Footlocker

Rakann Ammari Fin 431, Exam #1 February 17, 2010 Foot Locker Incorporated: Risk Prevention Methods Foot Locker Incorporated (ticker symbol: FL) is a U. S. based company that operates worldwide. Their services include the sale of various athletic equipment, sports apparel and products. According to their company background, as of the beginning of 2009 Foot Locker operates roughly 3,600 retail stores in 21 countries worldwide (â€Å"About Us†).Although Foot Locker provides their goods through both local retail stores and an online based â€Å"direct-to- customers† program, my risk management tactics will primarily focus on local retailers and warehouses and their risks. The five risks I have chosen are employee theft within the local branches and through bank accounts, customer theft within the store, physical injuries to customers and employees on Foot Locker property, property damage to Foot Locker property due to obscene weather conditions and the risk of fluctuating p rices of necessary inputs that are used in the production of various Foot Locker goods including footwear.One of the most essential inputs in the production of footwear is rubber. As a risk manager, I must take into account the possibility of the cost of rubber increasing. According to the commodities index ran by indexmundi. com, the price of rubber has increased every month for the past 6 months. In January 2010, the price of rubber increased to $139. 73 from $92. 86 merely 6 months ago in August of 2009 (â€Å"Rubber Monthly Prices†). This nearly 34% increase in the commodity price of rubber could have devastating effects on Foot Lockers cost of production.This increase will potentially increase the cost of producing foot and athletic wear, which in turn will increase retail prices. The need for consumers to purchase high end Foot Locker products will then decrease as retail prices increase. Rubber remains the main input in producing footwear; however the leather used in e veryday footwear is prevalent enough to be looked at. Due to the fluctuating productivity and efficiency during the current economic downturn, buyers tend to be less predictable. â€Å"Earlier, the buyers anticipated sales trend and placed orders well ahead of time.But now they wait to ensure retail off-take before placing orders. Improving speed of operations even as one keeps cost down is important (â€Å"Business Line†). † This efficiency has brought down leather prices. â€Å"Leather prices are also dropping and this contributed to leather costs coming down to 50-60 per cent from 70 per cent (â€Å"Business Line†). † Although this decrease in leather costs could potentially help the cost of footwear production, the main input in footwear production is rubber. As the price of the main input of my product increases, I must be ready to counteract this risk.In doing so, I am also performing another risk by hedging the cost of my inputs. I must be willing to set a pre-determined price of rubber to be purchased from my wholesaler for a set amount time. Although I take the risk of the price falling below my set price, since the prices have increased at a constant rate for the past 6 months my current risk is dramatically lower. By setting the price 6 months ahead of time I, as a risk manager, potentially prevent the 34% loss that could have occurred over the past 6 months. Along with the speculative risk of price fluctuation, there are many pure risks that come when providing goods to consumers.Employee theft is one of the most common risks an employer or company takes on when doing business. â€Å"Every year billions of dollars are lost by businesses nationwide to employee fraud and theft and the number of incidents are rising. † (Schaefer 1). Employees could steal cash, merchandise, and illegally redirect customer account information to a private account. â€Å"A former Foot Locker employee was sentenced to five years probati on and ordered to pay nearly $26,000 in restitution for taking the company’s money to cover his Internet gambling debts (The Maui News). Although a prison sentence and or a large fine may be the consequences of such employee theft, the $385,000,000 of cash and cash equivalents (2009) available for theft seems to lure in potential thieves (â€Å"Balance Sheet†). The $1,120,000,000 in merchandise inventory available for possible theft is a savoring number to employees and even Foot Locker customers. Shoplifting is a prevalent crime within the United States that must be controlled by risk managers.During December of 2009, a Foot Locker in Atlanta, Georgia was robbed when â€Å"police arrested two adults and four juveniles in a smash and grab job. † (CBS Atlanta 1) Unlike employee theft, customer theft is limited to the $1,120,000,000 in merchandise inventory (â€Å"Balance Sheet†). Although the inventory and cash could potentially be recovered from the emplo yee(s) or customer(s) through a lawsuit, as a risk manager I would need to take preventative action. I would create loss control by having surveillance cameras both watching customer and employee actions.This includes surveillance on all cash registers and credit card machines. Also, I would inform both the customer and employee they are being watched and remind them of the potential prison punishment for any crime committed by posting signs throughout the store. For employees I would conduct thorough background checks to prevent the hiring of former high profile convicts. I would also spread the finances among various managers; I would not allow a single manager to keep track of or control the finances of any single retail store or warehouse.Finally, as a risk manager I would follow up on any customer complaints with any banking issues and take into account any reported suspicions by employees about other employee or customer theft. In order to further prevent loss, I would purchas e an insurance policy to insure any outsized amount of fraud or crime committed. Another risk held by business owners is the possibility of a lawsuit by customers and or employees for sustaining bodily injuries. Customers or employees may slip on an unmarked wet spot causing a concussion or other bodily harm.Also, a tall person might hit an unmarked metal shutter or sign. Injuries may range from a â€Å"no problem† scrap or bump to a serious lawsuit involving several injuries. An employee may sever his or her spine after falling off a 20 foot latter while trying to stock merchandise; or be severely harmed while operating footwear machinery within a company warehouse. The potential loss and costs can be irreparable depending on the lawsuit. Several precautions should be set in place. Prior to employment, I would mandate all employees to sign a contract indicating that a lawsuit against Foot Locker cannot be conducted.The contract would include bodily injuries. However, a sever ance package under workers compensation will be rewarded to all deserving employees pending a full investigation. As of 2009, company severance packages totaled $13,000,000 (â€Å"Balance Sheet†). I would also provide training on how to stock merchandise within a retail store; warn customers of a wet floor or potential harmful area; and teach employees how to operate equipment within a warehouse. For customer lawsuit prevention, I would have managers post clear signs where potential harm may occur.Also, I would post a sign right outside of every retail store transferring injury risk to all customers that step foot into a Foot Locker location. Furthermore, I would purchase several insurance packages against high stakes lawsuits from employees or customers that obtained bodily injuries on Foot Locker property. Using these measures reduces Foot Locker’s liability to customers and employees. However, the risk to Foot Locker’s property is always rampant due to prospe ctive weather disasters. The potential cost during a weather disaster such as a flood or a hurricane can be enormous.Although the idea of all of Foot Locker’s stores and warehouses being affected at the same time is highly improbable, the potential can be exceedingly high. The net value (purchase price subtracted by accumulated depreciation) of Foot Locker’s buildings, furniture, fixtures & equipment reached $223,000,000 in 2009 (â€Å"Balance Sheet†). This amount of loss could potentially bankrupt Foot Locker without the possibility of coming back into business. To prevent such a loss, Foot Locker could place their warehouses in locations with a lower potential for harmful weather conditions.Locations that tend to have a hotter climate with low wind gusts are ideal due to the low probability of property damage. Also, I would purchase insurance on all property, furniture and equipment that would covered a loss due to catastrophic weather. A precautionary mea sure to minor damage could be using flood bags during a flood and making sure exposed sections of property are sufficiently covered to prevent wind from damaging interior assets. To add on, in order to protect employees from harm a risk manager should make sure all emergency equipment is working roperly and all employees understand emergency procedures. As a risk manager, assessing risks and developing the appropriate amount of precautionary methods to prevent potential risks is essential. Keeping track of these risks while evaluating the possible loss is just as essential; and a well developed report will help subordinate these risks.ReferencePage Footlocker. com. â€Å"About Us. † 2010.   http://www. footlocker-inc. com/company. cfm? page=aboutâ€Å"Gambling Debts Over Internet Tied to Thefts. † Former Footlocker Theft Case. 2010. The Maui News. 7 February 2008. http://www. aproundtable. org/gamblingsruinedlives/im. htmlIndex Mundi. â€Å"Rubber Monthly Prices. â €  2010. http://www. indexmundi. com/commodities/? commodity=rubber&months=300Schaefer, Patricia. â€Å"Employee Theft a Big Problem. † Business Know-How. 2006. Attard Communications. http://www. businessknowhow. com/manage/employee-theft. htm

Drugs and there effect on society Essay

We opened the chapter with the story about an outdoor company, and we end it with a story about another outdoor company. The company we’re discussing this time, based in Portland, Oregon, was the brainchild of a small group of executives who left big times jpbs at Patagonia, Nike, and Adidas. These individuals shared a belief that ‘ in addition to generating a profit, companies have an equal responsibilities to create positive social and environmental change.’ Putting their beliefs into action, the group formed Nau (which is Maori for ‘Welcome! Come in†). and Nau id not just another outdoor company! When deciding what Nau was going to be like and how it was going to do business, the founders knew they didn’t want to do things the way they’d always been done by traditional businesses. CEO Chris Van Dyke said, â€Å"We started with a clean whiteboard. We belived every single operational element in our business was an opportunity to turn tr aditional business notions inside out, integrating environmental, social, and economic factors.† From design to sales to finances, Nau is driven by these factors. Everything in Nau’s operation had been approached with sustainability and social justice â€Å"filter.† In the design area, the company, in partnership with its suppliers, developed 24 of its 32 fabrics to be more sustainable and to combine performance and visual appeal. Each supplier, manufacturer, and even Nau itself is bound by a code of conduct. To ensure that all parties are living up to the standards, their actions are overseen by an independent, nonprofit auditing and research firm. In the sales area, the way the company retails its products is also unique. Using a concept it calls a â€Å"Web-front,† Nau has combined the efficiency of the Web with the intimacy of a gallery like boutique. In the â€Å"store†, customers can try on clothes, but they use self-serve kiosks to purchase from the Web. Because in-store inventory is greatly reduced, the stores are small 92,400 squares feet compared to the standard 4,000 plus square foot outdoor retail store) . This approach saves operating expenses because less energy and fewer materials are used. Good for the planet†¦..good for the business. Finally, Nau has a unique financial approach it calls â€Å"aggressive altruism†. The company has pledged 5 percent sales to charitable organizations dedicated to solving crucial environmental and humanitarian problems. The â€Å"philanthropic  gold standard† is 1 percent of sales, and the average among all corporations is 0.047 percent. But although the amount it gives is unusual, what happens with Nau’s dollars is really exceptional: Nau puts the giving decision in the hands of its customers. They’re asked to indicate which â€Å"Partners for Change† they’d like their 5 percent to go to. Using this â€Å"conscious choice† process, Nau is â€Å"calling its customers out, daring them to connect the dots.† Discussion questions 1. What do you think of Nau’s approach to doing business? Is it being ethical and responsible? Discuss. 2. Will Nau’s approach have a limited appeal, or do you think it had staying power? What drawbacks might there be to what Nau is doing? 3. Is it a business’s responsibility to get customers to â€Å" connect the dots’ and make choices about social issues? 4. Are there lessons here for other businesses? Discuss. INSTRUCTIONS: 1. Students are required to form a group of 4 (FOUR) to 5 (FIVE) persons. One of the group members should be assigned as the group leader. Deadline: Submit your report in Week 5, which is 18.04.2014 (FRIDAY) before 12pm. * Late submission will not be entertained and you should bear the consequences.

Brain Tumour Glioblastoma Multiforme Problem Health And Social Care Essay

GBM normally affects people who older than 50 old ages old although the disease can happen in patients from all age group [ 2,25,28 ] . Patients suffer ictus, concern, ocular perturbation and sometimes personality alterations which can do great emotional hurt [ 25,30,31 ] . The average endurance of GBM patients is hapless, with about 12 to 14 months [ 7 ] . At this minute, the exact causes of GBM still remain vague to the scientists. Figure 1 GBM tumor is normally found in frontal and temporal lobe. Beginning: hypertext transfer protocol: //ebsco.smartimagebase.com/brain-tumor/view-item? ItemID=4027 Accumulative Word Count: 131 Possible Treatments Surgery Surgery is normally the initial measure to handle GBM by taking every bit much tumor as possible. It is non healing but aims to cut down the tumor ‘s size every bit much as possible so that other therapies right after the surgery can be more effectual. Furthermore, surgical resection Acts of the Apostless to alleviate hydrops by debulking tumor every bit good as being a alleviative intervention for neurologic symptoms such as ictus activity [ 7 ] . The surgery includes standard surgical process craniotomy which removes a subdivision of skull to expose the encephalon underneath in order to unclutter the tumor. Besides, patients may choose to undergo optical maser microsurgery or supersonic aspiration to hold their tumors removed. 2 1 3 4 Figure 2 Craniotomy hypertext transfer protocol: //ebsco.smartimagebase.com/surgical-craniotomy/view-item? ItemID=40345 Accumulative Word Count: 242 Radiation Therapy Normally, radiation therapy ( RT ) is administered instantly after surgery. It works chiefly by damaging the Deoxyribonucleic acid of tumor cells, killing any residuary tumor cells after surgical remotion of the tumour [ 3-6,32 ] . A research has shown that the average endurance clip has increased from 17 hebdomads ( treated with conventional attention ) to 37.5 hebdomads when the GBM patients were treated with RT entirely while combination of BNCU ( carmustine ) and RT produced a 40.5 hebdomad average endurance [ 11 ] . Table 1 Randomized surveies of post-operative radiation compared with no radiation therapy in malignant gliomaa [ 23 ] Study [ Ref. ] Study group Radiation dose Gy/ no. of fraction No. of patients randomized ( analyzed ) Median endurance ( hebdomads ) Overall endurance P value Shapiro et al. , 1976 [ 62 ] Connecticut RT + CT – 60 16 ( 16 ) 17 ( 17 ) 30 44.5 NR Not important Andersen, 1978 [ 1 ] Surgery entirely RT – 45/25 57 ( 57 ) 51 ( 51 ) 15b 23b †¹0.005 Survival at 6 months Walker et al. , 1978 [ 78 ] vitamin D Surgery entirely RT – 50-60/25-35 42 ( 31 ) 93 ( 68 ) 14c 36c 0.001 Walker et al. , 1980 [ 79 ] vitamin D Connecticut RT – 60/30-35 111 ( 111 ) 118 ( 118 ) 31 37 0.003 Kristiansen et al. , 1981 [ 36 ] vitamin D Surgery entirely RT + / – Connecticut – 45/25 38 ( 38 ) 80 ( 80 ) 23 47 NR Significant Sandberg-Wollheim et al. , 1991 [ 60 ] Connecticut RT + CT – 58/27 87 ( 87 ) 84 ( 84 ) 42 62 0.028 a CT, chemotherapy ; NR, non reported ; RT, radiation therapy. B Calculated from survival curve. 500 Multi-arm survey that included a radiation plus chemotherapy arm. For both surveies by Walker et al. , merely information from the radiation entirely arm are shown in Table 2. Kristiansen et Al. reported combined informations from the radiation entirely arm and the radiation plus chemotherapy arm. In each of these surveies, there was a important survival benefit favouring radiation plus chemotherapy compared with no radiation therapy but no important difference in endurance between radiation entirely and radiation plus chemotherapy ( informations non shown ) . degree Celsiuss Merely consequences for the evaluable patients were reported ( 31 patients in the surgery entirely arm and 68 patients in the RT arm ) . Accumulative Word Count: 329 RT is normally administered through external beam radiation but internal radiation called Brachytherapy is besides possible. Each manner differs in how the radiation beginnings are delivered to the tumour [ 4-6,32 ] . Using IMRT ( Intensity-Modulated Radiation Therapy ) , a machine such as additive gas pedal delivers precise high-energy radiation doses ( eg: X raies ) to the tumor accurately and kills the affected cells [ 6,33 ] . Most patients will have the intervention for five to seven hebdomads [ 6,32,34 ] . Typically, around 6000 to 6500 units of radiation are delivered over seven hebdomads [ 6 ] . In contrast, brachytherapy topographic point the radiation beginnings every bit near as possible to the targeted cells in shorter clip comparison to external radiation. It consists of radioactive implants in the signifier of catheters or seeds which has impermanent radioactive beginnings in the tumor [ 8 ] . Figure 3 Brachythrapy hypertext transfer protocol: //ebsco.smartimagebase.com/brachytherapy/view-item? ItemID=24923 Besides, stereotactic radiosurgery, a noninvasive method of presenting an intense and focused dosage of radiation to a little country can be used for GBM excessively. Treatment dose is individualized but the typical dosage is about 2500 units of radiation per intervention [ 6 ] . Other signifiers of radiation intervention such as installing of inflatable balloon incorporating liquid radiation or interpolation of monoclonal antibodies tagged with radioactive substances may be used [ 8 ] . Accumulative Word Count: 519 Chemotherapy Chemotherapy may be given after surgical resection and radiation. In this therapy, chemotherapeutic drugs play an of import function in impacting retroflexing cells by damaging the Deoxyribonucleic acid of these cells. The most normally used drugs are carmustine ( BNCU ) , lomustine ( CCNU ) , temozolomide ( Temodar ) and procarbazine. They are classified as alkylating agents which are DNA-damaging drugs. These drugs alkylate the Deoxyribonucleic acid in the tumor cells, doing the dual strands to be cross-linked to each other in an inappropriate manner. This thereby, blocks DNA reproduction and bit by bit leads to cell decease [ 4,5,8 ] . Soon, Gliadel Wafer – a biodegradable wafer soaked with BNCU is prevailing among the interventions. This is done by engrafting wafers in the pit after surgical remotion of the tumor. The wafers so easy let go of high concentrations of BCNU straight into the tumour country over a period of 2-3 hebdomads. Gliadel does non supply a remedy for GBM but is believed to be capable of protracting endurance. Apart from that, temozolomide is more frequently administered orally on monthly rhythm for 6-12 months after surgery and radiation as a care therapy [ 6,8,28,29 ] . Traditional chemotherapy drugs can be effectual, but most of them do non separate between healthy and tumour cells, thereby forestalling the disposal of high doses to kill the unnatural cells. What is more, their generalised toxicity can do terrible side effects. Targeted therapy drugs like Avastin ( bevacizumab ) are more precise than some chemotherapy drugs and tend to hold fewer side effects. It has been approved by FDA in 2009 as a new biologic drug to handle GBM. Avastin acts chiefly as an angiogenesis inhibitors by decelerating the growing of new blood vass environing the tumor. It selectively blocks VEGF to suppress the activation of VEGF receptors tyrosine kinases VEGFR1 and VEGFR2 [ 13-15 ] . There are some surveies to turn out that approximately 20-30 % patients with GBM do react to the drugs [ 27 ] . Accumulative Word Count: 823 A Graph 1 Kaplan-Meier endurance curves for patients treated with steroids and ( A ) resective surgery merely, ( B ) resective surgery and radiation therapy and ( C ) resective surgery, radiation therapy and chemotherapy. [ 12 ] Bacillus C Accumulative Word Count: 848 Social and Economic Deductions The trouble to digest with the side effects of the medicines such as sleepiness and hair loss may do GBM patients to experience down and hurt. They may be easy frustrated by concerns they suffer often or experience suffering and hopeless after the diagnosing [ 34 ] . This could take to serious societal impact and would worry the people around them. Furthermore, most of the patients find it hard to return to work due to decrease in productiveness. A study has shown that with 91 % patients were employed before diagnosing, merely 33 % of them continue working after interventions. While health professionals who were still working experience employment alterations such as taking leave of absence to be with their loved 1s for interventions or taking on extra paid work might experience stressed and have to fight difficult to get by with the tough life [ 9 ] . In order to run a normal life, patients require undergo a plentifulness of interventions including hospitalization after surgery which would do great fiscal load. It is estimated that cost of GBM interventions ranged from ˆ10 893 to ˆ125 275 [ 22 ] . Trouble of obtaining insurance makes the status even worse. Drugs that are necessary for GBM interventions are expensive and are normally administered over long period of clip. All this becomes a beginning of depression which affects non merely the patients but their households and friends [ 9 ] . The return of GBM after conventional therapy is inevitable. This so creates unstoppable medical crisis every bit good as fiscal hurt to the patients and their households. Accumulative Word Count: 1084 Benefits and Hazards I believe a combination of surgery, radiation therapy and chemotherapy is the most effectual intervention for GBM presently. In malice of its forecast has remained hapless for the last few decennaries, patients do acquire better after adhering to this standard therapy. Although GBM can non be cured, the patients had have their survival clip prolonged, acquiring a opportunity to pass their last few months with their loved 1s in a meaningful manner [ 34 ] . Nevertheless, the interventions do enforce distressing side effects to human wellness. Despite killing tumour cells, alkylating agents used are considered toxic, ensuing in suppression or lowering of blood counts. They have been associated with important sickness, hair loss, weariness and sterility [ 5 ] . High doses of BNCU may take to damage and marking of the lungs while procarbazine can do raging concern, purging and numbness. Hence, doses of drugs administered have to be carefully monitored by doctor to avoid taking to unwanted effects. Recently invented drugs temozolomide, has comparatively mild side effects but they are still inevitable [ 6 ] . Meanwhile, hazard of developing acute leukaemia old ages subsequently is increased when patients are exposed to alkylating agents [ 5 ] . Avastin, a freshly developed drug, provides a more effectual therapy for GBM. However, it potentially creates fatal toxicity, doing the late closed surgical lesion interruptions down. Some claim that the development of toxicity by avastin may shorten endurance in some patients when it is added to radiotherapy and temozolomide. Thus, researches on the effectivity and safety of use of avastin should be carried on continually until desirable consequences are obtained [ 20 ] . In add-on, the return of the tumor is ineluctable, with the average endurance rate of patients who relapse runing from 3-6 months despite aggressive intervention [ 10 ] . Patients may develop the feeling that the medicines are useless or may give up because of the intolerable side effects and the unstoppable backsliding of disease. This will take to non-adherence to therapy and increase the hazard of mortality. However, in my sentiment, the multimodal treatments I discuss above are still considered the best solution for GBM as they outweigh the hazards by protracting the patients ‘ survival clip. Accumulative Word Count: 1432 Alternate Treatments Gene therapy Another promising attack of handling GBM is cistron therapy. Herpes simplex virus thymidine kinase/ganciclovir ( HSV-tk/GCV ) has evolved as a cytotoxic cistron therapy. In this instance, recombinant adenoviral vectors are used to give favorable consequences. Adenoviral HSV-tk ( AdHSV-tk ) is able to assail the residuary dividing tumour cells while go forthing the non-dividing nerve cells unharmed. What ‘s more, it can destruct the malignant neoplastic disease cells through bystander- consequence [ 19 ] . HSV-tk first converts GCV to GCV-monophosphate [ 16,17 ] . Then, cellular kinases farther convert this merchandise to GCV-triphosphate which is a hapless substrate for uninterrupted DNA elongation due to the lacking of 3 ‘ hydroxyl group that is needed to organize phosphodiester bond in chain-elongation-reaction. Ultimately, nonfunctional Deoxyribonucleic acid fragments are formed, triping programmed cell death in malignant neoplastic disease cells [ 18 ] . Nowadays, AdH SV-tk /GCV is going preferred comparisons to conventional radiation therapy and chemotherapy due to its fewer inauspicious effects. Figure 4 The rule of HSV-tk/GCV cistron therapy. hypertext transfer protocol: //www.gtmb.org/VOL4A/GTMBVOL4AHTML/23_Adachi_files/image001.gif Accumulative Word Count: 1575 Table 2 Surveies by Sandmair et Al. and Immonen et Al. demo a singular protraction of endurance in patients treated with AdHSV-tk [ 19 ] . Patients Vector Phase Gene Transfer Method Adverse Effectss Survival ( Months ) Response Brain Tumour Glioblastoma Multiforme Problem Health And Social Care Essay GBM normally affects people who older than 50 old ages old although the disease can happen in patients from all age group [ 2,25,28 ] . Patients suffer ictus, concern, ocular perturbation and sometimes personality alterations which can do great emotional hurt [ 25,30,31 ] . The average endurance of GBM patients is hapless, with about 12 to 14 months [ 7 ] . At this minute, the exact causes of GBM still remain vague to the scientists. Figure 1 GBM tumor is normally found in frontal and temporal lobe. Beginning: hypertext transfer protocol: //ebsco.smartimagebase.com/brain-tumor/view-item? ItemID=4027 Accumulative Word Count: 131 Possible Treatments Surgery Surgery is normally the initial measure to handle GBM by taking every bit much tumor as possible. It is non healing but aims to cut down the tumor ‘s size every bit much as possible so that other therapies right after the surgery can be more effectual. Furthermore, surgical resection Acts of the Apostless to alleviate hydrops by debulking tumor every bit good as being a alleviative intervention for neurologic symptoms such as ictus activity [ 7 ] . The surgery includes standard surgical process craniotomy which removes a subdivision of skull to expose the encephalon underneath in order to unclutter the tumor. Besides, patients may choose to undergo optical maser microsurgery or supersonic aspiration to hold their tumors removed. 2 1 3 4 Figure 2 Craniotomy hypertext transfer protocol: //ebsco.smartimagebase.com/surgical-craniotomy/view-item? ItemID=40345 Accumulative Word Count: 242 Radiation Therapy Normally, radiation therapy ( RT ) is administered instantly after surgery. It works chiefly by damaging the Deoxyribonucleic acid of tumor cells, killing any residuary tumor cells after surgical remotion of the tumour [ 3-6,32 ] . A research has shown that the average endurance clip has increased from 17 hebdomads ( treated with conventional attention ) to 37.5 hebdomads when the GBM patients were treated with RT entirely while combination of BNCU ( carmustine ) and RT produced a 40.5 hebdomad average endurance [ 11 ] . Table 1 Randomized surveies of post-operative radiation compared with no radiation therapy in malignant gliomaa [ 23 ] Study [ Ref. ] Study group Radiation dose Gy/ no. of fraction No. of patients randomized ( analyzed ) Median endurance ( hebdomads ) Overall endurance P value Shapiro et al. , 1976 [ 62 ] Connecticut RT + CT – 60 16 ( 16 ) 17 ( 17 ) 30 44.5 NR Not important Andersen, 1978 [ 1 ] Surgery entirely RT – 45/25 57 ( 57 ) 51 ( 51 ) 15b 23b †¹0.005 Survival at 6 months Walker et al. , 1978 [ 78 ] vitamin D Surgery entirely RT – 50-60/25-35 42 ( 31 ) 93 ( 68 ) 14c 36c 0.001 Walker et al. , 1980 [ 79 ] vitamin D Connecticut RT – 60/30-35 111 ( 111 ) 118 ( 118 ) 31 37 0.003 Kristiansen et al. , 1981 [ 36 ] vitamin D Surgery entirely RT + / – Connecticut – 45/25 38 ( 38 ) 80 ( 80 ) 23 47 NR Significant Sandberg-Wollheim et al. , 1991 [ 60 ] Connecticut RT + CT – 58/27 87 ( 87 ) 84 ( 84 ) 42 62 0.028 a CT, chemotherapy ; NR, non reported ; RT, radiation therapy. B Calculated from survival curve. 500 Multi-arm survey that included a radiation plus chemotherapy arm. For both surveies by Walker et al. , merely information from the radiation entirely arm are shown in Table 2. Kristiansen et Al. reported combined informations from the radiation entirely arm and the radiation plus chemotherapy arm. In each of these surveies, there was a important survival benefit favouring radiation plus chemotherapy compared with no radiation therapy but no important difference in endurance between radiation entirely and radiation plus chemotherapy ( informations non shown ) . degree Celsiuss Merely consequences for the evaluable patients were reported ( 31 patients in the surgery entirely arm and 68 patients in the RT arm ) . Accumulative Word Count: 329 RT is normally administered through external beam radiation but internal radiation called Brachytherapy is besides possible. Each manner differs in how the radiation beginnings are delivered to the tumour [ 4-6,32 ] . Using IMRT ( Intensity-Modulated Radiation Therapy ) , a machine such as additive gas pedal delivers precise high-energy radiation doses ( eg: X raies ) to the tumor accurately and kills the affected cells [ 6,33 ] . Most patients will have the intervention for five to seven hebdomads [ 6,32,34 ] . Typically, around 6000 to 6500 units of radiation are delivered over seven hebdomads [ 6 ] . In contrast, brachytherapy topographic point the radiation beginnings every bit near as possible to the targeted cells in shorter clip comparison to external radiation. It consists of radioactive implants in the signifier of catheters or seeds which has impermanent radioactive beginnings in the tumor [ 8 ] . Figure 3 Brachythrapy hypertext transfer protocol: //ebsco.smartimagebase.com/brachytherapy/view-item? ItemID=24923 Besides, stereotactic radiosurgery, a noninvasive method of presenting an intense and focused dosage of radiation to a little country can be used for GBM excessively. Treatment dose is individualized but the typical dosage is about 2500 units of radiation per intervention [ 6 ] . Other signifiers of radiation intervention such as installing of inflatable balloon incorporating liquid radiation or interpolation of monoclonal antibodies tagged with radioactive substances may be used [ 8 ] . Accumulative Word Count: 519 Chemotherapy Chemotherapy may be given after surgical resection and radiation. In this therapy, chemotherapeutic drugs play an of import function in impacting retroflexing cells by damaging the Deoxyribonucleic acid of these cells. The most normally used drugs are carmustine ( BNCU ) , lomustine ( CCNU ) , temozolomide ( Temodar ) and procarbazine. They are classified as alkylating agents which are DNA-damaging drugs. These drugs alkylate the Deoxyribonucleic acid in the tumor cells, doing the dual strands to be cross-linked to each other in an inappropriate manner. This thereby, blocks DNA reproduction and bit by bit leads to cell decease [ 4,5,8 ] . Soon, Gliadel Wafer – a biodegradable wafer soaked with BNCU is prevailing among the interventions. This is done by engrafting wafers in the pit after surgical remotion of the tumor. The wafers so easy let go of high concentrations of BCNU straight into the tumour country over a period of 2-3 hebdomads. Gliadel does non supply a remedy for GBM but is believed to be capable of protracting endurance. Apart from that, temozolomide is more frequently administered orally on monthly rhythm for 6-12 months after surgery and radiation as a care therapy [ 6,8,28,29 ] . Traditional chemotherapy drugs can be effectual, but most of them do non separate between healthy and tumour cells, thereby forestalling the disposal of high doses to kill the unnatural cells. What is more, their generalised toxicity can do terrible side effects. Targeted therapy drugs like Avastin ( bevacizumab ) are more precise than some chemotherapy drugs and tend to hold fewer side effects. It has been approved by FDA in 2009 as a new biologic drug to handle GBM. Avastin acts chiefly as an angiogenesis inhibitors by decelerating the growing of new blood vass environing the tumor. It selectively blocks VEGF to suppress the activation of VEGF receptors tyrosine kinases VEGFR1 and VEGFR2 [ 13-15 ] . There are some surveies to turn out that approximately 20-30 % patients with GBM do react to the drugs [ 27 ] . Accumulative Word Count: 823 A Graph 1 Kaplan-Meier endurance curves for patients treated with steroids and ( A ) resective surgery merely, ( B ) resective surgery and radiation therapy and ( C ) resective surgery, radiation therapy and chemotherapy. [ 12 ] Bacillus C Accumulative Word Count: 848 Social and Economic Deductions The trouble to digest with the side effects of the medicines such as sleepiness and hair loss may do GBM patients to experience down and hurt. They may be easy frustrated by concerns they suffer often or experience suffering and hopeless after the diagnosing [ 34 ] . This could take to serious societal impact and would worry the people around them. Furthermore, most of the patients find it hard to return to work due to decrease in productiveness. A study has shown that with 91 % patients were employed before diagnosing, merely 33 % of them continue working after interventions. While health professionals who were still working experience employment alterations such as taking leave of absence to be with their loved 1s for interventions or taking on extra paid work might experience stressed and have to fight difficult to get by with the tough life [ 9 ] . In order to run a normal life, patients require undergo a plentifulness of interventions including hospitalization after surgery which would do great fiscal load. It is estimated that cost of GBM interventions ranged from ˆ10 893 to ˆ125 275 [ 22 ] . Trouble of obtaining insurance makes the status even worse. Drugs that are necessary for GBM interventions are expensive and are normally administered over long period of clip. All this becomes a beginning of depression which affects non merely the patients but their households and friends [ 9 ] . The return of GBM after conventional therapy is inevitable. This so creates unstoppable medical crisis every bit good as fiscal hurt to the patients and their households. Accumulative Word Count: 1084 Benefits and Hazards I believe a combination of surgery, radiation therapy and chemotherapy is the most effectual intervention for GBM presently. In malice of its forecast has remained hapless for the last few decennaries, patients do acquire better after adhering to this standard therapy. Although GBM can non be cured, the patients had have their survival clip prolonged, acquiring a opportunity to pass their last few months with their loved 1s in a meaningful manner [ 34 ] . Nevertheless, the interventions do enforce distressing side effects to human wellness. Despite killing tumour cells, alkylating agents used are considered toxic, ensuing in suppression or lowering of blood counts. They have been associated with important sickness, hair loss, weariness and sterility [ 5 ] . High doses of BNCU may take to damage and marking of the lungs while procarbazine can do raging concern, purging and numbness. Hence, doses of drugs administered have to be carefully monitored by doctor to avoid taking to unwanted effects. Recently invented drugs temozolomide, has comparatively mild side effects but they are still inevitable [ 6 ] . Meanwhile, hazard of developing acute leukaemia old ages subsequently is increased when patients are exposed to alkylating agents [ 5 ] . Avastin, a freshly developed drug, provides a more effectual therapy for GBM. However, it potentially creates fatal toxicity, doing the late closed surgical lesion interruptions down. Some claim that the development of toxicity by avastin may shorten endurance in some patients when it is added to radiotherapy and temozolomide. Thus, researches on the effectivity and safety of use of avastin should be carried on continually until desirable consequences are obtained [ 20 ] . In add-on, the return of the tumor is ineluctable, with the average endurance rate of patients who relapse runing from 3-6 months despite aggressive intervention [ 10 ] . Patients may develop the feeling that the medicines are useless or may give up because of the intolerable side effects and the unstoppable backsliding of disease. This will take to non-adherence to therapy and increase the hazard of mortality. However, in my sentiment, the multimodal treatments I discuss above are still considered the best solution for GBM as they outweigh the hazards by protracting the patients ‘ survival clip. Accumulative Word Count: 1432 Alternate Treatments Gene therapy Another promising attack of handling GBM is cistron therapy. Herpes simplex virus thymidine kinase/ganciclovir ( HSV-tk/GCV ) has evolved as a cytotoxic cistron therapy. In this instance, recombinant adenoviral vectors are used to give favorable consequences. Adenoviral HSV-tk ( AdHSV-tk ) is able to assail the residuary dividing tumour cells while go forthing the non-dividing nerve cells unharmed. What ‘s more, it can destruct the malignant neoplastic disease cells through bystander- consequence [ 19 ] . HSV-tk first converts GCV to GCV-monophosphate [ 16,17 ] . Then, cellular kinases farther convert this merchandise to GCV-triphosphate which is a hapless substrate for uninterrupted DNA elongation due to the lacking of 3 ‘ hydroxyl group that is needed to organize phosphodiester bond in chain-elongation-reaction. Ultimately, nonfunctional Deoxyribonucleic acid fragments are formed, triping programmed cell death in malignant neoplastic disease cells [ 18 ] . Nowadays, AdH SV-tk /GCV is going preferred comparisons to conventional radiation therapy and chemotherapy due to its fewer inauspicious effects. Figure 4 The rule of HSV-tk/GCV cistron therapy. hypertext transfer protocol: //www.gtmb.org/VOL4A/GTMBVOL4AHTML/23_Adachi_files/image001.gif Accumulative Word Count: 1575 Table 2 Surveies by Sandmair et Al. and Immonen et Al. demo a singular protraction of endurance in patients treated with AdHSV-tk [ 19 ] . Patients Vector Phase Gene Transfer Method Adverse Effectss Survival ( Months ) Response

New Jim Crow Annotated Bibliography Example | Topics and Well Written Essays - 750 words

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Supply Chain Principles Term Paper Example | Topics and Well Written Essays - 2000 words

Supply Chain Principles - Term Paper Example The supply chain generally prevails in service and manufacturing organisations (Ganeshan & Harrison, 2010). Quality is observed to be the first aspect of consideration for any consumer in the existing competitive business scenario. Oak Hills facility is a division of The Oil and Gas Services Company (TOGS). It is headquartered in Houston, Texas. It can be observed that Oak Hills might be facing quality concerns because of certain issues. One such issue has been the rumour related to mergers. Lack of communication from management team towards the employees also tends to lower the morale of the employees, and hence the employees are not capable of adequately focusing upon the quality. The other problem was with respect to the lid-making process. It was observed that the company had to produce extra lids always because of the defects in the lid manufacturing method. This would give rise to cost in the Oak Hills. Incorrect amount of powder can be one of the critical issues in the manufacturing of the lids pressed from the powdered metals, especially because management assumes that seventy-five percent of the product variation occurs because of this aspect. Furthermore, there are a lot of powder deposits in the room. This actually demonstrates that some quantity of the powder is being lost by the press machine during the operation. It is also vital to weigh the lids once they are pressed. It has been observed that the weight of the lids needs to be recorded. Furthermore, the production process makes use of poka-yoke in order to check the magnitude of the completed lids, which is quite vital for statistical process control purposes. It is significant to take the samples of nearly three to five lids, and the workers are supposed to record adequate measurements on a control chart. Once the production run of lids is finished, it is significant to return the powdered metal to a proper storage conta iner. The containers are supposed to be sealed firmly if they are not in use so that the risk of stain of the powders from dust in the room along with outside air can be reduced to the minimum. If they are not sealed properly, it poses a threat and thus hampers the quality of the product. It has further been observed that Black Dome, which was an internal TOGS unit, favoured producing large batches of sensor boards. They had a poor on-time delivery record creating late deliveries. The employees were not equipped with the necessary skills of using statistical proce

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Capstone - Research Paper Example To put it briefly, study intends to illustrate the impact of the company’s mission, vision, and primary stakeholders on its overall success. In addition, the study conducts SWOT analysis for the company to determine its major strengths, weaknesses, opportunities, and threats. In the subsequent phase, the study discusses the various levels and types of strategies the firm may use to maximize its competitiveness and profitability. The study further outlines the communication plan for the company for devising strategies as well as it attempts to evaluate the managerial action based on the two corporate governance mechanism. Finally, the study presents recommendations for improving leadership within the company and assesses the impact of the company as a responsible (ethical) corporate citizen on bottom line supported with specific examples. The statement of mission and vision of the company are the core value that gives an idea about the identity and the reasons for its existence in the market. The company has established a clear statement that communicates its goals and objectives to stakeholders. It also supports the decision making process of the company (Alter, 2000). The mission statement of the company delineates the fundamental purpose for its existence. The impact of the company’s mission and vision is clearly apparent in its operations and decisions made by the top-level managers. The company in alignment with its mission and vision focuses on the demand of the consumers so that the highest customer’s satisfaction is delivered. The company aims to provide best stories according to the customer’s need and expectation to ensure growth and increase its profitability while producing films and news coverage that are widely appreciated by the customers. At the same time, the primary stakeholders of the company are constantly engaged in decision-making process with the aim of ensuring financial stability and enduring innovation necessary for operating

Argumentative five paragraph essay about Your grade should be what

Argumentative five paragraph about Your grade should be what during your academic school - Essay Example ehind this include: Personal commitment to the achievement of an A grade, working with colleagues to counter my weaknesses and build on my strengths, and I do not perceive myself as a failure. Learning is an ongoing process that highly depends on personal effort and commitment. My pursuit to achieve my academic goals and objectives informs what my school grade should be. Considering that I am an A material in terms of academic performance and school grading, I have to my way towards that. There are so many activities and efforts involved in the process of achieving the desired grade; personally, achieving an A grade guides my academic and learning process. There is no single student who can be said to be self-sufficient in the academic world. Every single student exhibits both strengths and weaknesses, all of which influence learning and academic performance. Personally, the school grade A is not a solely individual result. I appreciate the role that my colleagues play in enhancing my academic results. By combining the diversity group efforts and my own, then my performance is directed to grade A. While there are diverse and dynamic goals of joining the various academic systems, no one seeks to fail after all. In this regard, I do not perceive myself as a failure. Winning is the outcome that should come with my school work. For this reason, I head for the very best, and nothing less than that. I understand that there are huddles and challenges involved, but they serve as an encouragement in expecting and working for the best. Measures of individual performance are many in number, and an excellent grade in school constitutes part of these measures. Evaluating one’s goals and objectives from time to time is essential in monitoring progress towards the desired result. In the school, setting milestones marks the procedural attainment of the desired grade from time to time. This makes it easier to work towards the desired school grade. Personally, the process