Critically discuss the view that anti-globalisation arguments Essay - 4

Critically discuss the view that anti-globalisation arguments seriously undervalue the benefits that globalisation has delivered for all countries 01296 - Essay Example In this paper, role of anti-globalisation arguments in undervaluing benefits of globalisation has been critically assessed to determine its validity. According to different scholars, no specific definition of globalisation exists and consequently the debates initiates at this very point. However, in common language, globalisation can be defined as integration of several national markets into one common global forum where national boundaries are largely diminished (Das, 2010). It is an intensification of interconnectivity and movement of trade, finance, human and non-human resources, culture and investment (Robertson, 1992). According to studies, economic globalisation can be considered as the most influential force that has shaped the globe since the wars (Das, 2010; Huwart and Verdier, 2013). Over the time, globalisation became one of the drivers of structural changes with respect to global, regional and national economies. It is also referred to as a powerful transformative force on the face of world economy (Amin, 2004; Das, 2010). It was observed that globalisation has resulted in significant rise in value as well as volume of international trade in goods and services along with expansion in long and short periodic flow of capital (Amin, 2004; Huwart and Verdier, 2013). It was also gathered that liberalisation as a part of globalisation movement cause trade and financial integration and raised economic growth rate and earning rate. As the worldwide economic integration progressed and intensified, it caused increase in efficiency of various tangible and intangible resources and utilisation of inputs (Das, 2010). According to studies in 2007, the volume of goods and services in global multilateral trade was equivalent to $16.9 trillion and it was about 34 percent of total global gross domestic product (Huwart and Verdier, 2013). In the same year, private

Community Health Nursing Essay Example for Free

Community Health Nursing Essay Healthy People provide a 10-year national objective for improving the health of Americans. It has established benchmarks and monitored progress over time in order to encourage collaborations across the country, empowering individuals toward making knowledgeable health decisions, and measuring the impact of prevention activities. The vision is for a society in which all people live long and healthy lives. Objectives new to Healthy People 2020 are related to policies targeting young children through physical activity in childcare settings, television viewing and computer usage, recess and physical education in the Nation’s public and private elementary schools. Physical activity is important as it can improve health and quality of life for all, including those with disabilities. Increased physical activity in children and adolescents can improve bone health, cardiorespiratory and muscular fitness, decrease levels of body fat and reduce symptoms of depression. There is an epidemic of obesity among our children today, this is linked to the over use of computer games and television. Healthy People 2020 have set an objective that sets limits to screen time. It was rather interesting to me that the pediatrician informed me that my infant, now a toddler should not be watching television at all as recommended by the Journal of Pediatrics. As mentioned in The Journal for Nurse Practitioners, there is a dangerous link found between childhood obesity and asthma (Rance, O’Laughlen, 2011). A common assumption is that weight gain occurs because many asthmatic patients avoid exercise since physical activity can trigger their symptoms, though many contributing factors coexist (Rance, et. al., 2011). Interesting enough there has been a suggestion that overweight/obesity as a risk factor for developing asthma (Papoutsaakis, Priftis, Drakouli , Prifti, Konstantaki, Chondronikola, Matziou, 2013). As  an adolescent I was diagnosed with having chronic asthma, as I was extremely active and not an overweight child. Physical activity was a normal part of my daily afterschool routine, I ran track, was a member of the swim team and was on the cheerleading squad. So having asthma one should not exclude physical activity from their life as it helps to prevent obesity and other ailments. A study illustrated that children were more adept at identifying healthy foods and explaining their benefits than identifying activities that make their bodies healthy (Lanigan, 2011). This study also discovered that the media was the primary source of children’s health knowledge. Parents need to become more involved and lead by example as it pertains to the health and welfare of their children. This is why I often volunteer for the various optimist clubs in the community, sharing information on the importance of staying active, hydrated and eating a well balanced diet. I keep my kids in extracurricular activities such as sports, promoting physical activity and a healthy lifestyle. Early-learning professionals and parents need to play a more prominent role in teaching children about the benefits of healthy eating and activity (Lanigan, 2011). There has been a correlation between paternal influences on children’s weight gain, as a review demonstrated fathers who were overweight viewed themselves and their offspring as normal weight (Fraser, Skouteris, McCabe, Ricciardelli, Milgrom, Baur, 2011). The children in this study were more likely to eat fast food, eat at fast pace, eat when bored and were less likely to eat dinner together as a family (Fraser, et al., 2011). As it was hard to discern whether these behaviors are a result of children modeling behaviors displayed by their fathers’, although the heavier the fathers were the greater the number of hours their children spent in sedentary activities such as watching television and usin g the computer (Fraser, et al., 2011). One strategy not mentioned in Healthy People 2020 is mandating parent involvement and modeling, which I consider first line of defense for prevention of childhood obesity and related disease. The Affordable Care Act (ACA), builds on and strengthens the foundation for prevention and wellness established by Healthy People, the nation’s health promotion and disease prevention aspirations for a healthier nation (Fielding, Teutsch, Koh, 2012). The Guide to Community Preventive Services recommends making physical activity the easy choice by creating in our communities accessible parks and  recreation; encouraging the social norm of walking, bicycling, and climbing stairs where these activities can reasonably substitute for driving and riding elevators or escalators; and placing greater emphasis on mass transit and mixed residential and commercial development to encourage greater spatial integration of places where people live, work and shop (Fielding, et al., 2012). In conclusion, community based childhood obesity prevention programs with a school component focusing on both diet and physical activity is more effective at preventing obesity and overweight (Bleich, Segal, Wu, Wilson, Wang, 2013). As previously mentioned one strategy not mentioned in Healthy People 2020 is mandating parent involvement and modeling, which I consider first line of defense for prevention of childhood obesity and related disease. References Bleich, S. N., Segal, J., Wu, Y., Wilson, R., Wang, Y. (2013). Systematic review of community-based childhood obesity prevention studies. Pediatrics, 132(1), e201-e210. doi:10.1542/peds.2013-0886 Fielding, J. E., Teutsch, S., Koh, H. (2012). Health reform and healthy people initiative. American Journal of Public Health, 102(1), 30-33. doi:102105/AJPH.2011.300312 Fraser, J., Skouteris, H., McCabe, M., Ricciardelli, L. A., Milgrom, J., Baur, L. A. (2011). Paternal influences on children’s weight gain: a system review. Fathering, 9(3), 252-267. doi:10.3149/fth.0903.252 Lanigan, J. D. (2011). The substance and sources of young children’s healthy eating and physical activity knowledge: implications for obesity prevention efforts. Child: Care, Health Development, 37(3), 368-376. doi:10.1111/j.1365-2214.2010.01191.x Papoutsaakis, C., Priftis, K. N., Drakouli, M., Prifti, S., Konstantaki, E., Chondronikola, M., Matziou, V. (2013). Childhood overweight/obesity and asthma: is there a link? a system review of recent epidemiologic evidence. Journal of The Academy of Nutrition and Dietetics, 113(1), 77-105. doi10.1016/j.jand.2012.08.025 Rance, K., O’Laughlen, M. (2011). Obesity and asthma: a dangerous link in children: an integrative review of the literature. Journal for Nurse Practitioners, 7(4), 287-292. doi:10.1016/j.nurpra.2010.06.011

Are all managers Human Resource managers

Are all managers Human Resource managers Executive Summary The report discusses the various aspects in relation to the question posed for the assignment All managers are HR managers, agree or disagree? The report is placed in relation to the questions raised for and against the topic, and my thoughts on the question. The report is structured in the form of my quest to answer the questions raised with regard to the topic. The fundamental theories concerning the topic provide some light for the discussion, followed by examination of the current trends in organisations. The other aspects discussed in the paper relate to the managers implementation of HR practices and its relation on employee performance, and thereby the productivity of the organisation. The effects of poor implementation of the HR practices are highlighted to comprehend all the facets of the discussion. The conclusions are based on the aspects from the points of discussion and its relation to the effectiveness of HR implementation by managers. The references which were vital to the development of the paper are included in order to substantiate research done related to the topic. Introduction Are all managers HR managers Agree or disagree? As I read the question for the assignment, I had mixed answers running in my head. Understanding human resources in the literal sense would refer to employees of the organisation, and there would be a person responsible for any particular section of employees, known as the manager. In this view, managers related directly with the employees, and so they needed to be HR managers. However, the Human Resources Department wherever I worked always seemed to be busy as they dealt with all levels of the organisation, be it employees, managers, stakeholders or government, and their paperwork (or rather e-work) seemed unending. If all managers were HR managers, why would there be a necessity of a HR department? Would it mean that all functions done by the Human Resources personnel were done by the managers themselves? Would that be feasible? Would that not restrict the day-to-day operations carried out by the manager? If all managers were not HR managers, would all issues relating to the employees be raised to the HR department? Since managers, in most cases, have a direct relationship with their employees, would they not have to deal with all concerns related to their human resources i.e. employees? What would organisations that do not have an elaborate HR department do? With relation to agreeing or disagreeing with the question for the assignment, the numerous questions for and against it, left me confused. So it was necessary to understand the fundamentals of the keywords managers and HR, given by various scholars in order to take a stand for the topic. Fundamental Views Management Managers Management, according to Henri Fayol (1949) consists of seven functions such as planning, organising, leading, co-ordinating, controlling, staffing and motivating within an organisation in order to accomplish the established goals of the organisation. Figure 1 Manager Roles (Mintzberg 1975) From among these, the four main managerial functions are described as planning, organising, leading and controlling. (Simmering 2010) Figure 2 Functions of Managers (Overton 2007) A manager is an individual with formal authority to make decisions and carry out the four managerial functions in order to achieve the organisational goals and objectives. Within most organisations, there are three levels of management namely top level, middle level and first/line level managers (Management Study Guide 2009). At each management level, managers require certain skills necessary for successful management. Robert Katz identified three skills namely technical, conceptual and human skills that vary as per the management level. (Katz 1974) Conceptual skills refer to the formulation of ideas. Technical skills involve the technique knowledge and proficiency. Human skills refer to the ability to interact and communicate with people effectively. (Pride, Hughes and Kapoor 2008) Figure 3 Management Skills (Overton 2007) Interestingly from the figure above, although technical and conceptual skills vary greatly, human skills remain rather consistent throughout the various levels. Considering that human resources would relate only to the manager-employee interface, it could be then inferred that all managers are HR managers. However, understanding HR functions would be necessary to make the conclusion to the question. Human Resource Definition Functions Human Resource (HR) refers to consideration of employee as the most valuable assets or resources of the organisation. The inherent abilities, acquired knowledge and skills represented by the aptitudes and talents of the people employed in the organisation could be referred to as the human resources of the organisation. (Aswathappa 2008) The strategic and coherent approach to the management of these assets in order to achieve individual behaviour and performance that would enhance the organisations effectiveness is termed as Human Resource Management (HRM).(Oxford University Press, Ed. Jonathan Law. 2009 ) The functions of HRM are broadly classified into two categories namely managerial and operative functions. Managerial functions include planning, directing, organising and controlling while operative functions are related to recruitment, compensation, employee relations and development. (Hales 2005) The vast scope and functions of HR brought doubts about it being incorporated with the operational activities of managers especially line managers. For the purpose of this paper, general managers and deputy managers have been defined as strategic level managers whilst first-line level managers encompass supervisors and departmental heads. Figure 4 HR Functions Current trends Contrary to the traditional views of management, current trends indicate devolution of the HR into line management. (Gratton, et al. 1999) Restructuring the organisational hierarchy to flatter systems within the organisation has arguably contributed to the convergence of HRM and managerial practices. (Whittaker and Marchington 2003) With the global economic crisis, downsizing has become the trend or the need of times, where even HR departments were dissolved as a whole; this would substantiate Whittakers and Marchingtons (2003) finding that HR took second place in comparison to other business sectors of sales and marketing and finance. The introduction of flatter organisations resulting from heavy job-losses could be traced back to the early 80s of Hewlett-Packard. There was an intensification of managerial responsibilities and predominantly people management claimed most of the efforts of the managers. (McGovern, et al. 1997) In the current scenario, the increasing de-layered organisations (Torrington, Hall and Taylor 2004) would overly emphasize the necessity of all managers to integrate the HR functions of recruitment, training, monitor performance and provide appropriate appraisals. (Marcic and Daft 2008) Line managers and Direct interface Theoretically, managers may not be able to incorporate all the functions of HR but line managers have always been the direct control over the human resources under their responsibility. The flatter organisations have not diminished the human skills required as seen in Figure 3, but on the contrary are a necessity to engage in good people practices, which is as important as implementing personnel policies. (Lowe J 1992) The direct relationship of the line managers with the employees favour the implementation of the HR practices by the managers themselves rather than other personnel. (Sisson and Storey 2000) Research conducted by Bath University for CIPD (2009) found that line managers played a pivotal role in implementing HR practices and policies. People management practices such as induction, training, performance appraisal, employee communication; work-life balance and employee recognition were exercised significantly by the line managers. As discussed in the research, the people management processes can be designed by the HR personnel, but would be implemented most effectively by the managers. (Hutchinson and Purcell 2003) In order to assess the immediate effectiveness of the HRM, scholars such as Dyer and Reeves (1995) and Becker et al. (1997) suggested monitoring of employee performance which would be the factor affected directly. Performance and HR In an ultra-competitive marketplace, it would be necessary to maintain a productive and competitive workforce to achieve organisational success. Successful organisations are reliant on managers competence to attain and maintain high levels of individual job performance. (Hosie 2009) Employee performance is maximized through motivation which would be associated with the manager. According to Dyer and Reeves (1995) rigorous selection mechanisms and ample training opportunities along with incentives such as peer pressure to perform, monetary and non-monetary rewards increase employee motivation. Commitment is another factor that would boost employee performance. Organisational commitment is highly dependant on employee assessment of the level of support from the management. (Sharkie 2009) Managers in IBM are expected to be responsible to the development and satisfaction of employees. Surveys, career planning, performance appraisal and compensation utilized by line managers encourage employee commitment to the organisation. (Marcic and Daft 2008) Effective implementation of HR practices in organisations such as in IBM, would lead to greater employee motivation. As discussed by Gillespie and Mann (2004), that the trust subordinates place in the leader is directly proportional to motivation that would lead to better employee performance. Consequences of ineffective application of HR In the decentralisation of HR processes, line managers are often tasked with responsibilities of setting the agenda, dealing with workplace issues and providing direction to employees. As discussed by McGuire, et al. (2006), a conflict between the organisational and individual values of the manager, could lead to a trust deficit between the employees and the manager. (Renwick 2003) Decreased workplace happiness would lead to diminished employee performance, which would cost the organisation heavily in both productivity as well as having to pay higher compensation and insurance claims for the health conditions of employees. (Lyubomirsky, King and Diener 2005) (Hosie 2009) The negative effects of poorly applied HRM practices accentuate the requirement for greater knowledge in HR practices for all managers. It would be possible to design programmes for managers that would enhance the understanding of HR, such as Esprit employed within Hilton (UK) Hotels. However, the two main barriers line managers faced while incorporating their HR role were heavy workloads and short-term job pressures. (Watson, Maxwell and Farquharson 2007) These add to the findings of Renwick (2003) relating to the constraints for managers in effective management of HR such as lack of time, lack of ability or knowledge in HR practices, and distractions from general managerial operations. Other than improper implementation of HRM practices and its complications within the organisation, Earnshaw et al. (2000) found that without HR expertise even large organisations could face legal challenges. This would emphasize the necessity of efficient HR systems and constant guidance by HR specialists. Considering the various factors, as suggested by Jackson and Schuler (2000) a partnership approach through a triad approach of HR specialists, managers and employees would allow effective integration of HR activities into the work of line managers. However, if line managers and HR are to work in partnership to improve organisational performance, a minimum number of experienced HR specialists would be required. (Ulrich 1998) Conclusion The discussions throughout the paper have led to a few conclusions. The functions of HR and managers are not entirely different from each other, but noted by Aswathappa (2008), HR is a managerial function with assists managers with hiring, motivating and maintaining employees within the organisation. Line managers implement most of these HR roles as they are in direct contact with the human resources of the organisation. Effective HR implementation would lead to greater employee motivation and thereby productivity. However, lack of understanding and poor execution of HR practices could cost organisations heavily ranging from employee productivity to legal action. According to Dave Ulrich (1996), HRM encompasses the roles of being an employee champion, administrative agent, a strategic business partner and assisting in change management. HR departments in most organisations are concerned with the former two roles, and in which case, one could conclude that all managers are HR managers. However considering the complete scope and roles of HR, it would not be apt to agree that all managers are HR managers. It could be then, concluded that all managers exercise HR functions irrespective of their department and level considering the high level of human relations. It would be extremely important that they have adequate knowledge in handling HR in order to become effective managers and achieve maximum productivity, which is essential for all organisations across varying industries. HR professionals would have to assist and guide line managers consistently in achieving the strategic goals of the organisation. Effective coaching to line managers on HR practices and policies would allow HR professionals to take on the vital roles of being a strategic business partner and play an effective role in change management. (Gaskell 2007)

Mechanism and Optimization of Melphalan

Mechanism and Optimization of Melphalan Melphalan Introduction Cancer in general is referred to body cells that grows rapidly and over the limit of normal cells (Hayflick limit). There’s over 200 different types of cancer, where some cancer cells can spread to other parts of the body leading to further complications. It’s one of the biggest leading cause of death worldwide. Therefore interest in finding treatment and prevention for this disease has been growing. One of the most successful chemotherapy drugs is Melphalan. It’s been over 50 years in use and there’s an increase in research to improve this drug. It’s indicated for different type of cancer: for the analgesic treatment of multiple myeloma (MM) and for the alleviation of unresectable epithelial tumor of the ovary. It has also been used alone or in combination with other chemotherapy drugs for relief treatment of locally repeated or unresectable in-transit metastatic melanoma of the extremities. It’s also used in addition to other drugs or surge ry in breast cancer. Mechanism of action Melphalan belong to a class of chemotherapy drugs called nitrogen mustardalkylating agents. It’s the oldest class of anticancer drugs still frequently used. It’s a bifunctional alkylating agent which means it has two sites where the reactivity occurs. It displaces the chloride ion by amine nitrogen to form a cyclic amine ion (aziridinium ring) by intramolecular nucleophilic attack. Afterwards the DNA nucleophile undergoes a nucleophilic attack and opens the azidrine ring, which leads to the alkylation of DNA. The lone pair of electrons on the nitrogen in the drug will then be regenerated when the azidine ring cleaves. The same reactions happen on the second reactive site of the drug, by displacing the second chloride ion. (picture) This will lead to cross-linked DNA molecules through covalent bonds. The covalent bonds can be made in two different ways: either on the same DNA strand which will alter the shape permanently prevents other enzymes or molecules from binding t o it, or on adjacent strand therefore preventing replication/transcription process. (picture) The reaction happens in the N7-site of guanine, which is the most preferred nuclei acid. However the reaction can also take place at the N3-site of adenine. The alkylation of the nucleotide leads to miscoding of DNA as for example Thymine will bind to guanine instead cytosine. Due to the p-orbital of the benzene ring in melphalan that draws the lone pair electrons from nitrogen, this leads to reduction of reactivity to form the azirdine, hence only strong nucleophiles such as guanine will react with it. This has the benefit of reducing the side reactions with water, tissue and blood, leading to the drug can be given orally. The side chain of Melphalan is L-phenylalanine, meaning it has a component that act as the amino acid phenylalanine. (picture) Consequently the drug is most likely to be recognised as an amino acid, and it will be taken into the cell by transporter protein. This increase s the stability of the drug further. Optimization of Melphalan Despite Melphalan being used as an anticancer drug for over 50 years, it’s associated with many complications including poor solubility in water, variable bioavailability and rapid hydrolysis at physiological pH (11-14) which also increase the bioavailability problem. Another major problem is its rapid clearance from the blood circulation due to its short half-life (90 min). A study conducted in USA to tackle these difficulties by adding a poly ethylene glycol (PEG) to the Mel, in order to enhance the formulation of parental and oral administration. PEG is a synthetic polymer which is water soluble and non-ionic. It is an amphipilic polymer meaning it has an exceptional capacity to be soluble in both aqueous and organic solvents. This property makes it ideal for chemical conjugate of substance that has a biological effect. Another advantage of using PEG is it has exceptionally low level of antigenicity and immunogenicity. The process of conjugation is called PEGylation. Itâ₠¬â„¢s a two-step process where in the first step the activation and derivatization of PEG occurs with appropriate functional groups. In step two the conjugation of the activated PEG with Mel occurs. The NH2 group in melphalan undergoes a nucleophilic reaction with mPEG-succinimidyl propionate (mPEG-SPA) under the presence of DMAP catalyst. This reaction produces an amide bond, which is reasonably stable. The mPEG-SPA gets hydrolysed to mPEG and N-hydroxysuccinimide. Fig x. The study conjugated two molecular weight (MW) PEG: 2000 and 5000 Da. Variable test were conducted to measure the difference between the two different MW PEG conjugates and the parent drug Melphalan. The aqueous solubility of the conjugated Melphalan was measured by dissolution test, the results are shown in table 1. The table shows there is an increase in aqueous solubility of MpPEG-2000 by nearly 80 times reading as 7.2 ±0.12  µg/ml and increased by approximately 123 times for MpPEG-5000 reading as 11.07 ±0.8  µg/ml, compared to the measured solubility of the parental Melphalan of 0.09  µg/ml. This results can be explained due to the PEG chain being attached to the drug. On the other hand the haemolytic activity of melphalan versus its conjugates was also determined by assessing the haemoglobin content. The melphalan haemolytic activity was measured to 100% above the concentration 3.5  µg/ml (table 2). With regards to MpPEG-5000 only 48.8 ±1.5% haemolysis observed at concentration of 32  µg/ml (table 3). In case of MpPEG-2000 the highest percentage of haemolysis of 81.3 ±0.5% was recorded at concentration of 32  µg/ml (table 4). The lower haemolytic activity of the conjugates compared to melphalan might be due to the dominated property of polymeric carrier PEG. These results is an indication that the chain length of PEG plays an important role on the haemolytic activity. The property of delaying haemolysis is better in MpPEG-5000 compared to MpPEG-2000 even at higher concentrations. It also has an effect on the aqueous solubility due to the longer the chain the more hydrophilic backbone of PEG will be present. The percentage cumulative hydrolysis of the conjugates was observed in case of MpPEG-2000 to be 10.11 ±0.68 after 6 hours, whereas for MpPEG-5000 was only 5.21 ±1.2% after the same time (table 5). The low cumulative hydrolysis detected in MpPEG-5000 may be understood due to the ester linkage being protected by the PEG molecule du e to the steric hindrance. Furthermore the amide bond is more protected in MpPEG-5000 compared to MpPEG-2000 due to the shielding effect of the larger chain of PEG. Therefore the MpPEG-5000 can be an ideal candidate to provide a slow release drug formulation. Thus, increase the half-life of the drug and decrease the clearance. Clinical trials Conclusion This drug adds a small group, an alkyl group to the DNA to alter its structure and hence modifies the function. It’s an alkylating agent which means it adds an alkyl group to DNA. The alkyl group may be transferred as an alkylcarbocation, afree radical, acarbanionor acarbene(or their equivalents). Nitrogen mustards (NMs) form cyclic aminium ions (aziridinium rings) by intramolecular displacement of the chloride by the amine nitrogen. This aziridinium group then alkylates DNA once it is attacked by the N-7 nucleophilic center on the guanine base. A second attack after the displacement of the second chlorine forms the second alkylation step that results in the formation of interstrand cross-links (ICLs) as it was shown in the early 1960s. At that time it was proposed that the ICLs were formed between N-7 atom of guanine residue in a 5’-d(GC) sequence.[15][16] These kinds of lesions are effective at forcing the cell to undergo apoptosis via p53, a protein which scans the genome for defects. Note that the alkylating damage itself is not cytotoxic and does not directly cause cell death. For the analgesic treatment of multiple myeloma and for the palliation of non-resectable epithelial carcinoma of the ovary. Has also been used alone or as part of various chemotherapeutic regimens as an addition to surgery in the treatment of breast cancer, alone or in combination regimens for palliative treatment of locally recurrent or unresectable in-transit metastatic melanoma of the extremities, as well as for the treatment of amyloidosis with prednisone. http://www.bloodjournal.org.ezproxy.kingston.ac.uk/content/106/2/698 http://onlinelibrary.wiley.com.ezproxy.kingston.ac.uk/doi/10.1002/cncr.27820/full http://www.bloodjournal.org.ezproxy.kingston.ac.uk/content/117/24/6445 http://www.drugbank.ca/drugs/DB01042 http://cancerres.aacrjournals.org/content/44/7/2773.full.pdf+html http://pubs.acs.org.ezproxy.kingston.ac.uk/doi/full/10.1021/jo300351g http://www.bloodjournal.org.ezproxy.kingston.ac.uk/content/100/1/224 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4024156/ http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4286742/ http://ac.els-cdn.com/S0898656813000314/1-s2.0-S0898656813000314-main.pdf?_tid=c3b012a4-c411-11e4-944b-00000aab0f27acdnat=1425654312_d9351a386aa77b225426f1c34e100e88 http://ac.els-cdn.com/S0144861714004196/1-s2.0-S0144861714004196-main.pdf?_tid=00c4f2b8-c412-11e4-aee6-00000aab0f6cacdnat=1425654412_90fa9336c00ccddd1706b13914966246 http://ac.els-cdn.com/S0009279702000145/1-s2.0-S0009279702000145-main.pdf?_tid=458a0f50-c412-11e4-b306-00000aacb360acdnat=1425654528_8adc41f2576ed853db84f0b37d63aba7 http://ac.els-cdn.com/S0014827X03001642/1-s2.0-S0014827X03001642-main.pdf?_tid=8710dca6-c412-11e4-ba2b-00000aab0f02acdnat=1425654638_fb397da0e9304b218456d2a2da0cc6bf http://ac.els-cdn.com/S0144861714012533/1-s2.0-S0144861714012533-main.pdf?_tid=ffa7bf86-c412-11e4-9b6f-00000aacb361acdnat=1425654840_9033413b545510662226d20eec11b255 http://www.drugs.com/mmx/melphalan.html http://cancerres.aacrjournals.org/content/23/8_Part_1/1315.full.pdf http://www.hindawi.com/journals/jna/2010/543531/ https://books.google.co.uk/books?id=Sd6ot9ul-bUCpg=PA1208lpg=PA1208dq=nitrogen+mustard+aziridine+ringsource=blots=TMPCHHeGPrsig=tArK9BCztSsPXxLXMj2ojRGFG2shl=ensa=Xei=FggDVaHxFMatU_6zgfABved=0CD8Q6AEwBg#v=onepageqf=false Bifunctional alkylating agents (e.g., nitrogen mustards (melphalan, chlorambucil, cyclophosphamide, and ifosfamide) and chloroethylnitrosoureas (BCNU and CCNU)) possess two reactive sites. These agents cross-link DNA with proteins or, alternatively, cross-link two DNA bases within the same DNA strand (intrastrand cross-links) or on opposite DNA strands (ICLs). ICLs, which block replication forks, are the most serious cytotoxic lesions produced by most bifunctional drugs. Accordingly, the extent of ICLs correlates well with the cytotoxicity of nitrogen mustard drugs

Toys :: essays research papers

Toys"R"Us INTRODUCTION In this assignment I have chosen to focus on explaining what kind of company Toys"R"Us is, giving a brief, short summary of the firms history, their corporate responsibilities, what their competitive advantages are and how they implement their strategies through retailing and merchandise. I also found it relevant to explain the market situation in the toy-industry and what the trends are, for understanding what other difficulties that are important to consider in order to survive. SHORT HISTORY In 1948, a company which totally dedicated themselves to children and their needs, was formed by Charles Lazarus in Washington DC. This was a perfect timing in relation to the post-war baby boom period, the demand for accessories for children was high, and the main purpose for the company was to carry furniture for babies. After some time, he heard customers saying phrases like "I need a toy for my baby", so he began selling toys aswell. Mr.Lanzarus tried to give his customers what they wanted he understood early that this was the best way to keep his customers. In 1957, he opened his first toy supermarket, and with specialized retailing and the off-price positioning, he revolutionized the concepts in the pre-mall and discount days. After this success, he sold his business to Interstate, which later went bankrupt. Mr.Lazarus rejoined the company and made it profitable, and in 1978 it became a public company; Toys"R"Us,Inc. DIVISION OF THE COMPANY Today, Toys"R"Us is a $11 billion dollar company and they have over 1500 stores over the whole world. The company is divided into six different divisions: Toys"R"Us US Strongly focuses on strengthening the shopping experience by providing better service and better merchandise. There are around 680 locations of Toys R Us in the US. Toys"R"Us International Is licensed, franchised and operated through over 570 locations in 29 countries outside the US Kids"R"Us Consists of more than 375 locations where children ´s clothing and toys are all under one roof, and oughts to offer all of the latest fashions and of course high quality merchandise. Imaginarium Toysrus.com Developed in alliance with Amazon.com in order to offer an online shopping service. Babies"R"Us Offers everything parents need for their babies, like furniture, bedding, car seats etc. All products can be purchased under one roof By organizing their organization into these different divisions, it gives them a competitive advantage because it makes it easier to focus in the certain areas. These divisions are very different from each other, and needs specialization in all the different aspects.

The Dreamers of The Glass Menagerie :: Glass Menagerie essays

The Dreamers of The Glass Menagerie "The Glass Menagerie" by Tennessee Williams shows the struggle of two people to fit into society, Tom and Laura, and how society wouldn't accept them. They were the dreamers that were unjustly kept out and you may even go as far as to say persecuted into staying out and aloof like the other dreamers which are forced to become outcasts and not contribute to the actions of all. Tom and Laura, the two dreamers, were pushed by their mom, Amanda, to her frame of mind and the thoughts of a hard working society. They both stumbled on the fire escape which served as a gateway, physically and mentally. Tom had the problem of fitting in at the warehouse were he worked, because is the warehouse really a place for someone like him and his mind rebelled. Lastly you can see how society forced them to change and Laura to lose her status in order to fit in with Jim and that's shown by the horn breaking. Tom then realizes that and leaves which causes him to change too. Tennessee Williams artfully depicted this. The fire escape. A downtrodden red thing off the sides of buildings showing societies ineffectual escape from itself. In this case it served as a passageway between the real world and the dream one that Laura and Tom were living in at home. Both somehow stumbled both physically and mentally. When Laura said â€Å"I'm all right. I slipped but I'm all right†(47). She was trying to pass to the real world to do a real job and couldn't because of societies â€Å"inability† to accept her and her ways. She wasn't strong enough to make the trip by herself, but needed the moral support of the other dreamer in the area, which was Tom who came running out. Tom is the one who stumbles mentally in his inability to look at the escape, which would be his way out of the place. He was always losing his strength while out there smoking and looking out into the world. Recognizing the sounds and trying to connect but unable to. He was forced away and unable to bring up the strength inside himself to go out and leave and to stay strong as a dreamer. Forced by society to use it as a gateway instead of just keeping it the same and just a mode of transportation to go down. Every night you hear Tom say, "I'm going to the movies" (42). He uses that as an escape of the imagination which is what made him a dreamer.

Examining Musculoskeletal Injuries Health And Social Care Essay

Fractures or ligament hurts frequently require immobilisation for effectual healing. Subsequently, uninjured tissues for case ; sinews and joint capsules ( i.e. connective tissue ) undergo unfavorable alterations as a consequence of the forced deficiency of motion ( Loitz et al 1988 ) . As stated by ( Houglum 2005 ) â€Å" Mobility of the musculoskeletal system is determined by the composing of connective tissue and the orientation of assorted soft tissue constructions † . Connective tissue refers to clamber, facia, sinews, ligaments, joint capsules and musculus facia. Connective tissue can be farther discussed under ; intramuscular connective tissue and periarticular connective tissue. During the procedure of reorganization connective tissue has the inclination to shorten and go thick and fibrotic ( Houglum 2005 ) . ( Walsh et al 1989 ) found that connective tissue, ligaments specifically are influenced biomechanically, biochemically and morphologically by immobilisation. ( Noyes et al 1974 ) indicated that these influences on connective tissue are altered by 4 mechanisms: ( I ) changes in the synthesis and debasement equilibrium of collagen ( two ) alterations in collagen cross links ( three ) fluctuations in H2O and electrolyte content of connective tissue and ( four ) alterations in the alliance, figure and thickness of collagen fibers. Periarticular connective tissue: Composition of two constituents ; cells and extracellular matrix. Matrix is made up of collagen, elastin, reticulin and land substance. ( Donatelli & A ; Owens – Burkhart 1981 ) stated alterations to the construction of connective tissue are straight related to joint stiffness therefore ensuing in restricted motion. He besides noted the importance of collagen within connective tissue, making greater tensile strength and stabilisation through increased fiber binding. The mechanical strength of collagen is due to hydroxylation of lysine to hydroxylysine which histories for the increased fiber binding ( i.e. the cross – links of next collagen fibers ) . As these fibers mature the intra and intermolecular bonds ( cross – links ) rise in figure therefore supplying greater strength to the fibers. Within land substance glycoaminoglycans ( GAG ) binds with H2O making a semi fluid syrupy gel within which the collagen and fibrocytes are emb edded. The lubricator maintains a distance between the fibers, thereby allowing free glide of the fibers past each other and forestalling inordinate cross – linking ( Donatelli & A ; Owens – Burkhart 1981 ) . Land substance in connective tissue comes manus in manus with collagen with regard functional ability. ( Minns et al 1973 ) tested the importance of land substance in CT, through the usage of chelating agents and enzymes, what they found was a important lessening in stiffness, strength and other clip dependent belongingss in its absence. With immobilisation the production and lysis of collagen additions, it is besides believed that the loss of extensibility is non due to the volume of collagen deposited but from the country it is deposited it from ( Lederman ) . Furthermore a loss of GAG and H2O in the land substance consequences in fading of the extracellular matrix this cause ‘s less separation and more cross – nexus formation between collagen fiber s ( Woo et al 1981 ) . Post hurt, freshly formed fibrin and collagen fibers organize in a disorganised manner when immobilized. This reduces the entire tenseness strength of the tissue. Collagen fibres when aligned along the lines of mechanical emphasis produce their greatest strength. The importance of collagen alliance is apparent in the survey undertaken by ( Noyes et al 1974 ) ; he found a 39 per cent lessening in maximal failure of the anterior cruciate ligament in archpriest ‘s station 8 hebdomads immobilisation. Intramuscular connective tissue: Normally composes of epimysium, perimysium and endomysium. These connective tissues play a large function towards the snap of skeletal musculus as the non – contractile constituent. The extra binding of connective tissue to muscle cells preserves its dependability during contraction while guaranting close contact between the blood capillaries and nervousnesss within the skeletal musculus ( Jarvinen 2002 ) . Jozsa and co-workers found with immobilisation the degrees of endomysium and perimysium within the intramuscular connective tissue increased ensuing in separation of single musculus fibers, along with reduced degrees of blood capillaries and transverse sectional country of musculus fibers ( Jozsa et al 1988 ) . These connective tissues bind to muscle cells and conserves its unity during contraction and embracings blood capillaries and nervousnesss within the skeletal musculus to maintain them close attachment with each other. The accretion of endomysial and perimysial connective tissue may lend to the damage of intramuscular blood circulation, and the lessening in Numberss of capillaries may, in bend, lead to an addition in the sum of connective tissue, get downing a barbarous circle. These pronounced changes in the distribution, administration and architecture of the intramuscular collagen may eventually take to macroscopic loss of musculus extensibility and other tensile belongingss ( Jarvinen 1976, 1977 ) . Joint Immobilization: One of the chief utilizations of manual therapy is to bring forth elongation of the CT constructions that are abnormally keeping arthrokinematic gesture, through physiologic motions or accoutrement motions ( Maitland 2005 ) . Accessary motions ( joint drama and constituent of gesture ) are a type of inactive exercisings designed to re-establish joint drama through arthrokinematic gesture of ; axial rotation, slide, spin compaction and distraction. It ‘s highlighted that â€Å" joint drama † is indispensable for the return of normal joint map ( Mennell, 1964 ) . The strength of the mobilisation techniques with rhythmic oscillatory motions normally is categorized harmonizing to the 5-grade categorization system of Maitland ( Vermeulen et al 2006 ) . In conformity with the 5 – class system grade I and II performed toward the induction of accessible arthokinematic ROM intend to chiefly cut down degrees of hurting exposing analgetic effects, but non to stretch CT. ( 11 7 Kisner 25, 34 ) . While classs III and IV are chiefly employed as stretching tactics at terminal of available arthrokinematic ROM. Intending to stretch CT ( Threlkeld 1992 ) . Connective tissues have viscoelastic belongingss whereby distortion of its fibers consequences from a burden at changing rates, the elastic belongingss produce station mobilization kick with no alteration in length and the plastic belongingss result in lasting elongation ( Basmajian & A ; Nyberg 1993 ) , expressed through the emphasis – strain curve as seen in figure 1. ( Threlkeld 1992 ) found it was through fictile distortion that the resting length of CT changed. However, this is merely possible due to microfailure of separate collagen fibres i.e. CT harm must happen through breakage of links linking bordering connective tissue packages so these broken fibers will non factor in the kick of the tissue therefore making a new length of the CT. Mobilization techniques that stretch collagen construction s into their fictile scope of distortion addition ‘s the tissue ‘s mobility ( Maitland 1991 ) . Owing to the amplitudes of classs III and IV within the restricting ROM sufficient mechanical alteration is at manus to work the viscoelasticity belongingss of CT to incite lasting elongation, diagrammatically seen in Figure 2. ( Randell et al 1992 ) investigated grip and semivowel techniques on the joint stiffness of 18 topics post 2 hebdomads immobilisation of metacarpal breaks. This intervention resulted in a ample addition in active ROM and lessening in joint stiffness compared to the control group supplying grounds of the effectivity of joint mobilisation in changing mechanics of an immobilized articulation. A 2nd survey undertaken by ( Landrum et al 2008 ) used a grade III oscillation motion in the betterment of ankle dorsiflexion in an AP way, which resulted in a ample recovery in ROM. Inactive Stretching: ( Kisner & A ; Colby 2005 ) attest that non-contractile soft tissues are known to give more readily to a low strength, continuously applied stretch force, as used in inactive stretch. Low strength stretching consequences in optimum rates of betterment in ROM without exposing tissues, perchance weakened by immobilisation, to inordinate tonss of potentially hurt. Inactive stretching is performed by puting musculuss at their greatest possible length and keeping that place for a period of clip ( Anderson & A ; Burke 1991 ) . Inactive stretching is applied to re-establish tissue snap and decrease the strain in the muscle-tendon unit with joint gesture. There are two physical belongingss associated with musculus tissue that have an influence on the musculus sinew unit, they are creep and stress relaxation. ( figure 3. ) , ( Cross & A ; Worrell 1999 ) During weirdo, the sustained prolongation of the tissue under uninterrupted burden means that reorientation of collagen fibers ‘ and re distribution of H2O due to increasing overall strain in CT can originate, determined by the strain energy exposed to CT ( Purslow et al 1997 ) . This is typically low magnitudes within the elastic scope. Stress relaxation operates while the musculus – sinew unit is put under stretch at a kept up length, following weirdo, a lessening in force to keep the length and decrease in tissue tenseness is observed. Harmonizing to ( Kisner & A ; Colby 2007 ) the recovery versus lasting elongation depends on the force and clip of the distortion ( plastic ) phase in the emphasis – strain curve. Study undertaken by ( Talyor et al 1990 ) found through insistent stretching of musculus – tendon units of the extensor digitorum longus in coneies to a uninterrupted length well lowered peak inactive tenseness. He advances this farther, proposing that stretching reduced the â€Å" viscousness and/or stiffness of musculus sinews units † , holding a considerable affect in increasing of articulation ROM. In relation to hysteresis, it is believed to be a strong arrow of viscousness nowadays in tissue therefore ; low degrees of hysteresis station inactive stretching can bespeak a diminution in viscousness. ( Kubo et al 2001 ) besides provided grounds that inactive stretching for 10 proceedingss significantly decreased the stiffness and hysteresis of tendon constructions in median gastrocnemius musculus. Compare and Contrast of Techniques: Both therapies have associated outcome steps yet their application, effects, and force applied to connective tissue varies when bring oning these favorable result steps. With regard the application of joint mobilisations, surveies differ somewhat with regard to the length of clip the oscillatory motions are applied, ( Randall et al 1992 ) intervention dosage comprised of two sets of 20 oscillations, at a rate of 1 oscillation per sec with a interruption of 30 seconds between each set. Relation to inactive stretching ( Bandy et al 1997 ) stated for effectual additions in flexibleness determined by increased articulatio genus extension ROM one must execute inactive stretches for 30 or 60 seconds one or three times per twenty-four hours for 5 yearss per hebdomad. High buoy uping the fact that joint mobilisation seem to be more practical and less clip devouring than its opposite number. Decision: In decision there is still no consensus sing which therapy is the most successful for handling alterations to connective tissue and decreased ROM of articulations post immobilisation. Nevertheless through the literature research grounds has shown that low and high class articulation mobilizations in isolation and in concurrence with other interventions i.e. inactive stretching are efficient in cut downing hurting in patients and increasing joint scope of gesture with joint immobilisation. Role of Radiographer: