Medicine Bundle Speech Essay Example

Medicine Bundle Speech Essay Example Medicine Bundle Speech Essay Medicine Bundle Speech Essay Medicine Bundle Speech Outline l. Introduction: People would say Girls dont play hockey. Girls dont skate. I would say Watch this. This quote was stated by the first women to play full-time professional hockey in a position other than goalie, Halley Wisenheimer. This extremely talented female went against all the odds and came out on top. How awesome is that If you ask me, a fellow female hockey player, Id say its pretty incredible. I have been playing competitive hockey for the past 14 years of my life. Growing up playing a male nominate sport has impacted my life tremendously and in so many ways has helped form me into the person I am today. Fighting the never ending battle to be accepted and respected in a mans sport, developing the thoughts and emotions of a man, and the impact it has made on mine and my fathers relationship over the years are only a few areas in my life that hockey has impacted. II. Transition Statement: Being a female playing a mans sport is not easy, there is a high standard that you must live up to. A. First off men are naturally more competitive. Most men, in any male dominated sport, feel as though they have to prove their dominance to the female players, which in most cases results in some kind of injury. Over time I realized that I needed to learn to overcome the pain and fight back. I couldnt allow them to intimidate me. B. Secondly as a female Vive always had to fight for my spot on the team that I was I playing for. To be respected in the mens hockey world I quickly discovered that I had to strive to not only be the best female, but the best hockey player on the ice. This kind of demanding life style was difficult to adjust to at first and the stress, well it could be pretty overwhelming sometimes, but overall out-come and all the strengths that I have gained through it all has made me not only a stronger a hockey player but also a much stronger individual in general. Ill. Transition Statement: So with that said, we move along to next topic at hand, developing an understanding of a mans thoughts and emotions. Now many of you may be wondering what exactly it is I mean by this statement. Well as all of us already know men and woman have efferent ways of thinking; dealing with emotions, and senses of humor. Growing up playing hockey, I ended up having pretty much all male friends; therefore I didnt really get to experience the typical girl lingo, never really had much drama to deal with, and I missed out on all the hot gossip. A. The way I socially interact with people, and my way of thinking along with my smart remarks, and blunt personality come from my experiences hanging out with the guys, and also a majority of it comes from what we like to call locker room talk. Urban Dictionary defines locker room talk s the crude, vulgar, offensive, and often sexual trade of comments guys pass to each other. Exists solely for the purpose of male comedy and is not meant to be taken seriously. This quote sums it perfectly. You learn real quickly not to take things the guys. Now there was a time when I wasnt exactly thrilled about that, but over the years I have developed an appreciation for it. My friends have expressed to me time and time again that its their favorite part about me and its what makes me the strong, down to earth, free spirited, understanding and laid back female I am today. V. Transition Statement: Now let me take you back to where it all began. I was the first born female to my family in almost 3 generations. My father, who is from the east coast, and he grew up playing hockey, made it very clear to me as a child that he was hoping for a son. I wanted to be a dancer, as most little girls do, but no he insisted I played hockey instead. A. I didnt want to play hockey, I wanted to be a princess in a castle, or a mermaid under the sea, but instead I tossed those dreams to the side and proceeded to play hockey. For the first few years I had so much resentment towards my dad. Wouldnt you? As time progressed and I started to understand and develop a strong feel for the game, my resentment slowing started to subside. B. I could of been a dancer or a cheerleader, but because of my dads decision to put me in hockey Ive become a unique, strong, fear less, individual and have broken through so many barriers that most people never thought a female could do. For that, I am so very thankful and as the years fly by, its been what keeps us close. V. Conclusion: As Halley Wisenheimer so wisely stated, People would say Girls dont play hockey. Girls dont skate. I would say Watch this. She proves that Just because we as females are smaller and less competitive by nature doesnt mean we cant overcome these high boundaries and come out on top. Fighting the never ending battle to be accepted and respected in a mans sport, developing the thoughts and emotions off man, and the impact it has made on mine and my fathers relationship over the years are only a few areas in my life that hockey has impacted but they are defiantly the most important.

Andrew Jacksons Big Block of Cheese

Andrew Jacksons Big Block of Cheese Popular legend contends that Andrew Jackson received a big block of cheese at the White House in 1837 and served it to guests at an open house. The incident achieved allegorical status during the run of the television drama â€Å"The West Wing† and in 2014 it even inspired a day  devoted to social media outreach from the Obama Administration. In reality, two early presidents, Jackson and Thomas Jefferson, received gifts of enormous blocks of cheese. Both gigantic cheeses were intended to convey a symbolic message, though one was essentially celebratory while the other reflected some political and religious squabbling in early America. Andrew Jackson’s Big Block of Cheese The better-known enormous White House cheese was presented to President Andrew Jackson on New Year’s Day 1836. It had been created by a prosperous dairy farmer from New York State, Col. Thomas Meacham. Meacham was not even a political ally of Jackson, and actually considered himself a supporter of Henry Clay, Jackson’s perennial Whig opponent. The gift was really motivated by local pride in what was becoming widely known as the Empire State. In the late 1830s New York was prospering. The Erie Canal had been open for a decade, and commerce energized by the canal had made New York an economic powerhouse. Meacham believed making a mammoth cheese for the president would celebrate the region’s spectacular success as a center of farming and industry. Before sending it to Jackson, Meacham exhibited the cheese in Utica, New York, and stories of it began to circulate. The New Hampshire Sentinel, on December 10, 1835, reprinted a story from a Utica newspaper, the Standard and Democrat: †Mammoth Cheese - Mr. T.S. Meacham exhibited in this city on Tuesday and Wednesday of this week a cheese weighing 1,400 pounds made from the milk of 150 cows for four days at his dairy in Sandy Creek, Oswego County. It bore the following inscription: ‘To Andrew Jackson, President of the United States.’ †He also exhibited a National Belt, got up with much taste, presenting a fine bust of the President, surrounded by a chain of twenty-four States united and linked together. This belt is intended for a wrapper to the mammoth cheese when presented to the President.† Newspapers reported that Meacham had also made five other cheeses, each about half the size of the presidential cheese. They were intended for Martin Van Buren, a New Yorker who was serving as vice president; William Marcy, the governor of New York; Daniel Webster, the famous orator and politician; the U.S. Congress; and the legislature of the State of New York. Meacham, the intent of generation good publicity for his project, transported the enormous cheeses with great showmanship. In some towns, the enormous cheeses were paraded on a wagon decorated with flags. In New York City the cheeses were displayed to curious crowds at the Masonic Hall. Daniel Webster, while passing through the city, cheerfully accepted his great cheese from Meacham. The cheese for Jackson was shipped to Washington on a schooner, and the president accepted it at the White House. Jackson issued a letter of profuse thanks to Meacham on January 1, 1836. The letter said, in part: I beg you, sir, to assure those who have united with you in the preparation of these presents, in honor of the Congress of the United States and myself, that they are truly gratifying as an evidence of the prosperity of our hardy yeomanry in the State of New York, who are engaged in the labor of the dairy. Jackson Served the Big Block of Cheese The enormous cheese aged in the White House for a year, perhaps because no one really knew what to do with it. As Jackson’s time in office was coming close to its end, in early 1837, a reception was scheduled. A Washington newspaper, The Globe, announced the plan for the colossal cheese: The New York present is nearly four feet in diameter, two feet thick, and weighs fourteen hundred pounds. It was transported through the State of New York with a great parade, to the place where it was shipped. It reached Washington accompanied with a splendidly painted emblematic envelope. We understand the President designs to offer this great cheese, which is finely flavored and in fine preservation, to his fellow citizens who visit him on Wednesday next. The New York present will be served up in the hall of the Presidents mansion. The reception was held on Washington’s birthday, which was always a day of celebration in early 19th century America. The gathering, according to an article in the Farmer’s Cabinet of March 3, 1837, was â€Å"crowded to excess.† Jackson, reaching the end of eight controversial years as president, was described as â€Å"looking extremely feeble.† The cheese, however, was a hit. It was very popular with the crowd, though some reports said it had a shockingly strong odor. When the cheese was served there arose an exceedingly strong smell, so strong as to overpower a number of dandies and lackadaisical ladies, said an article which appeared on March 4, 1837, in the Portsmouth Journal of Politics and Literature, a New Hampshire newspaper. Jackson had waged the Bank War, and the pejorative term Treasury Rats, referring to his enemies, had come into use. And the Journal of Politics and Literature couldnt resist a joke: We cannot say whether the smell of Gen. Jacksons cheese denotes that he goes out in ill odor with the people; or whether the cheese is to be considered as a bait for the Treasury Rats, who are to be attracted by its scent to burrow in the White House. A postscript to the story is that Jackson left office two weeks later, and the new occupant of the White House, Martin Van Buren, banned the serving of food at White House receptions. Crumbs from Jacksons mammoth cheese had fallen into the carpets and been trampled by the crowd. Van Burens time in the White House would be plagued by many problems, and it got off to a horrible start as the mansion smelled of cheese for months. Jefferson’s Controversial Cheese The earlier great cheese had been given to Thomas Jefferson on New Year’s Day 1802 and was actually at the center of some controversy. What prompted the gift of the mammoth cheese was that Jefferson, during the political campaign of 1800, had been harshly criticized for his religious views. Jefferson contended that politics and religion should remain separate, and in some quarters that was considered a radical stance. Members of a Baptist congregation in Cheshire, Massachusetts, who had previously felt marginalized as religious outsiders, were happy to align themselves with Jefferson. After Jefferson was elected president, a local minister, Elder John Leland, organized his followers to make a remarkable gift for him. An article in the New York Aurora newspaper on August 15, 1801, reported on the making of the cheese. Leland and his congregation had obtained a cheese vat six feet in diameter, and used the milk of 900 cows.When our informant left Cheshire, the cheese had not been turned, said the Aurora. But would be in a few days, as the machinery for that purpose was nearly completed. Curiosity about the enormous cheese spread. Newspapers reported that on December 5, 1801, the cheese had reached Kinderhook, New York. It had been paraded into town on a wagon. It was eventually loaded onto a ship which would carry it to Washington. Jefferson received the great cheese on January 1, 1802, and it was served to guests in the unfinished East Room of the mansion. It is believed that the arrival of the cheese, and the meaning of the gift, may have prompted Jefferson to write a letter to the Danbury Baptist association in Connecticut. Jefferson’s letter, dated the day he received the cheese from the Massachusetts Baptists, has become known as the â€Å"Wall of Separation Letter.† In it, Jefferson wrote: Believing with you that religion is a matter which lies solely between man his god, that he owes account to none other for his faith or his worship, that the legitimate powers of government reach actions only, and not opinions, I contemplate with sovereign reverence that act of the whole American people which declared that their legislature should make no law respecting an establishment of religion, or prohibiting the free exercise thereof, thus building a wall of separation between church and state. As might be expected, Jefferson was criticized by his very vocal opponents. And, of course, the mammoth cheese was drawn into the mockery. The New York Post published a poem making fun of the cheese and the man who cheerfully accepted it. Other papers joined in the mockery. The Baptists who had delivered the cheese, however, had presented Jefferson with a letter explaining their intent. Some newspapers printed their letter, which included the lines: The cheese was not made by his Lordship, for his sacred Majesty; not with a view to gain dignified titles or lucrative offices; but by the personal labor of free-born farmers (without a single slave to assist) for an elective President of a free people.

Isaiah verse 1.1-2.1 Research Paper Example | Topics and Well Written Essays - 2500 words

Isaiah verse 1.1-2.1 - Research Paper Example The book and the verses even depicts about the different displays of cruelty and wickedness practiced by the kings on the Jewish followers. The different developments of the books hence reflect on the political and social developments that have been evident within the kingship of Jerusalem. Furthermore, the book develops and provides a better insight towards the fact that â€Å"Lord† is for the overall universe and is not secluded for a particular class or race. Commendably, in the book the prophet develops a better understanding towards the sins that may be bestowed on the evildoers or the cruel people of the earth (Broyles & Evans, 1997). With this emphasis, the research provides an in depth understanding of the different approaches and diverse statements provided by the prophet are developing a better understanding of the wickedness of the people that has been prominent within the society. The diverse needs of the research attempt developing an effective understanding towards the wrath of God that may fall upon people owing to their improper practices according to the verses in Isaiah 1.1-1.2. In the first verse, Isaiah depicts his views towards the different types of wicked approaches adopted by mankind for developing their lifestyle on the earth. The wicked approaches of mankind, with the political intention towards developing a hold on the society has been creating a strong negative impact on the social progression and a diverse impact on the social lifestyle of people. The prophet proclaims that this type of attributes will never be acceptable by God and would be dealt severely for such occurrences (Calvin & Calvin, 2000). Over the recent decades and centuries, human kind has always been indulged into some or the other kind of punishable offences that has been creating a degree of distress within the social system. This practices that were prominent within the Jewish society in Israel and Judah has been noted to be

Romantic Love Is a Poor Basis for Marriage Essay

Romantic Love Is a Poor Basis for Marriage - Essay Example Many people have claimed to have fallen in love, which then lead to marriages after a short time. Romantic love grows between people who know each other well, meaning that the people have to be increasingly in close contact with one another (Putte and Matthijs, 580). Love is thus taken as a bond that unites a couple in marriages, and the fuel that is supposedly making relationships in marriages to thrive. However, in closer examination of marriages in the society today, the aspect of love in marriages is blurred and in most cases hard to determine. This is because there are increasing rates of divorces and separations among young married couples, with others going to the extent of taking their partner’s life. Considering that romantic love involves close interaction and coherence in mutual understanding between the partners, these trends clearly portray that romantic love is a poor basis in marriages. Determining whether romantic love can thrive over time requires understandin g of the basic relationships, principles and their applications. This means that partners have to have a clear perception concerning such love in the short and long term basis and not depend on perceptions of others or higher expectations.â€Å"Love is an abstract construct that has been debated, discussed, mused and speculated over many years† (July, 1). ... These social models indicate that women tend to seek men with financial resources and men tend to seek physically attractive women (July, 3). In these social constructs, the issue of romantic love does not suffice in any event, and the issue of convenience takes lead in determining marriage partners. Securing the future the financial future of the family seems to be the priority in many women while men seek for the pride of having an attractive woman. These are issues of compatibility that have to be considered in marriages in addition to the romantic love. Infatuation that might be related to romantic love in most cases has been confused with love, and as many people get into marriages, infatuation is in most cases to blame. Mponda (16) in outlining the creation story in the book of Genesis notes that when men and women meet the opposite sex, there is a tendency to get excited and think that they have fallen in love. They will therefore start plans of staying together believing that they are in love. Mponda (17) defines infatuation as â€Å"having an intense but short lived passion for somebody.† Passion in this case is an intense enthusiasm for something. Since the passion is short lived, such marriages end up in divorces at an early stage. The close interaction mostly among the young people in most cases results to infatuation. Putte and Matthijs (580) compare this to the short romantic outbursts that are involved in romantic relationships. Social groups in addition accelerate these trends. However as the passion fades away, such romantic outbursts are temporary and fade away with time and thus cannot be best indicators in marriage. Glaser and Malarkey (176) argue that poor communication is responsible for

Duchess of Malfi Essay Example for Free

Duchess of Malfi Essay The Duchess of Malfi written by John Webster was first performed around 1613. A dramatic tragedy, the play is about a forbidden marriage between the Duchess and Antonio her steward, and the wrath of her brothers which leads to many of their deaths. Webster focuses on the role of rank to detail the emotions between relationships in an aristocratic family in a time when class was all important. He uses many distinctive features to convey the substance of the play and its characters, and give the actors playing the roles cues for stage performance. This extract is part of the proposal and marriage scene, one of the biggest emotional dramatic scenes of the play. The duchess is marrying in secret against her brothers wishes; their fear is that she will demean the family’s honour by remarrying. It also forms the most positive aspect of the play, using one of the traditional stage conventions of love, defiance and disapproval (Pacheco and Johnson (2012) pg. 93). This serves to provide a ‘lift’ to an otherwise dark play, and compares the lighter side of the Duchess’ sexual desire to her brother Ferdinand’s. The extract is set at the second half of Act 1 scene 1, the first half being to set the backdrop for the audience and give them a good idea of each character and a good indication of things to come. Specifically, the extract is between the Duchess finding out how Antonio feels about marriage and their union itself; here, the Duchess is convincing Antonio that he is worthy of her, that she is woman enough despite her brothers, her rank and her status as a widow. This is achieved by the features of Webster’s distinctive language and the stage directions (both written and performed through reading). The Duchess uses double meaning in her dialogue, ‘So now the grounds broke/ you may discover what a wealthy mine/ I make you lord of.’ (Webster, (2010[1623]) 1.1.432-33). She is referring to her own wealth and the value of his rank when they marry. This wordplay is also in the line ‘we are forced to woo because none dare woo us:’ (Webster, (2010[1623]) 1.1.446) she is again referring to her rank and playing on the word ‘woo’ to mean ‘woe’ (and the irony being that she is wooing him). These are very persuasive lines for Antonio, who feels unworthy of the Duchess despite the traditional gender roles being swapped, and the dominance of the Duchess being prevalent. He realises this with the line ‘These words should be mine,’ (Webster, (2010[1623]) 1.1.476). There is also wordplay in ‘All discord, without this circumference, / Is only to be pitied and not feared.’ (Webster, (2010[1623]) 1.1.473). The Duchess is referring to the situation they are in (secret wedding and/or the room), the wedding ring she has given him and to the confinement her brothers wish for her. There could also be reference to how Antonio will be should they marry – a higher rank, but it will be a secret for some time. The duchess is trying to assuage the fear of it all by saying without it there is only pity (for her). The metre and rhythm of the speech in this extract is another distinctive feature. It is un-rhyming blank verse and follows the rules of iambic pentameter except where Webster wants a character to pause, for example, ‘You were ill to sell yourself’ (Webster, (2010[1623]) 1.1.435) is only three feet of the full five feet line, leaving two for pause before the next line. This puts impact on that line but also on the ones following it. This technique is also echoed in the ‘woo’ line (Webster, (2010[1623]) 1.1.446); the metre of the line is slightly too long, which shows the Duchess’ unwillingness to follow orders. Likewise, the line ‘You have left me heartless, mine is in your bosom’ (Webster, (2010[1623]) 1.1.453) is too long, giving emphasis on the line and a cue for the actress playing the Duchess to use it for stage direction. The Duchess and Antonio’s dialogue overlaps through most of this extract; it makes them sound as if they are thinking together – giving the audience a feel for the emotional charge between the two characters. We have already seen from earlier in scene 1 that the Duchess is clearly defiant of her brothers, so it is little surprise to see that in response to Antonio’s fear of them she shrugs them off with the line ‘Do not think of them.’ (Webster, (2010[1623]) 1.1.472). this confirms the audiences view of her as being strong and resilient but also somewhat naive, and also gives them a clue of what is to come, especially when she follows with the lines ‘Yet, should they know it, time will easily/ scatter the tempest.’ (Webster, (2010 [1623]) 1.1.476). This dramatic irony confirms what the audience knows but Antonio does not: that her brothers are unaware of their impending marriage. Indeed, with these lines Webster is inviting the audience to fear the brother’s reaction too after hearing their earlier death threat to the Duchess. (Webster, (2010[1623]) 1.1.298-344) The depth of each character and difference of rank is shown in this extract by Webster’s use of figurative language. The Duchess continuously shows her determination and sprit, something which continues throughout the play – even to her death. And poor Antonio, who despite being honest and loyal, is overwhelmed at the turn of events and the metaphoric swapping of gender roles to the point where he is seeking solace in the Duchess’s words and is happy to be deluded ‘Would not have savoured flattery’ (Webster, (2010[1623]) 1.1.478). He is painfully aware that he is not equal in rank but will be in marriage, and his fears exaggerate her strength ‘These words should be mine,/ And all of the parts you have spoke, if some part of it/ Would not have savoured flattery.’ (Webster, (2010[1623]) 1.1.476-8) As for performance, the extract only provides one written key stage direction ‘(she kisses him)’ (Webster, (2010[1623]) 1.1.468). However, there is plenty in the reading of the extract to relate to performance. This also leaves room for interpretation in relation to performance possibilities. The pace of the dialogue changes depending on which character is speaking, for example, lines 445-462 are full of short syllables which quicken the rhythm of the metre to make it energetic and erratic, ‘And fearfully equivocates,’ (Webster, (2010[1623]) 1.1.448). It could serve to make the Duchess sound tense yet determined, and she could be sort of ranting in her attempts to convince Antonio. These lines also provide many words that can be used as stage direction, for example while she is speaking between lines 445 and 451 she could be pacing the stage and using her hands to emphasise her point ‘The misery of Thing it is not’ (Webster, (2010[1623]) 1.1.445-52). Also in ‘Go, go brag,’ (Webster, (2010[1623]) 1.1.452), she could point off stage as if inviting him to leave, either in an angry or defeated way. After, in ‘You have left me heartless’ (Webster, (2010[1623]) 1.1.453), her hands could go to her heart, and then onto his with ‘mine is in your bosom’ and leave them there for ‘you do tremble (Webster, (2010[1623]) 1.1.453-54). She could shake him at ‘awake, awake, man,’ (Webster, (2010[1623]) 1.1.459). The pace slows down again after Antonio has promised to protect her reputation; the syllables become longer and more even and written commas slow the dialogue to make it measured. This follows to the end of the extract so we can see that the Duchess is calmer and happy now that Antonio has accepted her proposal. This should reflect in the way that the person playing the Duchess should perform, especially when she is shrugging off the fear of her brothers, as it is almost nonchalant. The stage set up should have enough room for there to be complete focus on the characters and no superfluous scenery – perhaps only what is required to make it obvious what the room is, plus the table and chair for Antonio and the curtains for Cariola to hide behind. If the Duchess is pacing the stage while she rants there should be adequate room for this, and Antonio could follow behind her. Indeed, if he is seeking solace in her words, the actor may wish to appear meek (and therefore filling the gender and rank role) by following her blindly but also allowing her to turn to place her hands on him where necessary. In all, we can see how the distinctive features of Webster’s language have brought the play into being. The use of dramatic irony, metre and rhythm, imagery and figurative language to convey emotion, bring scenes to life and help the audiences perception. Webster also especially does this in his use of figurative language to create stage directions for the cast, which in turn helps them to set and convey the scene. With the play only having little written stage directions, Webster leaves the play open for the actor’s interpretation, and its possibilities onstage.

Essay --

Manufacturing sector is the third largest sector of Pakistan after service and agriculture. It is playing a vital role in the economy of Pakistan; the 18.7% GDP of Pakistan is contributed by manufacturing sector (Ministry of finance, 2012). However, due to contemporary forces of globalization, technological changes and changing customer’s demands for better quality, this important sector of Pakistan is now facing intense competition. Corporate governance is the main key to survive in this turbulent environment. According to Shleifer and Vishny(1997), corporate governance is the controlled mechanism which protects the interest of investors by handlingagency problems. In other words, corporate governance is the system of check and balances on management actions (Larcker, 2011). A number of studies provided the evidence between independence and ownership structure and firm performance. But the results are mixed and cannot be generalized. For instance, several studies stated that opportunistic actions can be taken due to privileged information in case of stock ownership (Yermack, 1997; Bartov and Mohanram, 2004). And many other studies suggest that managerial ownership increases the shareholder wealth by removing the agency problem. Similarly, the results of the literature focusing on linkage of independence and ownership structure with capital structure are mixed (Krishnamoorthy&Maletta, 2012; Larcker, 2011). Considerable research work has been done on linkage of corporate governance structure with firm performance and capital structure, particularly, in developed countries. However, there has been modest research on the influence of corporate governance variables such as board independence, audit committee independence, managerial... ... annual reports of respective companies. Other financial data is collected the â€Å"Balance Sheet Analysis of Joint Stock Companies Listed at Karachi Stock Exchange† published by State Bank of Pakistan. Data for share price were collected through from website of KSE. 3.3. Research models and methodology Following equations are to be tested: EPSit = ÃŽ ²0 + ÃŽ ²1BIit+ ÃŽ ²2ACIit+ÃŽ ²3OCit+ÃŽ ²4MOit + ÃŽ µit Eq. 01 MBit= ÃŽ ²0 + ÃŽ ²1BIit+ ÃŽ ²2ACIit+ÃŽ ²3OCit +ÃŽ ²4MOit + ÃŽ µit Eq. 02 DRit = ÃŽ ²0 + ÃŽ ²1BIit+ ÃŽ ²2ACIit+ÃŽ ²3OCit +ÃŽ ²4MOit+ÃŽ µit Eq. 03 Where firm performance either measured by MB or EPS. MB is Market to Book Ratio, EPS is Earnings per Share andcapital structure is measured by debt ratio,ÃŽ ²0 is the intercept, ÃŽ ²1, ÃŽ ²2, ÃŽ ²3 and ÃŽ ²4are regression slope coefficients. As data used for study is of panel type, so we used panel data estimation methods. Fixed effects model is used to test the relationships.

Nike Company Analysis

Nike Inc. International Strategic Marketing 8 Prepared for: 22-03-2009 Prepared by: Table of contents Case summary3 Analysis Growth strategy4 Competitor Analysis6 SWOT analysis8 Five forces model9 Nike Case Summary Nike is a major publicly traded sportswear and equipment supplier based in the United States. It is the world's leading supplier of athletic shoes and apparel, and a major manufacturer of sports equipment. They have a market share in the United States exceeding 40%. Nike also distributes its products outside the US. In 140 countries, Nike sells products through independent retailers , distributors etc. In the ever changing markets, Nike is facing multiple challenges to remain market leader. Foot Locker was always a great partner for Nike. Foot Locker, as the world’s largest footwear retailer, was an perfect way for Nike to distribute and introduce their new products. But Foot Locker wants to meet consumer demands. So Foot Locker said that they would reduce the more expensive Nike shoes, and focus on more midpriced shoes. This caused a break in the close relationship between Nike and Foot Locker. Nike is basically a distributor. They do not produce their products by themselves. Nike’s products are manufactured by third parties. So the main focus at Nike is on R and marketing. Innovation, and making the consumer actually want the product is key for Nike. Nike products are manufactured in Southeast Asia. The producer of Nike products are independent contractors where Nike does not own any of. The main reason why Nike products are manufactured in these countries is because of the low wages. Low cost labor significantly increases the gross margin on their products. These low wage countries had some significant downsides, thought . When the working conditions, as well as allegations of abuse and harassment became public (done by activists) Nike suffered serious bad publicity. For a company that heavily relies on marketing and PR, this is a serious problem. While Nike tried to neglect these allegations, activist continued to blame Nike. Because the focus at Nike is heavily at marketing and R, Nike always tries to create the right image for the consumer. They do this by constantly innovating (such as the Nike+ series), and attaching famous sports players to the brand. Players such as Tiger Woods, Roger Federer and Wayne Rooney. The last years Nike sees that competitions is catching up and in several segments demand is decreasing. While these are all external factors that influence the company, Nike remains stable in terms of sales, gross margin and operating profit (increased to 10,2 percent in 2002, from 9,3 percent in 2001). While Nike remains to have positive numbers, the industry growth is hard to predict. While, for example, women casual tennis footwear sees an explosive growth, premium priced athletic shoes is clearly declining. Also competition is not standing still. The main competitors of Nike are New Balance, Adidas, and Reebok. New Balance is a company focused on athletic sports. They operate in the market segments of running, walking , tennis basketball etc. Along with this, New Balance expanded their target market by acquiring Dunham Bootmakers. With this they were now also on the market of outdoors such as hiking, boat shoes and sandals. Another acquisition of New Balance took place in 2001 with PF Flyers which gave them acces to the casual market. Another competitor, Adidas, is the world’s number two on footwear and apparel worldwide. Adidas is very much comparable to Nike. With high end technology, and important sponsors. The last of the very important competitors is Reebok. Reebok is the largest growing company. The company changed of strategy when they got the exclusive NFL deal and stated sponsoring the in-field gear of NBA teams. The challenge for Nike is to remain ahead of the competition, continue to be innovative and make sure their image stays on top. Analysis Nike and its subsidiaries are selling an extensive line of sports products throughout the world. Nike is competing in the market with Adidas, Reebok, New Balance and many other brands. [pic] Growth Strategy Nike operates in several market segments. Within these segments Nike is always looking for ways to grow. Nike is an international company that makes sure they can sell their products in the best possible way. That is why Nike today has several different retail possibilities such as Nike factory outlets, Nike stores and others. In April 2002 Nike acquired the Hurley International and gained access to the market segment for surfing, skateboarding and other youth lifestyle extreme sports. Nike was already selling different products under brand names such as Bauer. But still Nike’s core business was athletic running shoes. But growth in sales in 2003 was not very large. Only the women tennis casual footwear was experiencing significant growth. But this was due to the fact that the casual lifestyle segment was gaining popularity at that moment. So Nike decided to shift some of its main focus to other markets in the casual market. The casual market is the market with the most potential growth according to analysts, but weak growth in equipment (basketball , running etc). The growth in the casual market takes place in the non-performance segment. Thus Nike has to adapt to the fact that Nike can also be seen as a fashion object. Nowadays Nike is still the company with the most market share not only in the US, but also globally. And with making innovations in the consumer market, Nike was able to increase the market share. An example is the ‘Air-Jordan shoe line ’ which became extremely popular. Nike should stay focused in analyzing the changing demands of consumers in order to maintain the market share. The Air Jordan shoe line were very popular, but when Jordan retired Nike should be ready to come up with a successor. Also, the company should not be afraid to shift to other markets. The casual non-performance market is clearly growing, and in the athletic market (Nike’s core business) growth is clearly declining. Internally, Nike should keep their focus on marketing and R, which is their strength. Nike does not produce its own products. Nike clearly made some mistakes in the past by hiring independent contractors they have no influence over. [pic] Nike has clearly suffered with the image of sweatshops in Southeast Asian countries. Because Nike does not produce the products by their own factories, they heavily rely on the image consumer has of the company. R is also a heavy factor for Nike. Nike is the global leader on the market, but they have to come up with constant new ideas product development and maintaining a high level of research in the desires of the consumer, Heinz will maintain successful. Competitor Analysis The market where Nike in is operating is high competitive. The athletic footwear, apparel and equipment segments are intensely competitive all around the world. Main competitors are the German-based Adidas, New Balance Athletic Shoe Inc and REEBOK. Adidas-Salamon AG The well known ‘three stripes’ Adidas is popular all around the world. Just like Nike, is Adidas producing all kind of products, most of them related to sports. Adidas is one of the largest competitors in the industry. One of the flagships of Adidas is still the ‘old-style’ sneakers (See picture). Also Adidas is working with sport stars in their marketing campaigns, in order to increase brand awareness and revenues. In 2002, this lead to an overall market share of 11% and global sales with a revenue of almost $7 billion. REEBOK In comparison with Nike and Adidas is REEBOK also producing casual clothes. With the brands Greg Norman, Rockport and Ralph Lauren, the company is selling casual clothes. Since 2000, the company is competing again with Nike. With the return of Paul Fireman, operating activities increased and Reebok was able to compete again. The company’s marketing budget for 2003 was reported to be $40 million. A high percentage of this amount is going to the basketball world. Reebok is sponsoring a lot of teams in the NBA in order to create brand awareness. Since 2005, Reebok is part of Adidas. New Balance Athletic Shoes For many years this company was working with the same shoe outlets. The shoe outlets were successful, but New Balance wanted more. Therefore the company decided in 2000 to include independently owned retail stores. In this stores, more products could be sold. By the end of 2002, New Balance was distributing their products to over 90 independent retail stores. With this new corporate strategy, the company was able to increase sales with 25% in 2001 and 2002. SWOT Analysis Nike Strenghts Brand awareness Nike is the most well known sports brand in the world. Everyone knows the Nike logo (the ‘Swoosh’) and the brand is popular because of its premium quality, design and image. Product range The company is offering many products on the market and therefore can compete in many segments. Because of the global market, Nike can produce on economies of scale. Nike does not own any factories, but chooses the cheapest location to produce (almost always Asia). When a cheaper location is found, Nike can easily switch because it does not own the factory. Research & development Nike is famous because of the nice design, and innovative products. Because the company is producing many products, a high amount of R is invested. But this money is worth it. Nike is always able to come up with innovative designs of clothes and products. Weaknesses Production circumstances Because of negative publicity, a lot of people nowadays associate Nike with bad working conditions for the people who manufacture the products. Child labor, unhealthy factories and dangerous work, all contributed to this image what some people have from Nike. The ethical responsibilities from Nike are important in order to create brand loyalty. Opportunities Product development Coming up with innovative products can be really profitable. Or producing so called ‘high profit’ margin products like watches and sunglasses. Threats Competition The market where Nike is in operating is very competitive. Especially the shoe market, has a lot of competition. Therefore Nike should stay focused on innovation, price/value ratio, marketing and customer service. Economic situation Most of Nike’s products are higher priced then comparable products. This mainly because of the brand image. When there is a recession, consumers are more persuaded to buy cheaper, comparable products from a different producer. 5-Forces Model [pic] The power of suppliers is low. For most products, Nike is using simple raw materials. These materials are available with many suppliers. Also Nike is famous for replacing its production many times. Nike produces the products, where it is the cheapest. [pic] The power of customers is also low. Because most of the sales are B2C, the buyers cannot concentrate and have low power. Only threat is that customers, can easily switch to other (comparable) products. pic] The threat of new entrants is low to moderate. The market is high competitive and dominated by a few large players. First of all, a high amount of investment is required. It is not cheap to produce such a high quantity of shoes, like Nike is doing. Next to this, the costs for R and marketing are extremely high. Therefore we can conclude, that a possible new entrant must possess over a lot o f capital, patience and qualities. [pic] The threat of substitutes is medium. Although the ‘switching costs’ for consumers are not there, Nike is noticing high brand loyalty. This is mainly because of the brand image, quality and with the shoes, the level of comfort. But consumers are price sensitive and are seeking for high value with their sports clothes and related products. In times of economic recession, consumers are seeking for ways in order to save money. This can be, searching for alternative brands. Therefore Nike must closely the monitor the consumer market and the domestic economy. [pic] The rivalry in the industry is high. Exit barriers are quite high, therefore the same players are already for a long time competing in the market. ———————– Market Share 2008

How Does Kazan Convey Ideas About Good and Evil in ‘on the Waterfront’? Essay

Elia Kazan’s portrayal of good and evil in ‘On the Waterfront’ is more than it meets the eye. Good and Evil appear in seperate characters and also at different times on the same characters. More importantly, Elia Kazan gets an important message across; No character is truly evil. Good is symbolised in numerous ways throughought the film. The church is one such example of this. It represents the highest order of purity and goodness, yet it is always on the background of the film. During Edie and Terry’s walk through the playground, the Church could be seen in the background, yet unlike other structures in the film such as the docks, the Church cannot be seen prominently, but rather it is mostly present in the background. Elia Kazan had perhaps used the Church to depict goodness as something present in all the characters, yet, much like the Church it is not always so prominent. Johnny Friendly is the primary antagonist ‘On the Waterfront’, however a question to be considered is that is he purely evil? Friendly’s name is not as ironic as it seems. It is true he is wicked enough to order chilling homicides and remain unperturbed afterwards, however he has a affection towards his underlings. After Friendly observes Terry being deeply shaken by his role in Joey’s death, he hands Terry a note of cash as a â€Å"present from your uncle Johnny. † This shows that Friendly has some level of compassion over his minions and appreciates their ‘good’ work. Despite some goodness inside him however, Friendly is still clearly a cold-blooded killer. Johnny Friendly’s menacing figure represents dictatorship in â€Å"On the Waterfront†. With a whole community of thousands working for him, Friendly still finds the need to murder the minority who disobey him despite having â€Å"the fattest piers and the fattest harbour in the world. † Although he has â€Å"two thousand deuce paying members: at his disposal, Friendly’s overpowering evil lusts for more dominance and this leads to the ultimate act of evil – the murders of multiple people. Although there is a flicker of goodness in him, Friendly remans a major source of evil in ‘On the Waterfront’. To the observant viewer, the presence of good and evil may be clear to see, yet it is the struggle between good and evil influence that is the platform of the film. The protagonist Terry Malloy is the tragic hero is entrapped in a battle between good and evil forces. The pure hearted Father Barry ad Edie Doyle attempt to rescue Terry from his conscience which constantly torments him by urging him to speak out the truth while the mob on the other hand attempt to influence him by providing threats and intimidating him. The mob goes so far as to murdering his brother in an attemt to break his spirit and also lure him to end his life too. In the end, the influence of good prevails and Terrt finally gives witness to the crimes of the mob. With his conscience cleared, Terry is now fianlly able to speak out against Friendly and the mob without loathing himself as he is no longer a â€Å"bum† in his own eyes. â€Å"On the Waterfront† is no film about Angels against Demons, but rather sheds light on the fact that good and evil are out there, yet is is upto us to allow either one to influence us. Similar to Edie, an individual may allow good forces such as the desire to uncover truth to affect them or they may allow evil forces such as greed to manipulate them and cause them to carry out needless, henious acts like Johnny Friendly. As viewers witness through Terry’s actions, in the end, ‘good’ and ‘evil’ are simply options. It is ultimately our choice to pick one to allow it to influence us. The choice is always ours to make.

Acute Cholecystitis Essay Example

Acute Cholecystitis Essay Example Acute Cholecystitis Essay Acute Cholecystitis Essay kulasekar Definition Cholecystitis is inflammation of the gallbladder, usually resulting from a gallstone blocking the cystic duct. Gallbladder inflammation usually results from a gallstone blocking the flow of bile. Typically, people have abdominal pain that lasts more than 6 hours, fever, and nausea. Ultrasonography can usually detect signs of gallbladder inflammation. The gallbladder is removed, often using a laparoscope. Cholecystitis is the most common problem resulting from gallbladder stones. It occurs when a stone blocks the cystic duct, which carries bile from the gallbladder Causes In 90% of cases, acute cholecystitis is caused by gallstones in the gallbladder. Severe illness, alcohol abuse and, rarely, tumors of the gallbladder may also cause cholecystitis. Acute cholecystitis causes bile to become trapped in the gallbladder. The build up of bile causes irritation and pressure in the gallbladder. This can lead to bacterial infection and perforation of the organ. Gallstones occur more frequently in women than men. Gallstones become more common with age in both sexes. Native Americans have a higher rate of gallstones. Symptoms The main symptom is abdominal pain particularly after a fatty meal that is located on the upper right side of the abdomen. Occasionally, nausea and vomiting or fever may occur. Exams and Tests A doctors examination of the abdomen by touch (palpation) may reveal tenderness. Tests that detect the presence of gallstones or inflammation include: Abdominal ultrasound Abdominal CT scan Abdominal x-ray Oral cholecystogram Gallbladder radionuclide scan A CBC shows infection by an elevated white blood cell count [pic] Outlook (Prognosis) Patients who have cholecystectomy usually do very well. Possible Complications Empyema (pus in the gallbladder) Peritonitis (inflammation of the lining of the abdomen) Gangrene (tissue death) of the gallbladder Injury to the bile ducts draining the liver (a rare complication of cholecystectomy) Cholecystitis is classified as acute or chronic. Acute Cholecystitis: Acute cholecystitis begins suddenly, resulting in severe, steady pain in the upper abdo men. At least 95% of people with acute cholecystitis have gallstones. The inflammation almost always begins without infection, although infection may follow later. Inflammation may cause the gallbladder to fill with fluid and its walls to thicken. Rarely, a form of acute cholecystitis without gallstones (acalculous cholecystitis) occurs. Acalculous cholecystitis is more serious than other types of cholecystitis. It tends to occur after the following: Major surgery Critical illnesses such as serious injuries, major burns, and bodywide infections (sepsis) Intravenous feedings for a long time Fasting for a prolonged time A deficiency in the immune system It can occur in young children, perhaps developing from a viral or another infection. Chronic Cholecystitis: Chronic cholecystitis is gallbladder inflammation that has lasted a long time. It almost always results from gallstones. It is characterized by repeated attacks of pain (biliary colic). In chronic cholecystitis, the gallbladder is damaged by repeated attacks of acute inflammation, usually due to gallstones, and may become thick-walled, scarred, and small. The gallbladder usually contains sludge (microscopic particles of materials similar to those in gallstones), or gallstones that either block its opening into the cystic duct or reside in the cystic duct itself. A gallbladder attack, whether in acute or chronic cholecystitis, begins as pain. The pain of cholecystitis is similar to that caused by gallstones (biliary colic) but is more severe and lasts longer- more than 6 hours and often more than 12 hours. The pain peaks after 15 to 60 minutes and remains constant. It usually occurs in the upper right part of the abdomen. The pain may become excruciating. Most people feel a sharp pain when a doctor presses on the upper right part of the abdomen. Breathing deeply may worsen the pain. The pain often extends to the lower part of the right shoulder blade or to the back. Nausea and vomiting are common. Within a few hours, the abdominal muscles on the right side may become rigid. Fever occurs in about one third of people with acute cholecystitis. The fever tends to rise gradually to above 100. 4 ° F (38 ° C) and may be accompanied by chills. Fever rarely occurs in people with chronic cholecystitis. In older people, the first or only symptoms of cholecystitis may be rather general. For example, older people may lose their appetite, feel tired or weak, or vomit. They may not develop a fever. Typically, an attack subsides in 2 to 3 days and completely resolves in a week. If the acute episode persists, it may signal a serious complication. A high fever, chills, a marked increase in the white blood cell count, and essation of the normal rhythmic contractions of the intestine (ileus- see Gastrointestinal Emergencies: Appendicitis) suggest pockets of pus (abscesses) in the abdomen near the gallbladder from gangrene (which develops when tissue dies) or a perforated gallbladder. If people develop jaundice (see Manifestations of Liver Disease: Jaundice) or pass dar k urine and light-colored stools, the common bile duct is probably blocked by a stone, causing a backup of bile in the liver (cholestasis). Inflammation of the pancreas (pancreatitis) can develop. It is caused by a stone blocking the ampulla of Vater, near the exit of the pancreatic duct. Acalculous cholecystitis typically causes sudden, excruciating pain in the upper abdomen in people with no previous symptoms or other evidence of a gallbladder disorder. The inflammation is often very severe and can lead to gangrene or rupture of the gallbladder. In people with other severe problems (including people in the intensive care unit for another reason), acalculous cholecystitis may be overlooked at first. The only symptoms may be a swollen (distended), tender abdomen or a fever with no known cause. If untreated, acalculous cholecystitis results in death for 65% of people. Diagnosis Doctors diagnose cholecystitis based mainly on symptoms and results of imaging tests. Ultrasonography is the best way to detect gallstones in the gallbladder. Ultrasonography can also detect fluid around the gallbladder or thickening of its wall, which are typical of acute cholecystitis. Often, when the ultrasound probe is moved across the upper abdomen above the gallbladder, people report tenderness. Cholescintigraphy, another imaging test, is useful when acute cholecystitis is difficult to diagnose. For this test, a radioactive substance (radionuclide) is injected intravenously. A gamma camera detects the radioactivity given off, and a computer is used to produce an image. Thus, movement of the radionuclide from the liver through the biliary tract can be followed. Images of the liver, bile ducts, gallbladder, and upper part of the small intestine are taken. If the radionuclide does not fill the gallbladder, the cystic duct is probably blocked by a gallstone. Liver blood tests are often normal unless the person has an obstructed bile duct. Other blood tests can detect some complications such as a high level of a pancreatic enzyme (lipase or amylase) in pancreatitis. A high white blood cell count suggests inflammation, an abscess, gangrene, or a perforated gallbladder. Treatment People with acute or chronic cholecystitis need to be hospitalized. They are not allowed to eat or drink and are given fluids and electrolytes intravenously. A doctor may pass a tube through the nose and into the stomach, so that suctioning can be used to keep the stomach empty and reduce fluid accumulating in the intestine if the intestine is not contracting normally. Usually, antibiotics are given intravenously, and pain relievers are given. If acute cholecystitis is confirmed and the risk of surgery is small, the gallbladder is usually removed within 24 to 48 hours after symptoms start. If necessary, surgery can be delayed for 6 weeks or more while the attack subsides. Delay is often necessary for people with a disorder that makes surgery too risky (such as a heart, lung, or kidney disorder). If a complication such as an abscess, gangrene, or perforated gallbladder is suspected, immediate surgery is necessary. In chronic cholecystitis, the gallbladder is usually removed after the acute episode subsides. In acalculous cholecystitis, immediate surgery is necessary to remove the diseased gallbladder. Surgical removal of the gallbladder (cholecystectomy) is usually done using a flexible viewing tube called a laparoscope. After small incisions are made in the abdomen, the laparoscope and other tubes are inserted, and surgical tools are passed through the incisions and used to remove the gallbladder. [pic] Pain After Surgery: A few people have new or recurring episodes of pain that feel like gallbladder attacks even though the gallbladder (and the stones) have been removed. The cause is not known, but it may be malfunction of the sphincter of Oddi, the muscles that control the release of bile and pancreatic secretions through the opening of the bile and pancreatic ducts into the small intestine. Pain may occur because pressure in the ducts is increased by sphincter spasms, which hinders the flow of bile and pancreatic secretions. Pain also may result from small gallstones that remain in the ducts after the gallbladder is removed. More commonly, the cause is another problem, such as irritable bowel syndrome or even peptic ulcer disease. Endoscopic retrograde cholangiopancreatography (ERCP) may be necessary to determine if the cause of pain is increased pressure. For this procedure, a flexible viewing tube (endoscope) is inserted through the mouth and into the intestine, and a device to measure pressure is inserted through the tube. If pressure is increased, surgical instruments are inserted into the tube and used to cut and thus widen the sphincter of Oddi. This procedure (called endoscopic sphincterotomy) can relieve symptoms in people who have an abnormality of the sphincter. Background Acute cholecystitis (AC) occurs as a result of inflammation of the gallbladder (GB) wall usually secondary to cystic duct obstruction. In 90% of patients, AC is initiated by impaction of a calculus in the neck of the GB or in the cystic duct. 22 Acute acalculous cholecystitis (AAC) represents inflammation of the GB in the absence of GB calculi. AAC occurs more commonly in children and adults who are critically ill or in those who have recently undergone stress in the form of severe trauma, burns, or major surgery. Acute emphysematous cholecystitis is characterized by the presence of gas within the wall and/or lumen of the GB. It occurs more commonly in diabetic men and less frequently in association with cholelithiasis. Emphysematous cholecystitis is considered either a complication of AC or a separate entity. For excellent patient education resources, see eMedicines Liver, Gallbladder, and Pancreas Center. Also, visit eMedicines patient education article Gallstones. Pathophysiology AC represents an acute inflammation of the GB caused in most instances by obstruction of the cystic duct, usually by a gallstone and resulting in acute inflammation of the GB wall. AC is one of the major complications of cholelithiasis. The inflammatory process begins with a calculous obstruction of the cystic duct or GB neck. The exact mechanism by which GB inflammation is initiated is unknown. Microorganisms can be identified in 80% of cases early in the disease onset; such organisms include primarily  Escherichia coli, other gram-negative aerobic rods, enterococci, and a number of anaerobes. The bacterial invasion is not considered  to be  a primary event, because in 20% of patients, no bacterial growth  occurs in  surgical specimens. 1 The general consensus is that bacterial infection is a secondary event,  not an initiating one. Spontaneous resolution of AC may occur within 5-7 days after onset of symptoms,  because of reestablishment of cystic duct patency. In the majority of such cases, fibrotic wall thickening of the GB occurs, which  is characteristic of chronic cholecystitis. In more than 90% of cholecystectomy specimens, the histologic pattern is  AC superimposed on chronic cholecystitis. If the cystic duct patency is not reestablished, inflammatory cell infiltration of the GB wall follows,  with the occurrence of  mural and mucosal hemorrhagic necrosis. Gangrenous cholecystitis may  be seen  in as many as 21% of AC patients. Acalculous cholecystitis occurs in a different clinical setting, occurring  more often in males, usually children and in those older than 65 years. The pathophysiology of acalculous cholecystitis is  not well  understood but is probably multifactorial. Systemic mediators of inflammation, localized or generalized tissue ischemia, and bile stasis probably work to gether. The population at risk for acalculous AC often has predisposing factors for bile stasis; such  populations include patients with  starvation, on parenteral nutrition, using narcotic analgesics, and  lacking mobility in postoperative states. Hypovolemia and shock also predispose such patients to tissue ischemia, although ischemia may be a primary event causing acalculous AC,  such as  small-vessel vasculitis,  or may be  a complication of hepatic chemoembolization. Often, functional cystic duct obstruction is present and is related to inflammation and viscous bile. Extrinsic compression may also play a role in the development of bile stasis. The majority of patients with acalculous AC disease have secondary infection with gram-negative enteric flora3; however, in patients with typhoid fever, infection as a primary event has been  identified with  Salmonella organisms. AIDS-related cholecystitis and cholangiopathy may be secondary to cytomegalovirus (CMV) infection  and infections with Cryptosporidium organisms. In patients who have  emphysematous cholecystitis,  ischemia of the GB wall is followed by infection with gas-forming organisms that produce gas in the GB lumen, in the GB  wall, or both. In 30-50% of patients, preexisting diabetes mellitus is present,  and the  male-to-female ratio  is 5:1. 22 Gas may be confined to the GB; however, in 20% of cases, gas is also seen in the rest of biliary tree. Gallstones are not present in 30-50% of cases, and the mortality rate is 15%. 2  There is a predisposition  for gangrene formation and perforation, but clinical symptoms are mild, which can be deceptive. Emphysematous cholecystitis  may occur after  chemoembolization  as palliation  for hepatocellular carcinoma,  following atheromatous embolism during aortography, and after GB hypoperfusion during cardiorespiratory resusc itation. The following factors have been  associated with acalculous cholecystitis4: Surgery, particularly abdominal Severe burns Gastroenteritis Severe trauma Total parenteral nutrition (TPN) Mechanical ventilation Blood transfusion reactions Dehydration Narcotic analgesia Diabetes mellitus Antibiotics, particularly broad spectrum Hepatic arterial embolization (islet cell tumors and hepatocellular carcinoma) Postpartum complications Vascular insufficiency and vasculitis such as systemic lupus erythematosus (SLE) and Sjogren syndrome Arteriostenosis/hypertension AIDS, CMV, Cryptosporidium infections Typhoid Empyema of the GB may develop as a complication of AC. In AC, the GB is usually distended  as a result of  inflammatory cells mixed with bile and calculi. The bile becomes infected as the disease progresses. In 85% of patients, the cystic duct disimpacts, and  the inflammation in the GB settles. If the cystic duct remains obstructed, the inflammatory process may progress to a GB empyema and  eventually  result in  perforation. Frequency United States Because of the close relationship between gallstones and AC, the distribution and the incidence of AC follow that of cholelithiasis. Gallstones may be present in more than 20 million  persons in the United States,  resulting in 500,000 cholecystectomies annually. In 10-20% of patients, AC complicates the course of symptomatic gallstones. 2   AAC accounts for 5-15% of cases of AC,22 with the  incidence  being higher in ICU patients, particularly  those with burns and trauma. Most cases of AC in the ICU are acalculous, but in this setting, the overall incidence of acalculous AC is only 0. 2%. In the majority of postoperative cases (90%), AC is acalculous. 5 Mortality/Morbidity The AC mortality of 5-10% is  mostly confined to patients older than 60 years. AC may be complicated by empyema, gangrenous cholecystitis, GB perforation, pericholecystic abscess, and bilioenteric fistula. Gangrenous cholecystitis is a frequent cause of GB perforation. Suppurative complications are more frequent in the elderly. Most localized perforations can be satisfactorily treated by means of surgery. Although free intraperitoneal perforation is  rare, it is associated with a mortality of 25%. Necrosis of the GB wall occurs in about 60% of cases of acalculous cholecystitis because gangrene and perforation are frequent. Mortality can be as high as 9-66%. 6 The higher mortality in AAC  has been  attributed to delayed diagnosis and comorbidities. The morbidity associated with emphysematous cholecystitis is also higher, because  GB wall gangrene and perforation. Recurrent symptoms are common in patients with AC who are treated expectantly, and most patients need elective cholecystectomy. Race Because of the close relationship between gallstones and AC, the incidence of  AC is expected to be higher in races with a higher incidence of gallstones. Such populations include Native Americans and persons of Chinese or Japanese descent. Sex The male-to-female ratio of AC is 1:3. AAC is more common in men than in women; the male-to-female ratio in AAC is 2-3:1. Acute emphysematous cholecystitis is also more common in men than in women. Age AC affects all age groups, but the peak incidence is in  persons aged 40-60 years. Approximately 50% of cases of AC in children are acalculous. Anatomy The GB stores and concentrates bile,  and the ducts function as a bile drainage system. The flow of bile through the bile ducts is affected by several factors, including hepatic secretory pressure, tone in the sphincter of Oddi, the rate of GB fluid absorption, and GB contraction. Anatomically, the GB is a pear-shaped musculomembranous reservoir lying in the GB fossa on the inferior aspect of the liver. The fundus of the GB lies close to the nterior abdominal wall and near the hepatic flexure of the colon. The surface marking of the GB fundus is in the region of the costal cartilage. At this point, it is covered by peritoneum, and its proximity to the hepatic flexure of the colon may obscure it. The body of the GB is adjacent to the duodenum, which indents and produces a frequent ultrasonographic artifact that mimics gallstones or a mass in the GB. An inflamed GB may perforate into the colon or duodenum because of the close proximity of the GB to these structures. The mucosa of the GB neck is thrown into folds, giving an echogenic appearance that may also mimic gallstones. A small pouch, known as the Hartmann pouch, projects from the right side of the GB neck. When visible, this finding is frequently associated with pathology, particularly dilatation. The GB fundus is often folded over, and the GB then assumes a double-barrel appearance. Pseudoseptation of the GB fundus  caused by  kinking or, occasionally, a true septum called the phrygian cap is seen in 2-6% of GBs. The phrygian cap is of no pathologic significance. A cystic artery supplies the GB, and it is usually a branch of the right hepatic artery. The artery lies in the triangle made by the liver, the cystic duct, and the common hepatic duct (CHD). Other, smaller tributaries supply the GB  through the right hepatic artery via the GB bed through the liver. Usually, the right hepatic artery passes behind the CHD and the cystic artery crosses behind the cystic duct. In 25% of cases, the common hepatic artery passes in front of the CHD and the cystic artery in front of the cystic duct. Recognition of GB blood supply is gaining increased importance because of vascular intervention in the liver, particularly chemoembolization. Catheters should be placed distal to the cystic artery to prevent embolic material from entering the cystic artery and causing GB ischemia. Ultrasonographic anatomy The GB is a pear-shaped anechoic structure indenting the inferomedial aspect of the right lobe of the liver. A linear echogenic line representing fat in the main interlobar fissure is interposed between the GB and the right main portal vein. The GB mucosa is hyperechoic, the submucosa and the muscle layer are hypoechoic, and the serosal surface fatty layer is hyperechoic. A linear fold is present on the posterior GB wall at the junction of the body and neck. Called the junctional fold, this structure is of no pathologic significance. Sound waves from the spiral valve of the neck may cast an acoustic shadow and mimic a gallstone. The normal thickness of the GB wall is usually less than 3 mm. Provided that the patient has been fasting for 8-12 hours, visualization of the normal GB should be nearly complete. In a truly fasting patient, nonvisualization of the GB is a pathologic finding in 96% of patients. GB dimensions The normal GB usually measures 7-10 X 2-3. 5 cm. In the fasting patient, the normal dimensions of the GB seldom exceed 4 X 10 cm. The size of the GB generally increases with age, but the GB wall thickness is unaffected by age. The normal wall thickness is 2-3 mm. Neonatal GB dimensions are 0. 5-1. 6 cm (mean, 0. 9 cm) X 2. 5 cm. The wall thickness is usually 1 mm. GB anomalies Many anatomic anomalies affect the GB. The recognition of these anomalies is important in the context of GB disease. Errors in GB surgery are frequently a result of the failure to appreciate variations in the anatomy of the biliary system. Anomalous positioning or orientation of the GB includes situs inversus when the GB is in the left upper quadrant. A GB  in the left lobe of the liver without situs inversus is rare. Heterotaxia, which represents an intermediate situs with GB in the midline, may be associated with asplenia, polysplenia, pulmonary isomerism, and congenital heart disease. An anomalous orientation may be present when the GB is vertical or horizontal. It may descend into the right iliac fossa, particularly in the presence of the Riedel lobe. Unusual locations include intrahepatic, suprahepatic, lateral, anterior abdominal wall, and retrorenal sites. The GB may also be present in the thorax, in the falciform ligament and/or interlobular fissure, and in the transverse mesocolon. A wandering GB results when the GB is suspended on its own mesentery. Recognition of this anomaly is important because  such a GB is  prone to torsion. Agenesis is a rare anomaly found in 0. 04-0. 07% of autopsies. Agenesis may be associated with biliary atresia, imperforate anus, CHD, and common bile duct (CBD) anomalies. Rarely, the GB opens separately into the duodenum. The most common anomalous shape is due to the phrygian cap, in which the fundus of the GB is folded back on itself, producing a kink in the fundus. The GB may rarely appear as a diverticulum with no cystic duct. Other anomalies include fishhook, a siphon, and an hourglass configuration. A diverticulum of the GB is extremely rare and usually located at the neck of the GB. This is rarely symptomatic unless it is complicated by calculus disease. Regarding GB duplication, true duplication is rare, but it has been reported in as many as 1 in 3000-4000 people, with a male-to-female ratio of 2:1. Triplication is even rarer, and it may be an incidental finding at autopsy. In duplication, each GB may have a separate cystic duct or there may be 1 shared cystic duct. A septate GB may have an isolated transverse septum. True duplication has a longitudinal septum. A multiseptate GB is extremely rare, with multiple loculi connected by small pores; patients with this condition are particularly prone to bile stasis and calculus formation. With an anomalous cystic duct insertion, the cystic duct may insert into the CBD or CHD high or low. The cystic duct is often intramural, running for some distance in the wall of the CBD within a common sheath. Congenital stenosis of the cystic duct is extremely rare, and it may be complicated by calculus disease. Heterotopic tissue may be present within the GB, where gastric or pancreatic tissue has been described within the GB wall. This tissue may mimic tumors. Clinical findings AC usually occurs with right upper quadrant pain and tenderness. The abdominal pain increases with time. The site of pain is usually the right subcostal region, although the pain may begin in the epigastrium or the left upper quadrant and then shift to the right subcostal region to the area of the GB inflammation. Referred pain to the right shoulder or the interscapular region may be experienced. Approximately 70% of patients have had previous attacks of similar pain that spontaneously resolved. Anorexia, nausea, and vomiting may occur, but vomiting is seldom severe. Most patients are afebrile and have no leukocytosis. When fever occurs, the patients temperature is seldom  higher than 38 °C. Chills are unusual, and their presence suggests a complicated cholecystitis (abscess or associated cholangitis). Palpation of the right subcostal area reveals muscle spasm. During deep inspiration, the tenderness becomes suddenly worse and produces an inspiratory arrest called the Murphy sign. The Murphy sign  cab be elicited with an ultrasound probe. In approximately 35% of patients, a distended, tender GB may be palpable as a distinct mass. This is an important clinical finding and may confirm the diagnosis. Approximately 20% patients with AC may have mild jaundice, which may be related to common hepatic and/or bile duct edema or to the presence of calculi within the CBD. 22 Most patients improve within 24 hours after hospitalization, and signs and symptoms gradually subside. However, persistent pain, fever and leukocytosis, chills, and more severe localized or generalized tenderness may indicate complicated disease such as abscess formation or GB perforation. The development of empyema of the GB can produce systemic toxicity, and it may be a predictor of GB perforation. Leukocytosis is pronounced with empyema and is usually in the range of 10,000-15,000/? L. The clinical differential diagnosis includes acute pancreatitis, perforated peptic ulcer, gonococcal perihepatitis (Fitz-Hugh-Curtis syndrome) in women, acute hepatitis, pneumonitis, pyelonephritis, cardiac disease, sickle cell crises, and leptospirosis. AAC is difficult to diagnose clinically. It occurs often in children (50%) and in patients who are critically ill or who have recently undergone stress from severe trauma, burns, or surgery. Predisposing factors include prolonged fasting, immobility, and hemodynamic instability. Often, these patients cannot express pain; however, fever, jaundice, vomiting, abdominal tenderness, leukocytosis, and hyperbilirubinemia should lead to a high index of clinical suspicion. Children with AAC more often present in the outpatient setting than in other settings, and they usually present with  right upper quadrant  pain in the absence of gallstones. These patients are usually treated by means of cholecystectomy. Some elderly patients have few signs during their initial presentation with AC. A minority of adult patients, mostly elderly patients with AAC, also present in the outpatient setting. These cases are diagnosed and treated early and are associated with a good prognosis. Causes Hemolytic o Hemolytic anemias such as congenital spherocytosis (43-85%), sickle cell disease (7-37%), and thalassemia o Cardiac causes such as mitral valve stenosis and prosthetic heart valves o Pernicious anemia o Aortic aneurysm o Hypersplenism Metabolic o Overweight, female sex, fair complexion, fertile, and age of 40 years or older o Diabetes mellitus o Obesity o Hemosiderosis o Pregnancy o Prolonged use of estrogen/progesterone o Hyperparathyroidism o Cystic fibrosis o Pancreatitis o Hypothyroidism Muscular dystrophy o Crohn disease o Ileal resection and intestinal malabsorption o Type IV hyperlipidemia o Surgical bypass for obesity o Cholestasis Miscellaneous o Chronic hepatitis o Cirrhosis o Congenital biliary malformation (eg, Caroli disease) o Parasites (eg, ascariasis, liver flukes), which form a nidus for development of calculi o Drugs such as methadone o Biliary strictures ( eg, oriental cholangiohepatitis [bile stasis]) Genetic o Genetic predisposition in populations such as Native Americans o Higher incidence of intrahepatic gallstones in Chinese and Japanese populations Preferred Examination Clinically, few signs differentiate uncomplicated AC from complicated AC. Complications of AC may have serious clinical implications. These complications include perforation, pericholecystic abscess, and development of empyema and bilioenteric fistula. Therefore, radiologic imaging makes a substantial contribution to the differential diagnosis. Ultrasonography significantly aids  in the diagnosis of AC, although most ultrasonographic signs are not typical but suggestive of AC. Inflammatory pericholecystic reaction in the GB fossa is better depicted with CT than with other techniques. Also, CT is useful in making the differential diagnosis when obesity or gaseous distention limits the use of ultrasonography. MRI can demonstrate the same morphologic changes as CT, displaying inflammatory changes in the GB wall, pericholecystic fat, and intrahepatic periportal tissues. Plain radiography greatly contributes to the diagnosis of emphysematous pyelonephritis, and ultrasonographic and CT scan results can further confirm the diagnosis (although  CT scanning is  not strictly needed  to make  the diagnosis). Cholescintigraphy is an extremely sensitive diagnostic modality in diagnosing AC, although the findings are nonspecific. Oral cholecystography is of historical interest and has no role in the diagnosis of AC. Arteriography is seldom required for AC. Limitations of Techniques Plain radiographic findings may be entirely normal. Radiolucent calculi are visible. Opaque calculi in the  right upper quadrant  on plain abdominal radiographs may be an incidental finding and is not necessarily related to AC. Oral cholecystography is of historical interest and has a low sensitivity and specificity in the diagnosis of AC. The main features of AC on ultrasonography are all nonspecific findings. Examples include GB thickening, calculi in the GB, a positive ultrasonographic Murphy sign, and pericholecystic fluid. The sonographic Murphy sign is negative in as many as 70% of patients with AC. In a perforated GB, the wall of the GB is not well delineated, and a localized interruption of the wall may not be noted at the site of perforation. Ultrasonography has problems in making the diagnosis in obese patients and in patients with gaseous distention. The technique remains operator dependent. CT exposes the patient to a radiation burden, which may not be necessary. Arteriography is invasive and is seldom indicated. MRI has a limited availability; it is expensive; and it has problems in making the diagnosis in patients with certain prosthetics, surgical clips, cardiac pacemakers, or claustrophobia. Although cholescintigraphy is  sensitive, it has a low specificity and involves the use of ionizing radiation.

10 Fascinating Facts About Painted Lady Butterflies

10 Fascinating Facts About Painted Lady Butterflies The painted lady is one of the most familiar butterflies in the world, found on nearly all continents and in all climates. They are a favorite subject of study in elementary school classrooms and are a familiar visitor to most landscape gardens. Yet common as they are, painted ladies have some unique attributes.  Here are 10 fascinating facts about the painted lady, or  Vanessa  cardui. 1. The painted lady is the most widely distributed butterfly in the world. Venessa cardui  inhabits every continent except Australia and  Antarctica. You can find painted ladies everywhere from meadows to vacant lots. Its sometimes called the cosmopolitan butterfly, because of its global distribution. Although it is resident only in warmer climates, it often migrates into colder regions in spring and fall, making it the butterfly with the widest distribution of any species.   2. The painted lady is sometimes called the thistle butterfly or the cosmopolitan  butterfly. It is called the thistle butterfly because thistle plants are its favorite nectar plant for food; it is called the cosmopolitan butterfly because of its global distribution. Its scientific name- Vanessa cardui- translates as butterfly of thistle.   3. Painted ladies have unusual migration patterns. The painted lady is an irruptive migrant, meaning that it migrates independent of any seasonal or geographic patterns. Some evidence suggests that painted lady migrations may be linked to the El Nià ±o climate pattern. In Mexico and some other regions, it appears that migration is sometimes related to overpopulation. The migrating populations that move from North Africa to Europe may include millions of butterflies, and migrating populations numbering hundreds of thousands of individuals are common.  In spring, painted ladies fly low when migrating, usually only 6 to 12 feet above the ground. This makes them highly visible to butterfly watchers, but also rather susceptible to colliding with cars. At other times, evidence suggests that painted ladies migrate at such high altitudes that they are not observed at all, simply appearing in a new region unexpectedly.   4. Painted ladies fly fast and far. These medium-sized butterflies can cover a lot of ground, up to 100 miles per day during their migration. A painted lady is capable of reaching a speed of nearly 30 miles per hour. Painted ladies reach northern areas well ahead of some of their more famous migrating cousins, like  monarch butterflies. And because they get such an early start to their spring travel, migrating painted ladies are able to feed on spring annuals, like fiddlenecks (Amsinckia). 5. Painted lady butterflies do not overwinter in cold regions. Unlike many other species of butterflies that migrate to warm climates in winter, painted ladies die once winter hits in colder regions. They are present in cold regions only because of their impressive ability to migrate long distances from their warm-weather breeding areas.   6. Painted lady caterpillars eat thistle. Thistle, which can be an invasive weed, is one of the painted lady caterpillars favorite food plants. The painted lady probably owes its global abundance to the fact that its larvae feed on such common plants. The painted lady also goes by the name thistle butterfly, and its scientific name- Vanessa cardui- means butterfly of thistle.   7. Painted ladies sometimes damage soybean crops. When the butterflies are found in large numbers, they can do serious damage to soybean crops. The damage occurs during the larval stages when caterpillars eat soybean foliage after hatching from eggs.  Ã‚   8. Males use the perch and patrol method for finding mates. Male painted ladies actively patrol their territory for receptive females in the afternoon. Should a male butterfly  find a mate, he will usually retreat with his partner to a treetop, where they will mate overnight. 9. Painted lady caterpillars weave silk tents. Unlike other caterpillars in the genus Vanessa, painted lady larvae construct their tents from silk. Youll usually find their fluffy shelters on thistle plants. Similar species, such as the American lady caterpillar, make their tents by stitching leaves together instead. 10. On overcast days, painted ladies can often be found on the ground, huddling in small depressions. On sunny days, the butterflies prefer open areas filled with colorful flowers.

The Failures and Contributions of Herod the Great and the Herodians to Assignment

The Failures and Contributions of Herod the Great and the Herodians to the history of Judaism - Assignment Example Judas Maccabeus was the son of Mattathias. Maccabeus’ popularity lies not only because of his participation in biblical history but also because of his martial achievements. He proved his talents by leading the Maccabean Revolt. Judas displayed extraordinary skills as a leader, military tactician, and diplomat (Julius 2000). After attaining religious freedom, Judas and his friends turned their attention to politics. After the death of Judas Maccabeus, there came the leader Jonathon Maccabeus, the brother of Judas. Jonathan was a man of prudence and great skills (Julius 2000). As a diplomat, he could effectively utilize the internal strife of Seleucid and succeeded in expanding Jewish held territory and acquiring virtual independence. Jonathan was immediately followed after his death by his brother Simon, and he followed exactly what his brothers did. It was the strength of his military forces that forced the Seleucid king, Demetrius II to depend on Simon for help and support. The rulers followed after Simon, except the Antipater, were not much popular. Most of the leaders in the Intertestamental Period had kept secret plans with them. ...Therefore, one can identify the modern counterparts of the Judaism and the series of wars aimed at a particular sect of people or creed. Trace the history of Herod the Great and the Herodians. What were their major contributions to the history of Judaism and the Jews? What were their main failures? King Herod the Great (47-4 B.C.), first ruled as the Governor of Galilee (47-37 B.C.). He has often been regarded as a king who played a momentous role in the Herodian dynasty. Through his leadership and governing skills, he gained a proud reputation both with the Galilean Jews as well as with the Roman officials of Syria (Timothy, Gary 1998, 270). When Herod the Great became the King of the Jews, his rule created vivid reactions among the people and as such one can divide his rule into three definite periods: (1) The period o f consolidation (37-25 B.C.).