A Very Old Man With Enormous Wings - 1713 Words

Life in Colombia, is hard. A vibrant and lush country that has unfortunately had to endure the horrors of living in a constant state of civil war. This harsh reality of their country being at war all the time has cultivated strength, perseverance and a belief system uniquely embedded within the Colombian people. You can find this in the famous story A Very Old Man with Enormous Wings written by Colombian legend Gabriel Garcia Marquez. Of course, it is truly no surprise that these traits are not only found in but absolutely bleed through the literature written by Colombian natives. The hardships of daily life and the deep belief in mysticism shapes their everyday. Politics and religion have tremendously shaped the behaviors of people living in Colombia; this duality is quite evident in A Very Old Man with Enormous Wings. Colombia, a nation surrounded by the Pacific and Caribbean oceans was first explored by the Spanish in 1499. Although, they reached the land in 1499, no permanent settlement was established until 1525 with the city of Santa Marta. The Spanish then colonized the country, implementing it’s enlightened absolutist monarch system; which was typical of the time as the ruling force for the newly colonized nation. When the monarchy fell into disarray starting in 1808 due to the abdications of Charles IV and his son Ferdinand VII, which was caused by none other then Napoleon Bonaparte; the instability of the situation lead to the America colony desiring its ownShow MoreRelatedA Very Old Man with Enormous Wings700 Words   |  3 PagesA Very Old Man with Enormous Wings The story of A Very Old Man with Enormous Wings is a tale in which a pitiful looking man with wings is found outside of the home of Pelayo and Elisenda. Pelayo sees the man while he is removing crabs from their home and throwing them into the sea. His wife, Elisenda, was caring for their ill, newborn child at the time. Pelayo was frightened and pulled his wife into the courtyard to observe the old man. They believed him to be a castaway, but sought the adviceRead MoreA Very Old Man With Enormous Wings971 Words   |  4 Pagesâ€Å"A Very Old Man with Enormous Wings† Humans have a temptation to be selfish, to try to step over others to better themselves taking advantage of their weaknesses to reach the top. In the story by Gabriel Garcia Marques â€Å"A Very Old Man with Enormous Wings† this is portray, by showing how cruel and imperfect society can be. In the beginning of the story the weather in Mocondo the town where the story takes place, is used as a symbol of corruption. In Mocondo is always dark and rainy, interpretingRead MoreA Very Old Man With Enormous Wings Essay1500 Words   |  6 PagesKnown Verses the Unknown The unknown is a very vague concept when it comes to literature. Depending on the text and who is reading it, it can be understood in different ways. In Marquez’s â€Å"A Very Old Man with Enormous Wings† the village determines the unknown based off what they already about angels. In â€Å"The Elephant in the Village of the Blind† the blind villagers try to figure out the elephant by using their senses other than eye sight, to agree on the unknown animal. In the beginning of both textsRead MoreA Very Old Man With Enormous Wings1129 Words   |  5 Pages The title of Gabriel Garcà ­a Mà ¡rquez’s short story â€Å"A Very Old Man with Enormous Wings† says it all about the character who will turn the life of Pelayo, a simple villager, upside down when he discovers the mystery man in his backyard. The story demonstrates the coexistence of cruelty and compassion within humans and the way they react towards what’s considered as different. The way Pelayo and his wife treated the angel throughout the whole story emphasizes some aspects of the themeRead MoreA Very Old Man With Enormous Wings918 Words   |  4 PagesSet in a small village, A Very Old Man with Enormous Wings combines an intriguing mix of reality and imagination. The story begins when an old man with wings enters the scene. The characters in the story are faced with the conflict of who and what the man actually is and what to do with him. The main characters Peleyo, the one who first encounters the man, and his wife Elisenda, end up housing him in their chicken coop. As the story unfolds, some abuse the man while others go to him in hopes ofRead MoreA Very Old Man With Enormous Wings2731 Words   |  11 Pages Gabriel Garcia Marquez is a man of many talents. His greatest talent is that in all of his short stories, he uses this imagery that swallows the reader whole and spits them out into the very reality of his written words. This makes the reader forget to question reality, but to soak the reality up instead. The short stories I have chosen, show how human behavior is impacted through a person’s perception through which their reality is created. Our perceptions can make our fears seem so realRead MoreA Very Old Man With Enormous Wings Analysis703 Words   |  3 Pagesconcept. Both good and evil can come to life in countless forms, specifically in literature. Good versus evil is one theme that is explicitly displayed throughout â€Å"A Very Old Man with Enormous Wings†. Throughout the story, the feelings of good and evil rebound numerous times. Through the setting, motifs, and the very old man with enormous wings, himself, the reader is clearly able to identify the fac t that evil has corrupted the town; not even an angel can save them from the vices of evil. The storyRead MoreEssay on A Very Old Man With Enormous Wings1458 Words   |  6 Pages This is very much true for the short story â€Å"A Very Old Man With Enormous Wings† by Gabriel Garcia Marquez. Within the story, a winged man falls from the sky with no meaning or purpose. The man is shrouded in mystery. Nameless and unable to communicate with the native villagers, he lives among them. His intentions are never truly known to either the reader or to the villagers. However, the biblical parallels throughout the story help us unravel the mysteries behind this strange old man. By analyzingRead MoreA Very Old Man With Enormous Wings Essay1193 Words   |  5 PagesGabriel Marquez Garcia’s short story, â€Å"A Very Old Man with Enormous Wings,† is a children’s story about a fallen angel and the tribulations and humiliations he endures to finally be able to repair his wings and fly back to the divine. It was published in 1955, and it is categorized in the â€Å"magical realism† for it takes place in a real world where magic is possible. For me the author made the angel to represent Jesus Christ, because it shows a humble man, devoid of power, naked luxuries that cameRead MoreEssay on A Very Old Man with Enormous Wings1188 Words   |  5 PagesA Very Old Man with Enormous Wings   Ã‚  Ã‚  Ã‚  Ã‚  The fictional tale entitled A Very Old Man with Enormous Wings is an intriguing story which is expressed very well in the title. The story is about just that, an old man with wings. The only aspect that the title fails to point out is that he is an angel. I find the story to be somewhat interesting; however, it isn’t exactly hard to put down.   Ã‚  Ã‚  Ã‚  Ã‚  The one thing about this story that stands out the most, is the author’s use of tone. This is the main aspect

Should Marijuana Be Legalized - 1189 Words

Introduction To legalize or to not legalize drugs, that is the popular question lately. The current repeat visitor to each states legislative sessions is making marijuana legal. Currently in the United States there are twenty states with legal medical marijuana and the District of Columbia. Out of those twenty only Colorado and Washington have also legalized marijuana for recreational use. When it comes to legalizing drugs marijuana appears to be the most popular one being advocated for. However, does that leave the door open for other drugs to be advocated for as well? Should they all be legalized or just a select few? History of politics interfering with freedom to choose Good intentions will always be pleaded for every assumption of authority. It is hardly too strong to say that the Constitution was made to guard the people against the dangers of good intentions. There are men in all ages who mean to govern well, but they mean to govern. They promise to be good masters, but they mean to be masters (Daniel Webster). The 1920’s in the United States has been put in the history books as the prohibition era. Though the idea behind prohibition was paved with good intentions, prohibition brought ramifications that politicians did not anticipate. Such as, the rise of organized crime and immigration. By the 1930’s alcohol prohibition was repealed and the 21st amendment in the constitution was born. This is the only time a previous amendment has been repealed in its entiretyShow MoreRelatedShould Marijuana Be Legalized?849 Words   |  4 Pageswhether marijuana should be legalized. Around 23 states have legalized marijuana for medical and recreational use. In the state of Illinois, medicinal use of marijuana has been passed on April 17, 2013. Since January 2014, patients are able to obtain marijuana with a doctor s recommendation. The new debate is whether marijuana should be legalized for the general public as a recreational drug. Although some believe that marijuana is harmless, and that it has beneficial medicinal uses, marijuana shouldRead MoreShould Marijuana Be Legalized?1715 Words   |  7 PagesMarijuana in Society Cannabis, formally known as marijuana is a drug obtained from the tops, stems and leaves of the hemp plant cannabis. The drug is one of the most commonly used drugs in the world. Only substances like caffeine, nicotine and alcohol are used more (â€Å"Marijuana† 1). In the U. S. where some use it to feel â€Å"high† or get an escape from reality. The drug is referred to in many ways; weed, grass, pot, and or reefer are some common names used to describe the drug (â€Å"Marijuana† 1). Like mostRead MoreShould Marijuana Be Legalized?1489 Words   |  6 Pagescannabis plant or marijuana is intended for use of a psychoactive drug or medicine. It is used for recreational or medical uses. In some religions, marijuana is predominantly used for spiritual purposes. Cannabis is indigenous to central and south Asia. Cannabis has been scientifically proven that you can not die from smoking marijuana. Marijuana should be legalized to help people with medical benefits, econo mic benefits, and criminal benefits. In eight states, marijuana was legalized for recreationalRead MoreShould Marijuana Be Legalized?1245 Words   |  5 PagesMarijuana is a highly debatable topic that is rapidly gaining attention in society today.   Legalizing marijuana can benefit the economy of this nation through the creation of jobs, increased tax revenue, and a decrease in taxpayer money spent on law enforcement.   Ã‚  Many people would outlaw alcohol, cigarettes, fast food, gambling, and tanning beds because of the harmful effects they have on members of a society, but this is the United States of America; the land of the free and we should give peopleRead MoreShould Marijuana Be Legalized?1010 Words   |  5 PagesThe legalization of marijuana became a heated political subject in the last few years. Twenty-one states in America have legalized medical marijuana. Colorado and Washington are the only states where marijuana can be purchased recreationally. Marijuana is the high THC level part of the cannabis plant, which gives users the â€Å"high† feeling. There is ample evidence that supports the argument that marijuana is beneficial. The government should legalize marijuana recreationally for three main reasonsRead MoreShould Marijuana Be Legalized?1231 Words   |  5 Pagesshows the positive benefits of marijuana, it remains illegal under federal law. In recent years, numerous states have defied federal law and legalized marijuana for both recreational and medicinal use. Arizona has legalized marijuana for medical use, but it still remains illegal to use recreationally. This is absurd, as the evidence gathered over the last few decades strongly supports the notion that it is safer than alcohol, a widely available substance. Marijuana being listed as a Schedule I drugRead MoreShould Marijuana Be Legalized?1350 Words   |  6 Pagespolitics in the past decade would have to be the legalization of marijuana. The sale and production of marijuana have been legalized for medicinal uses in over twenty states and has been legalized for recreational uses in seven states. Despite the ongoing support for marijuana, it has yet to be fully legalized in the federal level due to cultural bias against â€Å"pot† smoking and the focus over its negative effects. However, legalizing marijuana has been proven to decrease the rate of incrimination in AmericaRead MoreShould Marijuana Be Legalized? Essay1457 Words   |  6 PagesSHOULD MARIJUANA BE LEGALIZED? Marijuana is a drug that has sparked much controversy over the past decade as to whether or not it should be legalized. People once thought of marijuana as a bad, mind-altering drug which changes a person’s personality which can lead to crime and violence through selling and buying it. In the past, the majority of citizens believed that marijuana is a harmful drug that should be kept off the market and out of the hands of the public. However, a recent study conductedRead MoreShould Marijuana Be Legalized?1145 Words   |  5 PagesLegalizing Marijuana Marijuana is a drug that has been actively used for centuries. This drug can be traced back to 2737 BC by the Chinese emperor Shen Nung. He spoke about the euphoric effects of Cannabis and even referred to it as the â€Å"Liberator of Sin.† Since early on, marijuana was seen as a medicinal plant that was recommended for medical uses. Marijuana is currently in schedule I, which means that physicians are not allowed to prescribe it in the United States (Hart, Ksir 2013). This drugRead MoreShould Marijuana Be Legalized?1596 Words   |  7 Pages But what needs to be known before a user can safely and completely make the decision if trying Marijuana is a good idea? Many do not want the drug to be legalized because they claim that Cannabis is a â€Å"gateway drug†, meaning it will cause people to try harder drugs once their body builds up a resistance to Marijuana, because a stronger drug will be needed to reach a high state. This argument is often falsely related to the m edical side of the debate over legalization. It is claimed that this would

Poetry †Love in Vain Free Essays

When I first laid my eyes on her, I thought I May never see again: she emitted Such a blinding light from her appearance A mastermind criminal she was to Steal the stars and trap them in her eyes which Left the earth in a starless blanket. A glance towards her would leave memories Worth remembering forgotten I was Swallowed by her heavenly features which With ease would take you. The red painted sky At sunset was reflected in her cheeks And the crimson of rage locked in her lips. We will write a custom essay sample on Poetry – Love in Vain or any similar topic only for you Order Now She was the food on my plate and the drink In my glass, the water in the lake and The pump of my blood. She was the scent of A flower, the fire in a furnace, the Glow of a light, the words in a poem She was everything and all revolved Around her. Lavishly sweet was the taste On her lips, which only a touch will leave You dazzled and the stress which you once had Would diffuse into nothing. Just with a wink In our sight, she’ll have anything she wants For you’ll be pampering to her needs. It is better to say ‘stay away from Such devils’ you would give them your life and They’ll leave you lifeless; you’d make them happy But experience it? No you will not. They’ll strip you of your wealth; to think you were In love would be the notion of a fool. Hell would upsurge if you deprive her of A single thing; such creations of God, Beautiful in stature, should not have hearts Of fiery temper like a volcano. Unless you obliterate her from your Mind from the first sight, you’ll be ensnared. Censor her from your mind and you’ll be free. Generous was god, when he let me be Free from this trap, like a fly from a web. And now I am free as a bird in the sky, And like the bird I watch below at those That fall into the similar hole to Me but to deep for them to climb back out. Those sorrowful memories play in my Head, but the pleasurable time I will Never forget. But was my love in vain? Or was it her playing me with her games? I find it hard to believe that I was Merely a pawn in the grasp of such a Woman, but was she ever a woman? How to cite Poetry – Love in Vain, Papers

Effects of Hip-Hop Throughout Generations free essay sample

Throughout Generations Hip-hop is a genre that has greatly influenced generations and has been used to inspire, motivate, and promote. Although the flirt thought of hip-hop is hip-hop music, it has involved into a sense of hip-hop culture. There are different categories of hip-hop such as music, dancing, style, and art. These days, hip-hop is expressed in many different ways. Because of its popularity, hip-hop can be used to shine light on important topics. Some of the popular hip-hop artists use it to help promote national crisis, positive social change, and education. However, there are some negativity towards hip-hop that may effect its image, but nevertheless, has inspired generations upon generations. The orally of hip-hop dates back to ancient African tribal rhythms and music, which traveled to America through slavery. The tribal chants would be known as would be known by African-American youths on streets and block parties.Busy Bee Stark, DC Hollywood, and DC Africa Bumboat are three New York artists who have been credited for creating the term hip-hop. We will write a custom essay sample on Effects of Hip-Hop Throughout Generations or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page (Reese). Rap music can be traced back to the Bronx in the asses where rap music was used by black youth to express homeless, along with graffiti, breakfasting, and style. Not only is hip-hop focused in the music industry. There have been styles of art such as graffiti, which was explored on alley streets and urban areas. Graffiti was another form of expression through a more imagery sense. Different styles of dancing were expressed through hip-hop music.Breakfasting was one of the most popular, which went into different styles of breakneck such as, Popping, Locking, Old School, Nu School, House, Grumping, House, and T. U. R. F. Dancing. All these styles would be a competitive hobby thin urban areas. Hip-hop has encouraged political activism within its community on particular issues. As more and more young people are influenced by hip-hop, as they become the age to vote, there have been artists that encouraged them to get out there and vote and becoming more involved in politics because it is their future that is being affected.When Public Enemy hit in 1989, they focused a lot of issues that were urgent, from ethnic studies to racism in education to affirmative action to college admissions. (Woods). In 2004, a hip-hop group known as Slam Bush was a group of artists who started an organization called the Slam Bush project in order to raise awareness on the opposition of President Bush in his re-election year. This project raised an 11% raise in voting amongst young adults. (Woods).Another artist, John Legend, is also known as a humanitarian and has been traveling around to different colleges, talking to students about the importance of political involvement. He has also been named to the board of Teach for America, a group that promotes professionals giving back by teaching in urban schools. (Hart). John Legend has won ix Grammar Awards and named one of the 100 most influential people by TIME magazine. He had also launched a Show Me Campaign, which works to break the cycle of poverty and fighting for quality education. Hart) The criticism towards hip-hop has been that it glossaries sex, drugs, and violence. Yes, a lot of black artists have been known for their specific vulgarity in the hip-hop industry. But there will always been vulgarity in any popular culture. Artists such as Ill Wayne is known for glorifying gangs, disrespecting woman, and associate self worth with material possessions in his music. He has even disrespected black women n his songs and turns his focus onto light skinned women. (Henderson). Ill Wayne even goes on to say that light skinned women make babies with good hair. Which has upset many proud black people. (Henderson). When it comes to the hip-hop scene now compared to the hip-hop scene in the asses, music these days are more shined on materialistic necessities and being superficial. The popular black artists these days such as Ill Wayne, Drake, Wiz Kalmia, and Kenya West, their music revolve around whats popular in the media, such as sex, M)LO, which stands for Mimi Only Live Once, has spread all throughout the youth.

Jewish Conservatisism Essays - Religion, Judaism, Culture

Jewish Conservatisism Conservative Judaism: Inception, History and Way Of Life The term Conservative had been attached to the moderates by the Reformers because the moderates had branded them as radicals. This name hardly describes the movement aptly. Conservative Judaism, is the American version of the principles of positive historical Judaism. The conservatives accept the findings of modern scholarship that Judaism is the product of a long period of growth and evolution. However, this process did not result in broken or inconsistent lines of development; quite the contrary, the major currents of Judaism run consistently through the extensive literature of the Jewish people, created in successive ages. (Rudavsky 338) Conservative Judaism is one of the largest of the various sects of Judaism. Conservative Jews make up about 40-45% of those Jews who affiliate. Conservative Judaism accepts the idea that Jewish law is binding upon Jews. Conservative Jews have an obligation to obey all the teachings and commandments of Judaism., For example, Conservative Jews emphasize the laws of keeping the Sabbath and keeping kosher. Conservative Jews believe that Jewish law is capable of evolution as humans learn more about interpreting the Torah. Therefore, Conservative Jews have changed some of the earlier interpretations. Men and women worship together in Conservative synagogues, people may ride in a car on the Sabbath to attend services, and women can be ordained as rabbis. Issac Leeser is generally regarded as the principal forerunner of Conservative Judaism in the United States. A native of Westphalia, Lesser acquired his religious and secular education before coming to American in 1824. He settled in Richmond, Virginia, where he was employed for several years in his uncles business. At the same time, he assisted the hazzan in the religious school of the local Sephardic congregation. During this period, he gained prominence by publishing numerous articles in defense of Jews and Judaism in American and foreign journals.(Dimont 231) Some Jews who affiliate with the Conservative sect claim that their main reason for belonging is the fact that they dont want to be Orthodox nor Reformed. While some individuals describe themselves as Conservative because of their alienation from Orthodox practices, others define themselves from the opposite direction they point out that they are not reform. (Sklare 206) For the most part, Conservative Jews feel that if one were to be reformed they would not really be Jewish. The Reformed sect, unlike the conservative do not obey most of the Jewish laws and traditions. Conservative Jew describes Reform as cold, churchlike, or going too far, rather than as being subversive or heretical. (Sklare 206) Although Conservative Jews do not associate themselves with the Reform movement, they are still influenced by some of their ideas. Conservatism has borrowed a number of the innovations instituted by the Reform wing. Orthodoxy, particularly in America has done likewise, though to a lesser degree. Among these changes are the improved decorum, the use of the vernacular and the regular sermon at services, as well as confirmation exercises in various forms. Mixed pews, the organ, and the elimination of the benediction by the priestly caste are among the modifications adopted by the Conservative congregations.(Gordis 122) Conservative Judaism says that the laws of the Torah and Talmud are of divine origin, and mandates the following of Jewish Law. At the same time, the Conservative movement recognizes the human element in the Torah and Talmud, and accepts modern scholarship that shows that Jewish writings also show the influence of other cultures, and in general can be treated as historical documents. The founders of the Conservative movement, the youngest group in modern Judaism, had no wish to create a new alignment in Judaism. They sought, rather, to unite all Jews who had a positive attitude toward Jewish tradition, in spite of variations in detail. Nonetheless, life itself led to the crystallization of Conservative Judaism, which is dedicated to the conservatism and development of traditional Judaism in the modern spirit.(Gordis 216) Since the inception of Conservative Judaism in the late 19th century, it is committed to Judaism not only as a faith but also as a system of law, and to the norms of ritual behavior. Conservative Judaism formally involves strict Jewish religious practice of the laws of diet and Sabbath-observance.

Global food retail industry Essay Example

Global food retail industry Essay Example Global food retail industry Essay Global food retail industry Essay Exective Summary Global nutrient retail industry has become tightly competitory in last few old ages. In dynamic operating environment, companies need to understand the competitory nature of the planetary nutrient industry means to understand altering consumer penchants. They are doing uninterrupted attempts to run into these demands in order to procure their places in the industry. Companies have the purpose to construct collaborative working relationships with stakeholders, the ultimate aim of constructing an efficient nutrient distribution system. Wal-Mart is the universe largest retail merchant in nutrient retail industry. The company operates retail shops in assorted formats. It operates more than 6,000 shops in the United States and in 13 international markets. Food retail industry is a extremely concentrated market, new entrants would confront trouble to go consecutive in this industry. Stable relationships with providers are indispensable to Wal-Mart concern. Wal-Mart is concentrating on spread outing its merchandise line by including demanding merchandises every bit good as environmentally friendly merchandises. When analysing the concern of Wal-Mart, they really use all three of the hard Ss of McKinsey s 7S model in their pursuit of their ends: Strategy, Systems, Structure. As a retail company, Wal-Mart offers a broad aggregation of merchandises to the consumers. the food market points can be placed as Wal-Mart s star merchandises. Appliance, kitchen tools, furniture, digital merchandises, music files and package are the hard currency cattles of the company. Pharmaceuticals, playthings, electronics and wellness merchandises are Wal-Mart inquiry Markss. The exposure development, jewellery and shoe merchandises distributed by the company are those that show low market portion. : Wal-Mart has the largest IT systems of any private company in the universe. It has made important investings in supply concatenation direction. Wal-Mart Stores aims to capture the market incursion in nutrient that it has achieved in difficult and soft line goods. The merchandise development squad often attends trade shows in Europe and cardinal manner capitals and travels to topographic points globally. Wal-Mart s variegation scheme of the 1980s was a great success in footings of tapping and acknowledging new market sections. Based from the analysis of the informations by appling selling and strategic theoretical accounts, it is appropriate to urge that the merchandise and service development scheme be applied by Wal-Mart, sing that these factors serve as the nucleus factors impacting its growing and advancement. Strategy Development in the Global Food Retail Supermarket Industry Globalization of retail is non an emerging or wholly new scheme, but a current focal point for many retail merchants. Established retail merchants have recognized that natural growing going more hard to prolong in domistic markets, enlargement into new markets is a necessary measure towards procuring future profitableness. To understand the competitory nature of the planetary nutrient industry means to understand altering consumer penchants and the nutrient industry attempts to run into these demands. The undertaking of traveling nutrient points from the marketer to purchaser is going progressively complex, affecting diverse local, national, and planetary issues. The nutrient retail industry consists of the entire grosss generated through supermarkets, hypermarkets, co-ops, discount houses, convenience shops, independent grocers, bakers, and all other retail merchants of nutrient and drink. Supply concatenation direction ( SCM ) is the direction of stuffs, information, engineering and financess from the natural stuff provider to the consumer. It has become extremely critical. It is now indispensable to a company gross bring forthing activities as it relates to growing, efficiency and client satisfaction. SCM is critical to a company fiscal success in footings of gross, cost and plus productiveness. It has the purpose to construct collaborative working relationships between distributers, retail merchants, makers, gross revenues and selling agents with the ultimate aim of constructing an efficient nutrient distribution system.The most of import end of planetary nutrient retail merchants and jobbers is to guarantee that the merchandises they sel l are safe. They act as the buying agent for the consumer and the concluding nexus in the supply concatenation. The supermarket nutrient industry continually seeks ways to do the state nutrient supply safer. Question One: Globalization in the nutrient retail industry Selected Company: Wal-Mart Wal-Mart Stores ( Wal-Mart ) is the universe largest retail merchant. The company operates retail shops in assorted formats. It operates more than 6,000 shops in the US and 13 international markets including the UK, Canada, Japan, Mexico, Brazil and China. The company retails a wide scope of ware and services at low monetary values. Wal-Mart operates its concern under three concern sections: Wal-Mart Shops, Sam s Club, and the international section. The company has more than 2,000 retail shops in other states. The operating formats vary from state to state. Strategic Alliances, Merger and Acquisition ( M A ; A ) activity ( WAL-MART IN INDIA ) Wal-Mart began looking into making concern in India back in 2005. At that clip Indian authorities was sing opening up foreign direct investing ( FDI ) to retail merchants. In November 2006, Wal-Mart round out Tesco for a joint venture opAÂ ­portunity with Indian Mobile services leader, Bharti. The ground was because Wal-Mart was more flexible about the retail theoretical account to be adAÂ ­opted. The company precedence seemed to be an early entry, so that the universe s largest retail merchant did non lose out on the Indian consumer roar. As per the understanding between the two corporate giants, Bharti would pull off the front-end of the concern, while Wal-Mart would take attention of the supply concatenation, logistics and other back-end opAÂ ­erations. India is a ready and appealing market for Wal-Mart with its turning in-between category of 250 million and an economic growing rate of about 9 % . Although the FDI Torahs of the state are comparatively rigorous, authorities functionaries are non opposed to prosecuting foreign concerns in the Indian market. Since the proclamation of the Wal-Mart/Bharti JV, one taking organisation has emerged to stand for the inAÂ ­terests of the little mom-and-pop shops. This is India FDI Watch and in add-on to educating the proprietors about Wal-Mart, they have held big mass meetings and presentations against Bharti, Wal-Mart, and other big-box retail merchants. The mom-and-pops have an advantage as they are handily located on street corners or in the bosom of metropoliss and normally have personal relationships with most consumers. However, they do non transport the assortment of goods that larger retail merchants do. Menace of New Entrants and Substitutes Bing that the nutrient retail industry is a extremely concentrated market, new entrants would confront trouble wining in this industry. In fact, it is extremely hard for price reduction retail merchants to perforate other markets as Wal-Mart tried to come in Germany and South Korea. The company was unsuccessful and had to draw out because of its unprofitableness. Retailers are capable to these obstructions: Economies of Scale Cost of Capital Distribution Channelss Substitute merchandises are merchandises that can be used as replacings for other merchandises to fulfill the same necessity of consumers. Wal-Mart benefits from this thought as discount houses have lower monetary values than section shops and consumers go for higher quality merchandise with the lowest monetary values. Wal-Mart is working on supplying the best client service possible but as a high-traffic shop, it is by and large impossible to supply one on one service. Dickering Power of Suppliers and Buyers Stable relationships with providers are indispensable to Wal-Mart concern. Without timely stock list bringings, Wal-Mart could non keep its full shelves and would lose clients. For this ground, the company engages in contractual understandings with its providers. This agreement is good for both parties, as the provider makes certain it will hold changeless entree to retail merchants with big market portion. This manner, providers have a guaranteed purchaser for the supplies and can set up specific monetary values. Consumers today are seeking for the best trades possible. They are waiting for price reductions and gross revenues to bulk up on merchandises. Discount retail merchants like Wal-Mart are making immense supercenter shops because they want their shops to go a one-stop trip. Customers know what they want and how far they are willing to seek for the point. Retailers must keep high stock list degrees to retain clients and their market portion. Customers going a twosome of stat mis to a shop privation to happen the merchandises they need in stock. Question Two: Global nutrient retail market kineticss The on-going alterations and inventions in planetary nutrient markets, every bit good as the tendencies in different sectors of the nutrient industry, make up a complex quandary with consumers, manufacturers, and planetary retailing and fabrication houses. A turning tendency in nutrient markets is the displacement in growing of nutrient gross revenues from high-income ( developed ) states to take down income ( developing ) states. Despite the displacement, per capita commercial gross revenues show broad regional disparities worldwide, though growing in nutrient gross revenues in the development states is expected to go on. In expectancy of this turning market, nutrient houses appear to be shifting themselves and puting in many developing states. Measures of fight vary at the house, industry and state degree. Competitiveness is influenced by such forces as technological inventions, public establishments, substructure support, steadfast organisational construction, and authorities policies. Small nutrient makers face macroeconomic restraints similar to those of big houses, such as exchange rate fluctuations and market entree barriers in foreign markets. Retail sector issues centered on the impact of globalisation on nutrient retailing in emerging economic systems, and the impact of altering consumer penchants on nutrient retailing. Although a state may import small nutrient, the impacts of globalisation impacts are reflected in its nutrient retail sector. Wal-Mart Profitability Secure Strategies A outstanding tendency in the retail industry is consumers purchasing less and less. Until about few old ages ago, consumers depended on recognition cards. They did non waver to add to their already big debts but now consumers are seeking to pay down debts alternatively. Wal-Mart price reduction shops, supercenters and jobber nines have maintained their monetary value leading scheme known as Save money A ; unrecorded better. This scheme was implemented in twelvemonth 2008 and is aimed at households with kids and in-between income consumers seeking to salvage. Wal-Mart is concentrating on spread outing its merchandise line by including health merchandises every bit good as environmentally friendly merchandises. With the high energy monetary values confronting consumers and the thoughts of eating healthier and natural nutrient, Wal-Mart has stocked merchandises that would appeal to these consumers while keeping its competitory monetary values. The company maintains a flexible direction manner where it is willing to fulfill altering demands. To run into demand, the company must promote directors to supervise high demand merchandises and bead unpopular merchandise lines that may be a waste of stock list infinite. Another tendency is discounter development of private labels. To vie with national trade names, supermarkets and retail merchants have developed their ain trade names with the cooperation of makers. These merchandises are to be distributed and sold merely in the retail merchants shops. Net Net income Margin measures how much out of every dollar of gross revenues a company really keeps in net incomes. A company with high net net income border indicates that it has better control over its costs. In this class, Wal-Mart outperforms Costco, BJ s and industry, but lags behind Target. This tabular array shows that how much Wal-Mart has been successful to put into nutrient retail installations in order to procure its future profitableness in footings of net incomes. Question Three: McKinsey s 7S model for placing nucleus competences and capablenesss, discourse the ability of Wal-Mart When analysing the concern of Wal-Mart, they really employ all three of the hard Ss in their chase of their ends: Scheme Systems Structure Their strength in all three of these S s is likely a large ground why they have been so successful. Scheme Wal-Mart s overall scheme is to ever supply the lowest monetary values. Additionally, they aim to hold a shop which provides convenience by leting consumers to happen everything they need under one roof.This scheme of convenience with low monetary values has driven Wal-Mart to be the concern leader that it is. Additionally, they plan to go on to spread out into markets non yet penetrated by major ironss, and some markets that are already saturated, such as New England and California.The other two difficult S s, systems and construction, support this scheme. Besides, low monetary values everyday has become the manner and shared values of Wal-Mart. Even the staff is wholly committed to supplying the lowest possible monetary values. The accomplishments of workers are besides geared to happening inefficiencies and towards diminishing monetary values. The low cost scheme has driven Wal-Mart to make things such as call providers collect, do off with maker representatives at gross revenues meetings, make off with regional offices, etc. Systems Wal-Mart has in topographic point a set of systems that helps it accomplish its scheme of low monetary values everyday. The largest and most profitable of these systems is the Information Technology system. Wal-Mart has employed computing machines, networking, and the cyberspace to cut down stock lists and waste, and velocity bringings. Wal-Mart can link to their providers and convey them informations so they know what Wal-Mart demands and when.The lower stock lists allow Wal-Mart to bring forth stock list turnover rates of around 70 % which is truly high. Additionally, Wal-Mart has worked with providers in order to better their efficiencies in production which they so pass to Wal-Mart and so to the consumer. Because of Wal-Mart scheme, these reduced costs due to systems let Wal-Mart to cut down consumer s monetary values. Wal-Mart has streamlined the supply system so good that it would be really difficult to happen any inefficiency and would be difficult for any rival to crush. Addi tionally, Wal-Mart has a really efficient human resource system set-up that has both largely kept employees happy, and resisted unionisation. Wal-Mart is the largest private employer and has developed systems to bind rises and fillips to public presentation. This encourages employees to believe of the company and to ever make their best. Structure Wal-Mart besides employs a good construction that works with the systems to authorise the low monetary value scheme. Wal-Mart has planned warehouses and integrated them with systems. Additionally, they place their warehouses strategically so that one warehouse can function many shops. They have developed clip agendas so that one truck can serve many shops and that after a bringing the truck can take back returned goods to the warehouse. The supercenter design itself is a structural advantage and scheme that Wal-Mart uses. This design allows consumers to come to a individual Wal-Mart shop to happen everything they need from food markets to gifts to apparels to dally. Wal-Mart has designed an efficient direction construction that allows it to extinguish the regional office. This construction entirely has saved Wal-Mart 1000000s of dollars a twelvemonth. When Wal-Mart topographic points shops in strategic locations and thrusts traffic utilizing convenience and so combines the gross reve nues with its systems and construction, people get a extremely efficient corporation that can cut costs to a bare-minimum which are so passed along to the consumer. If Wal-Mart continues to rule these three S s, it will go on to rule the retail market. Question Four: BCG merchandise matrix theoretical account, placing major merchandises of Wal-Mart As a retail company, Wal-Mart offers a broad array of merchandises to the consumers. These include food markets, playthings, dress for adult females, work forces and kids, jewellery every bit good as other difficult goods ; all of these merchandise lines are sold at sensible and by and large low-cost monetary values. In order to analyse the operation and public presentation of the selected merchandises of the company ( Wal-Mart ) , the Boston Consulting Group ( BCG ) Matrix is used. The Boston Consulting Group ( BCG ) Matrix is a tool developed to measure company concern units. Specifically, the BCG Matrix is used to measure the concern units degree of market growing and portion. The distribution done in this matrix was based on the 2008 gross study of the company. Stars In above diagram, the food market points map can be placed as Wal-Mart s star merchandise. The study stressed that this served as the top gross generator of the company, lending to 22 % in the entire gross revenues. While this generates the most hard currency flow, it should besides be considered that this merchandise causes the most inventory cost to the company, sing that Wal-Mart has to deduce its food market supplies to multiple providers or companies. Cash cattles On the other manus, the difficult ( contraption, kitchen tools, furniture ) and soft goods ( digital merchandises, music files, package ) are the hard currency cattles of the company. Compared to the food markets, the supply concatenation for these merchandises are less complex. The private-label goods are considered hard currency cattles peculiarly in the international sector. This is because American trade names do non exhibit the same impact or entreaty to foreign purchasers as with foreign consumers. As hard currency cattles, it is indispensable that Wal-Mart utilizations these merchandises to bring forth financess that would back up its other concern units peculiarly those categorized as stars and inquiry Markss. Question Markss Pharmaceuticals, playthings, electronics and wellness merchandises are Wal-Mart inquiry Markss. As indicated in the gross study, these merchandises may bring forth gross revenues but non plenty to counterbalance the degree of financess required to administer them. Multiple providers and dearly-won stock list make these merchandises the inquiry grade type. For this ground, it is practical that Wal-Mart see restricting the stock list of these merchandises to salvage on stock list disbursals. Dogs Finally, the exposure development, jewellery and shoe merchandises distributed by the company are those that exhibit low market portion every bit good as growing. Sing the figure of options available in the market with these merchandises, it is so hard for the company to maintain these merchandise lines. As certain retail merchants are focused on administering these goods, they have more concern flexibleness than Wal-Mart, leting them to get the better of gross revenues issues. Question Five: merchandise life rhythm and Ansoff growing matrix Product life rhythm Wal-Mart is committed to bettering operations, take downing costs and bettering client service. But the key to retailer Wal-Mart s success is its ability to drive costs out of its supply concatenation and pull off it expeditiously. Many supply concatenation experts refer to Wal-Mart as a supply chain-driven company that besides has retail shops. Wal-Mart s company doctrine ( The Wal-Mart Way ) is to be at the taking border of logistics, distribution, transit, and engineering. Wal-Mart has the largest IT systems of any private company in the universe. The Wal-Mart concern theoretical account would neglect immediately without its advanced engineering and supply concatenation. Wal-Mart has made important investings in supply concatenation direction. Ansoff growing matrix Ansoff matrix allows the sellers to look at different ways to turn the concern through bing merchandises and markets and new merchandises and markets. Furthermore, the matrix is composed of four assorted schemes: Market Penetration Wal-Mart Shops aims to capture the market incursion in nutrient that it has achieved in difficult and soft line goods. The retail giant, which posts more than a 10 % market portion in many nonfood classs, plans to lift up its nutrient portion through speedy supercenter enlargements. To accomplish their market incursion ends, they believe in three steering rules: Customer Value and Service Partnership with its associates Community engagement Merchandise Development Wal-Mart merchandise development group influenced the expression, feel and assortment of ware. The merchandise development group headed by strong communicators worked with the purchaser for the class and assorted providers to better the consistence of qualities and sizes of ware. The merchandise development squad often attends trade shows in Europe and cardinal manner capitals and travels to topographic points globally. The group findings are so on a regular basis presented to merchandisers, sellers and bundle interior decorators during the twelvemonth. Major seasonal tendency overview meetings are held for spring and autumn with smaller meetings held for summer and vacations. Market Development Wal-Mart ever seek to take advantage of on its international scheme, it is working in the way of buildAÂ ­ing new retail shops in other countries.They planned to educate militants around the universe about Wal-Mart retail development schemes and the company impact on local retail civilization. The three major tactics used by the company before to come in a state include: BuildAÂ ­ing partnerships with local concerns and organisations Working with authorities functionaries Taping into the turning in-between category buying power Diversification Wal-Mart s variegation scheme of the 1980s was a great success in footings of tapping and acknowledging new market sections. Sam s nine was the most successful variegation of all at the decennary by following wholesaling construct. The first Sam s Club launched in April 1983. The company, on the other side, opened its first Wal-Mart Supercenter in 1988. It was basically a complete Wal-Mart price reduction shop with a supermarket added to it. Wal-Mart variegation into new retail formats during the 1980s did more than better the house growing in the cardinal countries of retail. Diversification besides gave the company the opportunity to take hazards and experiment. Evaluation the Usefulness of Marketing and Strategic Models Based from the analysis of the selected company, it is so appropriate to urge that the merchandise and service development scheme be applied by Wal-Mart, sing that these factors serve as the nucleus factors impacting its growing and advancement. With this type of scheme, Wal-Mart can increase its gross revenues by agencies of modifying or heightening its bing merchandises and services. This scheme has been recommended as it has the ability to back up the company potency to make greater markets. Wal-Mart has multiple merchandise lines that will be affected by this scheme. With the BCG matrix, it is appropriate that the company starts off the development with its premier merchandise lines. Through this, the company will hold sufficient financess to back up other relevant activities in the hereafter. However, by agencies of this scheme, Wal-Mart will be able to beef up the market place of each of its merchandise divisions, ensuing to greater keep to these specific markets. The suggested scheme does non merely suit the intent of the company and support its future growing but has besides been recommended based on the capableness of the company to implement it. Wal-Mart has an efficient distribution system which in bend would back up this scheme. The civilization of the retail company besides fits the demands of this recommendation. Specifically, the company devotes ample clip and resources to develop and keep a skilled work force. With productive directors and employees, the bringing of the developed goods of the company will be made possible. As a consequence, greater satisfaction from the clients will be obtained. Mention Beginnings Text Books Lynch, R. ( 2006 ) Corporate Strategy, Fourth Edition, Financial Times Prentice Hall. Mintzberg, H. , Ahlstrand, B. and Lampel, J. ( 1998 ) Strategy Safari, Financial Times Prentice Hall Johnson, G. , Scholes, K. and Whittington, R. ( 2005 ) Researching Corporate Scheme: Text and Cases, 7th Edition, Financial Times Prentice Hall. Online Beginnings hypertext transfer protocol: //www.walmart.com/ hypertext transfer protocol: //walmartstores.com/sites/AnnualReport/2008/docs/wal_mart_annual_report_2008.pdf www.economist.com www.metrofoods.net/ www.ft.com www.ers.usda.gov/Briefing/GlobalFoodMarkets/Industry www.plunkettresearch.com/Industries/

Interview on perceptions of a product or servise and ways of Assignment

Interview on perceptions of a product or servise and ways of motivating customers and increasing customer satisfaction - Assignment Example Being the marketing manager of Samsung Company, I was tasked with the duty of establishing how consumers view our products, specifically the newly introduced Smartphone the Samsung Galaxy S4. This required a survey to be undertaken by interviewing consumers who own the phone. This is very important since in the Smartphone market, consumers are known to shift from one phone to another because of poor experiences and satisfaction. Thus, this paper will explain various aspects of consumer behaviour. It will analyse the findings of the interviews undertaken. Finally, the paper will make a presentation to the board of directors where it will conclude by establishing the importance of various aspects of consumer satisfaction and how it will benefit the company. Concepts in Consumer Behaviour When approaching consumer behaviour there are various concepts, theories and models involved (Sharma, 26). Consumer satisfaction is the level at which consumers feel a commodity has met their need or w ant. Normally customers are satisfied when the product in question fully meets the needs of the customer, which the business establishment has communicated through advertising and other marketing techniques. For example, a consumer is fully satisfied with a smart phone if it meets the technological and physical requirements, which the customer needs, and those that have been indicated on the phone’s specifications that have been communicated by the manufacturer. Thus if a company indicates that a Smartphone has high definition display yet consumers realise it does not, and then the consumer will be unsatisfied. Consumer perception is the manner in which consumers view a particular product with regard to its ability to satisfy them. Consumer perception is a very important aspect of consumer behaviour since it is one of the major motivators behind consumers when they are looking for products to buy in the market (Erlenkamp 26). This is especially the case in the smart phone mar ket, since a phone’s popularity greatly relies on how consumers perceive it regardless of other factors such as the phone’s specification. For example, a study done in the United States of America revealed that most Smartphone users opt to buy phones that they believe are good based on information from their friends and non professional opinions in social media over phones that are better in terms of specifications regardless of the both phones being of the same price range (Himmelsbach 92). Consumer motivation on the other hand, is the process of undertaking various measures and strategies to ensure that consumers in the market are motivated to purchase a particular product or products (Wright 120). Consumer motivation is very significant aspect since it ensures that a business establishment enjoys success since it will attract new customers as well as keep existing customers loyal. Examples of consumer motivation technique include sampling which results in attraction of many consumers. The Product The Samsung Galaxy S4 is a high end Smartphone released by the company in March 2013. The Smartphone was widely anticipated after the company announced its production and the features that the phone would possess. Furthermore, its predecessor, the Samsung Galaxy S3 had been

Masafi staregic marketing pan Essay Example | Topics and Well Written Essays - 4000 words

Masafi staregic marketing pan - Essay Example 8 Core Competencies 8 Future Industry Analysis 8 Market Analysis 9 Perceived Customer Value 9 Customer Analysis 10 Segmentation 10 Targeting 11 Positioning 11 Marketing Strategy 13 Service Marketing: 7Ps Framework 14 Brand Strategy 18 Final Budget 20 Recommendations 21 Appendices 25 Executive Summary The study will propose a marketing plan for Masafi’s mineral water. The project will start with the mission and vision of the organisation. Following these, the study will provide a brief history of Masafi. A PLC and BCG matrix has been implemented for the purpose of the study. Then a market analysis has been conducted in order to understand the customer value and current customer trend. Then the study will provide a marketing plan including overview of the industry, key competitors, STP analysis and Marketing Mix. Finally, the study will provide recommendation plans basis on the critical issues. Background Analysis Masafi is a growing FMCG company in the Gulf and Middle East regi on headquartered in Dubai. The organisation used to manufacture and distribute mineral water and other food products (Masafi, 2013a). Here the project will conduct a marketing audit for the mineral water and will propose a new marketing plan for the products. ... Product diversification and business expansion in different global markets. Retention of long-term leadership within the mineral water industry. Expansion of brand portfolio and provision of social and health services for the global community. Vision The vision statement of Masafi is â€Å"Premium Products for Enhanced life†. Organisational Setup Masafi was founded in the year 1976. Masafi has been able to enter the domestic market with an estimated start-up capital of 5.5 million US dollar. In the year 2007, Masafi earned revenue of 40.2 million US dollars. Masafi has joint ventures with several international companies. For example, the organisation has joint ventured with UAE based organisation Khadamat facilities in order to recycle the plastics that are used for packaging (Carter and Dunston, 2006, p.161). Product Portfolio Analysis The product portfolio analysis will determine the key product lines of Masafi in terms of Market share, PLC and BCG Matrix. Sales or Profit In the year 2002, Masafi managed to increase its growth by 8%. At that point of time, the economic situation was not favourable for mineral water industry. However, the organisation managed to sell more than 3.6 million litres of mineral water bottles in that specific year. Several experts at that point of time expected that the organisation would avail a significant growth during the next 10 years. In the year 2012, the organisation increased its growth by 6% comparing to the last year. In terms of market share and profit, the key products of Masafi are mineral water bottles and facial tissues. Product Life Cycle Masafi’s mineral water has a short life cycle. From the starting years, the organisation has introduced mineral water of various flavours. The

IN WHAT WAY CAN OPERATIONAL, FUNCTIONAL, STRATEGIC DESIGN MANAGEMENT Essay

IN WHAT WAY CAN OPERATIONAL, FUNCTIONAL, STRATEGIC DESIGN MANAGEMENT CONTRIBUTE TO THE BUSINESS GROWTH OF Artdinox - Essay Example The feedback will provide the base for the ideation process which will lead to new product development. Then the CEO along with the NPD team can take care of the design finalization. In the context of new products one of the most important pieces of information is the control and monitoring mechanism for the product when it is launched briefly into the market as a part of test launch. Art d'inox does a pilot launch through three to four hundred pieces of the new product and monitors it carefully in terms of control points and then depending upon the conclusion decision to further expand the production or to curtail it is taken. Also, the organization can form collaborations with design institutes of repute; in case of Art d'inox it could easily form alliances with National Institute of Design, one of the premier places of learning in its respective field. This encompasses creation of a design management function in the company. At the strategic level this deals with the incorporation of the design strategy into the basic philosophy and workings of key departments like marketing, communication and innovation departments, i.e. inculcating the deign strategy into the business strategy of the firm. ... Art d'inox's basic objective of turning stainless steel items into lifestyle products with the amalgamation of design and functionality through innovative surface finish and the use of combined materials has adhered to this concept. This leads to the planning stage where procedures and standard for quality are fixed. Art d'inox has a design center with a professional design team which works in tandem with NPD or the new product development team. In Art d'inox's functional structure the CEO leads the design vertical along with the NPD, which designs products after receiving pointers from marketing and sales teams. The finances have to be taken care of in terms of setting up supplier and so Art d'inox being a part of the Jindal Stainless Steel group has timely supply of high quality raw material at reasonable prices. Strategic Design Management This is the capability of the design philosophy to give shape to the organizational objective and transform it according to the vision. At the initiation level the basic strategy is defined and the objectives to be reached in terms of design are also communicated clearly. The very concept of Art d'inox lies in changing the perception about stainless steel utensils and items through extremely creative and functional designs. The CEO is at the helm of designing, who along with the NPD team looks after the various aspects of deign and new product launch. This structure ensures that the top management level is guiding the design team from the top and the philosophy also percolates from top through all the management layers and departments. In Art d'inox the CEO ensures the effective completion of this job. Human resources are extremely important, especially in a design

Rebound Tenderness in Diagnosis of Appendicitis in Children

Rebound Tenderness in Diagnosis of Appendicitis in Children Abdominal pain is a common presentation within the accident and emergency department [A+E] and specialist nurses working in this environment need to be familiar and confident in dealing with this presentation (Hibberts and Bushell 2007, Pines, Pines, Hall, Hunter, Srinivasan and Ghaemmaghami 2005). Abdominal pain can be associated with a wide variety of surgical and nonsurgical conditions, with the most prevalent cause being acute appendicitis (Lin, Chen, Chung, Ho, and Lin, 2009). The diagnosis of appendicitis is formulated from subjective and objective data including a patients history, abdominal examination, laboratory investigations and signs and symptoms. This assignment will critically analyse the clinical skill of testing for rebound tenderness and its relevance to diagnosing appendicitis in children. The clinical diagnosis of acute appendicitis in children is difficult for many practitioners (Broek, Ende, Bijnen, Breslau and Alkmaar, 2004). Between the years 2008 and 2009 the number of patients presenting to A+E within the UK who were diagnosed with appendicitis was 44,244 (NHS Information Centre, 2009). This equates to almost 0.3% of all presentations in A+E over one year. Approximately 9,300 of this population were between the ages of 0 and 14 years old (NHS Information Centre, 2009). However up to 25% of these 9,300 children with suspected appendicitis have a normal appendix at operation (Smink, Finkelstein, Garcia-Pena, Shannon, Taylor, and Fishman, 2004). Furthermore, the 25% of paediatric negative appendectomies now result in considerable clinical and economic costs to the NHS (Koepsell, 2002). These substantial figures are one of the primary reasons for specifying this assignment on children. In addition, the scope of practice within A+E covers paediatrics for many adult q ualified nurses and adult trained nurse practitioners. It is therefore imperative that the knowledge base for all A+E staff encompasses paediatrics at an advanced level as well (Cleaver, 2003). The overall accuracy for the clinical examination in diagnosing acute appendicitis has been reported to be between 54% and 70% in children (Birkhahn, Briggs, Datillo, Van Deusen and Gaeta, 2006). In addition Whisker, Luke, Hendrickse, Bowley and Lander (2009) suggest that only 4% of children have a miss-diagnosis of appendicitis in specialist paediatric centres, compared to 20% in district general hospitals. Despite the uncertainty of the diagnosis and the cost of miss-diagnosis to the NHS, appendicitis requires urgent treatment (Williams, et al., 2009). This is due to the risk of perforation, which occurs in approximately one third of cases in children (Neilson, et al., 1990). Therefore the need for a good clinical assessment at first contact in A+E is needed to provide a correct management plan and reduce on costs for the NHS. An abdominal examination should be performed where possible in a warm, well lit room with the patient well-draped and relaxed (Bickley, 2009). Initially the practitioner should undertake inspection, auscultation and percussion of the whole nine sections of the abdomen (Lippincott Williams and Wilkins, 2008). The final aspect of the abdominal examination should be palpation as this has the potential to be the most painful (Allan, 2008). Palpation is a process which should always be commenced away from the site of pain, as this will allow the patient to gain some reassurance from the practitioner and help them to relax (Bickley, 2009, Hibberts and Bushell, 2007). The practitioner should utilise the palmer surfaces of the fingers to identify any abnormal signs (Bickley, 2009). More specific palpation techniques can help to diagnose appendicitis, such as rebound tenderness (Bickley, 2009). This is performed by pressing slowly and firmly to a specific area and then withdrawing them quickly (Bickley, 2009). Practitioners should observe the patient and ask if pain was worse on pressing or letting go (Hibberts and Bushell, 2007). However, Bickley (2009) suggests that if any of the previous examinations such as light or deep palpation are positive then this should not be undertaken as it will cause undue pain for the patient. The whole process of abdominal examination in children follows the same system as in adults. However, the causes of abdominal pain in children are often different, encompassing a broad range of acute and chronic diseases (Bickley, 2009). Therefore it maybe pertinent to suggest that more emphasis should be placed special techniques such as checking for rebound tenderness rather than abdominal palpation and testing for rebound. The initial discovery and accreditation of rebound tenderness (also known as Blumbergs sign) is credited to a German surgeon called Jacob Moritz Blumberg (1873 1955). Many articles make reference to Blumbergs sign; however there appears to be no relevant literature, research or evidence base to support this surgeon was the gentleman who discovered this sign (Mantzaris, Anastassopoulos, Adamopoulos and Gardikis, 2008). A study undertaken by (Williams, et al., 2009) showed that out of 98 children who had acute appendicitis 91% had right lower quadrant tenderness on palpation however only 30% had rebound tenderness. Another study by Lin, Chen, Chung, Ho, and Lin (2009) also suggested that 43.4% of the 53 children examined with appendicitis had rebound tenderness. So both these studies suggest that positive rebound tenderness is an indication of an acute appendicitis in children and therefore cannot be ruled out of an initial differential diagnosis. Golledge, Toms, Franklin, Scriven and Galland (1996) specifically evaluated the â€Å"cats eye symptom† (pain going over a bump in the road), the cough sign, right lower quadrant pain to percussion, rebound tenderness and guarding. The data from this evaluation suggested that rebound tenderness had a likelihood ratio of 7.4 compared to the other signs which had likelihood ratios of between 1.1 and 4.1. This data therefore suggests that rebound tenderness is a very useful sign in the diagnosis of acute appendicitis, but that the other signs and symptoms are not (Moyer, et al., 2001). Overall rebound tenderness is useful sign for diagnosing appendicitis when there is a high suspicion of appendicitis and is accompanied with other diagnostic indicators (Moyer, et al., 2001). Another presentation to be considered in relation to abdominal pain and rebound tenderness is the duration of the pain experienced by the child. A study undertaken by Oshea, Bishop, Alario and Cooper (1988) involved 246 children from 13 to 18 years old who presented to the emergency department with a history of less than one week of abdominal pain. Results showed that the likelihood ratio of pain was greater when the child had the pain for more than 12 hours (Likelihood ratio: 1.3) compared to less than 12 hours (Likelihood ratio: 0.64). Later in the study pain duration was evaluated at less than 24 hours and more than 24 hours, with their likelihood ratios being 0.83 and 1.2 respectively. When compared to Andersson, et al. (1999) study of 502 patients aged 10 to 86 the greatest likelihood ratio was 1.7 at 7-12 hours after onset of pain. Based on both studies it is very difficult to see how duration of pain can lead to the diagnosis of appendicitis. Therefore, practitioners must not allow the duration of pain to prevent any further investigation into the diagnosis (Moyer, et al., 2001). Another symptom which could possibly indicate the diagnosis of appendicitis is fever (Gwynn, 2001). Cardall, Glasser and Gusss (2004) study evaluated two hundred and ninety three people aged between 7 and 75 who presented to the emergency department with suspected appendicitis. Temperatures were classed at greater than 99oF or less than 99oF. The study showed that 27% of patients whos temperature was 99oF. When the results were analysed in terms of specific temperature intervals, the highest likelihood ratio (3.18) was found in patients with temperatures greater than 102  °F. However, Bergerons (2006) study on clinical judgement suggests there is no clinical value with temperature as there is minimal sensitivity and specificity in the diagnosis of appendicitis. Therefore, as with duration of pain duration and levels of WBCC, temperature as a single entity has little diagnostic utility in the diagnosis of appendicitis unless it is combined with other signs and symptoms such as rebou nd tenderness (Cardall, Glasser and Guss, 2004). For many years laboratory tests such as white blood cell count (WBCC) leukocytes and C-reactive protein (CRP) have been used to support a diagnosis, but the considerable overlap with other inflammatory conditions accounts for the low specificity and positive predictive value of these tests (Stefanutti, Ghirardo and Gamba, 2007). Recent studies on adult patients who present with clinical signs and symptoms indicating acute appendicitis, show that appendicitis can be excluded if both leukocyte count and C-reactive protein value are normal (Gronroos, 2001). However, Stefanutti, Ghirardo and Gamba, (2007) suggest that only a few studies have been reported in paediatric patients and the role of WBCC and CRP in excluding acute appendicitis in children has not been confirmed. According to Andersson et al. (1999) children who present with signs and symptoms of appendicitis such as rebound tenderness and have a WBCC of 15000 only moderately increases the estimated risk of appendicitis. This t herefore shows that only at the extremes of the WBCC does this diagnostic indicator appear useful (Moyer, et al., 2001). Therefore, contrary to adult patients, normal leukocyte count, WBCC and CRP value cannot effectively exclude acute appendicitis in children. Another usual predictor of appendicitis is vomiting (Bergeron, Richer, Gharib and Giard, 1999). The study by Andersson et al. (1999) calculated the likelihood ratio for appendicitis in a patient with vomiting compared to one with no vomiting to be 1.8. In addition Reynolds and Jaffe (1992) study suggests that a combination of four predictors including; vomiting right lower quadrant pain, abdominal tenderness, and abdominal guarding. More specifically 97% of the 377 children studied who were diagnosed with appendicitis had two or more of these predictors. Therefore, a patient who presents to A+E with less than two of the above predictors is quite unlikely to have appendicitis. Alvarado (1986) conducted a retrospective study of 305 patients hospitalised with abdominal pain suggestive of acute appendicitis. Signs, symptoms, and laboratory findings were analysed for specificity, sensitivity, predictive value, and joint probability.Their importance, according to their diagnostic weight, was determined as follows: localized tenderness in the right lower quadrant, leukocytosis, migration of pain, shift to the left, temperature elevation, nausea-vomiting, anorexia-acetone, and direct rebound pain (Alvarado, 1986). This scoring system shown below is deemed by many surgeons as an easy aid for supporting the diagnosis of acute appendicitis (Khan and Rehman, 2005). A study undertaken by Baidya, Rodrigues, Rao and Khan (2007) investigated the diagnostic accuracy of Alvarado scoring system. The results showed that a score of >7 for an appendicitis was 88.2% correct in diagnosis. However, the diagnostic accuracy of an Alvarado score Despite recent advances in knowledge and diagnostic investigations, a population-based analysis in the United States found that the incidence of unnecessary appendectomy has not changed (Flum, Morris and Koepsell, 2001). Therefore to increase diagnostic accuracy, new modalities such as ultrasound scans have been introduced (Broek, Ende, Bijnen, Breslau and Alkmaar, 2004). Kaneko and Tsuda (2004) conducted a 10-year study using ultrasound scans to diagnose appendicitis in children and are convinced that ultrasound scans can identify inflamed appendices with 100% sensitivity and can also determine the severity as well. However Smink, Finkelstein, Garcia-Pena, Shannon, Taylor and Fishman (2004) suggest that the use of ultrasound has not decreased negative appendectomies as similar negative rates were present over a decade ago. Therefore on the basis of the available evidence, patients presenting to A+E with a strong clinical case of appendicitis should be referred direct to the surgeon without an ultrasound. In addition to the use of ultrasound scanning the use of computed tomography (CT) has been recently studied and evaluated. There are currently two perspectives in the literature regarding the use of CT scan for the diagnosis of acute appendicitis: one supporting its routine use due to the decreased incidence of negative appendectomies, and the other one against its routine use due to the increased cost and delay in surgical management (Ceydel, Lavotshkin, Yu and Wise, 2006). In addition the benefits of imaging eliminating inpatient observation and unnecessary surgery must be weighed against the malignancy risk from radiation, as well as discomfort of rectal contrast administration (Smink, Finkelstein, Garcia-Pena, Shannon, Taylor and Fishman, 2004). Ceydel, Lavotshkin, Yu and Wises (2006) retrospective study showed that the negative appendectomy rate was much less in patients who had CT scans (7.6%) compared to the non CT scan group (24%). Therefore clinicians within A+E use their cl inical judgement and place emphasis on the importance of routine history and an accurate physical examination utilising CT scans for atypical cases of acute appendicitis (Gwynn, 2001). Currently within the A+E department there is no specific pathway or tool for ruling in acute appendicitis in paediatrics. In addition Birkhahn, Briggs, Datillo, Van Deusen and Gaeta (2006) suggest that no major medical association or professional organisation currently endorses a standardised pathway for the evaluation of patients with suspected appendicitis. With up to 25 % of children having negative appendectomies it is therefore of clinical and financial value to consider the use of a scoring system to admit or discharge children who present with a possible acute appendicitis. Current systems are in place for other potential conditions such as myocardial infarctions, pancreatitis and pneumonia. These other systems have been audited locally and nationally and are currently working well within the trust, therefore the plans to introduce the Alvarado scoring system will be put forward in the next review of clinical practice meeting between nursing and medical staff. To conclude, this assignment demonstrates that for an emergency department practitioner in a fast paced A+E setting, the accurate diagnosis of acute appendicitis remains a challenge for the paediatric age group. An accurate history and physical examination, which as highlighted can be challenge in younger patients plays an important role in the diagnosis of early acute appendicitis (Mallick, 2008). Physical clinical signs elicited upon examination provide the practitioner with a good insight to expected diagnosis. However, the usefulness of rebound tenderness as a single examination has minimal clinical value. The whole patient picture which encompasses an accurate history, clinical examination, laboratory investigations and possible diagnostic imaging is therefore vital to providing a correct diagnosis. The use of clinical scoring systems like the Alvarado score can be a cheap and quick tool to apply in emergency departments to rule in acute appendicitis. This scoring system includes many aspects such as clinical history, rebound tenderness and laboratory investigations. This allows for observation and critical re-evaluation of the evolving clinical picture. Its application improves the overall diagnostic accuracy and consequently reduces negative appendectomies (Khan and Rehman, 2005). In clinical cases where the practitioner is unsure if the actual diagnosis is acute appendicitis other diagnostic imaging studies such as ultrasound and CT may be undertaken. This must only then be considered once a thorough clinical examination has not provided any indication for acute appendicitis and the benefits out way the risks. References NHS Information Centre. (2009). Primary diagnosis: summary. Retrieved November 21, 2009, from Hospital Episode Online: http://www.hesonline.nhs.uk/Ease/servlet/ContentServer?siteID=1937categoryID=202 Allan, B. (2008). History and examination (3rd ed.). Philadelphia: Mosby. Alvarado, A. (1986). A practical score for the early diagnosis of acute appendicitis. Annals of Emergency Medicine, 15 (5), 557-564. Andersson, R., Hugander, A., Ghazi, S., Ravn, H., Offenbartl, S., Nystrà ¶m, P., et al. (1999). Diagnostic value of disease history, clinical presentation, and inflammatory parameters of appendicitis. World Journal of Surgery, 23 (2), 133-40. Baidya, N., Rodrigues, G., Rao, A., Khan, S. (2007). Internet Scientific Publications. Retrieved December 22, 2009, from The Internet Journal of Surgery: http://www.ispub.com/journal/the_internet_journal_of_surgery/volume_9_number_1/article_printable/evaluation_of_alvarado_score_in_acute_appendicitis_a_prospective_study.html Bergeron, E. (2006). Clinical judgment remains of great value in the diagnosis of acute appendicitis. Canadian Journal of Surgery, 49 (2), 96-100. Bergeron, E., Richer, B., Gharib, R., Giard, A. (1999). Appendicitis is a place for clinical judgment. American Journal of Surgery, 177, 460 462. Bickley, L. (2009). Bates Guide to Physical Examination and History Taking (10th ed.). Philadelphia: Wolters Kluwer Health / Lippincott Williams and Wilkins. Birkhahn, R., Briggs, M., Datillo, P., Van Deusen, S., Gaeta, T. (2006). Classifying patients suspected of appendicitis with regard to likelihood. The American Journal of Surgery, 191, 497-502. Broek, W., Ende, E., Bijnen, A., Breslau, P., Alkmaar, D. (2004). Which children could benefit from additional diagnostic tools in cases of suspected appendicitis? Journal of Paediatric Surgery, 39 (4), 570-574. Cardall, T., Glasser, J., Guss, D. (2004). Clinical value of the total white blood cell count and temperature in the evaluation of patients with suspected appendicitis. Academic Emergency Medicine, 11 (10), 1021-1027. Ceydel, A., Lavotshkin, S., Yu, J., Wise, L. (2006). When should we order a CT scan and when should we rely on the results to diagnose an acute appendicitis? Current Surgery, 63 (6), 464-468. Cleaver, K. (2003). Developing expertise the contribution of paediatric accident and emergency nurses to the care of children, and the implications for their continuing professional development. Accident and Emergency Nursing, 11, 96 102. Flum, D., Morris, A., Koepsell, T. (2001). Has misdiagnosis of appendicitis decreased over time? A population-based analysis. Journal of the American Medical Association, 286, 1748-1753. Golledge, J., Toms, A., Franklin, I., Scriven, M., Galland, R. (1996). Assessment of peritonism in appendicitis. Annals of the Royal College of Surgeons England, 78, 11-14. Gronroos, J. (2001). Do normal leukocyte count and C-reactive protein value exclude acute appendicitis in children? Acute Paediatrics, 90, 649- 651. Gwynn, L. (2001). The diagnosis of acute appendicitis: Clinical assessment versus computed tomography evaluation. The Journal of Emergency Medicine, 21 (2), 119-123. Hibberts, F., Bushell, C. (2007). Physical assessment in gastroenterology abdominal examination. Gastrointestinal Nursing, 5 (7), 24 30. Kalan, M., Talbot, D., Cunliffe, W., Rich, A. (1994). Evaluation of the modified Alvarado score in the diagnosis of acute appendicitis: a prospective study. Annals of the Royal College of Surgeons, 76, 418-419. Kaneko, K., Tsuda, M. (2004). Ultrasound-based decision making in the treatment of acute appendicitis in children. Journal of Paediatric Surgery, 39 (9), 1316-1320. Khan, I., Rehman, A. (2005). Application of Alvarado scoring system in diagnosis of acute appendicitis. Journal of Ayub Medical College Abbottabad Pakistan, 17 (3), 17-21. Koepsell, F. (2002). The clinical and economic correlates of misdiagnosed appendicitis: Nationwide analysis. Archives of Surgery, 137, 799-804. Lin, C., Chen, J., Chung, T., Ho, Y., Lin, W. (2009). Children presenting at the emergency department with right lower quadrant pain. Journal of Medical Science, 25, 1-9. Lippincott Williams and Wilkins. (2008). Assessment made incredibly easy Philadelphia: Wolters Kluwer Health / Lippincott Williams Wilkins. Malik, K., Khan, A., Waheed, I. (2000). Evaluation of the Alvarado score in diagnosis of acute appendicitis. Journal of College of Physicians and Surgeons Pakistan, 10, 392-394. Mallick, M. (2008). Appendicitis in pre-school children: A continuing clinical challenge: A retrospective study. International Journal of Surgery, 6, 371-373. Mantzaris, D., Anastassopoulos, G., Adamopoulos, A., Gardikis, S. (2008). A non-symbolic implementation of abdominal pain estimation in childhood. Information Sciences, 178, 3860-3866. Moyer, V., Elliott, E., Davis, R., Gilbert, R., Klassen, T., Logan, S., et al. (2001). Evidence Based Paediatrics and Child Health. London: BMJ Books. Neilson, I., Laberge, J., Nguyen, L., Moir, C., Doody, D., Sonnino, R., et al. (1990). Appendicitis in children: Current therapeutic recommendations. Journal of Paediatric Surgery, 25 (11), 1113-1116. Oshea, J., Bishop, M., Alario, A., Cooper, J. (1988). Diagnosing appendicitis in children with acute abdominal pain. Paediatric Emergency Care, 4, 172-176. Owe, T., Williams, H., Stiff, G., Jenkinson, L., Rees, B. (1992). Evaluation of the Alvarado score in acute appendicitis. Journal of the Royal Society of Medicine, 85, 87-88. Pines, J., Pines, L., Hall, A., Hunter, J., Srinivasan, R., Ghaemmaghami, C. (2005). The interrater variation of ED abdominal examination findings in patients with acute abdominal pain. American Journal of Emergency Medicine (23), 483-487. Rehman, I., Burki, T. (2003). Alvarado scoring system in the diagnosis of acute appendicitis in children. Journal of Medical Sciences, 11, 37-41. Reynolds, S., Jaffe, D. (1992). Diagnosing abdominal pain in a paediatric emergency department. Paediatric emergency care, 8, 126-128. Smink, D., Finkelstein, J., Garcia-Pena, B., Shannon, M., Taylor, G., Fishman, S. (2004). Diagnosis of acute appendicitis in children using a clinical practice guideline. Journal of Paediatric surgery, 39, 458-463. Stefanutti, G., Ghirardo, V., Gamba, P. (2007). Inflammatory markers for acute appendicitis in children: are they helpful? Journal of Paediatric Surgery, 42, 773-776. Whisker, L., Luke, D., Hendrickse, C., Bowley, D., Lander, A. (2009). Appendicitis in children: A comparative study between a specialist paediatric centre and a district general hospital. Journal of Paediatric Surgery, 44, 362-367. Williams, R., Blakely, M., Fischer, P., Streck, C., Dassinger, M., Gupta, H., et al. (2009). Diagnosing ruptured appendicitis preoperatively in paediatric patients. Journal of American College of Surgeons, 208 (5), 819 825.

Pride and Prejudice :: essays research papers fc

In the novel Pride and Prejudice , Jane Austen takes you back to times where Pride were not only for the rich and noble and Prejudice were the issues of the time. This is a classical love story from the eighteenth century, which takes place in England. The novels focus in on a spirited young woman, Elizabeth and her family, the Bennets. Mrs. Bennets main goal is to get all of her daughters married, no matter what the consequence. Through many heart aches and pains Jane, Elizabeth and Lydia fulfills Mrs. Bennets dream and marries, but they may all not live happily ever after.   Ã‚  Ã‚  Ã‚  Ã‚  Jane was the first of five sisters to have an opportunity of engagement. A Mr. Bingley had just come to the town of Netherfield, who was the talk of the town. â€Å"A single man of large fortune; four or five thousand a year. What a fine thing for our girls!† (p. 9; Chapter I) Mrs. Bennet declared to have him over and for Mr. Bennet to become acquaint with him so he could meet up with the girls. The first meeting the two had with each other was at a ball where he asked to dance with her twice and did not let any other girl have that same pleasure. Jane fell instantly in love with him, as she explained to her sister Elizabeth â€Å"He is just what a young man ought to be.† said she, â€Å"sensible, good humored, lively; and I never saw such happy manners!-so much ease, with such perfect good breeding!† (p.18; Chapter IV) They would then have other meetings with each other and grew an intense liking for one another.   Ã‚  Ã‚  Ã‚  Ã‚  One day Jane was to go to Netherfield and have dinner with Miss Bingley. His sister did not really think she liked her brother because she showed him no particular affection. She tried to tell her to be more persuasive and when she did not she and Mr. Bingley’s friend Mr. Darcy took him out of town with haste. She received a letter on their departure and read it with Lizzy, â€Å"This is from Caroline Bingley; what it contains, has surprise me a good deal. The whole party have left Netherfield by this time, and are on their way to town; and without any intention of coming back again.† (p. 102; Chapter XXI) Jane wrote to Miss Bingley many times, but in return she was told that Mr. Bingley was spending much time with Miss Darcy. Crushed she decided to visit her aunt and uncle, the Gardiners.