Formative assignment - Organisational Culture Essay

Formative assignment - Organisational Culture - Essay Example The employees of the organization need to follow the rules and regulations in an effective way so as to maintain uniformity and evenness. Apart from this, the employees might try to present their inner ideas and information in front of all so as to enhance the quality of the product lines of the organization. Only then, the range of customers might get enhanced resulting in amplification of the entire turnover and net income of the organization (Empire Ltd) in this competitive market. Introduction The main aim of this report is to analyze and evaluate the importance of organizational culture. Other than this, the report also evaluates the ways by which human resources get influenced by culture of the organization. Side by side, the ways by which organizational socialisation is affected by the culture. To analyse all these crucial parts, the report is divided into five parts including literature review, data collection methods, finding and discussion along with a conclusion. Culture i s described as a sort of social glue that helps an individual to behave within an organization or society. Along with this, culture of an individual gets highly affected by the norms, beliefs, rules, regulations and attitudes attained from the ancestors. Due to which, the behaviour and thinking power of an individual widely varies from one individual to another. Thus, it might be stated that culture is a distinctive pattern of shared beliefs, values and norms that helps in shaping socialization, practices and rules of a specific group. However, it is the culture or attitude of an individual that helps in holding a group or community of individual together (Bratton & et. al. 2006, p. 234-267). Literature Review According to the author Bratton, organizational culture is described as a set of beliefs, values and assumptions that helps in the employees to tackle or handle any specific situation. It is the organizational culture that helps in enhancing the potential and devotion of the e mployees towards work. As a result, it helps in improving the performance of the employees thereby amplifying the total turnover and profit margin of the organization. Other than this, it also acts as a sense of certainty that helps an individual to deal or handle the challenging situations of the environment. Apart from this, organization culture also acts as a controlling mechanism that helps in presenting desired behaviour so as to maintain a uniformity and consistency within the concern. This might help an organization to retain its human resources for longer period of time resulting in improvement of its sustainability and competitiveness in the market among other rivals. Side by side, it also assists in maintaining a stable organization thereby fulfilling strategic goals and objectives. So, it is the organizational culture that helps an organization to expand its portfolio in the market among other competitors (Buchanan & Huczynski 2007, pp. 4-8). Hence, it might be depicted t hat organizational culture presents a sense of identity to the employees that enhances their willpower and dedication towards the responsibilities. Such type of organizational culture is also viewed within the organization of Empire Ltd and also among its employees. So, in spite of being such a small one, it holds a sustainable position in the market amo

Effects of Improving Productivity in Lost Foam Industry Essay Example for Free

Effects of Improving Productivity in Lost Foam Industry Essay The lost foam or expendable pattern-casting process is a relatively new process in commercial terms, but is gaining increased attention due to the environmental and technical benefits that are achievable for some types of casts. In the lost foam casting process, an expendable pattern is formed out of polystyrene foam. Patterns can be made manually, using automated systems or by molding those using a permanent die. Manual pattern making typically involves carving blocks and gluing sections together to build up the desired shape. The finished pattern is a single piece (i. e. no cores) incorporating all necessary gating systems. Process details and organizational: Lost foam casting is a type of investment casting process which uses foam patterns as the investment. This technique takes advantage of the properties of foam to plainly and inexpensively form castings that would be complicated or impossible, using normal cope and drag techniques. Why foam casting? In the world of metal casting, there are only three non-captive aluminum lost foam job shops exist, where the traditional process called sand casting remains at the top. But most of the companies could offer only with a lost foam facility. The manufacturers gives value-added castings, though the casting part might be initially more expensive, but the entire cost of the component, for the reason that of reduced or eliminated machining, less assembly and less of the other aspects, can make it more commercial for its customers. The green sand, permanent mold and die cast are lot of established processes but there is only handful of lost foam aluminum users. Even though the fact that there are only a small number of lost foam job shops across the country, some of the Irish and American Foam Cast still have to compete in the entire metal casting market. Due to the higher tooling costs than traditional casting the customers disregard lost foam strictly. Initially customers might be turned away by costs, but comparing to those cast by traditional methods certain lost foam components can be less-expensive. When estimating lost foam, with a total-cost point of view from design to finished component, customers save on unavoidable expenses in sand casting. Some of the customers were hesitant on utilizing lost foam because of its intricacies, when the Foam Cast drew in its first potential customers. But lost foam supplies the ability to design without interior while casting in geometry and features from the start. The lost foam can facilitate the staff to execute direct administration correctly over the casting process even with in the facility. Lost foam can also fabricate multiple parts to make one casting from thin to thick wall components independent of a riser. Advantages of Lost Foam Casting †¢ The lost foam casting can be used for precision castings of ferrous and non-ferrous metals independent of size. †¢ Compared to sand casting fewer steps are involved in lost foam casting †¢ In the foam casting system ‘Core making’ is eliminated. †¢ Binders or other additives and related mixing processes are eliminated. †¢ High dimensional accuracy can be achieved and thin sections can be cast (i. e. 3 mm). †¢ There is lower capital investment. †¢ The flasks used are less expensive and easier to use because they are in one piece. †¢ The need for skilled labor is reduced. †¢ Multiple castings can be combined in one mould to increase pouring efficiency. †¢ Lower operating costs can be achieved for appropriate castings. †¢ Complex castings, particularly internal sections, which require high dimensional accuracy and have thin sections, can be produced very cost effectively in comparison with to conventional sand molding processes. †¢ Fettling and machining is minimized due to high dimensional accuracy and the absence of parting lines or core fins. †¢ The shakeout process is simplified and does not require the heavy machinery required for bonded sand systems. †¢ High levels of sand reuse are possible. As little as 1-2% of the sand is lost as a result of spills. Periodically a portion of sand may need to be removed or reclaimed to avoid the build-up of styrene. Advantageous Productivity Areas of Lost Foam Process in Industry: ? Reduce Production Costs – The lost Foam process provides opportunity to reduce the labor as well as the content of energy and make other efficiency improvements must be pursued. As the activity based cost accounting approaches do the Lean manufacturing, six sigma and other concepts to progress operating efficiencies need to be practiced. Revolutionary technologies and process changes also should be investigated to achieve metal casting without the use of tooling. The industry should investigate the application and blending of statistical, shop floor layout, computer numerical control, and scheduling technologies to radically change the nature of EOQ’s, production release sizes, inventory levels, and delivery performance in metal casting plants. ? Reduce the Energy Content of Cast Products – In the lost foam system the energy consumption can be reduced by improving product quality thereby decreasing the scrap and melting requirements. The Improvements in equipment and process efficiencies can also save energy. The foam casting industry should build up a complete understanding of thermo physical behavior of alloys in melting, flow, and solidification as well as the capability to accurately simulate these behaviors. ? Waste Management – In the foam casting system, in order to enable increased reuse of foundry sand and other by-products and waste streams, more environmentally sound binders, and better emission treatment, the improvement in process are required. These Process improvements will also help to reduce scrap and thereby waste in casting processes. ? Reduced Labor Content of Cast Products –the current foam casting practices must be investigated in order to identify opportunities to decrease the number of steps in the process, develop and implement no-touch casting processes, and execute advanced information and control technologies. ? High-Quality, High-Performance Engineered Cast Components –the techniques to progress quality, precision and performance will result in fewer customer returns. The foam industry must develop an understanding of all process variation which affects the performance of castings in their applications; and develop process controls to ensure that variation is within allowable limits. Better performing products will also open new markets for metal castings. Tools are needed to capture digital, analog, or computer vision signals from all levels of the metal casting process to provide real time feedback about process status and to provide the ability to correct variances before they become product defects. The current status of Metal Casting Industry: According to Donahue â€Å"There have been significant advances from the past two years in aluminum lost foam, and yet domestic growth is almost non-existent†. The development have been made possible not because of a large group of lost foam metal casters but because of individual metal casters. According to Donahue, this influx of capital has contributed to advances in eight key areas of aluminum lost foam casting: * New types of foam which resists the folding and creating voids; * Improvement of the metal interface with sand by coatings; * Sand with low expansion rates that fill more quickly and completely; * More capable compaction systems; * reduced porosity through pressurized solidification; * Alloys that is more compatible with the filling process unique to lost foam; * modeling software; * gating advancements, such as hollow fiber sprues. Lean Manufacturing Lean Manufacturing is an operational strategy oriented achieving towards the shortest achievable cycle time by eliminating the waste. Its key thrust is to increase the value-added work by eliminating waste and reducing incidental work. The procedure often decreases the time between a customer order and shipment, and it is designed to radically improve profitability, customer satisfaction, throughput time, and employee morale. The advantages are lower costs, higher quality, and shorter lead times. The term lean manufacturing is invented to represent half the human effort in the organization, half the manufacturing space, half the investment in tools, and half the engineering hours to develop a new product in half the time. Jones and Mitchell (2006) as cited in Clive Atkinson Dr Margaret Linehan suggests Four significant benefits that can be gained through the adoption of lean management to an organization. First, increased productivity with the same workers with the existing resource levels. Second, the Improvement of delivery of work within less time. Third, reduction of error or defects and improved quality. As a Fourth one, Improved Customer satisfaction derived from the improved staff morale and a stable workforce. The characteristics of lean processes are: 1. Single-piece production 2. Repetitive order characteristics 3. Just-In-Time materials/pull scheduling 4. Short cycle times 5. Quick changeover 6. Continuous flow work cells 7. Collocated machines, equipment, tools and people 8. Compressed space 9. Multi-skilled employees 10. Flexible workforce 11. Empowered employees 12. High first-pass yields with major reductions in defects Lean Manufacturing integrates the use of Heijunka, level sequential flow, the heartbeat or pace of the production system, continuous flow manufacturing, cellular manufacturing, and pull production scheduling techniques such as Kanban. The Lean module explores the 5 Principles: †¢ Value: it deals with –What the customer is willing to pay for. †¢ Value Stream: Actions which adds value to a product or process. †¢ Flow: The continuous movement of product, favoring single-piece flow and work cells versus production lines. †¢ Pull: Replacing only material that is used and eliminating excessive inventory. †¢ Strive for Perfection: A relentless elimination of waste on a never-ending basis. Applying Kaizen as a Tool of Lean Manufacturing Technique: Kaizen Event: This is a quick-hit method for Lean process improvement. This tool needs organizational learning and readiness for implementation and is a power tool to eliminate waste in the facilities of casting industry. . Tools: Kaizen Model Kaizen was created in Japan following World War II. The word Kaizen means continuous improvement. It comes from the Japanese words kai which means change or to correct and Zen which means good. The Mixed model, one piece flow manufacturing can become a reality only when setup can happen in seconds. In these days several companies are doing mixed model assembly. Progressive automobile manufacturers use mixed model assembly methods to customize each vehicle as it comes down the line. The power of the approach presented in kaizen for quick change over is to help make it possible to do mixed modeling in production as well by making changeovers even faster. Kaizen is a system which involves every employee from superior management to the cleaning crew. Everyone is encouraged to come up with small improvement suggestions on a regular basis. This is not a once a month or once a year activity, it is a continuous process. These repeated small developments add up to major benefits. These will result in improved productivity, improved quality, better safety, faster delivery, lower costs, and better customer satisfaction. Above all of these benefits to the company, the employees working in Kaizen-based companies generally feels easier to work and more enjoyable resulting in higher employee moral and work satisfaction, and lower turn-over. With every employee looking for ways to make improvements, the expected results will be: Reduces Waste: In particular areas such as inventory management, waiting times, transportation, and worker motion, employee skills, over production, excess quality and in processes kaizen model will reduces wastage. Improvement: it improves in space utilization, product quality, use of capital, communications, production capacity and in the maintenance of employee. Kaizen Offer: It provides immediate results in the organization. Instead of focusing on large, capital intensive improvements, Kaizen focuses on creative investments which solve continually more number of small problems. Still the large and capital projects and major changes in that are needed; nevertheless kaizen improves the process of capital projects, the real power of kaizen is in the ongoing process of frequently making small improvements which develops the processes and reducing waste simultaneously. SMED SYSTEM: The other tool called SMED system is a process which makes possible to perform arrangement of equipment and changeover operations with in ten minutes, and is also used as an element of Total Productive Maintenance –TPM. Effects of 1. Forming of Implementation Team: The production employees/executors and professional team members, having responsibilities in their own sectors, represent the best alternative for team members. The purpose in implementing the 5S techniques is to enlarge the effectiveness through the development of knowledge and skills of the workers, and their responsibility. By this technique workers become more dedicated to their work; they are capable to understand appropriately the given situation and can take the correct decisions. Hence the implementation team members must act as a machine, production, tool and design technologist. 2. Training: The maintenance employees have to perform changeover team and machine setup has to be introduced into and qualified in implementing new methods and the procedures introduced into changeover procedures minimum once a week. Clarifying all the misunderstandings, training is forecasted to be done per team and questions as well as giving clear directions to enable faster and easier tool exchange (SMED). 3. Survey and screening of the situation prior to the method implementation Every changeover detail are recorded in video and complete work activity sequence is written down. Every move and every activity of the operator have to be recorded specifically, hence any unnecessary activity to attain even worse results. The same procedure recording should be done after implementing the method to establish the effectiveness in both applying the method and accomplishing the result (SMED). 4. Classification of Activity: In the classification of activity it is consists of the analysis of recorded material and the activities which can be divided into two groups: the internal and external ones. External activities are all the set up activities which can be performed while machine is in operation; where as the Internal set up activities are the ones that can be performed only if the machine is not in operation. The Internal activities refer to the dismantling of used tool, to the mounting of new ones and ascertaining communication in line of machine tool (SMED). 5. Transforming internal activities into external activities: The Transformation of internal activities into external activities is much possible. It is the most proficient procedure ever for decreasing machine outage rates (SMED). 6. Improvement of internal activities minimization – Set the tools visually, at the hand of operator (5S) – Using the connectors that may be rapidly exchanged for all tool power sources (5S) – Possible Usage of as many locating pins for accurate tool positioning. (SMED) – Cranes with sliding transporters (SMED) – Using of cranes for heavy tools only (SMED) – Using of standard tools as possible (SMED) 7. Improvement of External activities: – Placing visual markings for easier and faster identification (5S) – Using check list to prevent unpredictable events in resources preparation (5S) – â€Å"At hand† tool organization (5S) – Work place organization that decreases tool search time (5S) – Using appropriate tool preheating machine along with adequate device (SMED). 8. Forming and Standardization of the SMED procedures. 9. Saves quantification of savings reached by SMED. 10. CIP (Continuous Improvement Process) Applicability of Lean to Lost foam Industry: The five-step thought process for directing the implementation of lean techniques is easy to remember, but not easy to achieve: 1. By using the product family –the specification of value from the standpoint of the end customer. 2. Elimination of steps when necessary, that do not create value and identifying all the steps in the value stream for each product family. 3. Make the value-creating steps occur in tight sequence such that the product will flow smoothly toward the customer. 4. As flow is introduced, permit customers to pull value from the next upstream activity. 5. As value is specified, value streams are identified, wasted steps are removed, and flow and pull are introduced, begin the process again and continue it until a state of perfection is reached in which perfect value is created without any waste. There are several approaches an organization must take to meet the desired goal. Here, are some outlined tips to ensure a continuous lean transformation. 1. Identifying the company’s cultural model: Culture answers the question of how do we do things around here? and is actually the accumulation of leadership behaviors. Any organization which is serious about becoming lean needs to identify its cultural model and determine how to close the gap from the current cultural state to the ideal future cultural state. Once the base of improvement action works to build new principles, values and behaviors into the organization, then the ideal culture aspired to and begin to work on organized progress toward that ideal state is to defined. In the end, the organizations culture determines the ultimate success of any lean transformation. 2. A process improvement culture should be build: After identifying this model, a culture that practices process improvement should be build as part of daily life. Changing from a reactive culture to a process-improvement culture requires embracing an opposite approach. 3. Establishing a practice of leadership involvement The senior leadership committed to lean improvement only to drop off after the implementation gets started. Bringing leaders to the point where they recognize how to seek out waste before removing it drives the success of lean transformation. 4. Continually engage in rapid improvement events The most effective way a manager or manufacturing engineer learns how to apply lean tools and concepts is through participation in the initial week-long improvement event. The next step is to establish a series of these events as you develop new processes and uncover additional areas of waste, which will help you incorporate lean into every aspect of the business. Effects of Improving Productivity in Lost Foam Industry: Metal Casting industries that apply Lean manufacturing principles can be seen improvements in the following areas: †¢ Reduced Manufacturing Lead Time to less than 1 day †¢ Improved Delivered Quality – The defect rate is reducing to Six SIGMA level which is 3 Parts Per Million †¢ Improved Delivery Performance to 99+% †¢ Increased Inventory Turns to greater than 50 turns per year †¢ Reduced conversion costs on materials to finished goods is to 25 – 40% which is less than mass producers †¢ Reduced Manufacturing space to 35 – 50% which is less than mass producers †¢ Reduces New product development rate to less than 6 months References: Clive Atkinson Dr Margaret Linehan, An Analysis of Lean Management Procedures within Irish Motor Dealerships: International Journal of Buisnessand Management Vol . 3, No. 11, Retrieved July 18, 2009, from http://ccsenet.org/journal/index. php/ijbm/article/viewFile/894/849 Dennis Sowards, Lean Thinking is not a Fad Diet, Retrieved July 18, 2009, from http://www. masetllc. com/news/pdfs/0306-1. pdf Lean management practices in the pharmaceutical industry Heiko Gebauer, Michael Kickuth, Thomas Friedli International Journal of Services and Operations Management 2009 Vol. 5, No. 4 pp. 463 – 481 Kaizen, Retrieved July 18, 2009, from http://www. graphicproducts. com/tutorials/kaizen/kaizen-benefits. php Lost-foam casting, Retrieved July 18, 2009, from http://www.reference. com/browse/wiki/Lost-foam_casting Modern casting, Retrieved July 18, 2009, from http://goliath. ecnext. com/coms2/gi_0199-3666396/Finding-a-niche-with-lost. html Lost Foam Foundries find Energy-Saving Opportunities, Retrieved July 18, 2009, from http://www. foundrymag. com/feature/feature/67804/lost_foam_foundries_find_energysaving_opportunities Hobert E. Eppicch, Implementa tion ofMetal Casting Best Practices, Retrieved July 28, 2009, from , http://www1. eere. energy. gov/industry/metalcasting/pdfs/implementation_final. pdf

Offensive Lyrics Essay -- Music Censorship Essays

Offensive Lyrics Intro Ben, a child no more than the age of eight, adores his older brother James. James is in his mid-teens and is a huge fan of rap music. One of his favorites is Eminem. Ben, wanting to be as much like his brother as possible, does everything to become a complete copy of James. Ben dresses like him, eats the same food as he does, and even tries to mimic the way he walks. Ben even tries to listen to the same music that the older brother does. He asks his mom to buy one of the CDs that James has. His mother objects by telling him that the music that his brother listens to is not appropriate for someone his age. Ben, not knowing the meaning of what his mother says dismisses her comment and heads home with the intent to try to listen to the CD of James’ that his mother refused to buy him. After the car ride home Ben anxiously sneaks up the stairs to sample a clip of his brother’s collection. Ben turns on the CD and is immediately bombarded with a barrage of swearing, sexually explicit references, racial and homosexual slurs. Not knowing any better the boy, so excited to have been able to listen to music like his big brother, goes downstairs and repeats some of the words to his mother. In turn she explodes and sends Ben to his room where he sits not knowing what he did wrong. The next day Ben goes to school and repeats those same words to his classmates and teachers and proceeds to get himself expelled. All of this is due to the content of his big brother’s music. Although this is an antidote it is very possible that something like this could happen or has already happened. Inappropriate lyrics need to be either completely eliminated from artists songs or they need to be better censored by the... ... Biography. Available online: http://www.davidallancoe.com/bio/html (accessed October 24, 2002) Eminem Web (2000). Main Biography. Available online: http://www.eminemweb.com/bio.html (accessed October 25, 2002) Eminem World. Biography. Available online: http://www.eminemworld.com/bio.html (accessed October 25, 2002) Taylor, P. Lawmakers, Citizen Group Step up Efforts to Monitor Entertainment Industry. Available online: http://www.feedomforum.org/pakcages/first/ratinggame/part1.html (accessed October 27, 2002) Veinotte International. Ozzy Biography. Available online: http://www.veinotte.com/ozzy/madness.html (accessed October 25, 2002) Wiederhorn, J. (2002). Sex, Violence, Cursing: Explicit Lyrics Stickers Get Explicit. June 3, 2002. Available online: http://www.mtv.com/news/articles/1454956/20020603/may_lady.jhtml (accessed October 17, 2002)

The Economics of Illicit Drugs Essay -- Crime and Drugs

In this essay I will define drug abuse and show the economic impact of the sales of illicit drugs. I will introduce an argument for legalization and the impact to the economy. Next I will discuss some of the economic cost from lack of productivity, health care cost and other cost associated with Drug abuse. In order to understand the economic impact of illicit drugs we must first define what a drug is. A drug is defined as any substance other than food that affects the way your mind or body works. Abuse is defined as the wrong use or misuse of something. So drug abuse would be defined as the wrong use of drugs. As a D.A.R.E. officer, this definition has been ingrained into my mind for the past eighteen years. During my twenty years of Law Enforcement I have learned how dangerous drugs are to the economy. They damage your body and drug abuse also has a huge economic impact on the country. In the United States there are two types of drugs legal and illegal. The legal drugs have two subcategories, prescription and over the counter. Prescription drugs are placed into different categories called schedules. The ones that have a highest chance for abuse or addiction have a higher place in the schedule. Schedule I drugs are the drugs that have no safe or accepted medical use in the United States. Examples are heroin, marijuana, LSD, PCP, and crack cocaine. As you go down the schedule the drugs become less addictive and have a small potential for abuse, but are still controlled by the Drug Enforcement Agency. Schedule V are the lowest controlled drugs. Examples are codeine, valium and xanax Non prescription drugs are those that are sold over the counter and you do not need a prescription to purchase. The illegal o... ...0,000,000 on the health care, productivity and other cost, yet in the same time period we only spent $150 Billion on enforcing the drug laws. If we focused on the treatment and rehabilitation of drug abusers, I feel a substantial portion of the trillion dollars could be used for other things. The economic benefit could possibly be unmeasurable. Works Cited Bureau of Justice Statistics (BJS) . (n.d.). Bureau of Justice Statistics (BJS) . Retrieved April 10, 2011, from http://bjs.ojp.usdoj.gov/ Moomaw, R. L., Olson, K. W., & Edgmand, M. R. (2007). Crime and Drugs a Modern Delima. Economics and contemporary issues (7th ed., pp. 201-216). Mason, OH: Thomson/South-Western. THE ECONOMIC COSTS OF DRUG. (2001, September 1). National Criminal Justice Reference Service. Retrieved April 7, 2011, from www.ncjrs.gov/ondcppubs/publications/pdf/economic_costs98.pdf

Barriers to Communication

Sender-oriented †¢Receiver-oriented Sender oriented barriers: It can be either voluntary or involuntary. At any cost, efforts should be made on the part of the sender to identify and remove them. Some of the barriers that are sender oriented are: ? Badly expressed message: concrete ideas and well structures message ? Loss in transmission: correct choice of medium or channel ?Semantic problem: simple words and accurate understanding of intension ? Over/under communication: quantum of information should be right ? I’ Attitude: avoid I attitude ?Prejudices: mind free of bias Rules to overcome the sender oriented barriers: ?Plan and clarify ideas ?Create a climate of trust and confidence ?Time your mind carefully ?Reinforce words with action ?Communicate efficiently Receiver-oriented barriers: ?Poor retention: jot down points ?Inattentive listening: improve concentration ?Tendency to evaluate: delay evaluation ?Interest and attitudes: develop interest ?Conflicting information : confirm with feedback, clarify Differing status and position: encourage juniors to come up with ideas and listen ? Resistance to change: be flexible ?Refutations and arguments: enter into healthy discussions Communication noise In any communication model, noise is interference with the decoding of messages sent over a channel by an encoder. There are many examples of noise: Environmental Noise: Noise that physically disrupts communication, such as standing next to loud speakers at a party, or the noise from a construction site next to a classroom making it difficult to hear the professor.Physiological-Impairment Noise: Physical maladies that prevent effective communication, such as actual deafness or blindness preventing messages from being received as they were intended. Semantic Noise: Different interpretations of the meanings of certain words. For example, the word â€Å"weed† can be interpreted as an undesirable plant in your yard, or as a euphemism for marijuana. Synta ctical Noise: Mistakes in grammar can disrupt communication, such as abrupt changes in verb tense during a sentence.Organizational Noise: Poorly structured communication can prevent the receiver from accurate interpretation. For example, unclear and badly stated directions can make the receiver even more lost. Cultural Noise: Stereotypical assumptions can cause misunderstandings, such as unintentionally offending a non-Christian person by wishing them a â€Å"Merry Christmas. † Psychological Noise: Certain attitudes can also make communication difficult. For instance, great anger or sadness may cause someone to lose focus on the present moment. Disorders such as Autism may also severely hamper effective communication. [11] Barriers to Communication Barriers to communication I Ways to overcome the barrier I A person could be deaf, so obviously they cannot hear what any body is saying to them, they wouldn't be able to hear somebody calling them over and they wont know If people are talking about them which could also lower their self esteem. I This person could still be communicated with by others that know sign language, people could learn sign language so they can interact and communicate with this person, or written communication could be used so people are still able to talk to this person.I People from different cultures may not speak the same language which is a barrier to communication, because they will not be able to understand what you are saying and you will not be able to understand them. I This can be solved by having a translator to help you communicate, you could also try to understand their language by having someone teach you. Pictures and signs could be used to communicate visually making It easier to communicat e.I Having a lack of confidence could be a barrier to communication because the person wont feel confident enough to speak to you, be reverse, shy and scared, and lack of confidence could prevent communication skills from developing. I Ways to overcome this could be to make the person feel comfortable, start off the conversation, make the person feel like you are interested and make them feel better about them selves. I If a person is blind they could feel uncomfortable speaking to people because they wont be able to see who they're talking too, feel vulnerable, scared and unsafe.I Having a person that they know and feel comfortable around with them, would help because they then would feel safe ND secure having somebody they trust with them I Speech difficulties. A person may not be able to speak due to damage to the brain or vocal cords or any other problems they may have which doesn't allow them to speak. I Electronic speech synthesizers could solve this problem. It allows people who have problems with speaking, to communicate with others although they can't actually speak themselves.I Having parent's who are deaf/have speech difficulties could be a problem,it could prevent communication skills developing because their parent's can't speak to hem, teaching them communication skills as they grow up. I Being at nursery, and schools will help this situation. The child will be around others who will speak and communicate in other ways with them. Teaching them communication skills. Having a family member, friend or helper who has no speech difficulties, around the child as he or she grows up would make a difference because he or she can pick up the communication skills they need from that person. Barriers to Communication Sender-oriented †¢Receiver-oriented Sender oriented barriers: It can be either voluntary or involuntary. At any cost, efforts should be made on the part of the sender to identify and remove them. Some of the barriers that are sender oriented are: ? Badly expressed message: concrete ideas and well structures message ? Loss in transmission: correct choice of medium or channel ?Semantic problem: simple words and accurate understanding of intension ? Over/under communication: quantum of information should be right ? I’ Attitude: avoid I attitude ?Prejudices: mind free of bias Rules to overcome the sender oriented barriers: ?Plan and clarify ideas ?Create a climate of trust and confidence ?Time your mind carefully ?Reinforce words with action ?Communicate efficiently Receiver-oriented barriers: ?Poor retention: jot down points ?Inattentive listening: improve concentration ?Tendency to evaluate: delay evaluation ?Interest and attitudes: develop interest ?Conflicting information : confirm with feedback, clarify Differing status and position: encourage juniors to come up with ideas and listen ? Resistance to change: be flexible ?Refutations and arguments: enter into healthy discussions Communication noise In any communication model, noise is interference with the decoding of messages sent over a channel by an encoder. There are many examples of noise: Environmental Noise: Noise that physically disrupts communication, such as standing next to loud speakers at a party, or the noise from a construction site next to a classroom making it difficult to hear the professor.Physiological-Impairment Noise: Physical maladies that prevent effective communication, such as actual deafness or blindness preventing messages from being received as they were intended. Semantic Noise: Different interpretations of the meanings of certain words. For example, the word â€Å"weed† can be interpreted as an undesirable plant in your yard, or as a euphemism for marijuana. Synta ctical Noise: Mistakes in grammar can disrupt communication, such as abrupt changes in verb tense during a sentence.Organizational Noise: Poorly structured communication can prevent the receiver from accurate interpretation. For example, unclear and badly stated directions can make the receiver even more lost. Cultural Noise: Stereotypical assumptions can cause misunderstandings, such as unintentionally offending a non-Christian person by wishing them a â€Å"Merry Christmas. † Psychological Noise: Certain attitudes can also make communication difficult. For instance, great anger or sadness may cause someone to lose focus on the present moment. Disorders such as Autism may also severely hamper effective communication. [11]

Essay about The Early Life of Machiavelli

Essay about The Early Life of Machiavelli Essay about The Early Life of Machiavelli Slide 2: The early life of Machiavelli Machiavelli was born on May 3rd 1469 in Florence, Italy, the first son and third child of attorney Bernardo di Niccolà ² Machiavelli and his wife Bartolomea di Stefano Nelli. He was born to an established though not affluent middle-class family whose members had traditionally filled positions in local government. Machiavelli was born in a tumultuous era- popes waged acquisitive wars against Italian city-states, and people and cities might fall from power at any time. Married Marietta Corsini, 1501; children: five. Slide 3: About his life He was born as aristocrat†¦.This is a member of a aristocracy government. His father was an aristocrat. The most powerful class in Greek history While little of the author's early life has been documented, it is known that as a boy he learned Latin and that he quickly became an assiduous reader of the ancient classics. His main political experience in his youth was watching Savanarola from afar. Soon after Savanarola was executed, Machiavelli entered the Florentine government as a secretary. His position quickly rose, however, and was soon engaging in diplomatic missions. He met many of the important politicians of the day, such as the Pope and the King of France, but none had more impact on him than a prince of the Papal States, Cesare Borgia. Unfortunately, for Machiavelli, he was dismissed from office when the Medici came to rule Florence and the Republic was overthrown. The lack of a job forced him to switch to writing about politics instead of being active. His diplomatic missions were his last official government positions. Slide 4: Fields of work During the renaissance, he was an Italian diplomat, political philosopher, musician, poet, and playwright. He was a founder of modern political science, and more specifically political ethics. Machiavelli is regarded by some as the founder of value-free political science. He describes politics as it is, not as it might be, and shows how this knowledge can be exploited to bring greater order into human affairs. But Machiavelli's science is anything but value-free: He prefers glory to security, and admires innovators more than conservatives. Though he writes both for republics and tyrants, many have argued that he favors one over the other. In fact, he clearly has a preference for republics, but believes that the founding father of every republic needs to possess unrestrained power. Machiavelli engaged in a flurry of diplomatic activity on behalf of Florence, travelling to the major centers of Italy as well as to the royal court of France and to the imperial curia of Maximilian. We have letters, dispatches, and occasional writings that testify to his political assignments as well as to his acute talent for the analysis of personalities and institutions. During his lifetime, Machiavelli was best known as a playwright, and the Mandragola is his most original play. In this comedy Machiavelli applies his views to ordinary, seemingly nonpolitical life: Callimaco, a young man, is attracted to young Lucrezia, who is unfortunately married to Nicia, an older man. Thus Callimaco agrees to a plan devised by the Machiavellian figure Ligurio to gain access to Lucrezia. As this is a work of fiction, and not a long one to read, I will not reveal the whole plot here so as not to spoil anyone’s fun. The Mandragola is regarded as a classic of Italian literature, illustrating Machiavelli’s versatility as an author. It touches on many of the themes common to his political works: people’s ambition to get what they want, the gray areas in moral life, criticism of the church and so forth. But here his irreverent attitude is more visible than in his more â€Å"serious† works. Slide 5: Impacts Scholars have argued that Machiavelli was a major indirect and direct influence upon the political thinking of the Founding Fathers of the United States. Benjamin Franklin, James Madison and Thomas Jefferson followed

Free Essays on A Dolls House

A Doll’s House In 1879 the first stage production of Henrik Ibsen’s A Doll’s House caused quite a stir, ending with what one critic called â€Å"the slammed door that reverberated across the roof of the world†. (Handout, A Doll’s House, Ibsen, pg 580) It is hard to imagine today that a woman leaving her husband and children behind to go find herself could even raise an eyebrow, but this was the Nineteenth Century. This was a time of openly displayed male dominance, where women were brought up to be economically, socially, and psychologically dependent on men and especially on the institutions of marriage and motherhood. Women were expected to be the trophy, the plaything, as well as the means for bearing children for their husbands and, during this time, women did what was expected of them. They allowed themselves to be spoiled and didn’t let on if they minded not being able to think for themselves. Ibsen’s character, Nora, turned all these traditiona l roles upside down in 1879, with one closing of the door. Nora Helmer was raised by her father according to the traditions of that period, meaning she was expected to absorb his opinions, ideas, and tastes rather than develop her own. She was made to believe her greatest role in life was in becoming a wife and mother. Her father, like her husband, did not take her seriously but treated her like a doll or a plaything. She performs for her husband in exactly the way he wants her to perform. He wants her to be pretty and childlike, with no head for business. Nora knows if she behaves the way he wants, it will make him happy. His values will have been flattered by her playfulness and his ego will be stroked. It is then she can get what she wants. That in itself brings a sense of power over men that women have always had, and maintain today. In the play, Nora has secretly borrowed money, by forging her father’s name to an IOU, to take her seriously ill husband ... Free Essays on A Doll's House Free Essays on A Doll's House I found A Doll’s house to be a very complex and a very well thought out play. Rather than presenting the traditional happy ending Ibsen decided to end the play with a twist, especially for the times. I decided to take the ending that Ibsen used and prolong it. Through out the play I had a connection with the character of Dr.Rank. I felt that he provided guidance and advice to household. Since Torvald confided in him so much I felt that Nora should as well. I sent Nora to Dr.Rank’s home was mostly because of the conversation they had earlier when Rank told Nora had some feelings for her and also the fact he was the only other person Nora trusted or confided in at the time besides her friend Kristine. Since Nora left her home so confident and headstrong I did not want that momentum to die in the next act (IV). Even though DR.RANK was not in the best physical and metal condition I still wanted him to be an asset to the play. I believed that having that conversation in RANK’S home showed that she did care for him as well and that she also trusted him and the advise he had. I wanted to show NORA and DR.RANK having something in common in act IV because I felt they had a small connection during the play. Plus I wanted to show a change in character with DR.RANK because I wanted him to continue throughout the play. At the very end, when NORA asked rank for money it was the punch line related to the incident with Krogstad. The reason being I feel that NORA could never the independent women that she dreams of. Nor does know any other lifestyle and she always has to be controlled or comforted by someone.... Free Essays on A Doll's House In Henrik Ibsen’s, A Doll’s House, the character of Nora Helmer goes through the dramatic transformation from a kind a loving mother to an empowered woman. Her transformation is the personification of feminism during the nineteenth century. Torvald, her husband, represents society in the way he treats his wife. Nora rebels against this treatment and comes to realize that she is her own person, not a mother, not a wife, but a woman. In Act I Nora is still nothing more than a child, careless in her action and not thinking ahead to the possible consequences. She enters the scene, just returning from her Christmas shopping, planning to have a big holiday party. Her husband, Torvald, tells her that their budget this year won’t permit them to have the usual big holiday party they usually have. He speaks to her in a very condescending way, representing the way society viewed women at the time. Her treats her like a child, telling her that she doesn’t know better and calling her pet names like â€Å"songbird† and saying that she is â€Å"scatterbrained†. Society at this time viewed woman in the exact same way. Creatures meant to be taken care of because they â€Å"did not know better†. Torvald’s condescending manner serves to slowly push Nora closer and closer to the edge, finally pushing her over in the end. Toward the end of Act I a man named Krogstad enters onto the scene. This is the man from whom Nora has borrowed four thousand crowns to finance a trip to southern Italy. This meeting begins Nora’s slow transformation from the inferior half of society to the empowered woman. Krogstad comes to Nora seeking a favor. He works at the bank where Torvald is the manager and he has broken the law, but still wants to keep his job. He asks Nora to try to persuade Torvald to let him keep his job. When Krogstad asks this favor of Nora he highlights another role that society demands of women. He recognizes the feminine influ... Free Essays on A Doll's House â€Å"People who questioned how Nora Helmer could fare in the world on her own were not aware that it is a common theme in folklorethat of the innocent creature journeying through the world to discover basic human values...Only an innocent, fearless creature has the power of vision to see through false values of sophisticated society†{Marianne Sturman). This quote lays the foundation for the circumstances that kept the character, Nora, innocent and quite naive to the ways of the world. But, innocence should not be mistaken as an inability to adapt and overcome, as Nora completely demonstrates her ability to do so in Henry Ibsen’s play, â€Å"A Doll’s House.† Nora’s innocence allows her to see through the subterfuge and masks that polite society obtain in order to make their way in the world. However, in the time this play is set, Nora is kept, much like a doll, away from the necessity to struggle for a living. Lack of struggle does not make her unintelligent; in fact, she is just the opposite, having become a master manipulator. Of course, like most women of her time period, manipulation was the only way in which they could achieve their own goals. In this respect, women were reduced to the role of children. The men of the time, especially her husband Torvald, belittle their women and define them based on their potential as a companion, housekeeper, and the ability to produce offspring. This attitude is quite evident in Torvald’s belittling attitude of Nora. In one of the very first scenes between the two, the reader realizes that Torvald is going to be a domineering and demeaning person to Nora. He downplays her suggestions with dull phrases such as â€Å"how like a woman†(Ibsen 1011) and â€Å"Spendthrifts are sweet, but they use up a frightful amount of money† (Ibsen 1012). These are the types of phrases one uses with a child, which serves to reduce Nora to the status of a child. Torvald seems to take an ownership manne... Free Essays on A Doll's House A Doll’s House I believe that â€Å"A Doll’s House† could be updated because; most of the central ideas are still prevalent in today’s society. There are still women today that feel trapped by their marriages, still run away from their marriage’s leaving children behind, and still feel that it is important to do more then get married and have children. One of the reasons that I feel that â€Å"A Doll’s House† could be updated is that many women of today still feel trapped by their marriages. Some women, I’m sure this might be more common in upper class societies, fell that they are not equal to their husbands, just like Nora felt. They don’t receive all of the prestige and praise that their husbands do, and they wonder what their role is in the marriage. Many women of today still feel like they are a â€Å"doll† with nothing of importance to do. They have nannies and babysitters that practically raise their children, and so they feel that they don’t bring any real influence in raising their children. Just as Nora felt she didn’t have much influence in raising her children. Her husband even at one time was going to take her children away from her. In some cases all of these feelings can only be made worse if the wife in the marriage has no real college education. Then in this case she, is unable to get a job that is comparable to her husbands. This is exactly the problem that Nora had, and it was very frustrating to her. All these issues in today’s society can leave any women feeling trapped in her marriage just as Nora felt. On another note, although it is a lot more common now if not even a more accepted part of today’s society, women still run away from their marriage leaving children behind. All thought it would not be as shocking today’s society as it was in Nora’s time, there are still many cases of a wife leaving her family. I sure that everyone knows somebody that this has happened to... Free Essays on A Doll's House Influence Of Antigonism On A Doll's House It is very difficult to label something as a first in literature. Much the way inventions are often adaptations of previously patented objects, most authors borrow ideas and techniques form pre-existing media. In order to truly classify something as a first one must look for something entirely revolutionary, something that has never been done before. Two of these so called "firsts" include the first modern novel with Flaubert's Madame Bovary and what has been called the first modern play in Ibsen's A Doll's House. Regarding the latter, it is important to realize that while the play did break several molds which had endured for centuries, much was borrowed and adapted from past works. Of these, another "first" emerges for having shown a strong influence on Ibsen and his revolutionary play. Coincidentally, it is what historians refer to as on of the first plays in existence, Sophocles' Antigone. In merely looking at the surface, one notices right away that both plays are significant in that they avoid the social temptation of using a man as a protagonist. Looking deeper into the stories, however, one can see that in even more contradiction with society, the female characters go against men. Both Antigone and Nora step into the spotlight as the female hero who has been put in a compromising situation and is forced to decide whether it is more important to follow what society dictates, or go with what they feel is moral and just. Antigone is faced with the death of both brothers, one who is to be buried with full military rites, while the other, under dictate of the king, is to be cast aside and allowed to rot in the sun. She places family before the law, and ventures out to give her brother a proper burial. In A Doll's House, Nora too must decide where the line between right and wrong is drawn. In order to save her husband's life, Nora forges her fa... Free Essays on A Doll's House A Doll’s House In 1879 the first stage production of Henrik Ibsen’s A Doll’s House caused quite a stir, ending with what one critic called â€Å"the slammed door that reverberated across the roof of the world†. (Handout, A Doll’s House, Ibsen, pg 580) It is hard to imagine today that a woman leaving her husband and children behind to go find herself could even raise an eyebrow, but this was the Nineteenth Century. This was a time of openly displayed male dominance, where women were brought up to be economically, socially, and psychologically dependent on men and especially on the institutions of marriage and motherhood. Women were expected to be the trophy, the plaything, as well as the means for bearing children for their husbands and, during this time, women did what was expected of them. They allowed themselves to be spoiled and didn’t let on if they minded not being able to think for themselves. Ibsen’s character, Nora, turned all these tradition al roles upside down in 1879, with one closing of the door. Nora Helmer was raised by her father according to the traditions of that period, meaning she was expected to absorb his opinions, ideas, and tastes rather than develop her own. She was made to believe her greatest role in life was in becoming a wife and mother. Her father, like her husband, did not take her seriously but treated her like a doll or a plaything. She performs for her husband in exactly the way he wants her to perform. He wants her to be pretty and childlike, with no head for business. Nora knows if she behaves the way he wants, it will make him happy. His values will have been flattered by her playfulness and his ego will be stroked. It is then she can get what she wants. That in itself brings a sense of power over men that women have always had, and maintain today. In the play, Nora has secretly borrowed money, by forging her father’s name to an IOU, to take her seriously ill husband ...

List of Poets Laureate of the U.S.A.

List of Poets Laureate of the U.S.A. Who are all the poets who have served the Library of Congress as Consultant (the old title) or Poet Laureate Consultant (the new title)? Learn more about the lives and works of these distinguished artists through the resources listed below. 1937-1949 Joseph Auslander 1937-41: His sonnet, â€Å"To My Despoiler†Allen Tate 1943-44: His essay on writing poetry, â€Å"Narcissus As Narcissus†Robert Penn Warren 1944-45Louise Bogan 1945-46Karl Shapiro 1946-47Robert Lowell 1947-48Leonie Adams 1948-49Elizabeth Bishop 1949-50 1950s Conrad Aiken 1950-52: First to serve two termsWilliam Carlos Williams: Appointed to serve two terms in 1952 but did not serve.Randall Jarrell 1957-58Robert Frost 1958-59Richard Eberhart 1959-61: â€Å"A Student’s Memories of Richard Eberhart,† by David Graham 1960s Louis Untermeyer 1961-63: His poems â€Å"Prayer,† â€Å"Summons† and â€Å"On the Birth of a Child† and â€Å"Reveille†Howard Nemerov 1963-64Reed Whittemore 1964-65Stephen Spender 1965-66James Dickey 1966-68William Jay Smith 1968-70: His â€Å"Epigrams† 1970s William Stafford 1970-71Josephine Jacobsen 1971-73Daniel Hoffman 1973-74Stanley Kunitz 1974-76Robert Hayden 1976-78William Meredith 1978-80 1980s Maxine Kumin 1981-82Anthony Hecht 1982-84Robert Fitzgerald 1984-85: Appointed and served in a health-limited capacity, but did not come to the Library of CongressReed Whittemore 1984-85: Interim Consultant in Poetry  Gwendolyn Brooks 1985-86  Robert Penn Warren 1986-87: First to be designated Poet Laureate Consultant in PoetryRichard Wilbur 1987-88Howard Nemerov 1988-90 1990s Mark Strand 1990-91Joseph Brodsky 1991-92Mona Van Duyn 1992-93Rita Dove 1993-95: Her poem, â€Å"Lady Freedom Among Us†Robert Hass 1995-97:  Poems, translations, bibliography and articles about Hass’ workRobert Pinsky 1997-2000​:  His Favorite Poem Project 2000s Stanley Kunitz 2000-2001​Billy Collins 2001-2003: His Poetry 180 Project to bring poetry into American high schoolsLouise Glà ¼ck 2003-2004Ted Kooser 2004-2005: Excerpt from his book, The Poetry Home Repair Manual, Practical Advice for Beginning PoetsDonald Hall 2006-2007: His reading of, â€Å"Poetry Across the Atlantic,† in a historic joint reading with U.S. Poet Laureate Hall and UK Poet Laureate Andrew MotionCharles Simic 2007-2008Kay Ryan 2008-2010:  Her poems, audio readings and podcasts 2010s W.S. Merwin 2010-2011Philip Levine 2011-2012Natasha Trethewey 2012-

Science Essay Example | Topics and Well Written Essays - 1750 words

Science - Essay Example Once in the sea, they typically stay there around 4 years before returning up the rivers they came from to spawn. 3. Wildebeast – nomadic migration, performed by wildebeasts as a function of seeking out new grazing and better sources of drinking water; this typically is a relatively short migratory route. Occurs on a seasonal basis and is dependent upon the quality of grass and the availability of water within the affected regions. Other species such as the impala accompany the wildebeasts in this mass migration pattern. 4. Humback Whales – seasonal migration. Humpback whales spend the winter months in warmer climates while during the summers they hunt for krill and small fish in polar climates. Performed on a seasonal/yearly basis; this typically is a relatively long migratory route. Humpback whales are known not to eat while in the warmer waters closer to the equator during the winter months. 5. Dall Sheep – altitudinal migration. Dall sheep typically spend the winter months in lower elevations where they can dig through the snow to find patches of existing grass. However, once the summer months appear, they climb back up into higher elevations; both for protection and due to the fact that food is also abundantly available there; this typically is a relatively short migratory route. ... The average arctic tern lives about 20 years and during this time can cover over 1.5 million miles! 7. Golden Eagles-partial migration. The golden eagles ultimately a bird that exhibits a partial migration in the fact that not each and every one of the species leaves it habitat as part of the migration. The migration itself is a medium to long migratory route that has as its purpose breeding in the sub Arctic regions of Alaska and Canada; returning to warmer climates once the summer is at an end. The golden eagle is the emblem of perhaps more countries than any other animal. It is officially the emblem of Albania, Kazakhstan, Mexico, Austria, and Germany. 8. Sea Turtles (pick any one of the 8 species) – reproductive migration. Green sea turtles travel vast distances from their feeding grounds to the beaches that they will ultimately deposit their eggs upon. Currently, green sea turtles, like the other sea turtles, are endangered due to human activity and the overall lack of en vironmental conditions that they can lay their eggs unadulterated. 9. Locusts – is a type of animal that exhibits an interruptive migration. These migrations are incumbent upon the region that the locust is in and the availability of the food source within this region. The distances traveled are usually not as far as many of the other species that have been discussed. Locust migration has been known to cause vast amounts of damage and ultimately the deaths of tens of thousands of people throughout history as the result of famine caused by the destruction in crops and grassland that they can effect. 10. Great Gray Owls- are indicative of a nomadic migration. The nomadic patterns of the great grey owl are little understood;

Assessments in Instructional Design Essay Example | Topics and Well Written Essays - 750 words

Assessments in Instructional Design - Essay Example Generally, assessments are understood as tests that measure the levels of competence, knowledge or skills as results from instruction (Shank, 2009, p.1). Accordingly, good assessments of learning results measure whether students are capable of doing things they have to be able to do as instruction’s result. Dirks writes that assessments consist of two components. These are measurement and evaluation (Dirks, 1997, p.3). Measurement deals with describing students’ performance with the help of a quantitative and/or qualitative approach. Evaluation is about judging the adequacy of either students’ performance or sample work (Erickson & Wentling, 1978, p. 3). Importantly, there can be identified five principal types of assessments use. These are 1) Communication of the student’s achievement status 2) Providing self-evaluation data to a person who is learning 3) Learner placement for certain educational programs/paths 4) Motivation of a student 5) Evaluation of the instructional programs effectiveness (Guskey, 1996). Given this, the appropriate use of assessment can be explained as the one that successfully combines the aforementioned dimensions. In other words, appropriate use of assessment communicates achievement statuses of students, gives learners information for self-evaluation, helps place learners within selected educational programs, motivates students, helps find out whether an instructional program has been effective or not. The use or misuse of assessment can be evaluated through identifying whether the learning goals have been achieved. To illustrate, Shan thinks that â€Å"to determine if needed results have been achieved, results are often measured and assessed against a predefined set of standards† (Shank, 2009, p.1). In instructional design, these are known as learning objectives. For example, if a learning objective for a course of Business Etiquette is to teach students to identify the relevant actions for a numbe r of situations in business where these skills are to be used, the assessment designed as a learning game is inappropriate. This can be explained by the fact that just measuring whether the information presented by the professor has been remembered does not provide any measurement of students’ ability. To design appropriate assessments one should view them as an inseparable part of a complex instructional process. The latter combines 1) designing objectives that relate to needed results and are relevant to them; 2) designing assessments that are relevant to learning objectives; 3) designing instruction that is relevant to both objectives and assessments; 4) evaluation all three components to ensure they are relevant and needed results have been achieved (Shank, 2009, p.1). To judge about the assessment’s appropriateness one should identify whether the assessment can be characterized as 1) valid; 2) reliable; 3) feasible; 4) having stakes. Assessment’s validity i s understood as â€Å"the extent to which the assessment procedure measures what it is intended to measure† (Henning-Stout, 1994, p. 229).

Soto Essay Example | Topics and Well Written Essays - 750 words

Soto - Essay Example Soto exhibits several strong purposes in writing this essay. The first thing that the reader will notice is that this author writes to entertain. The reader can visualize the boy in the story trying to find something to do other than watch ‘the perfect family’ on television all summer. His interactions with others throughout the story, while carrying an underlying tone we will analyze in a moment, are written in a narrative format that is easy to follow along. Whoever reads the story can feel a part of the boy’s life and truly visualize what he spends his summer days doing. When he encounters Mrs. Moore in his effort to do some work at her house, she exclaims â€Å"It’s summer, and there ain’t no leaves† (Soto 24). This makes us all remember the days of our youth and our good-natured encounters with the neighbors. A subsequent, more serious purpose to this essay lies in the life of the boy and his siblings. Soto appears to be asking the reader to empathize with the characters in the story. Adults all around them seem to be communicating that, because of their Hispanic heritage, they can only go so far up the ladder of success in society. So, they spend their days watching the perfect ‘white’ family on television and wishing, almost, that they had been born into a different family, or at least at a different time. This is a social message. Soto is effectively asking his audience to imagine being a child who feels others around him are superior to him simply because of their race. He also is asking the reader to visualize being a child and discovering that nearly every adult in your life supports the notion that you are stuck where you are and cannot advance. It is certainly not a ‘pretty picture’, but it is certainly a message that certainly gives the reader pause to reflect and consider. Soto was effective in pointing the readers, in an entertaining fashion, towards a serious social problem faci ng the country. He takes issue with boys and girls who are told their dreams cannot come true even before they reach the middle of adolescence. The boy’s two siblings seem to already have bought into this notion. His brother, in essence, spends his days playing around in the ditch and really desires to do nothing else. Sensing that there is more to life, the boy begins to strike out on his own and try to make something of himself. Sure, this is just a story, but the message and purpose is clear. Soto really desires to use this essay to point towards this perceived social injustice and he challenges society to take action. To this end, the author is effective. One of Soto’s ideas during this essay is that adults perpetuate this feeling in minority children that they are destined to a life that is inferior to others. He demonstrates this with the boy’s mother. Early in the story, the narrator’s mother tells him â€Å"Boy, are you a crazy Mexican. Where did you get the idea that people eat turtles?† (Soto 23). The implication of the mother throughout is clear. While she certainly seems to love her children, she believes that, since they are Mexican, they cannot be like the ‘white children’ they see on television. Sure, you want your children to be proud of their race. Upon analyzing this essay and its purpose, however, it is

Entrepreneurial DNA Reading Assignment Essay Example | Topics and Well Written Essays - 1000 words

Entrepreneurial DNA Reading Assignment - Essay Example Various definitions have attempted to present what it takes to become successful entrepreneurs. Some relate entrepreneurial success to age, education among other factors. While these factors are essential in ensuring the success in business, they lack reliability and validity. However, Entrepreneurial DNA development types present an understandable, valid and reliable approach. As a result, BOSI represents the four types of Entrepreneurial DNA that exists among entrepreneurs. These types relate to Builder, Opportunist, Specialist as well as an innovator that form the DNA of entrepreneurship. Builders tend to possess the characteristics related to high maintenance with a keen focus on increasing the sales volume and the lowest limit that an organization may effectively operate (Abraham 2011). These individuals are like chess players in the business environment as they concentrate on achieving two or more moves ahead of other players in the business environment. Opportunists, on the ot her hand, attribute everything at their disposal as achievable. To the opportunist, the word the word failure only exists in the mindset of a person but not in the real world. One of the significant achievers that Abraham suggests as an opportunist is Richard Branson, who has successfully enlarged his business empire based on his instinct ability to identify a course of corporate action and react. Opportunists influence workers towards achieving milestones that under typical situations workers may fail to meet. The other type of entrepreneurs relates to specialists who engage and focus on defined set of activities and works to achieve perfection. A leading example is Bill Gates and his Microsoft Corporation, where he has focused on one thing and worked to perfect the results of the activity. Abraham recognizes these types of entrepreneurs as essential to the economy as they play a significant

Coursework of Qualitative and Ouantitative Research Essay

Coursework of Qualitative and Ouantitative Research - Essay Example (selecting respondents to match certain criteria, e.g. socio- emographic) the more cost-effective, and still reliable. While it may seem most cost-effective to buy in a mailing list (which may be sold as a "sample"), it is highly likely that the poor quality of the list, and the resultant low response rate will produce highly misleading and unreliable results. A larger sample is better than a smaller one, but not in direct proportion; for example, for the analysis to be twice as good, a sample needs to be four times as large, and to be three times as good, nine times as large. A professional agency will be able to advise on the way to achieve the best balance between quality, quantity and cost in sampling to produce reliable findings. Quantitative Data Collection Different methods are used to go ahead with a quantitative research including telephone, postal , on-line and face-to-face methods . In addition, observation studies are growing in popularity. Each has its pros and cons, depending on the time and budget constraints and objectives of the research. For example, postal surveys or self completion surveys are likely to be recommended only in certain circumstances. Quantitative Question-Design Very distinct skills are required to undertake qualitative or quantitative research effectively. Researchers have to be able to design questions which are clear, consistently interpreted, widely understood, unambiguous, meaningful, relevant and tightly defined a more difficult task than it may appear to outsiders. In addition, the full questionnaire must be capable of extracting rich and relevant information which will help managers to make more effective...Therefore , the need is for smaller but focused samples rather than large random samples , which qualitative research categorizes data into patterns as the primary basis for organising and reporting results. 4."It certainly seems reasonable to suggest that one may have a better understanding of a community member's situation by reading a descriptive passage than just looking at demographic statistics"(Kruger,2003)

Entrepreneurial DNA Reading Assignment Essay Example | Topics and Well Written Essays - 1000 words

Entrepreneurial DNA Reading Assignment - Essay Example Various definitions have attempted to present what it takes to become successful entrepreneurs. Some relate entrepreneurial success to age, education among other factors. While these factors are essential in ensuring the success in business, they lack reliability and validity. However, Entrepreneurial DNA development types present an understandable, valid and reliable approach. As a result, BOSI represents the four types of Entrepreneurial DNA that exists among entrepreneurs. These types relate to Builder, Opportunist, Specialist as well as an innovator that form the DNA of entrepreneurship. Builders tend to possess the characteristics related to high maintenance with a keen focus on increasing the sales volume and the lowest limit that an organization may effectively operate (Abraham 2011). These individuals are like chess players in the business environment as they concentrate on achieving two or more moves ahead of other players in the business environment. Opportunists, on the ot her hand, attribute everything at their disposal as achievable. To the opportunist, the word the word failure only exists in the mindset of a person but not in the real world. One of the significant achievers that Abraham suggests as an opportunist is Richard Branson, who has successfully enlarged his business empire based on his instinct ability to identify a course of corporate action and react. Opportunists influence workers towards achieving milestones that under typical situations workers may fail to meet. The other type of entrepreneurs relates to specialists who engage and focus on defined set of activities and works to achieve perfection. A leading example is Bill Gates and his Microsoft Corporation, where he has focused on one thing and worked to perfect the results of the activity. Abraham recognizes these types of entrepreneurs as essential to the economy as they play a significant

Samsung Electronics And Its Managerial Essay Example | Topics and Well Written Essays - 1500 words

Samsung Electronics And Its Managerial - Essay Example The study will investigate the electronics industry in general and it will focus on Samsung Electronics and its managerial, operations and product distribution style as a model which can be duplicated by Chinese Companies. Samsung rose from the bottom of a mass produced, low price, export dumping electronic company to be situated as the number three electronic company in the global market. There are no Chinese Companies which hold this distinction of being a leader in any industry. The study will point out why and how the Korean Company has become an industry leader. The study will pursue this topic because Samsung’s management and operations style is extremely successful, and its importance as a business model can serve as an example to other companies on how an aggressively focused Research and Development department, and a well thought out marketing concept can make the difference in a company’s bottom line. The beneficiaries will at a minimum be two-fold; for studen ts who are interested in how a successful company plans its short and long term objectives for project development. How important it is to identify your primary market during the conception and development of a product and how critical it is to produce high-end quality products and not waver on corporate pricing structures. It will exhibit to the business the person how critical it is to establish policy and make it stick. The information presented by the study will provide the inner details of a strategy which exhibits sound long-range business.... style is extremely successful, and its importance as a business model can serve as an example to other companies on how an aggressively focused Research and Development department, and a well thought out marketing concept can make the difference in a company's bottom line.The beneficiaries will at a minimum be two fold; for students who are interested in how a successful company plans its short and long term objectives for project development. How important it is to identify your primary market during the conception and development of a product and how critical it is to produce high-end quality products and not waver on corporate pricing structures. Moreover, it will exhibit to the business person how critical it is to establish policy and make it stick. The information presented by the study will provide the inner details of a strategy which exhibits sound long range business planning and reflects positive results, based on a system which is successful. 3 Section 2 The objectives of the study will be to show that the system which Samsung functions under is replicable and can be applied to any business which is committed to remain focused. Section 3 "Samsung Electronics, the consumer electronics giant in Korea, posted its financial performance for the first quarter, 2006 at 13.96 trillion won, which represents a one percent growth compared to the first quarter of 2005" (Survival) "Samsung electronics revealed this year's TFT - LCD monitor sales through November. The company has maintained its world market leadership by selling 5

Joint Commission Accreditation, Certification, and Licensing Essay Example for Free

Joint Commission Accreditation, Certification, and Licensing Essay Given health record completion policies, correctly apply accreditation or licensing standards to determine the organization’s compliance. Write a 1-page paper on how you think Joint? organization’s compliance. Commission’s standards impact health record completion and organizational compliance. Be sure to discuss advantages/disadvantages of being accredited by Joint Commission. The Joint Commission on Accreditation of healthcare organizations (JCAHO) is a non-profit and independent accreditation organization that provides accreditation and certification for various healthcare organizations, health plans, health packages and hospitals in the US. It has been functioning in the US, and is recognized throughout the world. More than 15, 000 healthcare organizations in the US have been accredited and certified by the Joint Commission. An organization that subscribes to accreditation by the JCAHO would constantly have to make an effort to reach certain performance standards. JCAHO gives greater importance to maintaining patient safety standards and improving the quality of care (The Joint Commission, 2008). The Joint Commission has accredited several aspects of medical care including ambulatory care, assisted living, behavioral healthcare, critical care, laboratory services, home care, surgeries, old age clinics, staff and employees, disease-management, long-term care, etc (The Joint Commission, 2008). It is very important that the healthcare organization complies with the specifications mentioned by the JCAHO. Firstly, the healthcare organization has to understand the importance of having these specifications in place. It would benefit the organization and also the patients, insurance companies, government and the general public. The litigations against malpractice are significantly fewer when a hospital has accreditation. Flowsheets that record detailed information and observations of the patients vitals and care administered would help in precise documentation. An electronic system would act as an aid in ensuring that the specifications of the joint Commission are enforced and followed. Studies have demonstrated that the compliance levels of the JCAHO specifications are around 50 % in all healthcare organizations that subscribe to accreditation by this organization. The outcome of any case would certainly be better if the specifications laid down by the JCAHO are followed. Frequently, the Joint Commission would be conducting surveys and suggested measures to be implemented in order to improve the status of the employees and the patients. One way of ensuring that the organization complies with the JCAHO specifications is to have several monitoring devices in place. These include surprise checks, regular visits, inspection of the records, etc. The information transmitted and stored in the hospital database should be accessible to the JCAHO for the purpose of monitoring. Patient surveys are another method of ensuring compliance by the JCAHO. Another way would be to record the cases of malpractice against the healthcare organization (Massachusetts General Hospital, 2007). There are several requirements a hospital or a healthcare organization has to follow in order to get accredited to the JCAHO. These include: ? Following the recommendations launched by the AMH and the BHC ? Following the requirements of the HIPAA ? Having a system that fulfills the recommendations lay down by the JCAHO regarding flow of information (using software tools such as TIER). ? Some of the important criteria regarding the information management system includes: 1. Maintain confidentiality of the patient information 2. The internal and the external needs have to be addressed through comprehensive planning 3. Security of the information – accessibility only to the relevant staff members 4. Data, which can be collected, analyzed and decisions-made. 5. Addressing the education and training needs – Information should be presented to the staff members and the patients in an automated manner 6. Information and clinical records presented to the patients should be comprehensive and specific. The Joint Commission accreditation has several advantages and disadvantages. Advantages: †¢ The patients would be having greater confidence in the healthcare organization and health plan. †¢ In the market, there would be greater competition between the healthcare organizations. †¢ The risk management would be more efficient. †¢ The business practices and ethics would improve. †¢ The human resource management process would be better. †¢ Insurance companies and third parties would have better relationships with the healthcare organization. †¢ Compliance with the terms and conditions mentioned by the regulatory bodies would be better. Disadvantages: †¢ Information provided to the JCAHO could be potentially misused. †¢ The hospital would be spending huge sums of money for the purpose of accreditation and would actually not be involved in improving patient care. †¢ Unhealthy competition may be propagated. References: Brink, L. J. (2004). â€Å"JCAHO Information Management Standards and TIER† Retrieved on February 18, 2008, from Hospitals for a Healthy Environment Web site: http://www. sequest. net/articles/TIER%20and%20JCAHO%20IM%20Standards. pdf Hospitals for a Healthy Environment (2007). â€Å"Guide to JCAHO Environment of Care Standard 1. 10.1† Retrieved on January 29, 2008, from Hospitals for a Healthy Environment Web site: http://www. h2e-online. org/regsandstandards/jcahoEC1. 10. 1. html Masshecutes General Hospital (2007). â€Å"Massachusetts General Hospital Summary of the Joint Commission Findings. † Retrieved on January 29, 2008, from MGH Web site: http://www. massgeneral. org/findings_summary. html The Joint Commission (2008). â€Å"Joint Commission Requirements. † Retrieved on January 29, 2008, from The Joint Commission Web site: http://www. jointcommission. org/Standards/Requirements/

Follicular Lymphoma Case Study

Follicular Lymphoma Case Study The clinical condition given was a 33 year old patient diagnosed with chemotherapy resistant advance follicular lymphoma. Lymphoma is a type of cancer of the lymphocytes, which belongs to the white blood cell family of the body.1 White blood cells circulate the body through an extensive network of lymphatic systems, illustrated in figure 1, which includes the bone marrows, spleen, thymus and the lymph nodes. Lymphoma is categorized into two, the Hodgkin lymphoma and the non-Hodgkin lymphoma (NHL). Follicular lymphoma belongs to the group of NHL that affects the B-cell lymphocytes, which plays a critical role in immune response by producing antibodies in human body. Under the view of a microscope, follicular lymphoma produces a nodule or follicular structure, as the name suggested. Microscopic image of follicular lymphoma can be seen in figure 2. Diagnosis Diagnosis requires a biopsy of a lymph node, involving the process of obtaining a small amount of tissue for testing in the laboratory.5, 6 However, biopsy alone will not be sufficient to diagnose the lymphoma. Other scans on the abdominal, chest, or pelvic areas by using techniques such as Computer Tomography Scan (CT-Scan), Positron Emission Tomography (PET-Scan), will aid diagnosis as well.7, 8 According to the National Comprehensive Cancer Network (NNCN) Guidelines, laboratory test which is inclusive of full blood count, uric acid level, serum calcium level, as well as liver function test are needed in order to confirm diagnosis.9 Follicular Lymphoma Stages and Classifications Staging is important in patient with follicular lymphoma as it divides patient into group and determines what kind of treatment is needed, or whether treatment is required. Generally, NHLs are divided into four stages, summarized in table 1 below. Follicular lymphomas categorized in stage II, III, and IV are termed as advanced follicular lymphoma, as the case of the patient in the scenario. 5, 6 Table 1: Stages of NHL in terms of regions involved. Stages Descriptions Stage I Only one of the lymph node is involved Stage II Two or more lymph nodes from the same side of diaphragm are involved Stage III Lymph nodes at both sides of the diaphragm are involved Stage IV Involves a number of lymph nodes, tissues or organs Furthermore, lymphomas can generally be described as Low Grade, Intermediate Grade, or High Grade, depending on the speed they grow, based on the Revised European-American Lymphoma (REAL) grading system1, 6. Generally, low grade lymphomas are slow growing, while high grade lymphomas are characterized by rapid growing tumor cell which requires aggressive treatment compared to low grade and intermediate grade lymphomas. Ironically, many High Grade lymphoma can be cured, while low grades lymphoma tends to reappear and contribute to relapses.6 Apart from the general lymphomas grading, follicular lymphomas have their own grading system, which are separated into three grades. According to the World Health Organization (WHO), the follicular lymphomas are categorized according to the number of centroblast (large follicular cell) present while the tumor was scanned by using the highest power of magnification on the microscope.1, 5, 6 The grades were summarized in table 2. Causes A research done by Bosga-Bouwer et al. over 30 patients indicates that genetic factors are the primary causes of follicular lymphomas. The research used southern blotting technique, polymerase chain reaction, and fluorescence in situ hybridization to confirm a translocation in the chromosome 14 and 18, which affects the bcl-2 proto-oncogene, and the main function of bcl-2 genes is to prevent apoptosis of B-cell lymphocytes.10 Overexpression of the bcl-2 gene results in prolonged survival rate of the cell due to the prevention of programmed cell death.1, 10 Signs and Symptoms Symptoms of follicular lymphoma include adenopathy, night sweats, weight loss, and fever. Adenopathy represents painless swelling in one the lymph nodes. Another important indicator includes elevated levels of Lactate Dehydrogenase (LDH), an enzyme that facilitates the conversion of pyruvate to lactate. 11 However, it is important to note that some of the patient lymphoma will be asymptomatic. Complications Follicular lymphoma will further complicate by increasing tumor bulk and threaten end-organ function. After a given period of time, it might transform into a more rapid growing lymphoma- the diffuse large B-cell lymphoma (DLBCL). In contrast, DLBCL is a much more aggressive form of NHL. According to a research done by Horning and Rosenberg, 25% to 60% of the patient will transform from follicular lymphoma into DLBCL12. A paper done by Lossos et al. suggested that the transformation to DLBCL includes multiple genetic mechanisms no single gene is responsible for the transformation13. Apart from that, another paper by Montoto from Cancer Research UK Medical Oncology Unit, demonstrates that the risk will be significantly higher (P-value = 0.02) if a patient was in an advanced stage of follicular lymphoma, which is the situation present in the case scenario14. It was also found that there are no statistically significant differences between the time of initiation of therapy and chances o f transforming from follicular lymphoma into DLBCL. If a patient with DLBCL is not treated accordingly, it is often fatal 5, 14. Furthermore, tumor of follicular lymphoma might relapse and further develop into chemotherapy resistant follicular lymphoma. Chemotherapy resistant lymphoma occurs when the lymphoma that has been responding to chemotherapy had begun to grow, resisting the effects of the therapy. The resistances are acquired through a number of mechanisms, namely genetic transformation of the B-cells. When this occurs, as seen in the case, the treatment option will be narrowed down, since chemotherapy is no longer an option.15 Incidence, Morbidity, and Mortality Rate Follicular lymphomas have an incidence rate of 2500 cases each year in the UK.16 It exhibits the second highest incidence rate among all the lymphomas, with the first being DLBCL. 17 It dominates 30% of all the NHL and it is the most common type of Low Grade NHL.1, 17 Prognosis Index is used to predict the treatment options and outcome of follicular lymphoma. A Follicular Lymphoma Prognosis Index, developed by Solal-Celigny, is currently being used internationally18. This prognosis index takes into account of 5 factors, which are age (>60 years), stages of follicular lymphoma (stage III IV), hemoglobin levels (low), numbers of lymph nodes/organs affected (>4), and levels of LDH (high) 17, 18. 91% of patient which suffers none of the abovementioned factors will live longer than 5 years. If the patient suffers from two or three of the factors in Follicular Lymphoma Prognosis Index, the rate of living longer than 5 years will drop to 78% and 43% respectively 18. In the UK, the median age of onset of follicular lymphoma was 60 years old, as compared to 67years old in the United States (US) 16, 19. In the US, according to the National Cancer Institute, rate of mortality was the highest among those from 75-84 years old, with a death rate of 33.7%. However, in those patient aged from 20-34 years old (case scenario patient aged 33years) mortality rate was only 1.6%. The average death rate of patient with NHL was 7.1 per 100,000 men and woman per year in the US19. Evidence Based Treatment Options of Follicular Lymphoma Follicular lymphoma can be considered incurable, but fortunately the growing tumors are sensitive to radiation and chemotherapy. Treatment options of lymphomas are highly based on severity of the symptoms and stages of lymphoma.5,20 If patient is asymptomatic, prescribers often employs a wait and watch approach, and according to studies, there is no difference in the survival rate between patients who were treated earlier and patients who were treated according to wait and watch method. 20 Treatments options are summarized in table 3. Treatment options Descriptions Radiotherapy Uses ionizing radiation to destroy cells Chemotherapy Uses drugs to stop or slow down the growth of cells Monoclonal antibody Uses proteins that targets rapid growing cells Radioimmunotherapy Radioactive isotopes combined with monoclonal antibodies Bone Marrow Transplant Transplantation of stem cells Radiotherapy One of the ways to treat follicular lymphoma is by performing radiotherapy, which is also called radiation therapy. It was preferably use in Stage I or Stage II of the lymphomas which are localized.20, 21 The mechanism of radiotherapy includes usage of ionizing radiation such as beta and gamma rays to destroy the tumor cells and impairs their growth, while the body removes them through a natural process. Currently, the method employed in treatment of lymphoma tumor is known as the external beam therapy. 20, 21, 22 External beam therapy is done from a machine outside the patient, which is known and the linear accelerator. Radiation to body parts above the diaphragm is known as Mantle Field radiation, while radiation to parts below the diaphragm is known as Inverted Y-field radiation.22 A study by Aviles has shown that survival rate of a patient treated with radiotherapy for a 5 years period was 48%, and if used together with chemotherapy, the patients survival rate will be increased to 83%.23, 24 According to another research by MacManus, 40% of the radiotherapy patient remained disease free after 10 years. Chemotherapy Chemotherapy involves the usage of drugs to stop or slow down the growth of lymphoma B-cells, hence managing the lymphomas symptoms.5, 6 Chemotherapy drugs only target specific rapid-growing cells such as tumor cells, and impairs their ability to multiply and growth. 20 However, many cell lines in patients such as bone marrow, hair follicles, and the lining of the gastrointestinal tract are rapid-growing cells and therefore, it will be targeted by chemotherapy drugs as well, causing the side effects. Initial responses towards chemotherapy are usually high, and therefore, it is considered as the first line-treatment in treating NHL.20 Many protocols of chemotherapy combination were proposed, with the common ones being the CHOP and CVP. CHOP therapy includes the usage of four drugs- Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone while CVP therapy uses Cyclophospharmide, Vincristine, and Prednisone.5, 6, 20 A research by Fisher had concluded that CHOP should be used as first line treatment for advanced grade non-Hodgkin lymphoma, with a result of 44% survival rate in 1138 patient after a period of 3 years.26 However, a more recent study by Hiddemann suggested that the use of Rituximab, a monoclonal antibody, together with CHOP greatly improves the response rate of patient to 96% (P-value of 0.011), and reduce the chances of treatment failure by 60%. The study, which was done on 2005, proves that R-CHOP is the superior frontline treatment of choice for advanced follicular lymphoma compared to CHOP. According to the British National Formulary 57 (BNF 57), the usage of CHOP will produce side effects such as oral mucositis, hyperuricaemia and tumour lysis syndrome. Nausea and vomiting is also the common side effects of chemotherapy drugs, and it may lead to refusal of further treatment. Bone marrow suppression and alopecia are also of the core problems of chemotherapy drugs. Monoclonal Antibody Therapy Monoclonal antibody therapy works by using antibodies that sticks to the surface of specific groups of cells, such as cancer cells, and trigger the bodys natural immune system to destroy these cells. 5 The advantages of monoclonal antibody compared to chemotherapy is that they are more specific compared to chemotherapy. Rituximab is used to treat follicular lymphoma, due to the mechanism of action of binding to CD20 protein- the abundant protein on the surface of B-cell. Rituximab causes the death of the cell by the induction of apoptosis. 29 According to the BNF 57 and North London Cancer Guideline, Rituximab is used to treat stage III and IV follicular lymphoma, or in those patient that had a relapse after treatment of chemotherapy, or those that other treatment options are exhausted.16, 28 Nice guidelines recommends that Rituximab should be given as a third-line treatment, and should only be given as first line with combination of chemotherapy to patient with stage III and IV follicular lymphoma. A meta-analysis research by Vidal et al. reveals that when Rituximab was given as a maintenance therapy, it significantly improves overall survival rate and the relapse rate of patient, compared to patient that did not have Rituximab as maintenance therapy.29, 30 Another research by Hauprock and Hess indicates that Rituximab improves survival rate if given as relapse therapy and maintenance therapy.31 When given together with CHOP chemotherapy, it greatly improves the overall outcome of a patient. Adverse side effects of Rituximab appears to be infusion related side-effects, namely the cytokine release syndrome, which is characterized by fever, chills, nausea and vomiting, as well as tumor pain. Radioimmunotherapy Radioimmunotherapy consist of one radioactive isotope and a monoclonal antibody to assist specific cell targeting. The radioactive isotope which is attached to the antibody will release radiation once the antibody is bound to the specific cell type, hence killing the cells.21, 32 This method is considered to be a more advance therapy compared to chemotherapy and monoclonal antibody therapy. There are two drugs available now in radioimmunotherapy, namely Bexxar and Zevalin.32, 33 Zevalin consist of two radioactive isotopes called indium-111 and yttrium-90. The purpose of indium-111 in the drug is to enables physician to view the paths of the drug in the body, while yttrium-90 is the therapeutic portion of the drug. Zevalin is administered via the intravenous route together with Rituximab over a time of ten minutes, over a course of a week. The main side effect of Zevalin is lowered blood cell count, normally observed 4-6 weeks after the treatment. However, Zevalin is considered to be advantageous in terms of side-effects as it does not exhibits the normal side-effects of chemotherapy drugs, such as alopecia, nausea and vomiting. In a clinical trial involving patients with NHL, Zevalin manage to produce a response rate of 70-80%. Furthermore, in the same trial, Zevalin produces responses in patient who no longer respond to chemotherapy and Rituximab.32 A review by WitZig showed a response rate of 82% to Zevalin in patient with low grade NHL. The advantages of Zevalin Therapy are that it only uses a single dose of radiation and it is being well tolerated by the patient, which was proven in the study.34 In another randomized controlled trial done by WitZig and Gordon et al., Zevalin was proved to be more superior than Rituximab, with an overall response rate of 80% compared to 55% in treating follicular lymphoma. Apart from that, another immunotherapy drug called Bexxar, is a combination of Tositumomab and Iodine I 131 Tositumomab. Tositumomab is a monoclonal antibody targeting the CD20 protein in the B-cell Lymphoma, while Iodine I 131 Tositumomab is a radiolabeled derivative of the monoclonal antibody. Beta-radiation released by Iodine 131 is responsible for killing of the tumor cells. Bexxar is given in two different sets of intravenous infusion, two weeks apart.   Common side-effects of Bexxar include suppression of bone marrow, which is characterized by low blood counts. Bexxar might also cause hyperthyroidism and anti-murine antibody formations.   A research done by Kaminski et al. shows that Bexxar produces a very high response rate of 95% in 76 patients who enrolled in the study. 75% of the patient in the study still had a complete remission even after 5 years. This research of Bexxar rivals any kind of therapy previously used in treating follicular lymphoma, including chemotherapy, as Bexxar therapy will be completed in just one week, and proves to be more effective. Another study, by Jacene, comparing Bexxar and Zevalin, reveals that Bexxar will cause less bone marrow suppression compared to Zevalin, although both were generally well tolerated.   Treatment Recommendation for Patient in Case Scenario According to the patient in the case scenario given, he is currently 33 years-old and he developed chemotherapy resistant advanced follicular lymphoma recently. Advanced follicular lymphoma indicates that his condition is in either stage III or IV, involving lymph node on both sides of the diaphragm and/or organs. In this case, since the follicular lymphoma developed resistance, chemotherapy is no longer an option. According to the BNF and the NICE guideline, Rituximab monotherapy could be given to patients who have relapsed stage III or IV follicular lymphoma, which developed resistance to chemotherapy. 28, 29 It is recommended that the patient takes 375mg/m2 of Rituximab over a period of 21 days, according to the instructions in NICE guideline. The patient has to be on it for 8 cycles which is approximately 6 months.   Rituximab was proved to induce better response and improve overall survival rate in follicular lymphoma patient according to the meta-analysis of randomized trial performed by Vidal et al. and another study done by Hauptrock and Hess (mentioned above in treatment). Another study by Monila further supports the usage of Rituximab as it increase both response rate and survival rate as well as improving the long-term prognosis of follicular lymphoma patient. All these evidence validates the treatment option of using Rituximab in the patient. The cost of Rituximab based on the evaluation of Assessment Group Model in the NICE guideline is approximately  £8500 per life year gained in patient younger than 60 years-old and  £9700 per life year gained in patient aging 60 years-old and above. It is considered cost effective based on the evaluation of the NICE guideline. If treatment using Rituximab proves to be unsuccessful, radioimmunotherapy drug Bexxar will be recommended. Although Bexxar is still considered a new drug, the clinical trials done by Kaminski shows a remission rate of 75%. Bexxar had also been evaluated in one of the study, which shows that 86% of the patient achieved a complete response in Stage III and IV follicular lymphoma. Conlusion In conclusion, patient with chemotherapy resistant advanced follicular lymphoma should be treated with Rituximab, followed by Bexxar and Zevalin. All in all, with the new advances in radioimmunotherapy, the joint effort of health care professionals and the utilizing of guidelines with evidence-based research, patient with the follicular lymphoma, although incurable, will still be able to lead a healthy and fruitful life.