant increased risk of maternal mortality due to obstetric hemorrhage has been noted in the Jehovah’s Witness population. The increased risk of death was found to be 6-fold in a recent national review of 23 years experience in the Netherlands and 44-fold in a much smaller study of 391 deliveries in a US tertiary level center. 24, 25]  Discussion regarding the implications of such prohibitions should be undertaken early in the pregnancy whenever possible and subsequently reviewed. In almost all cases in which surgical management is chosen after medical management has failed, not attempting surgery would lead to maternal death. Even an unstable condition cannot be considered a true contraindication. One type of surgery may be chosen over another, but when medical management has failed, surgery is most likely the o nly life-saving option. Proceed to  Workup READ MORE ABOUT POSTPARTUM HEMORRHAGE ON MEDSCAPE RELATED REFERENCE TOPICS * Postpartum Hemorrhage in Emergency Medicine * Hypogastric Artery Ligation * Bakri Balloon Placement| RELATED NEWS AND ARTICLES * Haemostatic Monitoring During Postpartum Haemorrhage and Implications for Management * Dose and Side Effects of Sublingual Misoprostol for Treatment of Postpartum Hemorrhage * Uterine Balloon Effective for Post-Partum Hemorrhage in Developing Countries| About Medscape Reference References 1. Berg CJ, Atrash HK, Koonin LM, Tucker M. Pregnancy-related mortality in the United States, 1987-1990. Obstet Gynecol. 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Rogers J, Wood J, McCandlish R, Ayers S, Truesdale A, Elbourne D. Active versus expectant management of third stage of labour: the Hinchingbrooke randomised controlled trial. Lancet. Mar 7 1998;351(9104):693-9. [Medline]. 8. Prendiville WJ, Elbourne D, McDonald S. Active versus expectant management in the third stage of labour. Cochrane Database Syst Rev. 2000;CD000007. [Medline]. 9. Jackson KW Jr, Allbert JR, Schemmer GK, Elliot M, Humphrey A, Taylor J. A randomized controlled trial comparing oxytocin administration before and after placental delivery in the prevention of postpartum hemorrhage. Am J Obstet Gynecol. Oct 2001;185(4):873-7. [Medline]. 10. Sheiner E, Sarid L, Levy A, Seidman DS, Hallak M. Obstetric risk factors and outcome of pregnancies complicated with early postpartum hemorrhage: a population-based study. J Matern Fetal Neonatal Med. Sep 2005;18(3):149-54. [Medline]. 11. Blomberg M. Maternal obesity and risk of postpartum hemorrhage. Obstet Gynecol. 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Xiong X, Buekens P, Alexander S, Demianczuk N, Wollast E. Anemia during pregnancy and birth outcome: a meta-analysis. Am J Perinatol. 2000;17(3):137-46. [Medline]. 27. Stainsby D, MacLennan S, Hamilton PJ. Management of massive blood loss: a template guideline. Br J Anaesth. Sep 2000;85(3):487-91. [Medline]. 28. Bonnar J. Massive obstetric haemorrhage. Baillieres Best Pract Res Clin Obstet Gynaecol. Feb 2000;14(1):1-18. [Medline]. 29. Stoneham MD. An evaluation of methods of increasing the flow rate of i. v. fluid administration. Br J Anaesth. Sep 1995;75(3):361-5. [Medline]. 30. Choi PT, Yip G, Quinonez LG, Cook DJ. Crystalloids vs. olloids in fluid resuscitation: a systematic review. Crit Care Med. Jan 1999;27(1):200-10. [Medline]. 31. Roberts I, Alderson P, Bunn F, Chinnock P, Ker K, Schierhout G. Colloids versus crystalloids for fluid resuscitation in critically ill patients. Cochrane Database Syst Rev. Oct 2004;18:(4):CD000567. 32. Hewitt PE, Machin SJ. Massive blood transfusion. In:  ABC or Tran sfusion. London, England: BMJ Publishing; 1998:49-52. 33. Hughes DB, Ullery BW, Barie PS. The contemporary approach to the care of Jehovahs witnesses. J Trauma. Jul 2008;65(1):237-47. [Medline]. 34. Atoyebi W, Mundy N, Croxton T, Littlewood TJ, Murphy MF. Is it necessary to administer anti-D to prevent RhD immunization after the transfusion of RhD-positive platelet concentrates?. Br J Haematol. Dec 2000;111(3):980-3. [Medline]. 35. Franchini M, Franchi M, Bergamini V, Salvagno GL, Montagnana M, Lippi G. A critical review on the use of recombinant factor VIIa in life-threatening obstetric postpartum hemorrhage. Semin Thromb Hemost. Feb 2008;34(1):104-12. [Medline]. 36. Ahonen J, Jokela R, Korttila K. An open non-randomized study of recombinant activated factor VII in major postpartum haemorrhage. Acta Anaesthesiol Scand. Aug 2007;51(7):929-36. [Medline]. 37. Franchini M, Manzato F, Salvagno GL, Lippi G. Potential role of recombinant activated factor VII for the treatment of severe bleeding associated with disseminated intravascular coagulation: a systematic review. Blood Coagul Fibrinolysis. Oct 2007;18(7):589-93. [Medline]. 38. Gibbins KJ, Albright CM, Rouse DJ. Postpartum hemorrhage in the developed world: whither misoprostol?. Am J Obstet Gynecol. Aug 1 2012;[Medline]. 39. OBrien P, El-Refaey H, Gordon A, Geary M, Rodeck CH. Rectally administered misoprostol for the treatment of postpartum hemorrhage unresponsive to oxytocin and ergometrine: a descriptive study. Obstet Gynecol. Aug 1998;92(2):212-4. [Medline]. 40. Lokugamage AU, Sullivan KR, Niculescu I, et al. A randomized study comparing rectally administered misoprostol versus Syntometrine combined with an oxytocin infusion for the cessation of primary post partum hemorrhage. Acta Obstet Gynecol Scand. Sep 2001;80(9):835-9. [Medline]. 41. Vaid A, Dadhwal V, Mittal S, Deka D, Misra R, Sharma JB. A randomized controlled trial of prophylactic sublingual misoprostol versus intramuscular methyl-ergometrine versus intramuscular 15-methyl PGF2alpha in active management of third stage of labor. Arch Gynecol Obstet. Mar 11 2009;[Medline]. 42. Gulmezoglu AM, Forna F, Villar J, Hofmeyr GJ. Prostaglandins for preventing postpartum haemorrhage. Cochrane Database Syst Rev. 2007/07;18;(3):CD000494. 43. [Best Evidence] Winikoff B, Dabash R, Durocher J, Darwish E, Nguyen TN, Leon W, et al. Treatment of post-partum haemorrhage with sublingual misoprostol versus oxytocin in women not exposed to oxytocin during labour: a double-blind, randomised, non-inferiority trial. Lancet. Jan 16 2010;375(9710):210-6. [Medline]. 44. [Best Evidence] Attilakos G, Psaroudakis D, Ash J, Buchanan R, Winter C, Donald F, et al. Carbetocin versus oxytocin for the prevention of postpartum haemorrhage following caesarean section: the results of a double-blind randomised trial. BJOG. Jul 2010;117(8):929-36. [Medline]. 45. Criscuolo JL, Kibler MP, Micholet S, et al. [The value of antibiotic prophylaxis during intrauterine procedures during vaginal delivery. A comparative study of 500 patients]. J Gynecol Obstet Biol Reprod (Paris). 1990;19(7):909-18. [Medline]. 46. Hallak M, Dildy GA 3rd, Hurley TJ, Moise KJ Jr. Transvaginal pressure pack for life-threatening pelvic hemorrhage secondary to placenta accreta. Obstet Gynecol. Nov 1991;78(5 Pt 2):938-40. [Medline]. 7. Maier RC. Control of postpartum hemorrhage with uterine packing. Am J Obstet Gynecol. Aug 1993;169(2 Pt 1):317-21; discussion 321-3. [Medline]. 48. Seror J, Allouche C, Elhaik S. Use of Sengstaken-Blakemore tube in massive postpartum hemorrhage: a series of 17 cases. Acta Obstet Gynecol Scand. Jul 2005;84(7):660-4. [Medline]. 49. Akhter S, Begum MR, Ka bir Z, Rashid M, Laila TR, Zabeen F. Use of a condom to control massive postpartum hemorrhage. MedGenMed. Sep 11 2003;5(3):38. [Medline]. 50. Brees C, Hensleigh PA, Miller S, Pelligra R. A non-inflatable anti-shock garment for obstetric hemorrhage. Int J Gynaecol Obstet. Nov 2004;87(2):119-24. [Medline]. 51. Johanson R, Kumar M, Obhrai M, Young P. Management of massive postpartum haemorrhage: use of a hydrostatic balloon catheter to avoid laparotomy. BJOG. Apr 2001;108(4):420-2. [Medline]. 52. Propst AM, Thorp JM Jr. Traumatic vulvar hematomas: conservative versus surgical management. South Med J. Feb 1998;91(2):144-6. [Medline]. 53. Lingam K, Hood V, Carty MJ. Angiographic embolisation in the management of pelvic haemorrhage. BJOG. Sep 2000;107(9):1176-8. [Medline]. 54. Stanco LM, Schrimmer DB, Paul RH, Mishell DR Jr. Emergency peripartum hysterectomy and associated risk factors. Am J Obstet Gynecol. Mar 1993;168(3 Pt 1):879-83. [Medline]. 55. Zelop CM, Harlow BL, Frigoletto FD Jr, Safon LE, Saltzman DH. Emergency peripartum hysterectomy. Am J Obstet Gynecol. May 1993;168(5):1443-8. [Medline]. 56. Doumouchtsis SK, Papageorghiou AT, Arulkumaran S. Systematic review of conservative management of postpartum hemorrhage: what to do when medical treatment fails. Obstet Gynecol Surv. Aug 2007;62(8):540-7. [Medline]. 57. Plauche WC. Peripartal Hysterectomy. In: Plauche WC, Morrison JC, OSullivan MJ, eds. Surgical Obstetrics. Philadelphia, Pa: WB Saunders; 1992:447-65. 58. OLeary JA. Uterine artery ligation in the control of postcesarean hemorrhage. J Reprod Med. Mar 1995;40(3):189-93. [Medline]. 59. AbdRabbo SA. Stepwise uterine devascularization: a novel technique for management of uncontrolled postpartum hemorrhage with preservation of the uterus. Am J Obstet Gynecol. Sep 1994;171(3):694-700. [Medline]. 60. Clark SL, Phelan JP, Yeh SY, Bruce SR, Paul RH. Hypogastric artery ligation for obstetric hemorrhage. Obstet Gynecol. Sep 1985;66(3):353-6. [Medline]. 61. Floyd RC, Morrison JC. Postpartum Hemorrhage. In: Plauche WC, Morrison JC, OSullivan MJ, eds. Surgical Obstetrics. Philadelphia, Pa: WB Saunders; 1992:373-82. 62. Vedantham S, Goodwin SC, McLucas B, Mohr G. Uterine artery embolization: an underused method of controlling pelvic hemorrhage. Am J Obstet Gynecol. Apr 1997;176(4):938-48. [Medline]. 63. Pelage JP, Le Dref O, Mateo J, et al. Life-threatening primary postpartum hemorrhage: treatment with emergency selective arterial embolization. Radiology. Aug 1998;208(2):359-62. [Medline]. 64. Chauleur C, Fanget C, Tourne G, Levy R, Larchez C, Seffert P. Serious primary post-partum hemorrhage, arterial embolization and future fertility: a retrospective study of 46 cases. Hum Reprod. Jul 2008;23(7):1553-9. [Medline]. 65. B-Lynch C, Coker A, Lawal AH, Abu J, Cowen MJ. The B-Lynch surgical technique for the control of massive postpartum haemorrhage: an alternative to hysterectomy? Five cases reported. Br J Obstet Gynaecol. Mar 1997;104(3):372-5. [Medline]. 66. Price N, B-Lynch C. Technical description of the B-Lynch brace suture for treatment of massive postpartum hemorrhage and review of published cases. Int J Fertil Womens Med. Jul-Aug 2005;50(4):148-63. [Medline]. 67. Hayman RG, Arulkumaran S, Steer PJ. Uterine compression sutures: surgical management of postpartum hemorrhage. Obstet Gynecol. Mar 2002;99(3):502-6. Medline]. 68. Cho JH, Jun HS, Lee CN. Hemostatic suturing technique for uterine bleeding during cesarean delivery. Obstet Gynecol. Jul 2000;96(1):129-131. [Medline]. 69. Dildy GA 3rd. Postpartum hemorrhage: new management options. Clin Obstet Gynecol. Jun 2002;45(2):330-44. [Medline]. 70. Wilkinson C, Enkin MW. Manual removal of placenta at caesarean s ection. Cochrane Database Syst Rev. Jul 18 2007;(3):CD000130. 71. Anorlu RI, Maholwana B, Hofmeyr GJ. Methods of delivering the placenta at caesarean section. Cochrane Database Syst Rev. Jul 16 2008;(3):CD004737. 72. Royal College of Obstetricians and Gynaecologists. Green-top guideline no 27. Placenta Praevia: Diagnosis and Management. Available at: http://www. rcog. org. uk/guidelines. asp? PageID=106amp;GuidelineID=17. London, England: RCOG Press; 2001:[Full Text]. 73. Descargues G, Douvrin F, Degre S, Lemoine JP, Marpeau L, Clavier E. Abnormal placentation and selective embolization of the uterine arteries. Eur J Obstet Gynecol Reprod Biol. Nov 2001;99(1):47-52. [Medline]. 74. Cook DJ, Reeve BK, Guyatt GH, et al. Stress ulcer prophylaxis in critically ill patients. Resolving discordant meta-analyses. JAMA. Jan 24-31 1996;275(4):308-14. [Medline]. 75. Smaill F, Hofmeyr GJ. Antibiotic prophylaxis for cesarean section. Cochrane Database Syst Rev. 2002;CD000933. [Medline]. 76. American College of Obstetricians and Gynecologists. ACOG educational bulletin. Postpartum hemorrhage. Number 243, January 1998 (replaces No. 143, July 1990). American College of Obstetricians and Gynecologists. Int J Gynaecol Obstet. Apr 1998;61(1):79-86. [Medline]. 77. Begley CM. A comparison of active and physiological management of the third stage of labour. Midwifery. Mar 1990;6(1):3-17. [Medline]. 78. Enkin M, Keirse M, Neilson J, et al, eds. A Guide to Effective Care in Pregnancy and Childbirth. 3rd  ed. Oxford, England: Oxford University Press; 2000. 79. Lewis G, Drife J, eds. Hemmorhage. In:  Why Mothers Die 1997-1999: The Confidential Enquiries into Maternal Deaths in the United Kingdom. London, England: RCOG Press; 2001:94-103. 80. Prendiville WJ, Harding JE, Elbourne DR, Stirrat GM. The Bristol third stage trial: active versus physiological management of third stage of labour. BMJ. Nov 19 1988;297(6659):1295-300. [Medline]. 81. Villar J, Gulmezoglu AM, Hofmeyr GJ, Forna F. Systematic review of randomized controlled trials of misoprostol to prevent postpartum hemorrhage. Obstet Gynecol. Dec 2002;100(6):1301-12. [Medline].

How to Use the German Personal Pronoun Es

How to Use the German Personal Pronoun Es The German personal pronoun es is the English equivalent of it and has similar functions. It is mostly a substitute for a noun and can: Act as a subject, therefore be in the nominative case.As a subject es can be placed either before or after the verb.Es donnert in der Ferne - It is thundering in the distance.In der Ferne donnert es.Act as an object, therefore be in the accusative case.Its position can sometimes be changed, either after the verb or after the subject.Das Fernsehen ist kaputt. Ich werde es morgen reparieren - The t.v. is broken. I will fix it tomorrow.Morgen werde ich es reparieren.But not changeable with the following sentence:Das Kind weint. Ich beruhige es - The child is crying. Im consoling him/her. See Personal Pronoun Chart for a listing of es in all cases. Es is used in daily conversation such as when describing the weather or stating the time. Es ​however, is used more often in German. Also, not only can the position of es be changed, it can even be eliminated, depending on its function.See the following functions of es, take note of the similarities with English, learn the differences and then practice with this exercise. Es Functions Similar To English: When describing the weather.Es schneit heute - It is snowing.Es hagelt sehr viel - It is hailing a lot.When describing time.Wie spt ist es? What time is it?Es ist viertel vor acht - It is a quarter to eight.When describing things.Es ist weich - It is soft.Es schmeckt gut - It tastes good.Describing smells/dynamics of noises.Es stinkt hier - It stinks here.Es duftet schà ¶n - It smells nice.Es ist laut - It is loud.Es ist sehr still jetzt - It is very still/quiet now.However more specific noise descriptions usually cant be translated with it, such as:Es rauscht draußen - Theres a rustling outside.Um Mitternacht gibt es immer ein Klopfen an meiner Tà ¼r - At midnight, there is always a knocking at my door.To introduce a general remark/statement:Es ist schwierig heutzutage Arbeit zu finden - It is difficult nowadays to find work.Es ist wichtig organisiert zu sein - It is important to be organized.Es stà ¶rt mich - It disturbs me.To introduce a subsequent subordinate clause:Ich f inde es schrecklich, dass sie nicht essen will - I find it awful that she does not want to eat.However, when that same clause is placed at the beginning of the sentence, es will no longer be used: Dass sie nicht essen will, finde ich schrecklich.

Effect on Restaurant Tipping of a Helpful Message Written on the Back Research Paper

Effect on Restaurant Tipping of a Helpful Message Written on the Back of Customers Checks - Research Paper Example icle entitled Effect on Restaurant Tipping of a Helpful Message Written on the Back of Customers’ Checks written by Rind & Strohmetz (1999) aimed to determine the effect of a written message at the back of customer’s checks on the amount of tips given to restaurant servers. The participants of the research were eighty one dining parties who ate at a northern New Jersey restaurant. The study was conducted over a three-week time period from March to April of 1997 with only one female server as actively involved in the process. The findings revealed a consistency with the author’s hypothesis that writing at the back of the customers’ checks would increase the amount of tips given to the server. The article based its theoretical framework from previous researches in the field of restaurant operations, particularly on tipping as additional sources of income for servers (Lynn & Mynier, 1993; Schmidt, 1985). Found at the beginning of the article, right after the introductory paragraph, the conceptualization stage presented references to various previous researches on the subject. An article (Statistical Abstracts, 1990) was cited to indicate the number of people working in the United States as waiters or waitresses. Other studies mentioned factors affecting tipping in the restaurant industry (Rind & Bordia, 1996) and server-diner interactions which entailed writing simple messages, like â€Å"Thank You† at the back of the customers’ checks as having influenced the amount of tip percentages given to servers (Rind & Bordia, 1995). The current research aims to present a parallel study on check manipulation by designing two conditions: written message by one female server with the message informing the customers of a good deal in future dining experience; versus no message written at the back of the check. The study employed an experimental method of research with statistical and correlational analysis. The experimental method was designed according to two

Agriculture and the European Union Essay Example | Topics and Well Written Essays - 3500 words

Agriculture and the European Union - Essay Example The European Union (EU) has undergone a great deal of renegotiations over the past several decades, indeed changing its own titles and formats until finally it resembled the EU of today; a European-wide economic organization focused on the homogenisation of the European economic state. The purpose of this supranationalism has been simply to increase trade throughout Europe and to facilitate this goal it has been the duty of EU government officials to closely monitor agricultural policies in member states. In 2004, the European enlargement agreement was drafted so that the organisation might have some framework from which to actually govern the growing EU, with member states reaching from Great Britain right into eastern Europe as ex-Soviet states bid for entry1. In terms of the established Common Agricultural Policy (CAP) of the EU, the enlargement has directly affected original EU members in that CAP subsidies arranged prior to the expansion were immediately lessened and a new level of standardisation was created as new countries gained access to EU funding and official economic policies. Because of the enlargement, EU nations are currently facing reforms in terms of trade prices, environmental agendas, animal welfare and the further industrialisation and eventual commercialisation of member states. How the EU deals with modernised agricultural policies will directly affect the stability of the EU in general and the position of its influence in world affairs. In terms of the CAP today, it seems that this nearly 60 year old agreement is failing when it comes to the best economic options for EU members.Negotiations have been happening for years to organise a European-wide marketplace, and so far the EU is the only large-scale organisation of this sort in the world. To enhance failing economies within the continent and ultimately to create a strong market that was viable on the world stage, European nations thought it in their best interests to band together and develop trade laws that would benefit each nation in the long run. This organisation meant the standardisation of various levels of economy so that prices could be stabilised and producers might receive the government aid needed to keep working. Jonsson and Elgstrom explain how the term 'multi-level governance' is used in terms of the EU to encompass the awkward arrangement of government officials and local policy2. Essentially, this multi-level government is exactly what the EU legislation is based upon and it's the largest economic organisation of its kind in the entire world. EU officiates must tend to supranational matters while still leaving an allowable measure of sovereignty to each member state in terms of national law and municipal issues. In terms of agriculture and human rights, however, ultimately the EU holds precedent over national level government if a committee or individual does approach it. It is the wish of the EU organisation that each of its member countries adhere strictly to trade and practical agreements in such a way that promotes equality between citizens and fair standards of living and economics for individuals and businesses throughout the realm. If a state is found to be acting in a manner not i n keeping with these principles of human rights, animal rights and safe practices then it faces sanctions by EU legislature. EU Enlargement Before 2002, the EU had a stable 15 members and it wanted more. In terms of membership, there was no shortage of interested nations, particularly in the eastern half of the continent, but officials realised that if they were to suddenly expand their numbers it would become necessary to share their current supranational income with poorer countries. Cowles and Smith explain that at the turn of the new millennium, it was expected of EU officiates to work towards two basic goals; monetary

The characterisation of Lady Macbeth Essay Example for Free

The characterisation of Lady Macbeth Essay Compare and contrast the way in which the characterisation of Lady Macbeth and the setting and atmosphere are developed in three productions of act 1 scene 5 Macbeth was performed for James I in August 1606 at Hampton court. He was asked to be King of England by Queen Elizabeth I when she was dying, because she didnt have any children to become her successor and he was the closest heir. James VI of Scotland became James I of England in 1603 after Queen Elizabeths death. Shakespeare based the story Macbeth on a book called, The History of Scotland written by Raphael Holinshed. In this true story Banquo helped Macbeth kill Duncan but because James was a descendant of Banquo, Shakespeare thought it would be indiscreet to suggest that one of Jamess ancestors had committed regicide. Duncans son Malcolm killed Macbeth in real life where as Macduff killed him in the play. The witches were added more into the play because James wrote a book about witches. The Elizabethans were also very interested in witchcraft and the supernatural. Macbeth is a story about regicide. In Shakespeares time the people thought that regicide was the greatest crime anyone could commit. They thought that God appointed kings to rule over the kingdom and any attack towards them meant that they were attacking God. In Macbeths letter he tells Lady Macbeth everything they do not have any secrets from each other. In the play Lady Macbeth thinks that Macbeth is too kind to murder Duncan and become king rather than waiting until he dies normally. Yet I fear thy nature; it is too full o the milk of human kindness to catch the nearest way. She is thinking that she has to control Macbeth to murder Duncan. Hie thee hither, that I may pour my spirits in thine ear. She wants to drive away all the things that would stop him being king. And chastise with the valour of my tongue all that impedes thee from the golden round. She wants to take away all her feminine values and replace them with pure evil to become a sexless, pitiless fiend so she can be able to commit such a great crime. Unsex me here, and fill me from the crown to the toe top-full of direst cruelty. She makes him ignore the fear of no afterlife in order to become king. As soon as she hears that Duncan is coming, she talks about killing him. O never shall sun that morrow see! she is telling him to hide the fact that they are going to kill Duncan from him but still be thinking it. Look like the innocent flower but be the serpent undert. She is trying to control Macbeth to kill Duncan just after she has heard that he is coming. And you shall put this nights great business into my dispatch. In the Royal Shakespeare Production Lady Macbeth is powerful, she can control what Macbeth does, she manipulates him with sexual persuasion to do what she wants him to do. She turns away from him and makes him move to her, this shows that she has power over Macbeth and can manipulate his actions. She is wearing a black flowing robe that covers up her shape and a black hat that covers up her hair. She is not very feminine, this portrays her as evil and capable of killing Duncan to become queen. When she is thinking about killing Duncan, she shows intense concentration. They embrace each other when Macbeth comes in; this shows that theyve got a very close relationship. In the BBC Production Lady Macbeth has not got much power over Macbeth. She runs up to him when he enters and he turns away from her when shes talking. She is wearing a long beige dress with a rope belt and has long hair, she is more feminine than the Lady Macbeth in the Royal Shakespeare Production because her clothes show more of the shape of her body. She does not seem as evil, but when she changes her voice she transforms the way she portrays the character. She moves around when shes thinking of how to kill Duncan and doesnt concentrate that much. She does stop and look through a window theres a long dramatical pause while she is thinking. this adds to the effect and shows that she is thinking about something important like murdering Duncan. She uses sexual movements and gestures in the unsex me scene; I dont think this is how Shakespeare intended this scene to come across. In the film by Polanski, Lady Macbeth is stroking some dogs when she is reading the letter from Macbeth, this shows her as sensitive and loving and not a devious, evil woman which I think is what Shakespeare wanted her to come across as. When shes talking about what Macbeth could become, she does not seem very exited. The unsex me scene is moved to when shes standing outside on her own, she is portrayed as evil when she changes her voice. When Macbeth comes in she runs up to him, he picks her up and carries her up the stairs, this portrays her as weak and childlike. She has little power over Macbeth, she has a little sexual persuasion but she doesnt seem to be able to manipulate him very much. When she says that they will kill Duncan, O never shall sun that morrow see. She comes across as playful and childish. She does not seem to be able to commit regicide, and too innocent to be filled with direst cruelty I think that the Royal Shakespeare production was the closest to the representation that Shakespeare portrayed in this play. The clothes she wore showed what Lady Macbeth was like. The actress played Lady Macbeth well because she showed that she is evil and manipulative using her movements and voice, she has power over Macbeth and influences what he does. In the BBC production she has not got as much power over Macbeth as in the Royal Shakespeare Production. She does not show that she is evil until she changes her voice. Her clothes show that she is more feminine and less capable of committing regicide. She uses sexual persuasion more than mental persuasion, this shows that she is not as calculating. In the Polanski film she is childlike and does not seem to be able to kill someone or even think about killing someone. She is very feminine because she is wearing a light blue dress, which shows the shape of her body. In my opinion Polanski got the character of Lady Macbeth completely w rong.

Our Town Analysis :: essays research papers

Our Town Analysis   Ã‚  Ã‚  Ã‚  Ã‚  In fact my town does not resemble the setting displayed in this play although I am sure the setting of our ancestors’ towns were much like this one. Back then everybody knew each other and they did not have to lock their doors and they had a strong fear of death and judgement which was indirectly implanted in their religion.   Ã‚  Ã‚  Ã‚  Ã‚  This play was interesting because the representation of death portrayed as being so sudden. When death hit Emily, she suddenly realized how she had wasted her life on earth because they were repeating the same actions everyday of their. She became sad and also regretful that she could not tell her husband George to get on with his life and end this incessant mourning.   Ã‚  Ã‚  Ã‚  Ã‚  The setting is very important because the play is set in a small simple town and it demonstrates the precise actions of people of that time. The setting is special because it is vague therefore it lets your mind imagine the precise details of the scene. This is interesting because you see the scene the way you want it so the author does not need to go into dull descriptions which are not too pleasing.   Ã‚  Ã‚  Ã‚  Ã‚  The atmosphere is very obvious in this play because it is one of the most prominent factors in the play itself. In the first act the dominant mood is happiness because everybody is pursuing their normal activities and gossiping and the first act is used to introduce the characters for us to know their attitudes. In the second act the action is sped up and there is a special event which is marriage involves George and Emily. Emily shows a great deal of hesitation and the attendants at the ceremony are discussing the couple and how they were when they were young. In the third act the mood is sorrow and sadness caused by the death of Emily and her reaction at the overview of her own life.   Ã‚  Ã‚  Ã‚  Ã‚  The relationship between George and Emily is very evident throughout the whole play. In the first act they shared a boy/girl relationship and were good neighbors.

Analysis of “the Chrysanthemums”

In the world created by John Steinback, in the story of â€Å"The Chrysanthemums†, being an intelligent girl whose accepted into the society is a hard task. Elisa is caught up in all the household work while not being able to enjoy any of the outside world. She’s shown to have the life and struggles of a typical house wife, who is passive and not strong enough, lacking the attributes it takes to step out of her comfort zone and take responsibility and action to make herself content. The setting sets the mood of the story, as the fog represents her being unable to clearly see the realities of life. The author does a great job of keeping the narration somewhat discreet, which keeps the reader thinking, and let’s us figure out the motivations of the characters ourselves. When Elisa and Henry are first introduced, their relationship seems friendly but lacking love and passion. The way they compare their work, her garden and his business, and how they go about their daily routines makes them seem like friends or business partners, but not much more. This reminds me of â€Å"The Painted Door† by Sinclair Ross, in which Ann and John live in a passionless isolation on their farm. I noticed the use of literary devices such as similes to enhance the story; for example, â€Å"like a fawning dog. † I also noticed that Elisa's bulky and restrictive clothing was a metaphor for her true desires and personality being suppressed, as a woman. The theme of gender inequality is present, and can specifically be seen in the conversation Elisa has with the man from the wagon, in which he says the life he lives is not for a woman. I also noticed the author employed symbolism to enhance this message through the chrysanthemums. The chrysanthemums could be seen as a symbol for women, in that they are pleasant to look at, yet when they are offered up for a purpose, they are often rejected, as the chrysanthemums were. More specifically, the flowers symbolize Elisa, in that they are strong and beautiful, but also face rejection as she does. I think the author's purpose of writing this story is to say that the unfair treatment of women is a prevalent and existing issue that needs to be addressed. In evaluation, the story was quite effective, as it got to the point clearly, concisely, and quickly, while portraying a strong and meaningful message.