Saturday, August 31, 2019

Experiential Leadership Essay

Executive Summary    The researchers’ aim is to point out to the effect of Experiential Leadership in the selected company liked Barras Home Improvements. Background:    The Progress Report Name of the Business Manager of Barras Home Improvement Company is Mike Allen. He supervised 16 employees. Eight of them were assigned in office and eight were outside in the field. Nature of business/service market Barras Home Improvements was formed in 1987. During the past year, the company has positioned itself as a leader in the sales and home improvement. Home Improvement is the field of expertise in fact customer can easily choose their desired lay out for their home improvement, guided by the advice support to meet the great improvement of the home. In addition, they are now celebrating a twenty years in service. Barras Home Improvements Company is classified as family Business. They have large selection of Kitchens, Bathrooms and Bedrooms gallery lay-out or so called showrooms. Their mission statements are choice and value for money, service and quality product, and first class workmanship. The purposed of the operation of the company is to provide customer with highest standards of quality and service. Their products are sinks, taps, wall and floor tiles, Amtico flooring and shower enclosures and etc. They are also specialised in the complete installation service covering every aspect from plumbing and electric’s, plastering and minor building work and tiling to maintenance free ceilings. Insurance work is also undertaken and a 12 month written guarantee is given on all our work. We are both CORGI and NIC EIC registered. They also have a promotion of  £50.00 deposit only for the customers instillation fee Customer scope and demographics The informational data that the company can offer to the customer is as follows: Local: This Company is situated at the top of Clay Lane, off Ball Hill Shopping Centre on the Walsgrave Road. M6 –   Heading South: Leave M6 at Junction 3. Follow A444 towards Coventry. Turn   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   left into Mercer Avenue and the showroom is at the top of this road, which is at   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚     the junction of Clay Lane. M6 – Heading North: Leave M6 at Junction 2. Follow signs for the A4600 heading towards Coventry City centre. At Ball Hill shopping centre on the Walsgrave Road turn right into Clay Lane and our showroom is at the junction with Barras Green and Mercer Avenue.    Organizational Structure of the Barras Home Improvement Company Organization’s Workforce The Barras Home Improvement Company was subdivided into two groups of 8 in the office and 8 in the out field for installation and contractors. The people in office were responsible for customer service and do some paper works and entertain clients or customer. And in addition they lead the customer on the computer lay outing for the home improvement processing. Presentation Situation; The current situation of the organization is very exciting.   Recently, business has relocated to a larger and more efficient facility. This move will enable the company to streamline its method of operation and increase its bottom line. Market environment; The market place is undergoing tremendous technological change. New Technologies of Home improvement and materials are making products increasingly attractive stronger and less costly.   The business is poised now to take advantage of these changes, and expect to become an important supplier of home appliances and home improvement installation. Products and Services; The raw material and other home appliances that we are using were the latest awith high quality materials. This is primarily due to the strong influence of committed manufacturers and the demands of the appliances and raw materials. Gathering and Collection of Data: This investigation adopted the descriptive method of research as this is the appropriate way in evaluating the manager of the Barras Home Improvement Company in relation with his experience in Leadership Management style and behavior. This will be viewed from the responses of his 16 employees in the company. The descriptive method is also defined as studying components to serve as direction in reaching the goal. Its purpose is to tell what exist or what is about a certain business phenomenon, predicting and identifying relationships among and between the variables describe. The data and information was gathered through interview of some customers of Barras Home Improvement Company, employees and through internet the profile of the company has been gathered and studied.    Facts: The company is still a leading company in terms of home improvement because of the experienced manager of the company. The trend of the company was remarkably improving because of the good feedback and referral of the customer. They have the additional benefit of being able to provide a computer aided photo-realistic image that can even show the kitchen, bathroom or bedroom in the finish of their own choice. The Actual Report    Executive Summary    This paper studies the company named Barras Home Improvements (BHI). The purpose of this study is to evaluate effectiveness of the Experiential Leadership Manager to the Business Flows specifically in family business like BHI. This study was conducted to enlighten other businessmen in the market place to exercise Experiential Leadership Management. Background: Barras Home Improvements was formed in 1987. During the past year, the company has positioned itself as a leader in the sales and home improvement. Home Improvement is the field of expertise where a customer can easily choose their desired lay out for their home improvement, guided by the advice support to meet the great improvement of the home. In addition, they are now celebrating a twenty years in service. Barras Home Improvements Company is classified as family Business. They have large selection of Kitchens, Bathrooms and Bedrooms gallery lay-out or so called showrooms. The purpose of the operation of the company is to provide customers with highest standards of quality and service. Their mission statements are choice and value for money, service and quality product, and first class workmanship. Their products are sinks, taps, wall and floor tiles, Amtico flooring and shower enclosures and etc. They are also specialised in the complete installation service covering every aspect from plumbing and electric’s, plastering and minor building work and tiling to maintenance free ceilings. Insurance work is also undertaken and a 12 month written guarantee is given on all our work. They are both CORGI and NIC EIC registered. They also have a promotion of  £50.00 deposit only for the customer’s instillation fee Definition of the Problem       The objective & goal of this research is to evaluate the strength and weaknesses of experiential leadership management in business. The Barras Home Improvement is the company that will be treated on this study. Initially, a simple random sample of 16 employees will be given a baseline test organized by the researcher. The results will be compiled for later comparison with the research results, and those initially tested will no longer take part in the study. Questionnaires are one of the most popular ways in which data may be collected. These are used for a range of purposes and will often be the tool used to collect quantitative data. But it is worth mentioning that although this may be classified as mostly a quantitative process of collecting data it may also be a qualitative method, depending on the number, depth and style of the questions. Research questions This study sought to evaluate the Business Manager of Barras Home Improvement Company. Specifically, it aimed to answer the following questions: How to determine the degree that the person like working with task and people? What is the Leadership dimension of the Business Manager of Barras Home Improvement Company possess? What practice of leadership style does the Business Manager of Barras Home Improvement Company have? Is there a significant effect on experiential leadership management to the Barras Home Improvements company employees?    HYPOTHESIS: Ho  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   :  Ã‚   There is no significant effect on experiential leadership management to the Barras Home Improvements employees.                      THEORETICAL Framework   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   the theoretical framework adopted for this study may be reflected in this model below. Input  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Process  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚     Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   output    Figure1. This paradigm was used to determine the effect on experiential leadership in the Barras Home Improvements.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   This model suggests that Leadership behavior and leadership style survey questionnaire may be anchored on the manager of Barras Home Improvement Company who is Mike Allen. The conceptualization of this study revolved around the notions clearly represented by this model. The paradigm of the study consists of the inputs that contain all those which have been studied in this research. The process consists of the survey questionnaires that were used to analysis the company data.   The output consists of the effects of Experiential Leadership Management to the company performance. Analysis of Variance was also used to treat the data statistically. Research design    Sample Size: All the employees were included in the sample and then the researcher calculated the weighted mean of the survey questionnaire to determine the effect of experiential leadership. Sample selection: Employees of Barras Home Improvements company were selected as sample selection of this study Instrument used: This study used a survey questionnaires of leadership behavior and leadership style    Editing of data: Standard editing and coding procedures with MS-EXCEL program. Analysis of data: Simple tabulation and cross-tabulation used. RESULTS: The following results were gathered and tabulated with the use of leadership survey questionnaire: This study reveals that the Manager of Barras Home Improvements Company has a characteristic of a Team leader. This is because the score 6.9 in the people section and a score of 7.3 in the task section revealed it. The quad where the two lines intersect is the leadership style in case of Team Leader quality. The manager used delegative and democratic leadership style. Sometimes he also used autocratic leadership style may be because it is necessary and it is revealed in the scores that 26 means being autocratic. This means that the style was used in some cases where the problem arises or decision making is required in the process for humanitarian sake. Conclusions: From the results of the experiential leadership management evaluation the following conclusions were drawn: The more experience the manager have the more effective and organized the business is. Experienced manager has more wisdom than an autocratic manager or even none experienced leader. Managers need to be team leaders for building much effective and successful business. A Team leader is the most ideal manager a company needs. Recommendation: This study suggests every businessman to undergo on the survey questionnaire to identify if their characteristics are autocratic, democratic or free reign. The new public relation officers must widen the scope and topics. Leadership Questionnaire Questionnaire Below is a list of statements about leadership behavior. Read each one carefully, then, using the following scale, decide the extent to which it actually applies to you. For best results, answer as truthfully as possible. Never  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Sometimes  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Always  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚     Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   0  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   1     Ã‚  Ã‚  Ã‚  2   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  3   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  4   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  5   _______ encourages team to participate when decision making time comes and also attempts to implement ideas and suggestions. _______ â€Å"Nothing is more important than accomplishing a goal or task†. _______ closely monitor the schedule to ensure a task or project will be completed in time. _______ enjoy coaching people on new tasks and procedures. _______ â€Å"The more challenging a task is, the more he enjoys it. _______ encourages employees to be creative about their job. _______ seeing a complex task through to completion, he ensures that every detail is accounted for. _______ found it easy to carry out several complicated tasks at the same time. _______ enjoy reading articles, books, and journals about training, leadership, and psychology; and then putting what have been read into action. _______ when correcting mistakes, he do not worry about jeopardizing relationships. _______ He manages time very efficiently. _______ He enjoys explaining the intricacies and details of a complex task or project to my employees. _______ breaking large projects into small manageable tasks is second nature to me. _______ nothing is more important to him than building a great team. _______ He enjoys analyzing problems. _______ He honors other people’s boundaries. _______ He Counsels his employees to improve their performance or behavior which is second nature to me. _______ He enjoyed reading articles, books, and trade journals about my profession; and then implemented the new procedures he learned.       Scoring Section Put your answers on the spaces provided for every question. PEOPLE TASK    Question 1.______   4.______   6.______   9.______   10.______   12.______   14.______   16.______   17.______   TOTAL ________ X 0.2 = ________    Question 2.______ 3.______   5.______   7.______   8.______   11.______   13.______   15.______   18.______   TOTAL ________ X 0.2 ________ Leadership Style Survey Directions: This questionnaire is about leadership style ideas. Please encircle any of the number provided for at right-end of each item/statement to express your honest judgment by using the following code: Category  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Weight Almost Always True   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚     Ã‚  Ã‚  Ã‚  Ã‚  5 Frequently True   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚     Ã‚  Ã‚  Ã‚  4 Occasionally True   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚     Ã‚  Ã‚  Ã‚  3 Seldom True   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚     Ã‚  Ã‚  Ã‚  2 Almost Never True   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚     Ã‚  Ã‚  Ã‚  1 1. I always retain the final decision making authority within my department or team. 5 4 3 2 1 2. I always try to include one or more employees in determining what to do and how to do it. However, I maintain the final decision making authority. 5 4 3 2 1 3. I and my employees always vote whenever a major decision has to be made. 5 4 3 2 1 4. I do not consider suggestions made by my employees as I do not have the time for them. 5 4 3 2 1 5. I ask for employee ideas and input on upcoming plans and projects. 5 4 3 2 1 6. For a major decision to pass in my department, it must have the approval of each employee or the majority. 5 4 3 2 1 7. I tell my employees what has to be done and how to do it. 5 4 3 2 1 8. When things go wrong and I need to create a strategy to keep a project or process running on schedule, I call a meeting to get my employee’s advice. 5 4 3 2 1 9. To get information out, I send it by email, memos, or voice mail; very rarely is a meeting called. My employees are then expected to act upon the information. 5 4 3 2 1 10. When someone makes a mistake, I tell them not to ever do that again and make a note of it. 5 4 3 2 1 11. I want to create an environment where the employees take ownership of the project. I allow them to participate in the decision making process. 5 4 3 2 1 12. I allow my employees to determine what needs to be done and how to do it. 5 4 3 2 1 13. New hires are not allowed to make any decisions unless it is approved by me first. 5 4 3 2 1 14. I ask employees for their vision of where they see their jobs going and then use their vision where appropriate. 5 4 3 2 1 15. My workers know more about their jobs than me, so I allow them to carry out the decisions to do their job. 5 4 3 2 1 16. When something goes wrong, I tell my employees that a procedure is not working correctly and I establish a new one. 5 4 3 2 1 17. I allow my employees to set priorities with my guidance. 5 4 3 2 1 18. I delegate tasks in order to implement a new procedure or process. 5 4 3 2 1 19. I closely monitor my employees to ensure they are performing correctly. 5 4 3 2 1 20. When there are differences in role expectations, I work with them to resolve the differences. 5 4 3 2 1 21. Each is responsible for defining their job. 5 4 3 2 1 22. I like the power that my leadership position holds over subordinates. 5 4 3 2 1 23. I like to use my leadership power to help subordinates grow. 5 4 3 2 1 24. I like to share my leadership power with my subordinates. 5 4 3 2 1 25. Employees must be directed or threatened with punishment in order to get them to achieve the organizational objectives. 5 4 3 2 1 26. Employees will exercise self-direction if they are committed to the objectives. 5 4 3 2 1 27. Employees have the right to determine their own organizational objectives. 5 4 3 2 1 28. Employees seek mainly security. 5 4 3 2 1 29. Employees know how to use creativity and ingenuity to solve organizational problems. 5 4 3 2 1 30. My employees can lead themselves just as well as I can. 5 4 3 2 1 Scoring Section Put your answers on the spaces provided for every questions. Item Score Item Score Item Score 1 ______ 2 ______ 3 ______ 4 ______ 5 ______ 6 ______ 7 ______ 8 ______ 9 ______ 10 ______ 11 ______ 12 ______ 13 ______ 14 ______ 15 ______ 16 ______ 17 ______ 18 ______ 19 ______ 20 ______ 21 ______ 22 ______ 23 ______ 24 ______ 25 ______ 26 ______ 27 ______ 28 ______ 29 ______ 30 ______ TOTAL _______ TOTAL ________ TOTAL ________    Authoritarian Style    Participative Style    Delegative Style    (autocratic)    (democratic)    (free reign)                         References:    Covello, Joseph and Hazelgren, Brian, (1998). Your First Business Plan.Sourcesbooks 3rd Ed., Inc.USA Culp, C.(2001), The Risk Management Process: Business Strategy and Tactics, Wiley, New York, 60 -75. Gardner, Lawrence , (2006) Why businesses fail: †¦ and strategies for a successful turnaround, Detroiter, retrieved July 3, 2006, Kiyosaki, Robert T. and Lechter, Sharon L. (2002) Prophecy. Rich Dad’s.Warner Business Books, Inc. USA Spindler, A.,(1984) Publication Information: Book Title: The Politics of International Credit: Private Finance and Foreign Policy in Germany and Japan, The Brookings Institution, Washington, DC., P. 37-50. Vlieghe, G.(2001) Corporate Liquidations in the United Kingdom, Bank of England Financial Stability Review Weygandt, Jerry J., Kieso, Donald E. and Kimmel Paul D. (1998) Financial Acounting, John Wiley and son Inc. Canada Yoder James, (2004) Time diversification and changing volatility in an options pricing framework, Journal of Academy of Business and Economics    Unpublished Book: No author, (2007) My firm, Business Resource Services, has developed a process that I call â€Å"Profit Mastery.†,   At the risky end of finance – Credit derivatives, Economist   

Friday, August 30, 2019

IBM Corporation Turnaround Essay

IBM leading the technology industry passed through several challenges in last few decades. IBM had undergone significant changes to ensure effectiveness of its business. Market competition and globalization of industry decreased the effectiveness of IBM requiring change in structure and work setting. IBM focused on its core competencies while successfully adopted new managerial structure placing emphasis on flexible decision making with increased responsibility on first line managers. Case Statement IBM was successfully leading the technology industry since its formation and profitably penetrated in various markets globally. However, the company expanded incautiously resulting in increased overhead cost; although profits were soaring but gradual change in demand by the end of year 1990 create significant financial problems for company depicted in huge losses for the consecutive three years. This case identifies the reasons which root to IBM condition in 1990 and sequential pattern of changes in structure which affected the financial performance of company. This case classifies the role of management in IBM performance and associated impact of overhead on company potential to grow. Basically, this case categorizes the problems which plunged the IBM to move towards failure and associated role of management. Situation Analysis of IBM under John Akers Leadership IBM was controlling approx. 70% profits of global technology industry in 1980s beginning era. However, during the last years of decade company was encountered with serious problems that affected the performance of company. John Akers, CEO of IBM appointed in year 1985, created significant changes in organization structure and work settings; defined new setting of decision making and operational procedures conforming his attitude and behavior. Company returns on assets and on equity started eroding and finally move towards negative return on business. IBM suffered with decreasing market share, loss of profits, negative perception building of customers towards IBM, increasing competition, and failures in product launch (Hitt et al. , 2007). IBM was striving hard to compete with new entrants in market, maintain its profitability level, and kept high market demand for its mainframe computers. Company was following bureaucratic structure, centralized decision making hindering to the growth of company. IBM overhead costs were momentous to industry average cost; overhead costs were three times of industry, company was offering high perks and benefits to employees, majority of employees were detrimental to work requirement, executives were not fully productive and were relying on junior members to perform their duties (creating unnecessary employment). Company had 125 data centers globally; internally organization was not proficient in IT management resulting in bad performance of IBM. Research department of IBM appeared unable to design products in consideration of customer demand which created significant problems in the beginning of 1991 (Hitt et al. , 2007), pushing company towards change in management structure, and requiring large scale operational change in organization to cover up its cost from current demand level. SWOT Analysis of IBM IBM is operating globally leading the industry with its unmatched solution compare to competitor’s offerings remarking the business performance. A brief SWOT analysis of IBM is as under: Strengths IBM offers a range of solutions to numerous businesses which differentiated it from competitors. IBM was dealing in mainframes, mainframe storage, single user personal computers, minicomputers, and client/server solutions. Company was soaring high profits from the industry, therefore spending high amount on R&D to invent and design products in consideration of future demand (Hitt et al. , 2007). IBM has strong brand image which increases the company sustainability and efficiently penetrate in competitive markets. Company had effective teams of personnel; reach to customers was valuable due to high value propositions. Weaknesses IBM was following bureaucratic structure and senior executives were running the operational decisions; limited decision making power reduced the innovation and hindered the growth of company. Company had employed unnecessary people to fulfill job tasks, increasing the cost. However, senior management members were relying on junior/support members for reporting purposes which resulted in refined information flow necessary for organization function irrespective of challenges that can be faced in long run. Executives’ remuneration was very high compare to services in return to organization; overhead costs dramatically increase as different competitors entered in industry (Hickman, 2006). IBM did not focus on offering of browser and network integration application which revolutionized the industry in early 1990s; however investing in OS/2 operating system resulted in financial losses. Opportunities IBM being one of the giant leaders of technology industry secures high profits and market share. This provides company an opportunity to overtake small business entities to offer diverse and complete range of products to customer (one stop solution). Competitors were investing huge amount on new products creation which IBM can use in its product portfolio to reach global consumers to increase brand value. Threats New competitors which include DELL, ACCENTURE, COMPAQ and MICROSOFT focused on offering computer products at cheap prices (Hitt et al. , 2007); IBM rely on Intel for some of its core physical component supply; IBM customer relationship management strategy; inefficiency of R&D to design innovative solution; market globalization and organization structure created direct threats to IBM market share.

Intro to Chicano Studies

David E. Dominguez April 21, 2013 ECC RM 169 Introduction to Chicano Studies Midterm Have you ever noticed the numerous similarities between you and your peers? No? Perhaps the way you speak upon one another, the tone, maybe the diction, or even the syntax of your voice can all be apart of ones culture. However, communication is only one of the very many key elements when taking in and digesting the term, ‘Culture’ along with its eclectic and widespread meaning.Now, when I say, â€Å"take in and digest†, I simply am referring to act of embracing and understanding the complete meaning of the word and its effect on our everyday life. Many professionals such as Anthropologist, Doctors, Psychologist, Economist and many more Scientist have their own definition of what culture may be, as well as your regular neighbors, classmates, co-workers, and even teachers. So why is this measly word so important?Well figure this, there is only one race everything else is culture, h ere in the United States of America we are what is defined as a multi-cultural society, nationwide. This means that within our country resign many different ways of life, entertainment, appearance, language, social classes, and even many deaths due to disease, thus resulting in a grand amount of what are called cultural clashes.Categorized as conscious and unconscious, these confrontations have an enormous effect on our civilization. Culture is an essential part of conflict and conflict resolution. Cultures are like underground rivers that run through our lives and relationships, giving us messages that shape our perceptions, attributions, judgments, and ideas of self and other. Though cultures are powerful, they are often unconscious, influencing conflict and attempts to resolve conflict in imperceptible ways.In other words, there are many circumstances in which these types of conflicts are in a sense, uncontrollable, meaning our regulatory system of life may have been pre-judged, now bare with me here, to my understanding due to my research, cultures are more than language, dress, and food customs. Cultural groups may share race, ethnicity, or nationality, but they also arise from cleavages of generation, socioeconomic class, sexual orientation, ability and disability, political and religious affiliation, language, and gender- nd this just to call upon a few. There are also very many theories to this term, culture. For example, The Resource Pot defines culture as mutual adaption of diversity in life, also as respect and celebrated diversity. On the other hand, the concept and theory of The Salad Bowl reveals another meaning to culture, such as acculturation, acculturation is when two or more cultures come into psychological, physical, or even environmental contact and begin to alter their original customs to further adapt to that in which they have discovered.This theory also reads that this part of culture is â€Å"color blind†, not literally of cour se but symbolically, towards race and ethnicity. Lastly there is the theory of The Melting Pot, which is a more assertive and aggressive form of acculturation, in which the dominant of the two cultures will succeed and overthrow, if you will. This particular theory also portrays the word Ethnocentrism. This is the act of judging ones culture based upon your own cultures’ ways and or beliefs.Emic and Etic are terms used by anthropologists and other social scientists referring to two different types of data collected on human behavior. Often used by cultural anthropologists, an â€Å"emic† point of view is one where the analysis of behavioral and cultural systems is defined in terms that are meaningful to the individual who is a participant within that culture, also known as an â€Å"insider's view†. The emic perspective arises from the participant of the culture being observed.Now, the Etic point of view is which comes from the â€Å"outsiders† of the part icular culture in which is being observed. In a comparison, the Etic perspective is used if the representations are in accord with scientific observers. The etic perspective employs a more logical, analytical and anthropological analysis of one who does not participate in the cultural that is being observed. However, despite any differences between these two perspectives, and due to my educational research, anthropologists agree that any ethnographic work ought to be represented using both the emic and etic views.To fully understand a culture, anthropologists must be able to understand the culture empathetically and scientifically. The two approaches build off one another and allow for a wider understanding of culture. Also, there are many elements in which may influence ones social and personal behaviors/identity as well as their mentality and psychological judgment or comprehension. Just to point out a few- life experiences, environment, personal choices, and Adversity†¦ erso nally, I believe you have to give back to those more in need to fully understand who you are as a person, in today’s society it is a â€Å"give me all about me† society and the more you give the more you gain as an individual and the more you grow and develop your own genuine not manufactured characteristics. Yes, I said manufactured characteristics, believe it or not but people are many times shaped and formed into who they are due to what they watch or see on the television screen or from what they hear on the radio stations, even within our children, its an epidemic.The mentality of the youth in any community as well as anywhere else across the globe, is very gullible and vulnerable. For instance, I observe the television shows on the Disney Channel that my four year old, soon to be five year old little sister watches, and I have learned that in each showing there is constant affectionate and loving relationships between young boys and girls. Now although it is port rayed as humor and may seem completely innocent, it makes me wonder how this will effect my baby in the future, along with the sexual and intimate lyrics played both on the radio stations and at home.I feel that the media contributes to the epidemic of pregnancy in young women now a days. That is just one personal opinion of observation from my perspective as an older brother as well as a young Chicano. I have come across these connections between Disney Channel’s young affairs, the radio stations, and the epidemic of pregnancy through my own personal experiences and visualizations of the youth in my family and across the city. My theory goes on much more into depth but lets stay on topic.The media is only another element in which may influence ones identity; another involves the environment, the habitat, and the beings all around the individual. When we enter the world we enter naked physically, socially, and culturally. Unlike other living creatures humans need social exper ience to learn their culture and survive. Only humans rely on culture rather than instincts to ensure the survival of their kind. The natural thing to humans is to create culture. Culture has to be learned it is not apart of a biological make up; but our biological make up makes culture possible.We as humans do not inherit habits and beliefs we acquire them during the course of social experiences. We come into this life without a language, social class, values, morals, religion, race, we do not even know how to love or hate. It is through human contact that people learn to become members of the human community. Culture is the values, beliefs, behaviors, and materials that form the way of life for humans. Culture interprets our surroundings for us and gives us meaning and allows us to express ourselves.To learn any culture is to learn a person’s values, ideas and of what is desirable in life. Values underline or preferences, guides or choices, indicate what we hold worthwhile in life. Values help define the character of a culture, but it does not provide specific courses of actions. Without any morals or values in life there is no culture, and once again, without culture what is life? What is the point of life without Culture? Without Culture life would be meaningless and boring, I think it is an extraordinary craft to learn ones culture who differs from you.

Thursday, August 29, 2019

Using both examples of theory and practical cases (both company and Essay

Using both examples of theory and practical cases (both company and country examples) assess the relative importance of political and cultural factors in influencing global investment decisions - Essay Example Before establishing investments in a foreign country, it is important to assess the status of its politics as well as its cultural orientation. This is because politics and culture of the host country are major determinants of the success of foreign investment in it. Ignoring political threats in global investment decisions puts the company at a high risk of failure. (Cateora, Philip R. and John L. Graham, 1998 pp.23-25). In recent years, politics and the threats they pose to foreign investors determine the success of a company. They are the ones that actually determine the winner or looser. Investment policies of a country are normally formulated nationally through local policy plans. This could lead to uncalled for negative impacts on the global market. Political intervention on the market systems of many countries is rampant. This is happening in the developed and developing countries, necessitating caution while companies consider investing in foreign countries. The regulations of the global market are being changed time and again by politicians and can be disadvantageous to foreign companies especially those that invest heavily on fixed assets such as in the tourism industry where companies make huge capital outlay for assets such as buildings and infrastructure. The major threat caused by political interference is over-regulation thereby bringing in impediments to open capital flow which may ad versely affect the global market (Mooij Marieke. 1998 pp. 38-41). Political risks are the possibilities that may occur in the host country due to political decisions or actions that may have a negative impact on the business. In such cases, companies may end up loosing their money or fail to perform according to the expectations. They include confiscation of property due to local misunderstanding, changes in currency value, restrictions of business activities, politically instigated violence such as the one that was experienced in Rwanda in 1992,

Wednesday, August 28, 2019

Collabrative working with parents and others Essay

Collabrative working with parents and others - Essay Example This report shows among other details: the child's progress report annually; tabulation of performance of local schools and regular updates on their child's school from private inspectors. The government’s Education Act governs all schools in relation to their provision of educational needs, especially to the distinctive educational disadvantaged pupils, to ensure that such children receive an education that is of the same quality as their counterparts in the mainstream educational system. The Education Act ensures the involvement of parents in the learning process by encouraging them to express their views. They are also encouraged to act on their parental concerns whenever troubled about their children’s wellbeing in the school environment. The government has increased speculation in families and young children and participation in the creation of wide-ranging programmes aimed at transforming early childhood education and care. The National Childcare Strategy was impl emented. This policy sort to bring the early child development programmes, and the social services authorities together to ensure the provision of educational and social amenities to children from needy families (Tomlinson. 2005, p. 35). The QCA/DFEE was later established to promote stakeholders in education and social environment plan how their work contributes to the new early learning goals. The government provides funding that oversees the promotion of children’s personal, social and economic development through formal education and ensuring children remain in right environments to govern their rights. The government, through the Children Social Services Department, seeks to ensure that the rights of children are maintained in the family setting. The government has laid down responsibilities for all parents, to maintain healthy children. Such parenting responsibilities include provision of medical care to the children whenever they are sick, provision of basic education t o all children despite their mental and physical abilities, provision of a safe environment for child development and provision of basic needs for the child. The government gains custody of children whose parents do not support these basic needs and put the children in foster homes. Within any given social situation, the wants, needs and aspirations of different stakeholders may be quite different. It is, therefore, paramount that we identify the relevant stakeholders in order to understand their roles in the collaborative system. It is essential that the pupil should be included as a stakeholder. By looking at an individual pupil or a group of pupils, one can easily determine who the stakeholders are by observing the needs and wants of these pupils and looking at who can fulfill them and how. All stakeholders present their own personal opinions and understanding of the situation; thus, such collaboration will result in the achievement of set goals regarding situations faced by pupi ls and children. When these partnership work effectively, all the parties involved feel they have been able to realize collectively what they would not have if they worked individually (Tomlinson. 2005, p. 76). However, conflicts are bound to arise in any collaborative measure. The important thing, when faced with such a problem, is to consider what is in the interest of the children. We note

Tuesday, August 27, 2019

Proj Risk Mgmt Essay Example | Topics and Well Written Essays - 1250 words

Proj Risk Mgmt - Essay Example Strategies to control the risks are identified, plans are established on how to deal with the risk, and the correct action is taken (PMBOK, 2008, pp 309). Risk audits are also carried out to examine the value of the risks responses when dealing with the cause of the risk, and how effective the risk management plan is. When conducting the risk management, trend analysis is used to monitor performance of the project. Technical measurements compare technical accomplishments during a project implementation to the project management schedule. Moreover, the technical performance can be used to compare the results of the management plan with the targets. In order for the risk management plan to be effective, reserve analysis is carried out to compare the amount of reserve that has remained to the total amount of risk remaining. In addition, the amount of time required to tackle a risk depends on the number of risks identified (PMBOK 2008, Pp 310). Project schedule slippage This term means t he delay in the completion of a project from the estimated time scheduled for completion. A project can be delayed due to various reasons such as; lack of proper planning, re-doing of a particular section of work for some time hence taking over the expected time, lack of enough resources for a project to be completed on time, proper planning and willingness to carry out the task. A lot of time is wasted when resources, tools, and equipments run out of stock, thus the employees have to wait for delivery. Indeed, this wasted time is not accounted for. Another factor to consider is the time wastage due to un-inevitable event, for instant, the illness of a coordinator will require waiting until he gets better or hiring a new one who will take time to familiarize with the project. Schedule delay may cause problems to the owners and contractors of that project in that, the additional time added may amount to many unplanned added costs. Therefore, it is important for every project to be ma naged to a schedule (Hullet, 2009, pp, 1). Diagnostic metrics This metric is used to provide information on a system. Diagnostic metrics assess the situation of a system, detect any anomalies, and forecast on future problems based on the latest date. The root cause of a variance is usually determined via the use of metrics. With the cause of each variance identified, it easy to know what measures to take. After dealing with the main variance problem, it is easier to tackle related problems that will arise in the project (Kendrick, 2010, pp 278). However, â€Å"metrics can be used to detect changes, make performance and progress visible, evaluate progress evaluation, and trigger process improvements† (Kendrick, 2009, pp 237). Since incorrect activity duration estimates may push all personnel into work too early or too late, how can a Project Manager motivate their teams by learning more accurate estimating? First, a manager can match a task to an employee depending on his avai lability, such that, he is sure that the task will be completed within the agreed time. This strategy makes it possible for an employee to dedicate his effort on the assignment since the manager relies on him. Secondly, the manager may reallocate assignments to those employees who have fewer assignments. This creates a sense of equality among employees. A manager can also assign critical part of an

Monday, August 26, 2019

Plagiarism disscussion 1 wk 4 Assignment Example | Topics and Well Written Essays - 250 words

Plagiarism disscussion 1 wk 4 - Assignment Example Having been expelled from the school on the basis of plagiarism may darken the individual’s academic and professional career thereafter. Students dropped out of school for such reasons find it hard to get admission in reputable universities or get recommendation letters from their former teachers. Personal consequences of plagiarism include compromised ability to think creatively, and poor academic writing skills. Unless an individual learns how to avoid plagiarism, his/her writing lacks the standard that is appreciated among the academicians and professionals. The most fundamental way of avoiding plagiarism is thoroughly reading and comprehending the guidelines given by the American Psychological Association (APA). In addition to that, one should practice writing following those guidelines. The more the practice, the better the chances of zero plagiarism. Some writers think that if they write an excerpt by themselves without actually plagiarizing, they can use it multiple times anywhere because it is their property. This is termed as ‘self-plagiarism’ (iThenticate, 2011). A writer may reproduce his/her own writing in the future but not without citing the previous source that he/she had written in the

Sunday, August 25, 2019

Military Essay Example | Topics and Well Written Essays - 1250 words - 1

Military - Essay Example advanced capabilities, the need of an amphibious force has come under media scrutiny in the recent times because a full-fledged amphibious operation has not been conducted ever since the end of World War 2 (only small scale operations have been conducted). Additionally, the cost of maintaining an amphibious force is also very high (Mullen, 2008). However, the amphibious force provides some specific advantages to the military power, given the volatile relationship that the United States has with several nations across the globe. This study takes a look at some of the reasons because of which United States still needs the capability to conduct amphibious operations. Most of the operations that are conducted in the modern day are of a joint nature, where all the branches of the military collaborate to achieve the mission. In any joint operation, the presence of an amphibious force provides a certain edge (Forbes, 2012). For instance, because of the advancement in technology related to military aircrafts and artillery, most countries anticipate air-raids and ground operations and therefore, do not pay enough attention to protects it littoral area (area which is near to the shore of a water body). Such areas are often only protected by a small coast card and small navy units deployed in certain points. In such cases, an amphibious attack can prove to be successful because the hostile nation will not be able to defend the littoral region against the strong and powerful amphibious attack of the US military. Even if the littoral area is defended by the forces, the amphibious force has the capacity to respond in a rapid manner and this provides the military with a strong forward presence (Speller and Christopher, 2001). One of the main tactics of a joint operation is to disperse the forces so that the hostile military is not able to focus on one particular region and respond in a strong manner. In such a scenario, the amphibious force proves to be a strong point

Saturday, August 24, 2019

What sorts of support did people get from religion in the ancient Essay

What sorts of support did people get from religion in the ancient world - Essay Example In other words, it could be asserted, that the Greek Mythology was the forebear for all subsequent performance arts. In the primitive world, mythology served as a primitive form of theatre. But this is only one side of the truth. Myths were cleverly used by the religious leaders to impose their authority on the unsuspecting masses. This was done by distorting and warping historical truth in a way that strengthened their present hold over the masses. (Bremmer 1994) Ancient Religion laid the foundation for Rational Enquiry: It is surprising to learn that the Ancient Stoics sought religion for intellectual reasons. For them religion is an avenue for rational enquiry into the natural laws. The Ancient Stoics reasoned thus – since all physical phenomena followed natural laws and explainable by reason, the creator of this world himself must be comprehensible through the same instrument. Reason itself is divinity. This is quite an advanced usage for religion, one has to admit. But this theological framework had its failings, for rationality does not answer all questions on nature. Religion, inevitably it would seem, belong to a realm beyond rational enquiry. On this account, when the oracle at Delphi proved difficult to interpret and understand the Greek were not surprised. Gradually, the Stoics came to associate exclusively all that is unknown to the divine, thus deviating from their more advanced provisions for rational enquiry in religio n. Religion as a Means of Control: The Greek and Roman theologians detested the concept of religious tolerance. Religion was little more than a cult at this time, centred on tradition and manifested through elaborate rituals. When contact with new cultures brought notice to new gods, they were assimilated or added to the existing pantheon. Britain is a good example – here altars to Mars, Hercules and Epona are found. On the darker side, it was common in Rome to make sacrifices to the new god in the way of

Friday, August 23, 2019

Puzzle 1 Assignment Example | Topics and Well Written Essays - 250 words

Puzzle 1 - Assignment Example Viewers can decide whether they see art, which makes their makers, artists, although artists, particularly humans, can use their autonomy to say that they are artists, whether their viewers agree or not. These artists are making art because they have viewers who can accept their works as art, even if there may be differences amongst the latter’s views. I believe that these creators are all artists or painters because they have the skills to make art and viewers who can accept their works as art. What makes them artists or painters is that they can create works of art based on their own perceptions of the world and using their painting skills, and that they have audiences who can appreciate their art. Some people might say that chimpanzees or elephants cannot perceive the value and effects of art, but I believe that they have their own ways of expressing art, as these videos prove. In addition, I believe that they are â€Å"good† artists to those audiences who see their paintings as â€Å"good† works of art because they like the total effect of these works and they find meaning in these paintings. As for the question of determining if one better than the other, it is hard to answer that because â€Å"better† art is in the eye of the beholder. In other words, I do not think that any person, even those who are called art critics and art connoisseurs can absolutely say that one painting or painter is better than the other since, in the end, people, as art consumers have different tastes and preferences in art and they can still choose what they think are â€Å"better† art works. Furthermore, determining the â€Å"better† art depends on both or either viewer or creator. Some viewers immediately think that human arts are better than animal-made arts because of the preference for the creators. Other viewers, on the opposite, do not consider who/what the painter is and prefer to appreciate art depending

Thursday, August 22, 2019

Leadership styles Essay Example | Topics and Well Written Essays - 750 words

Leadership styles - Essay Example Delegative leaders permit group members to make decisions. This style is best used in circumstances where the head needs to trust on experienced employees. The leader cannot always be correct at all times; thus, and that is why they entrust other duties out to professional and reliable or responsible group members. Leadership attributes needed for graduate level nurses may include team building and communication skills, management and technical competencies, personal integrity, strategic vision or action orientation and personal skills. All these attributes are needed to be a good leader. Leaders are often described as being unrealistic, fortified with strategies. Meaning that strategy and aspiration must be implemented to lead others to a future goal (Kelly, 2012). A potential leader is required to use problem-solving methods to retain member’s efficiency and improve group recognition. They should also be active, eager to have an inspirational impact on other people. They should be focused in finding solutions and pursue to encourage other colleagues. Leaders must be ready to practice these essential qualities even to their work so as to gain the admiration and confidence of his or her group members and guide the progress of clinical exercise, by exhibiting an active leadership style. A leader ought to influence the prosperous progress of other staff members. Leaders should also ensure that qualified standards are sustained and allowing the development of capable experts. Leaders who are looked up upon as driving forces are always admired by their staff members. They are always highly considered as a source for motivation and role models for nurses who inspire to be leaders in the future (Rigolosi, 2013). Leadership for the head nurses is mostly about the following: resolving conflict; delegating appropriately; making decisions, acting with integrity and responsibility. The role also includes encouraging others and being responsive of

State of Israel Essay Example for Free

State of Israel Essay The two friends remain separated till the official declaration of the State of Israel is made by the United Nations. When it is obvious that Israel will ultimately win over the Arabs, Reb Saunders gives in and allows his son to renew his friendship with Reuven. Though the bond of friendship between them is once again secured and strengthened, Reuven bears a grudge against Danny’s father. Throughout the novel, Reuven is portrayed as being highly intellectual and open-minded and not one to judge a person on impulse. But when it comes to Reb Saunders, Reuven makes quick and harsh judgment of him. However, towards the end of the novel, Reuven appreciates Danny’s father’s approach and realizes he had missed seeing the complexity of his character. Reb Saunders gives a convincing explanation for all his actions. Through his characters, Potok presents an insight into the American Jewish faith in the wake of the Holocaust. Moreover, the conflict between modernity and tradition is captured picturesquely. The emotional turmoil of the characters just could not be expressed better. The novel also portrays the various ways in which Jewish observance is balanced with the modern life in America in the twentieth century. These fundamental differences in their opinions push the novel in an interesting manner. Thus it is clear that Zionism had different effects on different people. Though we see the impact of Zionism in Potok’s novels, we cannot say for certain if he was in favor of it or against it from this novel. It is clear that Potok is trying to voice his thoughts through the characters. But the characters themselves are divided in their views. So, what could be told about the effect of Zionism is, it is present just like any other event in a novel, the characters reacting in different ways as they would to other events in life. Zionism was a part of life and reality, and people had various approaches to it. We can see the effect of Zionism in almost all the characters. Almost all the characters are affected by a single person’s view. An individual’s perspective of Zionism affects the lives of many people around him. Reb Saunders’ anti-Zionist stance, sort of, changes when he gives his son permission to talk to Reuven. Reb Saunders finally apologizes to Reuven and Danny for causing the separation. When Reb Saunders explains the reasons behind his actions, Reuven feels great admiration for him. Saunders’ only concern is that his son should be humane and should understand the pain and sufferings of his fellow beings. He also wants Danny to stick to the religious beliefs and observe the Ten Commandments. When this is assured, Saunders does not have much difficulty in allowing his son to choose the profession of his liking. Reb Saunders is grateful for having got to know Reuven and his father. When Reb Saunders talks about the duties of Jews, he says that it the duty of every Jew to accept the destiny and the responsibilities of being born a Jew. His view is that a true Jew should pay little or no attention to the outside world and instead be immersed in the study of Jewish texts and dismiss the non-Jewish world around them. Even the slaughter of millions of European Jews in the Holocaust does not bring about the change in his views. He again feels that it is the will of the God. But towards the end of the novel, Reb Saunders’ view on the duties and obligations of the Jews seem to dilute. He is able to accept Danny’s decision to become a psychologist. He is finally able to appreciate the fact that one could be true to his faith and still be bonded with the outside world. These events are not only a milieu for the novel, but also adds significantly to the plot. These writers relied more on their imaginative and writing skills. Henry Roth was yet another American Jewish writer who in his own superior style picturesquely portrayed the cultural conflicts of the immigrant Jews. Though there was a long break after his successful debut novel Call It Sleep, critics feel that this single novel is credible enough to gauge his style.

Wednesday, August 21, 2019

Hemoglobin Malaria Haemoglobinopathies

Hemoglobin Malaria Haemoglobinopathies Despite major advances in the understanding of the molecular pathophysiology and control and management of the inherited disorders of hemoglobin (haemoglobinopathies), thousands of infants and children with this disease are dying. As a result in heterozygote advantage against malaria the inherited hemoglobin disorders are the commonest monogenic disease. Population migrations have ensured that haemoglobinopathies are now encountered in most countries including the UK. Haemoglobinopathies have spread from areas in the Mediterranean, Africa and Asia and are now endemic throughout Europe, the Americas and Australia. This review examines the available literature to find out more about the prevalence of haemoglobinopathies in the UK. The data on the demographics and prevalence of the gene variants of haemoglobinopathies was extracted from books, journals, reference sources, online databases and published review articles from the WHO. Introduction It has been estimated that approximately 7% of the world population are carriers of such disorders and that 3000 000 4000 000 babies with severe forms of haemoglobinopathies. Haemoglobinopathy disorders occur at their highest frequency in tropical regions and population migrations have ensured that they are now encountered in most countries. Because of this, haemoglobinopathies have become a global endemic, so the World Health Organization published journals and reviews with recommendations on screening programmes and management of haemoglobinopathies. The programmes are tailored to specific socioeconomic and cultural contexts and aimed at reducing the incidence, morbidity and mortality associated with these diseases. www.who.int/en/ The WHO Executive Board wrote a review on haemoglobinopathies. In this article, the WHO Executive Board recognized that the prevalence of haemoglobinopathies varies between communities, and that insufficiency of relevant epidemiological data may hamper effective and equitable management of haemoglobinopathies. On this note England implemented the LIVE programmes. The Executive Board also recognizes that haemoglobinopathies are not yet officially recognized as priorities in Public Health Sector. This raised an issue about awareness of haemoglobinopathies. The WHO Executive Boards advice for prevention and management of haemoglobinopathies was to design, implement and reinforce in a systematic equitable and effective manner, comprehensive national, integrated programs for prevention and management of haemoglobinopathies, including surveillance, dissemination, such programs being tailored to specific socioeconomic and cultural contexts and aimed at reducing the incidence, morbidity and mortality associated with these diseases. www.who.int/en/ With immigration in the UK on its highest, the prevalence of haemoglobinopathies is expected to increase. The NHS has implemented programmes for individuals with haemoglobinopathies by implementation of LIVE program (NHS Plan, 2000). LIVE program is set-up to implement variant screening in the whole of UK by the year 2007. LIVE program started as early as January 2004 in high prevalence. The NHS Trusts involved are to offer variant screening by end of 2004/5 (NHS Plan, 2000). Low prevalence Trust are expected to have implemented the screening program by January 2008 and so far 86 out of 90 Trusts have successfully implemented the program. Antenatal and Newborn Screening programs have compiled a training pack to assist Low Prevalence Trusts with the implementation of haemoglobinopathies screening programmes. The NHS Plan (2000) made a commitment to implement effective and appropriate screening programs for women and children including a new national linked Antenatal and Newborn screen ing programs for haemoglobinopathies. The NHS Plan (2000) recommends that all pregnant women living in high prevalence areas are offered screening for haemoglobinopathies. All pregnant women living in low prevalence areas are offered screening for haemoglobinopathies. If a woman is identified as being at increased risk using the family origin questionnaire, she will then be offered screening for haemoglobinopathies (NHS Plan, 2000). The Low Prevalence Trust is where the fetal prevalence of sickle cell disease is less than 1.5 per 10 000 pregnancies. Low prevalence trusts are to offer screening for variants based on an assessment of risk determine by a question to women about their babys fathers family origin by the end of 2005/6 (NHS Plan, 2000). Background on Haemoglobinopathies Haemoglobin: is the oxygen carrying capacity of the blood and it is also a protein. Haem is iron containing pigment, while globin is made up of chains which are a globular tetrameric protein which accounts for 97.4% of the mass of the haemoglobin molecule (Tortora et.al., 2006) . The globin tetramer consists of four polypeptides which are two alpha (ÃŽ ±) chains and two non-alpha chains. The synthesis of ÃŽ ¶ and ÃŽ µ chains is done during the first 10 to 12 weeks of fetal life. Within the fourth to the fifth week of intrauterine life ÃŽ ± and ÃŽ ² chains are synthesized. The non-alpha is beta (ÃŽ ²), gamma (ÃŽ ³), delta (ÃŽ ´), epsilon (ÃŽ µ) zeta (ÃŽ ¶) chains. Haemoglobin transports oxygen from the lungs to all parts of the body and it gives blood its red colour (Fleming, 1982) Haemoglobin synthesis Haem and globin synthesis occur separately but in a carefully coordinated fashion. Globin synthesis is under the genetic control of eight functional genes arranged in two clusters, the ÃŽ ± globin gene cluster on chromosome 16 and the ÃŽ ² globin gene cluster on chromosome 11. The major haemoglobin in the foetus is HbF (ÃŽ ±ÃŽ ²) 2 and in adults HbA (ÃŽ ±ÃŽ ²) 2 (Fleming, 1982). Haemoglobin Structure The primary structure of haemoglobin is made-up of amino acid sequence of globin. And the secondary structure comprise of nine non-helical sections joined by eight helices; tertiary structure describes globin chain folding to form a sphere and the quaternary structure of haemoglobin describes the tetrahedral arrangements of the four globin subunits ( Fleming, 1982). The external surface of each folded globin is hydrophilic and the inner surface is hydrophobic, this protects the haem from oxidation, which is also why each haem chain sits in a protective hydrophobic pocket. In haemoglobin A, ÃŽ ± ÃŽ ² dimmers are held together strongly at the ÃŽ ±1 ÃŽ ²1 or ÃŽ ±2ÃŽ ²2 junction. The tetramer is held together much less tightly at the ÃŽ ±1 ÃŽ ²2 and ÃŽ ±2 ÃŽ ²1 contact areas (Fleming, 1982). Haemoglobin function Each haemoglobin molecule can carry four oxygen molecules. Oxygenation and deoxygenation are accompanied by molecular expansion and contraction via haem haem interaction (Bienz, 2007). Under physiological conditions, blood in the aorta carries about 19.5ml of oxygen per 100ml of blood. Upon entering the tissues about 4.5ml of oxygen are donated per 100ml of blood. 2,3-DPG is an important modulator of haemoglobin A oxygen affinity in red cells (Fleming, 1982). Haemoglobin disorder (haemoglobinopathies) Haemoglobinopathies is a hematological disorder due to alteration of a genetically defect, that results in abnormal structure of one of the globin chains of the haemoglobin molecule (Bienz, 2007). Haemoglobinopathies are any of a group of diseases characterized by abnormalities, both quantitative and qualitative in the synthesis of haemoglobin (Hb) (Bienz, 2007). Qualitative affecting the quality of haemoglobin e.g. Sickle cell disorder and quantitative affecting the amount of haemoglobin produced e.g. Thalassaemias. Most of them are genetically inherited but occasionally they can be caused by a spontaneous mutation. Haemoglobinopathies are the worlds most common monogenic autonomic and recessive disease in humans (Anionwu et.al., 2001). 2.1Haemoglobinopathies fall into two main types; There are two categories of haemoglobinopathies. The two categories are: qualitative and quantitative; Qualitative affecting the quality of the haemoglobin e.g. Sickle cell disorder. In this disease the globin structure is abnormal. Quantitative the haemoglobin structure is normal but the amount of haemoglobin produced is affected. e.g. alpha and beta thalassaemias (Bienz, 2007). History of haemoglobinopathies In 1910 Herrick wrote an article in it he used the term â€Å"sickle† to describe the shape of the red blood cells of a 20 year old medical student from Grenada. This student had consulted Dr Herrick in 1994 complaining of a cough, fever and Feeling weak and dizzy. He constantly had anaemia episodes, jaundice, chest complications as well as recurring leg ulcers on both ankles. When his blood was examined, his red blood cells showed a large number of thin, elongated, sickle shaped and crescent- shaped forms (Herrick, 1990). The name thalassaemia was coined by the eminent haematologist George Whipple in 1936 as an alternative to the eponymous ‘Cooleys anaemia. He wanted a name that would convey the sense of an anaemia which is prevalent in the region of the Mediterranean Sea, since most of the early cases originated there. Thalassaemia is derived by contraction of thalassic anaemia (from the Greek thalassa -sea, an none and anemia blood) (Fleming,1982). Origins and Geographic distribution of haemoglobinopathies Carriers are found in all parts of the world: people from the North Mediterranean (South Europe) coast are 1-19% carriers. People of Arab origin are over 3% carriers. In Central Asia 4-10% and in South East Asia, the Indian subcontinent and China 1-40% carriers (the very high rates in this part of the world are due to HbE). In the Americas, North Europe, Australia and South Africa the local population has very low carrier rates but thalassaemia is still present because of the significant immigration from high prevalence area (Anionwu et.al.; 2001). Sickle cell and thalassaemia disorder mainly affect individual who are descended from families where one or more members originated from parts of the world where falciparum malaria was, or is still endemic. Population with such ancestry include those from many parts of Africa, the Caribbean the Mediterranean (including southern Italy, Northern Greece and Southern Turkey), Southeast Asia and thalassaemia gene is much wider now due to the hi storical movements of at-risk populations to North and South America, the Caribbean and Western Europe (Livingstone 1985). The geographic distribution of the thalassaemias overlaps with that of sickles cell disease. This is because carriage of these abnormal genes affords some protection against malaria. Thus, being heterozygous for one of these conditions offers a selective survival advantage and increases the opportunity for these genes to be passed on (Campbell et.al.,2004) 4Types and terminology of sickle cell and thalassaemia There are various types of sickle cell and thalassaemia disorders. The thalassaemia syndromes include alpha and beta thalassaemia major as well as beta thalassaemia intermedia. Sickle cell disorders (or Fickle cell disease include sickle cell anaemia (Hb SS), Sickle haemoglobin C disease (Hb SC) ÃŽ ² disease and E beta thalassaemia (www.sickle-thalassaemia.org/sickle.cel.htm) 4.1Sickle Cell Disorder: affects the normal oxygen carrying capacity of the red blood cells. The red blood cell forms a crescent or a sickled shape when it is deoxygenated. The ‘sickled cells are unable to pass freely through capillaries; the sickle cells also get stuck in blood vessels forming clusters which block the blood vessels and the blood flow. They dont last as long as normal, round red blood cells, which leads to anemia. This results in a lack of oxygen to the tissues in the affected area, resulting in hypoxia and pain (sickle cell crisis). Other symptoms include severe anaemia, damage to major organs and infection (NHS Antenatal and Newborn; 2006). There are several types of Sickle cell disease. The most common are: sickle cell anemia (SS), sickle hemoglobin C disease (SC), sickle beta plus thalassaemia and sickle beta zero thalassaemia. Each of these can cause pain episodes and complications. HbSS sickle is due to two sickle cell genes (â€Å"S†), one from each parent. This is commonly called sickle cell anemia. An individual with sickles cell anemia have a variation in the ÃŽ ²-chain gene, which then causes a change in the properties of hemoglobin which results in sickling of red blood cells (www.sickle-thalassaemia.org/sickle.cel.htm) HbSc inherited one sickle cell gene and one gene from an abnormal type of haemoglobin called â€Å"C†. It is due to the variation in the ÃŽ ²-chain gene. An individual with this variant suffers from mild chronic haemolytic anaemia. (NHS Antenatal and Newborn; 2006). HbS beta thalassaeamia: This form of sickle is due to inherited one sickle cell gene and one gene for beta. 4.2Thalassaemias: is a term used for the description of a globin gene disorders that results from a diminished rate of synthesis of one or more globin chains and a consequently reduced rate of synthesis of the haemoglobin or haemoglobins of which that chain constitutes a part ; ÃŽ ± thalassaemia indicates a reduced rate of synthesis of the ÃŽ ± globin chain, similarly, ÃŽ ², ÃŽ ´, ÃŽ ´ ÃŽ ² and ÃŽ µ ÃŽ ³ ÃŽ ´ ÃŽ ² thalassaemia indicate a reduced rate of synthesis of the h, ÃŽ ´, ÃŽ ´, +ÃŽ ² and ÃŽ µ + ÃŽ ³ + ÃŽ ´ + ÃŽ ² chains, respectively (Modell et.al, 2001). Thalassaemia is the most common single gene disorder known. It is autosomal recessive syndromes, which is divided into ÃŽ ±- and ÃŽ ² thalassaemia. Types of thalassaemia There are two types of thalassaemia: (i)Thalassaemia minor (thalassaemia trait) (ii)Thalassaemia major Thalassaemia minor is when a person inherits one thalassaemia gene, while thalassaemia major is a severe form of anaemia if a person inherits two thalassaemia genes, one from each parent (Bienz, 2007). Subtypes of thalassaemia Alpha (ÃŽ ±) thalassaemia results from inadequate production of ÃŽ ± chains, which are normally controlled by two pairs of chromosomes. If one or two are malfunctioning, then there is a healthy carrier state. If three are non- functional then anaemia results, known as HbH Disease, which can be quite severe but usually does not need blood transfusions and is compatible with a normal life span (Anionwu et al, 2001). If all four genes are non functional then the result is severe anaemia of the unborn child, leading to heart failure and death (miscarriage). This condition is known as hydrops felalis (Fleming, 1982). Beta (ÃŽ ²) Thalassaemia is caused by the bodys inability to produce normal haemoglobin, leading to a life threatening anaemia (Bienz, 2007). The severity of illness depends on whether one or both genes are affected and the nature of the abnormality. If both genes are affected, anemia can range from moderate to severe. Beta thalassaemia results from inadequate or lack of production of ÃŽ ² chains (Anionwu et.a.l, 2001). Homozygous, ÃŽ ² thalassaemia has two forms: major, in which the patient can survive only with regular transfusions of blood and intermedia in which the patient can survive with occasional or even with no transfusions at all. The condition requires frequent blood transfusions and treatment to prevent complications from iron overload, such as diabetes and other endocrine disorders (Anionwu et.a.l, 2001). Both of these conditions can restrict a child or adults ability to conduct their normal daily activities and can have profound psychological affects on individuals a nd their families This form of thalassaemia is the most important and constitutes a major public health problem in many parts of the world, because of the high frequency of carriers and the demanding treatment that must be followed (Fleming, 1985). Association of Haemoglobinopathies with Malaria Malariais a vector borne infectious disease caused by protozoan parasites. It is widespread in tropical and subtropical regions, including parts of the Americans, Mediterranean, Asia and Africa. It causes diseases in approximately 515 million people and kills between one and three million people, the majority of whom are young children. Malaria parasites are transmitted by female Anopheles mosquitoes. The parasites multiply within red blood cells, causing symptoms that include symptoms of anemia (Campbell et al, 2004). Sickle cell developed as a by product of human defense mechanisms against malaria. The most severe form of malaria, falciparum malaria, leads to very high death rate in young infants. This is particularly a problem between the time immediately after birth, when they are protected by immunity from the mother, and the time when they are old enough to acquire their own immunity. Malaria is a parasite which lives within the red blood cells and feeds off the protein that is contained within those red cells, haemoglobin (Campbell et al, 2004). When the malarial parasite enters the blood stream through a mosquito bite, it penetrates the red blood cells by attaching to the outside membrane or envelope of the red blood cell and gaining entry (Franklin, 1990). Once in the red blood cell, the malarial parasites use the haemoglobin as a source of energy, so that they multiply within the red cells. The parasites multiple filling-up the red blood cells and once they are filled-up the red cells bur st, thereby releasing the multiple parasites in the blood. Each new young parasite enters a single cell again and multiplies again, thereby causing a disease or infection. Whenever the parasites burst out of the cells they cause illness and fever in patients. Malaria can be severe by causing death; death is believed to be caused by red cells not being able to pass through the narrow gaps in the smallest blood vessels and by blockage of tissues when so many parasites are in the red blood cell (Campbell et al, 2004). Over the years human genes developed ways to prevent malaria becoming serious and potentially lethal, the developments were to prevent malarial parasites from spreading and multiplying (Tortora et.al,2006). The most changes were changes (mutation) in the type of haemoglobin (haemoglobin S) within the red blood cell which would in turn slow down the multiplying of the parasite (Campbell et al, 2004). The individuals with haemoglobin S are known to have a sickle cell trait or being carriers of sickle cell haemoglobin. When sickle-cell haemoglobin has given up its oxygen in the cells, the red cells stick together to form crystalline groupings of haemoglobin known as polymers. The red blood cells become deformed into sickle shapes and the presence of these crystalline polymers within the red cells inhibits the growth of the malarial parasite (Beinz, 2007). Even though individuals with haemoglobin S stills suffer from malaria, they are protected from the most severe effects of malaria (Li vingstone, 1985). Diagnosis Diagnosis for sickle cell disease The most used diagnose test for sickle cell is the haemoglobin electrophoresis. HbS and HbC amino acid substitutions change the electrical charge of the protein, the migration pattern of the haemoglobin with electrophoresis or isoelectric focusing results in diagnostic patterns with each of the different haemoglobin variants. HbSBeta-thal requires careful evaluation of red blood cell count and mean corpuscular red cell volume (MCV) and specifically quantifying HbA, S, A2 and F. In emergency setting, the presence of HbS is detected using a five minute solubility test called sickledex. Sickledex test does not differentiate sickle syndromes from the benign carrier state (HbAS or a sickle trait (NHS Antenatal and Newborn; 2006). Diagnosis for thalassaemias When testing for thalassaemias, a blood test is the simplest and most effective test for diagnosis and also the use of a test called Haemoglobin Electrophoresis. The blood of individuals with thalassaemias tend to be microcytic (smaller in size) and hypochromic (paler in colour) (NHS Antenatal and Newborn; 2006). 7 Pathophysiology 7.1Sickle-cell Sickle-cell anemia is caused by changes (mutation) in the structure of the ÃŽ ² -globin chain of the haemoglobin replacing the amino acid glutamic acid with the less polar amino acid valine at the sixth position of the ÃŽ ² chain. When two wild type ÃŽ ±-globin subunits associate with two mutant ÃŽ ²-globin subunits forms hemoglobin S. Haemoglobin S polymerizes under low oxygen conditions, which causes distortion of red blood cells and also causes red blood cells to lose their elasticity, resulting in red blood cells forming an irreversible sickle shape (Fleming,1982). Very often a cycle occurs, as the cells sickle they cause a region of low oxygen concentration which causes more red blood cells to sickle. Repeated occurrence of sickling causes cells to not return to normal even when oxygen levels are normal. The deformation of cells makes it difficult for the cells to pass through capillaries resulting in vessel occlusion, severe anemia, ischemia and other problems (Beinz, 2007). 7.2Thalassaemias The pathophysiologic effects of the thalassaemias range from mild microcytosis to death in uterus. The anaemia manifestation of thalassaemia is microcytic hypochromic haemolytic anaemia (Belcher, 1993). The haemoglobin abnormality is caused by substitution of a single amino acid for another; or substitution of two amino acids, also amino acid deletion or fusion (point of mutation) and the synthesis of elongated chains. In alpha trait, one of the genes that form the alpha chain is defective (Beinz, 2007). In alpha-thalassaemia minor, two genes are defective and in haemoglobin H disorder, three genes are defective. Alpha-thalassaemia major is most fatal thalassaemia disorder; this is because four of the chains forming genes are defective. Without alpha chains, oxygen cannot be released to the tissues (Belcher, 1993). In beta-thalassaemia haemoglobin abnormality is due to the uncoupling of alpha and beta-chain synthesis. This causes a depression in beta-chain synthesis, resulting in er ythrocytes with a reduced amount of haemoglobin and accumulation of free alpha chains, which are unstable and easily precipitate the in cell (Bienz, 2007). 8.Causes Genetic control of haemoglobin synthesis The synthesis of structurally normal haemoglobin chains is determined by allelic genes situated on the autosomal chromosome (Beniz, 2007). Haemoglobinopathies occur due to an inheritance of one or more faulty copy of gene(s) that contain the information for the cells to make the globin chains. The gene may result in abnormality in the production or structure of the haemoglobin protein causing haemoglobinopathies (Franklin, 1990). Thalassaemia is an inherited autosomal recessive blood disorder. Genetic defects in Thalassaemia results in reduced synthesis of one of the globin chains which make up haemoglobin. Reduced synthesis of one of the globin chains causes the formation of abnormal haemoglobin molecules, which in turn causes anaemia. Anaemia is a symptom of the Thalassaemias. It is caused by under production of globin proteins, often through mutations in regulatory genes (Franklin, 1990). Inheritance of Haemoglobin Disorder Due to haemoglobin mutation, individuals who had haemoglobin trait had a resistance to dying from malaria, therefore passed on their haemoglobin trait gene to their children (Campbell et.al,2004). As time went on more individuals with the trait were born and eventually individuals who had haemoglobin trait had children together (Franklin, 1990). In that satiation (partnership), if both parents carry the trait gene, there is a one in four chance that any one child will receive the haemoglobin trait gene from one parent and also from the other, thereby having a haemoglobin disorder(Franklin, 1990) . Clinical Manifestations 9.1Thalassaemias clinical manifestations Individuals who inherited the alpha trait are usually asymptomatic, with possible mild microctyosis. Alpha- thalassaemia minor has signs and symptoms almost identical to those of beta-thalassaemia; mild microcytic hypochronic anemia, enlargement of the liver and spleen, and bone marrow hyperplasia (Belcher, 1993). Alpha- thalassaemia major cause hydrops fetalis and fulminana intrauterine congestive heart and liver, edema and massive ascites. The disorder usually is diagnosed post mortem (Bienz, 2007). Beta-thalassaemia minor causes mild to moderate microcytic-hypochronic anemia, mild splenomegaly, bronze coloring of the skin, and hyperplasia of the bone marrow. Skeletal changes depend on the degree of reticulocytosis, which in turn depends on the severity of the anaemia (Bienz, 2007). People who have beta-thalassaemia minor usually are asymptomatic, whereas those with beta- thalassaemia major the anemia is severe, resulting in a great cardiovascular burden, with high output congestive heart failure (Belcher, 1993). Blood transfusions can increase the persons life span by a decade or two. Individuals with beta-thalassaemia major have an enlarged liver and spleen, and growth and maturation are retarded (Belcher, 1993). A characteristic deformity develops on the face as the bones expand to accommodate hyperplastic marrow (Belcher, 1993). Both and beta thalassaemias major are life threatening. Children with thalassaemia major usually are week, fail to thrive, how poor development and experience cardiovascular compromise with high-output failure; if the condition goes untreated, these children die by 6 years of age (Modell et.al., 2001) Blood transfusions can return haemoglobin and hematocrit to normal levels, alleviating the anaemia induced cardiac failure. Iron overload and hemochromatosis, which are complications of transfusion therapy, are treated with chelating agents (Bienz, 2007). . 9.2.Sickle-cell clinical manifestations The severity of sickle cell disorder depends on the amount of haemoglobin S and the clinical manifestations, which are signs and symptoms of the individuals with sickle-cell (Belcher, 1993) . Manifestations of the sickling are those of hemolytic anemia; pallor, jaundice, fatigue and irritability. Extensive sickling can precipitate four types of crises: vaso-occlusive or thrombotic crises and a plastic crisis (Belcher, 1993). A vaso-occlusive crises begins with red blood cells sickling in the microcirculation. Vasospasm brings a log-jam effect causing blood flow to stop flowing in the vessels and this will lead to thrombosis (blood clot formation) and infarction of local tissue occur, resulting in ischemia, pain and organ damage (Modell et.al.,2001). Vaso-occlusive crisis is believed to be extremely painful and lasts an average of 4 to 6 days. This crisis may develop spontaneously or may be precipitated by localized hypoxemia (low PO2) exposure to cold, dehydration, acidosis (low pH), or infection. In infancy, sickle-cells first manifestation is the symmetric painful swelling of the hands (see Fig 3) and feet, but in older children and adults, the large joints and surrounding tissues become swollen and painful. Individuals with the sickle-cell disorder suffer from severe abdominal pain caused by infarction in abdominal structures (Belcher, 1993). Any cerebral vascular accidents may cause paralysis or othe r central nervous system deficits, and if penile veins are obstructed priapism may occur. Studies have shown that bone, especially weight- bearing bones, are also a common target of vaso-occlusive damage, this is due to bone ischemia (Bienz, 2007). The spleen of individuals with sickle-cell disorder is frequently affected due to its narrow vessels, functions in clearing defective red blood cells and this results in a sequestration crisis (Belcher,1993). A sequestration crises, is occurrence of large amounts of blood pool in the liver and spleen. It only occurs in young children and death results from cardiovascular collapse (NHS Antenatal and Newborn,2006). An aplastic crisis develops when a compensatory increase in erythropoiesis is compromised; this then results in profound anemia (Belcher,1993). A hyperhemolytic crisis is rare but may occur with certain drugs or infections. G-6-PD deficiency, when also present, contributes to this type of crisis (Belcher,1993). Clinical manifestations of sickle cell disease do not usually appear until an infant is at least 6 months old. The most cause of death in individuals with sickle-cell anemia is infections, but it is major problem at all ages. Infections are due to splenic dysfunction from sickle damage (Belcher,1993). This occurs from a few months of age especially with certain bacteria e.g. pneumococcal sepsis. Infection tends to rapidly overwhelm the immune system (NHS Antenatal and Newborn,2006) . Sickle-cell haemoglobin C is known to be milder, with symptoms related to vaso-occlusive crises resulting from higher hematocrit and blood viscosity. Obstructive crises cause sickle cell retinopathy is most common in older children, and this include renal necrosis, and aseptic necrosis of the femoral head (Belcher, 1993). The mildest of sickle-cell is the sickle-cell thalassaemia the individuals with this form of sickle-cell tend to be microcytic and hypochromic, which makes the cells less likely to clog the microcirculation even when sickling (Belcher, 1993). Severe hypoxia can be seen in individuals with the sickle cell trait and may cause vaso-occlusive episodes. The cells in these people form an ivy shape (Belcher, 1993). Recent studies have shown that stroke is co-exiting with Sickle cell disease. At least 1% of patients with sickle cell disorder suffer from stroke and those individuals result in physical disability, IQ reduction, Learning difficulties, TIAs and seizures (Beinz, 2007). Treatment of haemoglobinopathies. 10.1Treatment in Sickle-cell anemia. Febrile illness: Children with fever are screened (a full blood count, reticulocyte count and blood culture taken) for bacteremia. In young children the fever is treated with intravenous antibiotics, the children would be admitted at the hospital so that they can be monitored (Belcher, 1993).. But older children with reassuring white blood cell counts are managed at home with oral antibiotics, but if the older children have a history of bacteremia episodes, they get a hospital admission. (Modell et al, 2001) Zn administration: is when zinc is given to stabilize the cell membrane (Beinz, 2007). Painful (vaso-occlusive) crises: individuals with sickle cell disorder experiences painful episodes called vaso-occlusive crises. Vaso-occlusive crises is often treated symptomatically with analgesics (Beinz,2007). Pain management requires opioid administration at regular intervals until the crises has gone. The frequency, severity and duration of these crises episodes vary tremendously form episodes to episode or from person to person (Belcher,1993). Individuals who suffer from milder vaso-occlusive crises manage their pain on NSAIDs e.g. diclofenac or naproxen. And if the crises is severe, individuals require inpatient management, where intravenous opioids. Diphenhydramine is used to stop the itchiness associated with the opioids (Modell et al, 2001). Acute chest crises management is similar to vaso-occlusive crises treatment with the addition of antibiotics, oxygen supplementation for hypoxia, and close observation. If the pulmonary infiltrate worsen or the oxygen requirements increase,

Tuesday, August 20, 2019

Causes of the Decline in Voter Turnout

Causes of the Decline in Voter Turnout â€Å"What explains the decline in voter turnout in most democracies in the last few decades? In your answer, consider one or two explanations that you consider most important and empirical evidence supporting or rejecting them†. According to Dalton (1988) â€Å"citizen involvement in the political process is essential for democracy to be viable and meaningful†. They suggest that â€Å"limited political involvement is a sign of weakness because it is only through dialogue and participation that societal goals are defined and achieved in a democracy. Voting, though it requires little initiative and cooperation with others, is the most visible and widespread form of citizen involvement†[1]. Over the past three decades, voter turnout in the UK and other democratic countries has decreased significantly, I will discuss what I consider to be two of the most important explanations for the decline in voter turnout across various democratic countries. These being political disengagement and dissatisfaction and the reduction in the value of voting. I have chosen these due to the fact there is significant empirical evidence supporting both explanations, as will be explored below. The first part of this ess ay will explain some statistics regarding the levels of voter turnout, following this, I will discuss the idea that political disengagement and dissatisfaction could be considered one of the most significant contributors to the decline in voter turnout and how the depleting value of the vote can cause people to refrain from voting altogether. A democratic country is defined as being a country in which â€Å"all eligible citizens have the right to participate in the political system, either directly or indirectly when it comes to making the decisions that will affect them†[2]. The decline in voter turnout throughout democratic countries in the last few decades is fast becoming a problem due to the fact democracy depends on voter participation. The decline in voter turnout can be noted in the UK where voter turnout reduced from 75.3% in 1987 to 68.7% in 2017, suffering substantial dips throughout this period, as was found in 2001 in which voter turnout dropped to 59.4%. Figure 1. A line graph showing the decline in general election turnout since 1945. Taken from: Ukpolitical.info. Voter turnout at UK general elections 1945 – 2017 | UK Political Info. [online] Available at: http://www.ukpolitical.info/Turnout45.htm. The same thing can be seen in other democratic countries. For example, voter turnout in the US during Mid-Term Elections has decreased from 60.89% of registered voters voting and 41.07% of voting age voters voting in 1986 to 54.16% of registered voters voting and 39.51% of voting age voters voting in 2014. The same cannot be said for Presidential elections, where we see an increase from 76.98%/56.28% voting in 1988 and 78.76%/60.52% voting in 2016. However, the most recent statistics do show a decline from 2004 onwards. One possible explanation for this could be the voters feel as though a Presidential election is more important, it gains more media coverage and affects the whole country. Therefore, it would be useful to consider some of the reasons for this selective decline in voter turnout. Figure 2: Levels of voter turnout in US midterm elections from 1982 to 2014. Taken from: Sos.wa.gov. [online] Available at: https://www.sos.wa.gov/elections/voter-participation.aspx Figure 3: Levels of voter turnout in US presidential elections from 1980 to 2016. Taken from: Sos.wa.gov. [online] Available at: https://www.sos.wa.gov/elections/voter-participation.aspx. The first of my proposed explanations for the decline in voter turnout is the public’s political disengagement and dissatisfaction. Before I continue, it is important to distinguish between voter apathy and voter alienation in order to determine whether there is a decline in voter turnout due to an increased laziness throughout the public or due to the public feeling as though they can no longer relate to their politicians, my first point of discussion focusses on the latter. Crewe et al (1992) suggested that apathy indicates a lack personal responsibility, a â€Å"passivity, and indifference for political affairs. It denotes the absence of a feeling of personal obligation to participate. However, voter alienation implies an active rejection of the political system†. The alienation the public are feeling when it comes to politics was found by Dr. Ruth Fox to stem from the fact that the parties we have to choose from are â€Å"all the same, the politicians are all the same, they are not like us†[3]. This could mean that the public can no longer identify with the candidates they are voting for. Politicians have become so detached from the average person, that the public cannot find any logical reason to want to vote them into power and consequently, do not vote at all. This could be considered one of the most crucial factors to contribute to a declining voter turnout because the aim of an elected Government is to represent the public’s views in Parliament to ensure that the decisions made, and laws created, benefit the country in the most inclusive way possible. Therefore, when the public feel as though they are not being accurately represented in Parliament they can feel alienated which in turn, promotes disinterest and a feeling of disengagement among the public with regard to politics. The British Academy stated that â€Å"British society has become, for the most part, disengaged with politics†¦In the case of British voters, it is important to understand the scale and depth of their disenchantment†. This can be considered important because if we can engage the public in politics through their MPs and other representatives, this would subsequently improve voter turnout. The second of my proposed explanations for declining levels of voter turnout is the idea that the public no longer places any value in voting, believing that their votes will not make a difference. The House of Commons Political and Constitutional Committee found this especially â€Å"when the member of the public lived in an area in which there was a safe seat, that is, where the party of the elected representative was unlikely to change[4]†. The value of voting can be considered an important explanation for the decline in voter turnout because if the public does not feel as if their vote will make a difference, or produce the outcome they prefer, they will be less inclined to even try. It was suggested by Ioannis Kolovos and Phil Harris that voters â€Å"weigh up the costs and benefits of their actions, meaning that the public will turn up to vote when they consider that the benefits of such an action outweigh the costs[5]†. An example of how the public have been made to feel disengaged with politics can be seen in the last election in which the Green Party and UKIP had significant support, resulting in a considerable number of votes. Under a different political system, these parties would have won 85 seats. Unfortunately, for the people that voted for them, the Green Party and UKIP only gained 1 seat each. Therefore, it appears that when people see that a significant percentage of the electorate are completely ignored due to the current political system, they give up on voting entirely due to the fact they think that their votes will not make a difference leading them to believe that the act of voting had little benefits. This could explain the decline in voter turnout in most democracies in the last few decades. There are many factors that can explain the decline in voter turnout in most democracies over the last few decades. In this essay, I have focused on and provided empirical evidence for what I believe to be two of the most important; political disengagement and dissatisfaction and the reduction in the value of voting. The need for politics to be more inclusive and for the public to feel as though they can relate to their representatives would considerably help the rates of voter turnout as they would feel as though their vote means something and would contribute to an outcome that would benefit themselves as well as others. They would also feel more involved in the political process which, in turn would allow them to restore the value of their vote because as the public begins to feel more engaged and satisfied with their representative in Parliament, they would place a value on their vote as they would know that it could potentially make a difference. REFERENCES: 1) Anon, (2018). [online] Available at https://www.researchgate.net/publication/228215776_What_Affects_Voter_Turnout [Accessed 9 Jan. 2018]. 2) Crewe, I 1992, Changing votes and unchanging voters, Electoral Studies, 11, 4, p. 335-345, Scopus ®, EBSCOhost, viewed 12 January 2018 3) Dalton, Russell J., Citizen Politics: Public Opinion and Political Parties in Advanced Industrial Democracies, 5th edition (Washington DC: CQ Press, 2008), p. 37. International Institute for Democracy and Electoral Assistance, â€Å"Voter Turnout Database†, International IDEA website. 4) E-International Relations. (2018). Why is Turnout at Elections Declining Across the Democratic World? [online] Available at http://www.e-ir.info/2012/09/27/why-is-turnout-at-elections-declining-across-the-democratic-world/ [Accessed 9 Jan. 2018]. 5) Hooghe, M, & Kern, A. 2017, The tipping point between stability and decline: Trends in voter turnout, 1950-1980-2012, European Political Science, 16, 4, p. 535-552, Scopus ®, EBSCOhost, viewed 14 December 2017. 6) Kolovos, I. and Harris, P. (n.d.). Voter Apathy in British Elections: Causes and Remedies. pp.2-3. 7) Kolovos, I. and Harris, P. (n.d.). Voter Apathy in British Elections: Causes and Remedies. Pp.3. 8) Lop.parl.ca. (2018). Democracy Defined | Our Country, Our Parliament. [online] Available at: https://lop.parl.ca/About/Parliament/Education/ourcountryourparliament/html_booklet/democracy-defined-e.html [Accessed 12 Jan. 2018]. 9) Publications.parliament.uk. (2014). [online] Available at: https://publications.parliament.uk/pa/cm201415/cmselect/cmpolcon/232/232.pdf [Accessed 11 Jan. 2018]. 10) Sos.wa.gov. (2018). [online] Available at: https://www.sos.wa.gov/elections/voter-participation.aspx [Accessed 11 Jan. 2018]. 11) Southwell, PL 2008, THE EFFECT OF POLITICAL ALIENATION ON VOTER TURNOUT, 1964-2000, Journal Of Political & Military Sociology, 36, 1, pp. 131-145, SocINDEX with Full Text, EBSCOhost, viewed 11 January 2018. (http://eds.b.ebscohost.com/eds/pdfviewer/pdfviewer?vid=2&sid=13872f22-38b9-460a-bd0c-4953cc4c2455%40pdc-v-sessmgr01) 12) Stuart, C. (2016). Why is the turnout for UK elections so low?. [online] Quora. Available at: https://www.quora.com/Why-is-the-turnout-for-UK-elections-so-low [Accessed 10 Jan. 2018]. 13) Ukpolitical.info. (2018). Voter turnout at UK general elections 1945 – 2017 | UK Political Info. [online] Available at: http://www.ukpolitical.info/Turnout45.htm [Accessed 11 Jan. 2018]. ONLINE SOURCES Reasons for low voter engagement: https://publications.parliament.uk/pa/cm201415/cmselect/cmpolcon/232/23205.htm Written evidence submitted by Tim Knight (VUK 69) http://data.parliament.uk/writtenevidence/committeeevidence.svc/evidencedocument/political-and-constitutional-reform-committee/voter-engagement-in-the-uk/written/8287.html Written evidence submitted by 38 Degrees (VUK 50) http://data.parliament.uk/writtenevidence/committeeevidence.svc/evidencedocument/political-and-constitutional-reform-committee/voter-engagement-in-the-uk/written/7510.html Written evidence submitted by Ian Sheppard (VUK 51) http://data.parliament.uk/writtenevidence/committeeevidence.svc/evidencedocument/political-and-constitutional-reform-committee/voter-engagement-in-the-uk/written/7575.html Written evidence submitted by Michael Yates (VUK 53): â€Å"Why does the UK experience low voter engagement† http://data.parliament.uk/writtenevidence/committeeevidence.svc/evidencedocument/political-and-constitutional-reform-committee/voter-engagement-in-the-uk/written/7880.html Written evidence submitted by David H Smith (VUK 59): Reasons for and impact of low voter engagement. http://data.parliament.uk/writtenevidence/committeeevidence.svc/evidencedocument/political-and-constitutional-reform-committee/voter-engagement-in-the-uk/written/7970.html [1] Voter Apathy in British elections: Causes and Remedies, pg2-3 [2] Democracy Defined | Our Country, Our Parliament. [3] House of Commons Political and Constitutional Committee: Voter engagement in the UK (2014-15) S3, Pg. 7 [4] Written evidence from 38 Degrees [VUK 50], Ian Sheppard [VUK 51], Michael Yates [VUK 53], David H Smith [VUK 59], Tim Knight [VUK 69], [5] Voter apathy in British elections: Causes and Remedies