Narcolepsy Essay -- Disorder Sleep Sleepy Health Essays

Narcolepsy Tiredness, regardless of whether because of rest apnea, overwhelming wheezing, idiopathic hypersomnolence, narcolepsy or a sleeping disorder from any number of rest related disarranges, compromises a large number of Americans' wellbeing and monetary security (1). Maybe to some degree most worried of these clutters are those that permit rest without having any authority over when it happens-idiopathic hypersomnolence and narcolepsy. The two are firmly related in that both reason people to nod off without such control, yet narcolepsy happens with no dreaming during snoozes (2). For a considerable length of time, narcoleptic individuals have been nodding off in corners, worried, as they have given various endeavors to attempt to remain engaged and alert. However, other than the exorbitant exhaustion that individuals experience, there most likely should be more that can be related with causing such tiredness among individuals at an uncontrolled level. There may particularly not be an exp lanation including the I-capacity of the cerebrum, as individuals don't know about when essentially they will fall into their profound rest. Narcolepsy has been clinically characterized as a ceaseless neurological issue that includes the body's focal sensory system (CNS). The CNS is essentially similar to an expressway of nerves that conveys messages from the mind to different pieces of the body. Along these lines, for individuals with narcolepsy, the messages about when to rest and when to be conscious once in a while hit barricades or reroutes and show up in an unlucky spot. This is the reason somebody who has narcolepsy, not oversaw by meds, may nod off while having supper or occupied with social exercises or even on occasion when they are so centered around being alert, yet they can't be because of their narcoleptic nature. Much of the time, be that as it may, conclusion... ...r individual sadness. Works Cited: 1)Sleep Apnea, Snoring, Narcolepsy, Insomnia and Other Causes of Daytime Fatigue http://members.tripod.com/~sleephealth/sleepdisorderssleepapnea.html 2)Better Sleep Now! http://www.dreamdoctor.com/better/narcolepsy/6.shtml 3)Center for Narcolepsy: Symptoms and Diagnosis http://www.med.stanford.edu/school/Psychiatry/narcolepsy/symptoms.html 4)Living With Narcolepsy http://www.sleepfoundation.org/distributions/livingnarcolepsy.html 5)Sleepnet.com Apnea Forum http://www.sleepnet.com/apnea18/messages/434.html 6)Seratonin: The science of Well-Being http://www.angelfire.com/hello there/TheSeer/seratonin.html 7)Sleep Channel: Narcolepsy http://www.sleepdisorderchannel.net/narcolepsy/treatment.shtml 8)Sleep: Alternative and Integral Therapies http://www.holistic-online.com/Remedies/Sleep/sleep_ins_food-and-diet.htm

Ah Are You Digging On My Gra free essay sample

Ok, Are You Diging On My Gra Essay, Research Paper The inconsequentiality of human life contrasted with the progress of clasp and continuation of the existence cadence are investigated in both Thomas Hardy # 8217 ; s # 8220 ; Ah, Are You Diging On My Grave # 8221 ; and John Keats # 8220 ; When I Have Fears # 8221 ; . Tough uses the connections between a dead grown-up female and her family unit, companions and pet to demo this irrelevance, while Keats utilizes the pomposity of nature. In spite of the fact that the refrain structures utilize distinctive riming procedures, likenesses are found in their developments. Tough writes as they say ain innovative movement however utilizes four of the six verses to closer view various delineations of the grown-up female # 8217 ; s associations with those left hindquarters. The fifth is utilized as a structure up of expectation, and the closing verse is utilized to demo both the narrator and the peruser how in the blink of an eye what we consider of import and significant throughout everyday life, can be decreased or overlooked in the lives and everyday modus operandis of those left rear end. Keats, in the interim, utilizes a standard poem signifier, using his three quatrains to each give an alternate representation of what the grown-up male would like to bring through throughout everyday life. The closing rhyming pair shows his trustworthiness of his life as meager and undistinguished when contrasted with the broadness of nature and the universe in general ; # 8220 ; - at that point in the shore Of the wide universe I stand completely, and accept Till Love and Fame to nothingness make sink. # 8221 ; These stanza structures are composed from various purpose of perspectives ; Hardy composes as a grown-up female as of now in her grave, and Keats as a grown-up male still alive. However the two narrators go to the choice that what we consider to be critical in our lives, is every now and again of little to no significance after we pass on. Time will experience, and life will go on simply as will without us. Be that as it may, both of the narrators make sense of this reality in extremely various manners. The grown-up male in Keats # 8217 ; section structures, while alive, has offered clasp to stop and perceive how his interests are demonstrated fiddling, and thus thwart his bullying. Assumeably this will help him to luxuriate his life, and to be grateful for whatever cut he is left with. The grown-up female in Hardy # 8217 ; s stanza structure, by and by, is as yet distracted with her life, considerably after she is dead and covered in her grave. It takes the # 8220 ; everyday run # 8 221 ; of her Canis familiaris to do her perceive how little she truly has influenced the lives of people around her. The inconsequentiality of the grown-up female in Hardy # 8217 ; s stanza structure is appeared in four separate delineations. The first looks at the relationship with her hubby. On the other hand of goi nanogram to her calm site with blossoms and misery, he has simply marry another, more extravagant grown-up female. While she lies in her grave, and still thinks about her hubby as her â€Å"loved one† , he is securing on with his life and giving the adoration that he one time had for her to another grown-up female. Her children are other than trying to go on, perceiving that no blossoms or consideration for her grave will ever pass on her dorsum to life, and thus accepting that there is no use agonizing on what was. Indeed, even the 1 who was her foe in life no longer despises her, accepting that to disdain her is a misuse of endeavor. At last, the woman’s pet Canis familiaris, the â€Å"one genuine heart† , who likely stayed by her dependably throughout everyday life, and cherished her over some other, has overlooked her, just recovering her and her grave as he by chance begins to dive an opening in her grave site to cover an issue that remains to be worked out on an everyday walk. In the mean time, the grown-up male in Keats # 8217 ; sonnet perceive his irrelevance in a far gentler, and simpler way. At the point when he begins to stress over perishing before he has recorded everything his head is brimming with, or about whether or non he # 8217 ; s making a trip to see the grown-up female he cherishes again, he takes himself to # 8220 ; the shore of the wide universe # 8221 ; , and gives himself how fiddling such concerns are. He understands that when he is gone, the universe will look after turning, life will proceed to go on, and it # 8217 ; s a rather disparaging encounter for him. The two characters go to the acknowledgment of there unimportance through entirely various ways. The grown-up female in Hardy # 8217 ; s refrain structure, appeared to be rather vain and likely believed her life to be hidden. Lamentably she had to perceive reality through the fore-referenced occasions. On the different manus, the grown-up male in the Keats # 8217 ; stanza structure is in amazement of nature and the universe around him. He is glad that he discovered love, and can come to footings with the way that life will go on without him. In light of the tragic and appalling subjects to both refrain structures, I genuinely didn # 8217 ; t luxuriate both of them such much, however if I somehow happened to see one to be my leader over the other, it would hold to be John Keats # 8217 ; # 8220 ; When I Have Fears # 8221 ; . I found that the development ( the way that it was written in the work way ) , and the rhyming structure, made it a drum sander and simpler read. I discovered Thomas Hardy # 8217 ; s # 8220 ; Ah, Are You Diging On My Grave? # 8221 ; to be somewhat unexceptional. I had work with keeping up my going to during the section structure and felt he could hold expressed what is on his mind in an a lot shorter or conceivably less unyielding way. 341

11 Fears Every Entrepreneur Must Overcome

11 Fears Every Entrepreneur Must Overcome When you see some famous entrepreneurs on TV or the internet, you probably think “Wow, their life must be great, they have their own business, and they have it easy in life!”However, that is definitely not the case.Being a successful entrepreneur is one of the toughest “jobs” one may have. It includes a lot of stress because you would have some very hard decisions to make and it is definitely not a profession for everyone.Today we are here to talk about some of the struggles you may have if you are an entrepreneur or if you want to become one.We will discuss what entrepreneurs fear the most, whether they are experienced or new to what it really means to be an entrepreneur.Without any further due, let’s begin!1. FEAR OF CHANGEAs we grow up, we meet new people, learn new things and build our character along the way.So, we can say that living a life is going through a series of constant changes.Sometimes those changes make us feel fear, but eventually, it is something we canno t control and to what we can only adapt and accept it.That’s why we often try to stay in our comfort zone, where we feel safe and where we can act naturally and without having to worry about anything.So, in other words, we prefer peace and quiet. But why is that so bad?Well, the world around us is constantly changing.New inventions, new products and new systems of production change the way not just business is done, but the way we live our lives every day.And in today’s world, the business environment is very dynamic and is changing rapidly.In order for you, as a company, to be successful and even survive in that kind of world, you have to be open to changes and learn to adapt to them.If you try to ignore them, you won’t be able to keep up with your competitors, which could lead your business to an unfortunate end.Innovation and adaptability are keys to success and are an essential part of modern business, so you need to be able to accept that fact and try to make the best of your situation.Learn new ways of production, think of some innovative products or different versions of products and your business will stay alive and it is more likely that it will become a success.2. FEAR OF FAILUREOne of the most common fears, not just in business, but in every-day life as well, is the fear of failure. Fear that makes us either quit too early or just give up on doing something at all.For instance, let’s say that you really like some girl and that you would really want to get out with her.Of course, people will say you have two choices: either to try and ask her out, with some probability of rejection or to give up and move on with your life.As for me, I would say there is only one choice, which is to be a man and ask her out.There is nothing to lose here, except perhaps hurting your pride a bit if you get rejected.This is the way winners think. There is no try, just do or do not.Of course, all of this can also be applied to business. If you are an entrepreneur or you are willing to become one, you have to overcome your fear of failure and act because without trying and making some tough decisions, you cannot hope to build a successful business.What can you do to boost your self-confidence and reduce the fear of failure?Well, one very good solution is to have a backup plan in case you don’t manage to succeed to implement the plan you first had.That way, even if you failed, you would have a different approach to the situation and something else to do, which would help reduce the fear of failure and go through with your plans.3. FEAR OF NOT KNOWING ENOUGHOne of the most important lessons we learn, either at home or in school, is that knowledge is infinite and that no one can know everything, because there is always something new to learn about.That means our search for knowledge never ends and we are always trying to acquire new skills, learn new things and meet new people in order to broaden our views.That’s why it can often happen that we are afraid of doing something, just because we think we don’t know how to do it properly.Sometimes, we actually don’t know things.For instance, if you’re just starting your first job, no one will expect that you know how to do everything that is expected of you since it is your first job after all.In that situation, we may feel a bit afraid of failing to do our tasks and letting down your team, but that is something which shouldn’t bother you too much because you will learn over time.Being an entrepreneur, especially a new one, can feel overwhelming and you may not know everything related to it, so do not be afraid to ask other people about their own experiences and tough situations they had encountered.There are organizations where entrepreneurs can talk to each other and share their experiences in order to help new entrepreneurs start their own journeys.Apart from that, be sure to ask for feedback from your own clients and customers.That way you can what they like and do not like about your business, which would help you improve it.4. FEAR OF THE UNKNOWNAll throughout history, people have been afraid of the unknown.It is a natural human response, a defense mechanism of sorts, which helps us stay inside our comfort zone where we feel safe.For example, in medieval times, medicine was still unfamiliar to the people, but there were some people who knew how to use their environment and herbs with medicinal properties in order to heal others.Those people were often feared and their skills were associated with the devil, due to the very high influence church had during Dark ages.So instead of accepting their help, people were often reluctant to it and healers were often subjected to physical violence and murder.It is similar when it comes to everything else in life, as well as in business.When we meet something unknown to us, we have fears on how it could affect our business and whether it could be a good thing or something that could possibly have a ne gative impact on what we do.One thing that is certain is that which is unknown always lead to some changes and it is up to you to decide whether you want to succumb to that fear and let it consume you and have negative effect on your business, or you will try to face that fear and manage to conquer it in order to adapt to all those changes and potentially improve your business.One good way of doing that is having a really good business plan to follow, so make sure that when you need to create one, think very carefully on how you intend to build a lasting business plan.5. FEAR OF INVESTING IN YOUR BUSINESSOne very funny thought a lot of inexperienced entrepreneurs have is that they can form a business only to reap its benefits, without having to invest in it too much.Let me tell you something, that is simply not possible.If your real intention is to become a successful entrepreneur, you will have to invest everything, your money, your time and your skills in making your dream become reality.Investing your personal savings is always a risk, but it is a necessary risk because without innovation it is not possible for your business to advance and develop further.And that’s why people fear this.That is the case especially if you decide to invest your personal savings, which you had been gathering for a long time.The fear of losing that money intended for “rainy days” is very high in some people and it makes them reluctant and indecisive when it comes to starting a new business or investing in the existing one.That itself is not a good thing, because, in order to survive in today’s dynamic working environment, businesses need to be able to invest in acquiring new things, new equipment, new knowledge or simply new ways of doing the necessary job.Without it, companies cannot hope to be competitive on the market and without the option to be competitive, there is really no chance for them to survive and become market leaders.6. FEAR OF TAKING RISKSome people hav e a high-risk aversion, meaning they are not quite prepared to do something that might be considered rash if that something could potentially hurt them, their business or their reputation.They fear that they could lose everything by making one single mistake.And sometimes, they are right, there is a decision that could cost you everything.But, every darkness needs light, every yin needs yang.Thus, every decision that could potentially have very negative effects could also be very lucrative and greatly improve your business.Sometimes the payoffs can be huge, so it is worth risking.But let’s take into consideration that not every risk is the same.There is a risk that is dangerous and the one that is calculated. We can think of risks gamblers take as a dangerous risk. Why is that, you may ask? How is that risk differently than others, since there is a real possibility to win?Well, gambling is a dangerous risk because, by gambling, you are betting your money based on luck, on somethin g that is not quite proven to be lucrative. You can never know how the slot machines are set up unless you are a math genius, in which case you might as well be kicked out of the casino for “cheating” the system.Calculated risk is a risk where you can plan every step of the way, and move inch by inch towards a set goal.That way, you can carefully examine the chances presented to you and invest in the most lucrative ones.7. FEAR OF BEING A DISAPPOINTMENT IN OTHER PEOPLES EYESAnother very common fear, not just every entrepreneur, but also every person has, is the fear of disappointing people you love or work with.Whether it is your boss or your family members, the feeling is the same and it is awful.Because of that, we often try to please others in an attempt to meet their expectations and not let them down.And sometimes, by doing that, we hurt ourselves and potentially our businesses, which is definitely not a good thing.Being an entrepreneur is kind of like being a Ring-bearer i n the popular movie.It is a heavy burden and you cannot trust anyone, but yourself in order to achieve the goals you had set and improve your business to the point where people can call it a successful business.That said, what you should do, is focus on all those things that are important to you and your business.Of course, sometimes it’s good to take the advice given to you, but you shouldn’t accept each and every one of them just to please other people’s wishes and meet their expectations.That is the only way you will be able to become an independent and successful entrepreneur, by completing your own goals and building your life around things that you feel passionate about, and not by creating something just to please other people.It is how you could conquer your fear of being a disappointment in other people’s eyes.8. FEAR OF BEING IN UNCOMFORTABLE SITUATIONSWe are often being put in uncomfortable situations, both in business and in every-day life. We can almost never kn ow when it will happen, so we are basically diving into it unprepared.That fact could induce fear in each and every one of us. Sometimes that fear can affect us so deeply that we aren’t able to do what is required of us.For example, let’s consider people who are afraid of public speaking.Those people often get very nervous and tend to make mistakes during their speeches, not because they are not professionals in their field, but simply because they succumbed to their fear.However, that can be avoided.All you need to do is prepare yourself a bit, by practicing and even putting yourself outside your comfort zone in order to get used to the feeling of discomfort, because in business, there will be a lot of uncomfortable situations for you to face, so you need to be prepared.It’s no different than doing the things you need to train for first, such as climbing or even skydiving.Before you do both of those things, you have to train and learn how to do that, step by step, by handling some uncomfortable situations as well.Only when you are familiar with being uncomfortable, you will be able to conquer your fears and stay calm in every situation you are about to face, which would look very professional in other people’s eyes.9. FEAR OF NOT BEING RIGHTOne of the key characteristics of successful entrepreneurs is a competitive nature. They simply have to be competitive in order to survive in today’s dynamic business environment.Without it, there would be fewer actions taken and a higher probability of a company going into demise.In that case, people are afraid of making mistakes or not being completely perfect in what they do because they think it would put them under their competition, which could mean they could lose clients and customers.Sometimes they are right, there are serious mistakes that could cost you a lot.But, that doesn’t mean you should stop trying to correct those mistakes.Making mistakes is a way of learning what is good and what is ugly, wha t could work and what will simply not work.Without that, you would just be restraining yourself to not making difficult decisions at all.By doing that, your business would become stagnant and eventually collapse, simply because you were afraid of making mistakes.Making a mistake is better than being stagnant and doing nothing at all. It would teach you what you did wrong and what you could do to make it right the next time you find yourself in a similar situation.So, don’t be too harsh on yourself if you make mistakes, but rather try to learn from it and become better at doing what you want to do.10. FEAR OF NOT BEING GOOD ENOUGHWhether you are an experienced worker or just a beginner, there will always be one question you will ask yourself, which is whether you are good enough for the job or not.No one can know everything and every one of us is good at something, while not being good at something else.What we can do is to constantly learn new things, acquire new skills and improv e on our business and general personalities.Doubting in yourself and your own abilities is a very dangerous fear to have, especially if you are an entrepreneur.Sometimes, even if other people believe in you, you can feel like you are just not good enough for something. This situation even has a professional name, an imposter syndrome.One of the characteristics of this syndrome is that people who have it always tend to try making everything to be perfect, even when it is not possible.That leads to stagnation and delays in business, and sometimes people even reject to take certain action because they think it is not good enough.It is a very harmful thing to do to yourself, so you should learn how to conquer that fear and become the best version of yourself.You should focus on achieving the goals you had set, without having to worry too much about perfectionism.Of course, it is always better to do something the right way, but that right way doesn’t always have to be the perfect way t o do things.11. FEAR OF SAYING NODuring our life and business career, there will be a lot of possible paths to take, a lot of different projects and opportunities to accept.Sometimes, a large number of those may look appealing to us, almost forcing us to accept everything.That could lead to our schedule being too busy we simply cannot handle it anymore, which is a very bad thing. We would become less productive and more tired, with less time to cool off and regain strength.In that regard, some people have a fear of rejecting certain opportunities that present to themselves, because they feel like they could miss something very important in the future.While sometimes it may be the case, it happens more often that accepting every opportunity you get is a waste of time, because you would spend your very valuable time doing some unimportant things, instead of focusing on doing activities that matter.If you are an entrepreneur, you should focus only on things that are relevant to your li ne of work.In order to develop your business and advance further, you need to focus on improving the way you handle your business, which sometimes means rejecting certain opportunities that are not so important for your company.CONCLUSIONHey folks, that was everything we had prepared for you today. We went over some of the most important fears every entrepreneur can encounter.In order for you to become a successful businessman, you will have to overcome all of these fears, which is not an easy task.With that in mind, we decided to help you a bit further by sharing an excellent video made by Patrick Bet-David, in which he talks about how to conquer all these fears and become a successful entrepreneur.

John Kevin Rudd s Speech New Ideas And Perspectives

Discoveries lead to new ideas and perspectives. These can have many unexpected repercussions that alter many aspects of peoples lives. It is for this reason that discoveries, and the changes they may provoke are often confronting, forcing people to question their previous views, and expectations. Discoveries can adjust the ways we can view things in the past, present and future. Kevin Rudd’s Sorry speech confronts Australia with the truth of past wrongdoings that have taken place against aboriginals. Robert Gray’s Coast Road voices confronting viewpoints of forthcoming change in North Coast Town, and also disturbing discoveries relating to current proceedings in The Meatworks. These many forms of discoveries can potentially, have†¦show more content†¦Implying that they will react responsibly and hopefully reach a self-discovery. As shown, this speech conveys two main thematic concerns. Acknowledgement for the past and the suffering that has been inflicted, and hope of decreasing the initial confrontation that has been carried with the discovery. Optimistically, realising the positives in acknowledgement, and felt in an improved outcome. North Coast Town mainly explores Gray’s self-discovery about his fear of the unknown. The central theme of change is carried throughout the text. It is clear that this subject is confronting to the persona as they are seeing the last of what they recognise to be authentic, being replaced with the newer, industrialised culture. Developments were appearing more and more throughout coastline suburbs in the time which the text is set, as part of a push for the Australian economy. This created more amenities and population, but also tended to lose the original, community township feel. These transformations are conveyed through juxtaposition from the old to the new, the known to the unknown, â€Å"We pass bulldozed acres; the place is becoming chrome. tile-facing and plate glass, they’re making California; pass an Abo, not attempting to hitch, outside town.† This example also displays exaggeration, further developing Gray’s overwhelmed stance, the result of su chShow MoreRelatedExploring Corporate Strategy - Case164366 Words   |  658 Pagesfurniture giant News Corporation – corporate logic and corporate management in a worldwide media business. CRH – impressive international growth of an Irish company driven from a ‘lean’ corporate centre. Numico – difficulties with diversification for a Dutch nutritional products company. AIB – competing in the global banking industry: the challenges for a mid-size bank. SABMiller – an African brewer takes on the world: learning to thrive in difficult circumstances. MacPac – from a New Zealand start-up

Judith Jarvis Thomsons Defense Of Abortion - 1850 Words

The topic of abortion is extremely controversial. There are countless view points on when it is and is not morally permissible to abort a growing fetus. In attempts to understand or perhaps end the controversy, philosophers have pondered the morality of abortion and the many situations that may lead a mother to desire terminating her pregnancy. One such philosopher that explains why it morally permissible in most in situations to have an abortion is Judith Jarvis Thomson. Thomson has a well defended position on the morality of abortion when considering rape, saving the mother’s life and the desire to not have a child. However, Kate Greasley, another philosopher explaining the morality of abortion in various situations, disagrees with†¦show more content†¦Once Thomson laid the foundation for her defense of abortion, she began explaining her views on weather a woman could abort a fetus conceived via rape. However, to make her point, she does not talk directly about a mo ther and her unborn child. Instead, she creates the analogy of a kidnapped person and a forcible attached violinist (Thomson 2). In this analogy, the kidnapped individual is a raped woman and the violinist is the conceived fetus. Thomson furthers this analogy by stating that the kidnapped person is the only one in the world that had a compatible blood type to become the violinist’s dialysis machine and there was no other way to save him. She explains that after only nine months the person would be free and the violinist would be healthy to go on his way. Despite being the good Samaritan thing to do, Thomson claims that the person does not have the moral obligation to stay attached to the violinist. She goes further to say that it would be outrageous to force this person to support the violinist because it seems absurd to put the violinist’s right to life above the right of the person to decide what happened to his/her body (Thomson 2). Considering this conclusion, ther e is a profound problem forcing a raped woman to carry a fetus conceived from that violation to term. In other words, the fetus’ right to life does not outweigh the mothers right to her body when she does not consent to the act leading to conception. Despite Thomson’s clear descriptionShow MoreRelatedIn Don Marquis’ Article, â€Å"Why Abortion Is Immoral†, He1030 Words   |  5 PagesIn Don Marquis’ article, â€Å"Why Abortion is Immoral†, he argues that abortion is seriously immoral, except in rare instances. His main argument implies that it is wrong to kill a fetus because a fetus has a future-like-ours (FLO). In this paper I will analyze Marquis’ main argument, propose an objection to one of his premises, and then reference one of Judith Jarvis Thomson’s points in support of my objection argument. The central argument posed in Marquis’ article goes as such: P1: If a fetus hasRead MoreIs Abortion Morally Permissible?966 Words   |  4 PagesIn Judith Jarvis Thomson’s philosophy paper, A Defense of Abortion, she argues that abortion is permissible because an individual’s right over their own body outweighs a fetus’s right to life. In this paper I will focus on whether or not abortion is always permissible. First, I will present Thomson’s argument which says that abortion is sometimes permissible. I will do so by describing her â€Å"famous violinist† thought experiment. Next, I will object to Thomson’s claim and expand the scope of her argumentRead MoreThe Debate On Abortion And Abortion1448 Words   |  6 PagesAbortion. This word leaves most people feeling uneasy after just saying it out loud. The discussion of abortion is continuously left open-ended with millions of opinions, arguments, and questions. Abortions occur every single day leaving potential fathers devastated or thrilled, leaving friends and families broken and distraught or in contrast, proud. More importantly, leaving the potential mother uncertain and even destroyed. But with abortion in mind, what is considered wrong and what is consideredRead MoreA Defense Of Abortion By Judith Jarvis Thomson921 Words   |  4 PagesAbortion is a major issue that has lead to many different opinions, ideas, and various debates. Proponents for abortion often use the fact that a fetus is not a moral person to justify their position, whereas those who are against the issue often claim that a fetus is a moral person and should deserve every right a moral person has, including the right to live. Judith Jarvis Thomson, however, takes an entirely different approach. In her article â€Å"A Defense of Abortion† Thomson argues that even ifRead MoreA Defense Against Abortion By Judith Jarvis1439 Words   |  6 Pages In her article â€Å"A Defense Against Abortion,† Judith Jarvis Thomson explores the permissibility of abortion through both the rights of a fetus and of a woman, and further argues that abortion is sometimes permissible under circumstantial situations. Thomson offers multiple thought-experiments, but the one I am focusing on in my paper is her burglar-based argument. In short, this situation involves you leaving your window open, knowingly increasing the risk of a burglar entering your home. She furtherRead More The Controversial Issue of Abortion Essay1359 Words   |  6 PagesAbortion is a very controversial topic. This paper will discuss the opposing sides of the issue as well as my own personal opinion. The basic question is when a developing person actually becomes a person or alive. The following articles: A Defense of Abortion, by Judith Jarvis Thomson and Opposition to Abortion: A Human Rights Approach, by Baruch Brody discuss the opposing sides of the abortion is sue. I will be using and summarizing those articles in my evaluation of the topic abortion. Read More A Rational Look at the Abortion Controversy Essay3888 Words   |  16 PagesA Rational Look at the Abortion Controversy One of the most hotly contested issues inside and outside of biomedical ethics today is abortion. The discussion received a new impetus at the release of the controversial abortion drug RU-486, a pill to increase access to abortions and let women get them privately from their own doctor instead of facing shouting protesters at clinics.2 As is the case with all controversial issues, there are very passionate people on both sides of the fence. UnfortunatelyRead MoreEssay on Judith Jarvis Thomson: a Defense of Abortion1946 Words   |  8 PagesJudith Jarvis Thomson: A Defense of Abortion – CRITICAL EXPOSITION The goal of Judith Jarvis Thomson in her defense of abortion is to sway the ideas of those who are against abortion by challenging the arguments they give for thinking so. She begins by stating a premise. â€Å"For the sake of the argument† a human embryo is a person. This premise is one of the arguments most opponents of abortion use, but as she points out, isn’t much of an argument at all. These people spend a lot of their time dwellingRead More A Defense of Abortion by Judith Jarvis Thomson Essay1075 Words   |  5 PagesA Defense of Abortion by Judith Jarvis Thomson In the article A Defense of Abortion Judith Jarvis Thomson argues that abortion is morally permissible even if the fetus is considered a person. In this paper I will give a fairly detailed description of Thomson main arguments for abortion. In particular I will take a close look at her famous violinist argument. Following will be objections to the argumentative story focused on the reasoning that one persons right to life outweighs anotherRead MoreShould Abortion Be Legal For Women?1350 Words   |  6 Pagesmade it legal for women to have an abortion, society continues to debate whether or not women should have the right to have an abortion. Judith Jarvis Thomson’s famous article â€Å"A Defense of Abortion† defends a women’s right to have an abortion. However, I disagree with Thomson’s defense against abortions, and believe that abortions are highly immoral and should be illegal. Many whom are pro-choice argue that a fetus is not a person until birth. However, Thomson’s article is unique in that she openly

The Impact Of Personality And Gender Of Branding Decisions Free Essays

Personality and gender have an impact on branding decisions and reactions by consumers. Therefore, it would serve businesses well if products and services are shaped around customer preferences, knowing their unique and particular needs, and their sense of aesthetics. An evidence to support this contention is a study called ‘visual marketing’ in which participants were shown a slide containing stimuli for testing while an eye-tracking equipment monitored their eye movements. We will write a custom essay sample on The Impact Of Personality And Gender Of Branding Decisions or any similar topic only for you Order Now Afterwards, they were asked to indicate how much they liked/disliked the stimuli. Results showed that there is a clear correlation between the number of fixations on an image and subsequent spontaneous and prompted recall of that stimulus. There is also a better recall of images the participants had liked. This means, therefore, that when advertising or branding a product, the emphasis should be the need to know and understand the target audience, and what they like to see. Factors like space, color, imagery or details were found to have an effect on the beholder. For example, children would associate dark colors with negative emotions while happy emotions for bright ones. They would also prefer large figures to smaller ones. While the marketing rule stipulates that the costumer should always be the focus, however, the factor of the creator and the â€Å"production aesthetic† may deter the accomplishment of this end. Creatives tend to impose their personalities in their creations. Each creative has his/her own sense of self which always, consciously or unconsciously, come out through the work. Behind the brands out there in the market could be the reflection of personalities of the creatives who made them. An implication of this is that creatives will tend to produce work that reflects their own career aspirations, creative impulses, ethics and beliefs. They would produce advertising that appeal to themselves. They would produce work that they find appealing and interesting to them instead of to the consumers, contradictory to the marketing idea that the consumer preferences should take precedence over that of the creatives. Aside from aesthetic preferences, the gender of the creative also affects the branding of products. Gender affects the graphic expression of the individual. One’s shape, color, detailing and perspective preferences are usually associated with the gender one belongs to. To ensure that the product or service appeals to the target consumer, the ‘production aesthetic’ and the ‘preference aesthetic’ should be the same. The personality and gender of the creatives should be aligned with the consumers. Recruiters should hire marketing staff members whose personalities and genders are congruent to the external stakeholders. In an era of high competition, delivering products that appeal to specific customer segments is a high priority. Reference for the journal: Authors: Moss, Gloria Source: The Journal of Brand Management, Volume 14, Number 4, 1 April 2007 , pp. 279-300 Publisher: Palgrave Macmillan How to cite The Impact Of Personality And Gender Of Branding Decisions, Papers

Capital Discipline and Financial Market Relations †Free Samples

Question: Discuss about the Capital Discipline and Financial Market Relations. Answer: The retail market in UK is sailing into a perfect storm. This is because of recession stricken times when there was fall in profits and cutting jobs. Tesco Multinational Corporation had diversified its operations in terms of geography as well as products or services as it is provided to the customers. The supermarket retail chain in UK operates in 14 countries with more than 4811 stores. The employees who are working under Tesco Multinational Corporation are 4,72,000 (Sparrow, Hird Cooper, 2015). From the above pie-chart, it is quite easy to understand that Tesco Multinational Corporation has the highest market share and that is followed by Sainsbury (2nd position). The other company is Morrison, ASDA and other retailing supermarket chain hat operates in UK. Tesco Multinational Corporation dominates the UK market with a market share of around 30.5%. This company was the first company who had launch self-service system in their stores so that they can avoid long queues as it leads to high waiting time. In addition, the company had even arranged for in-store cameras for security purpose. In order to attain competitive advantage over their competitors, Tesco Multinational Corporation manufactures as well as sells its own labeled products (Rosenbaum-Elliott, Percy Pervan, 2015). Financial and Corporate Performance Tesco Multinational Corporation is one of the international companies that have strong reputation in the retail market where they aim at providing quality products as well as services. The supermarket retail giant seek to deliver the best results by providing highest returns to the shareholders as well as beneficial services to the customers and provide safe work environment for the employees (Peppard Ward, 2016). Ethical conduct means performing activities that is morally correct as well as honorable. In order to maintain valuation reputation and build on success, Tesco Multinational Corporation need to conduct the business in a way that is both legal as well as ethical. The corporate governance policies of Tesco Multinational Corporation believe in maintaining level of commitment by conducting ethical business practices. The company gives proper details about the business that comprises of ethical business behavior as well as defining the responsibilities of all the employee and company executives and representatives (Payne Frow, 2013). In addition to that, there were several governance issues that take place at Tesco Multinational Corporation. It was noted that companys admission had overstated figures at the time of half-year profit by 250 million Euros and there was even problem with the composition of Board of Directors and the company was claimed that they were using inappropriate accounting policies (zman, 2017). Ethics plays an important role for determining the level of success of any business enterprise. For instance, when an organization carry out its business operations by using ethical ways, then the company will increase their reputation in the market and finally have positive impact on the business activities. Ethics should be embedded in strategy adopted by company and at the time of decision-making process. However, Tesco Multinational Corporation is corporate social responsible business as well as had made Corporate Social Responsibility as a major role and properly publishes it in the annual report (Jenkins Williamson, 2015). Strategic options Tesco Multinational Corporation had already expanded in countries like UK, Asia, USA and Europe as we as has 6531 stores in and across the world. The supermarket retail chain still continues to open new markets for increasing their current market share as well as market growth (Hubbard, Rice Galvin, 2014). Diversification- It is important to consider the fact that diversification is the most risky strategy where a particular business enterprise enters and there is no information or facts available and has less experience to it. The risk can be a failure of acceptance of products by the consumers for not making enough of sales. However, Tesco Multinational Corporation had diversified their market by launching various non-food products into new market segments. Tesco Multinational Corporation enjoys long-term success because of which the companies remains focus and has main core vision that remain same at the time of implementing corporate strategy change based in changing scenario. It is because of the competitive global environment, if any business enterprise does not have clear vision, then the company actually has direction and may not be able to sustain in the near future. However, Tesco Multinational Corporation had established business strategies so that they can attain or achieve vision and mission statement stated by the company (Hensmans, Johnson Yip, 2013). The strategic management of Tesco Multinational Corporation is of the opinion that the mission statement, vision statement as well as strategic objectives plays major role towards attainment of success and make use of key performance indicators for measuring the level of performance in an organization. The Key performance that can be used by Tesco Multinational Corporation is the Balanced Scorecard approach as it measures both financial and non-financial aspects. There are four major perspectives of balanced scorecard that are addressed properly and these are customer perspective, business process perspective, learning growth perspective and financial perspective. Currently, Tesco Multinational Corporation follows a strategy that will help in maximizing customer value by using market-orientation strategy. The supermarket retail chain aims at providing quality products at a competitive price based on needs as well as preferences of customers. The above diagram shows the Porters generic strategic options adopted by Tesco Multinational Corporation within the next 5 years of time span. It is recommended to Tesco Multinational Corporation for following the generic strategies that had been proposed by Porter as it will help in gaining competitive advantage within next 5 years time frame. However, Tesco Multinational Corporation already has a reputed background where the company provides best quality products at affordable prices to the customers in order to achieve cost leadership with little efforts as it focus more on own label products sell by reducing production costs. Therefore, clearly defined market segment will help Tesco Multinational Corporation to target differentiated range of product lines to specific markets or positioning of few products on wide range of market segments (Goodman Dingli, 2017). Implementation of final strategy After using suitable criteria, three strategic options are determined and it is needed to select the best one for the company that they will follow in the near future. The three strategic options are criteria for suitability as well as acceptability and feasibility and it is needed to be judged for each of the options (Frynas Mellahi, 2015). Suitability- Here, the suitability criteria explain how the organization environment help in measuring the strategic implications of the business enterprise in a given surroundings. It is mainly used for integrating the strengths as well as weakness for efficient implementation of best strategies. The operational aspects of Tesco Multinational Corporation are continuously updated so that they can cope with the fast-changing environmental dynamics. Therefore, the environment as well as the market oriented operations of Tesco Multinational Corporation provide proper platform for implementing the strategies of cost leadership as well as product development largely. Feasibility- Here, feasibility means the scope of Tesco Multinational Corporation for operating in an environment after application of any of the above-listed strategies that need to be evaluated based on financial viability and time duration for implementing the strategy and other important factors such as internal skills as well as competencies that support the strategy option. However, Tesco Multinational Corporation already has a strong financial background as well as huge capital invested in technology that mainly focus more on product development, imitability or leadership strategies options that make Tesco Multinational Corporation occupy the leading position in and across the world. In order to implement these strategies, it is important for Tesco Multinational Corporation to focus on its core competencies and this is possible if the company start recruiting more skilled professionals. Acceptability- Tesco Multinational Corporation already has high brand recognition in the UK market but the company would not take long to implement the strategies in successful ways. The financials of Tesco Multinational Corporation are expected to increase rapidly after they start implementing the suitable strategic option. However, the cost benefit analysis shows benefit in a case where the company had already had upgraded technology operating in their stores as well as opted market oriented strategies that will retain customer loyalty. Therefore, product development as well as cost leadership would be considered as less risky and less costly venture that should be enforced. Monitoring and control of Future Performance The environmental factors as well as operational efficiencies of Tesco Multinational Corporation show the strategy of cost leadership to be best for creation of strategic fit for the company. In addition, the product development strategy had been discarded as compared to other strategies as the supermarket chain deals in wide variety of products as well as services (Frow et al., 2016). The cost leadership strategy mainly covers wide range of products as well as service that provide a boost to the customer purchase rate. However, the market share of Tesco Multinational Corporation is expected to increase where the company ranks in the third position in terms of revenues as it contributes mainly towards their missions of creating customer value. Reference List Borland, H., Ambrosini, V., Lindgreen, A., Vanhamme, J. (2016). Building theory at the intersection of ecological sustainability and strategic management.Journal of Business Ethics,135(2), 293-307. Frow, P., Payne, A., Wilkinson, I. F., Young, L. C. (2016). CRM and customer management: identifying and confronting dark side behaviours.Dark Side of CRM: Customers, Relationships and Management, 21-38. Frynas, J. G., Mellahi, K. (2015). Global strategic management. Oxford University Press, USA. Goodman, M., Dingli, S. M. (2017).Creativity and Strategic Innovation Management: Directions for Future Value in Changing Times. Taylor Francis. Haleem, F., Jehangir, M. (2017). Strategic Management Practices by Morrison PLC, UK. Analysis, Lessons and Implications.Middle East Journal of Business,12(3). Hensmans, M., Johnson, G., Yip, G. (2013). The Three Successful Strategic Transformers: Developments. InStrategic Transformation(pp. 76-96). Palgrave Macmillan UK. Hubbard, G., Rice, J., Galvin, P. (2014).Strategic management. Pearson Australia. Jenkins, W., Williamson, D. (2015).Strategic management and business analysis. Routledge. MacIntosh, R. and Maclean, D., 2014.Strategic management: Strategists at work. Palgrave Macmillan. zman, M. (2017).Strategic Management of Innovation Networks. Cambridge University Press. Payne, A., Frow, P. (2013).Strategic customer management: Integrating relationship marketing and CRM. Cambridge University Press. Peppard, J., Ward, J. (2016).The strategic management of information systems: Building a digital strategy. John Wiley Sons. Rosenbaum-Elliott, R., Percy, L., Pervan, S. (2015).Strategic brand management. Oxford University Press, USA. Samantara, R., Sharma, N. (2014). Talent Management at Tesco HSCA Case Study.Management and Labour Studies,39(4), 477-485. Sparrow, P., Hird, M., Cooper, C. L. (2015). Strategic Talent Management. InDo We Need HR?(pp. 177-212). Palgrave Macmillan UK. Tesco PLC. (2017).Tesco plc. Retrieved 19 October 2017, from https://www.tescoplc.com Varley, R. (2014).Retail product management: buying and merchandising. Routledge. Wood, S., Coe, N. M., Wrigley, N. (2016). Multi-scalar localization and capability transference: exploring embeddedness in the Asian retail expansion of Tesco.Regional Studies,50(3), 475-495. Wood, S., Wrigley, N., Coe, N. M. (2016). Capital discipline and financial market relations in retail globalization: insights from the case of Tesco plc.Journal of Economic Geography,17(1), 31-57.

Vampire Literature Flashcard

Vampire Literature

7 Ways Private School Prepares You for College

7 Ways Private School Prepares You for College When students apply to private school, it’s often with the ultimate goal of getting into a top college. But how exactly does private school prepare you for college? 1. Private Schools Offer Exceptional Academics The Association of Boarding Schools (TABS) researched just how prepared students were for college. When asked, students who attended both boarding schools and privates reported that they were more prepared for college both academically and in non-academic areas than those who attended public school. Private school students were also more likely to earn an advanced degree, with boarding school students coming in with the highest percentage of advanced degrees earned. Why is this? One reason is that private schools are designed to help students develop a love of learning, which means that they are more likely to continue their schooling beyond high school and undergraduate college. 2. Private Schools are Rigorous It’s not uncommon to hear a private school graduate come back from their first year at college saying that it was easier than high school. Private schools are rigorous, and demand a lot of students. These high expectations result in students developing strong work ethics and time management skills. Private schools often require that students participate in two or three sports and afterschool activities, while also offering clubs and activities, in addition to their academics. This heavy schedule means time management skills and a schoolwork/life balance are skills that students master before college. 3. Boarding School Students Learn Independence Students who attend boarding school receive an even better preview of college life, more so than students at a day school. Why? Because boarding school students live in dorms on campus, instead of at home with their families, they learn what it’s like to live independently, but in a more supportive environment than you might find at college. Dorm parents at boarding school play an active role in the lives of boarding students lives, providing guidance and encouraging independence as they learn to live on their own. From laundry and room cleanliness to waking up on time and balancing work and social life, boarding school challenges students to make responsible decisions. 4. Private Schools are Diverse Private schools typically offer more diversity than public schools, as these institutions tend to enroll students from not just one town. Boarding schools go even further, welcoming students from all over the world. Like colleges, diverse environments tend to provide rich experiences, as students live and learn with people from all walks of life. These varied perspectives on current events, lifestyles, and even pop culture references can enhance the academic classroom and broaden personal understanding of the world. 5. Private Schools have Highly Qualified Teachers The TABS study also shows that boarding school students are more likely to report having high-quality teachers than private or public schools. At boarding school, teachers are so much more than just classroom teachers. They are often coaches, dorm parents, advisors, and support systems. It’s common for boarding school students to stay in touch with their teachers long after graduation. Private school teachers typically dont just have teaching certificates, in fact, many private schools value experience over a teaching certificate. Private school teachers tend to have advanced degrees in their subject areas, and often have extensive professional backgrounds in their teaching subjects. Imagine learning physics from an actual engineer, or being coached by a former professional player? Private schools strive to hire the best in the business, and the students benefit greatly. 6. Private Schools Provide Personal Attention Most private schools boast small class sizes. At private schools, an average class size is often between 12 and 15 students, whereas the NCES reports that an average classroom ranges from about 17-26 students, depending on grade level and type of class. These smaller class sizes, which sometimes have more than one teacher, especially in kindergarten programs and primary school programs, mean more personal attention for students, no back row, and no chance of getting overlooked in discussions. Private school teachers are also expected to be available outside of normal class times for extra help, especially at boarding schools. This supportive environment  means  students receive even more opportunities for success. 7. Private Schools Help Students Apply to College Another benefit of boarding school, particularly when it comes to preparing for college, is the assistance students, and their parents, receive in the college application process. College Counseling offices work with students and their families to help find the best fit colleges and universities. As juniors, and sometimes even as freshmen or sophomores, students begin to work with qualified college counselors who help guide them through the college application process. From providing help with researching colleges and universities to reviewing financial aid and scholarships, college counselors work to help students find the schools that will help them thrive. With more than 5,000 colleges and universities in the United States, college counseling services can be invaluable to students and their families. Assistance in finding the right college doesnt just mean finding a school that offers a particular major, either. Private schools also help students capitalize on their strengths during the college admission process. College counselors can help students identify schools with targeted sports or art programs, which can be  helpful if scholarships are available. For example, a student who hopes to eventually pursue an MBA may opt for a college with a strong business school. But, that same student may also be a standout soccer player, and so finding a college with both a strong business program and an active soccer program can be a huge help. Boarding school coaches are often involved in helping student athletes get seen by top college recruiters, which could result in an athletic scholarship to play on an athletic team. College is expensive, and every bit of financial aid support can be a huge help in staving off mounds of student loans.

Supply Management Discussion Essay Example | Topics and Well Written Essays - 750 words

Supply Management Discussion - Essay Example It is only when these processes become difficult to undertake the problem of managing comes within the related equations. What I can propose to the IT Vendor Management is to offer them solutions which will cut back on the delays that are happening within the fore of the department and thus the lags are cropping up for all the wrong reasons. There is reason enough to believe such a premise because it promises quite a lot of understanding and comprehension on the part of the Vendor Management policy decisions and the related undertakings. My role as Manager is magnanimous because it has to pinpoint the exact need which will ascertain as to how the Vendor Management processes would be completed, and before that there is a necessity that any predicaments that come about, like delays within the hiring process, are taken care of immediately. This will make sure that the anomalies within the Vendor Management system are resolved in an amiable fashion. 2 This scenario is a classical example of a company going haywire even though it has made a name for itself within the global markets. HP is such a big name within the printer industry that it has almost become generic. The people associate HP with printers of all sorts, sizes and types. This is the reason why HP is easily adopted by people from different regions of the world and without any hindrances coming to the fore. This is irrespective of the cultural and racial tangents that have been much discussed about. What is important to understand is the fact that the company is doing all it can to make sure that the Supply Chain operations are in line with the different departments which are working under the aegis of HP itself. This will enable HP to have a single-minded business philosophy – to make sure that HP’s products remain supreme more than anything else (New, 2011). Also this will set the ball rolling as far as comprehending how new technological innovations and inventions could easily be decipher ed by the people no matter where they live or what kind of computer (and technological) usage they have within their ranks. Every organization goes through such instances of organizational and cultural issues once in a while, and it is only natural for a Manager like me to take pains with worries of these sorts. What I need to do in the meanwhile is to make sure that the company remains steadfast on to its most basic goals and objectives, and that there are no hiccups within these realms at all. 3 As the National Sales Manager for this pharmaceutical company, I am completely in the loop for the upgrade towards iPad 2 which is a must-have as far as the sales force realms are concerned. They need to be assured that their sales-related tasks and undertakings will not be hampered if they stick to iPad for the meanwhile. However, it is quintessential that they are given a focus test group, which is similar to how they were tested when they were allotted the new iPads. Since the element o f criticality is attached with the provision of iPads and iPad 2s, it is important that I initiate the process of the focus test groups – the sooner the better it will be for the sake of the organization. Also the fact that there is a contract in place with the iPads, it will make the task of not only my own self but also the ones working under me and with me very easier. There would be lesser predicaments that will come to the fore once the sales force is given

Preschool Literature Program Research Paper Example | Topics and Well Written Essays - 1250 words

Preschool Literature Program - Research Paper Example My effort in this regard would be to introduce literature-based instructional program to promote a combination of learning techniques including behavioural, cognitive and constructivist approaches. Selecting literature titles Developing literature-based instruction primarily involves selecting age appropriate literature material for children (Assessing Children’s Literature, 2003). When selecting a title it is important to consider how far children of that particular age group could connect to it. The title needs to make sense to them so that they can understand its meaning. It has to be kept short and simple and tell about the main subject of the story. As children of this age are not aware of abstract concepts, it is wise to have titles that describe concrete objects that children see around them, love to have and that would appeal to their imagination. A teacher could select a title depending on what she/he wants to teach them. So that children start learning values of life through literature and start associating with them from an early age. In this respect it has to be seen that the titles do not harp at any stereotypical ideas, prejudices and biases (Assessing Children’s Literature, 2003) as the main purpose of having literature-based learning is to inculcate liberal values in children. Selection of media When it comes to literature-based instruction for preschool children it is best to opt for an interactive media. Interactive media in this case would mean instructor-led teaching mode. For so small children the teacher would be the best medium for facilitating learning. The teacher or the instructor plays the pivotal role in building up an interactive learning environment either through reading storybooks or providing with audio-visual treat of a story. So whatever media she/he chooses, it is her/his interpretation of the text that the children will eventually pick up. Vygotsky (1985) claims that reading aloud makes way for an interactive p rocess between the adult and the child that helps the child comprehend the meaning of the text. Therefore the teacher has to ensure proper interaction in the class whether it is reading storybooks or audio-visual story-telling. Developmental goals in introducing literature based instruction Language development For preschool children the first step of learning is language learning. Language is best learnt in a given context. Literature provides the context for learning language. When the teacher reads out a story in a class and enacts it too where necessary, the children are introduced to a sea of new words used in a particular context. They not only learn a new word but its specific usage too. Had the word been taught independently, its significance would have been lost on the child. In this way the child’s vocabulary increases and also his ability to comprehend meaning in a given situation (Clay, 1976). Intellectual development Literature helps in developing critical thinki ng and heuristic skill. After reading out a poem or a story, or showing them a visual representation, the teacher should ask open questions about what the children saw or heard and through probing questions encourages the child to think about other alternatives. The teacher’s focus is to develop the child’s intellectual capacity. Personality development The process of interaction involves in forming and

Practice Nurses Role in Treating Chlamydia

Practice Nurses Role in Treating Chlamydia The practice nurses role in treating chlamydia and improving the sexual health of the nation Introduction Chlamydia treatment has been the focus of considerable research interest in the past few years. A huge proportion of what used to be called NSU, or was even undiagnosed non-specific pathology, is now recognised as being due to the chlamydia pathogen. It has now achieved the unenviable status of being considered responsible (numerically) for the greatest amount of sexually transmitted disease in the UK today (Duncan 1998) Given the fact that it is now therefore recognised as being a major contributing factor in the overall picture of sexual health, we must examine ways in which the NHS is set up to tackle the problem. (HPA 2003) As with many health related issues such as this there are a number of subsidiary issues that must be considered in relation to the main theme. These include the role of the screening process in trying to contain the prevalence of chlamydial infection, the practice nurse’s role in that screening process, the current thoughts on the treatment of chlamydia and the practice nurse’s role in not only the treatment, but also the partner tracing activity that is vital to try to stop the spread of the disease. (Fenton et al 2001) The practice nurse is generally ideally placed within the primary healthcare team to act as a central liaison point for many of these activities If we start by considering the whole issue of screening. On one level, one could be forgiven for thinking that the issues relating to screening are actually rather simple. We know that many cases of chlamydia are actually asymptomatic (see on). Given the fact that it can cause considerable damage and is eminently treatable, why not screen for it and get rid of it? Sadly, it is not as simple as that. (Simms et al 1996) The National Institute for Clinical Excellence (NICE) has set up the National Chlamydia Screening Programme (NCSP). It quotes its rationale for doing so as: Genital Chlamydia trachomatis is the commonest Sexually Transmitted Infection (STI) in England Genital chlamydial infection is an important reproductive health problem ~ 10-30% of infected women develop pelvic inflammatory disease (PID). A significant proportion of cases, particularly amongst women, are asymptomatic and so, are liable to remain undetected, putting women at risk of developing PID. Screening for genital chlamydia infection may reduce PID and ectopic pregnancy. The study itself was exemplary in design with an entry cohort of nearly 8,000 patients. The authors considered the efficacy of several different methods of screening and then compared the results of the programmes against the costs of allowing the disease to continue untreated in the community and these include all the sequelae of infertility, pelvic inflammatory disease and ectopic pregnancy in women together with the complications that can occur in the male partners (infertility again) and prostatitis. (Berry et al 1995) The paper even covered the incidence of both pneumonia and eye infections in their children. The structure of the study was quite comprehensive insofar as it compared the results of four separate groups One group received no screening at all, a second group were screened if they exhibited mucopurulent cervicitis, the third group included all women who were less than 30 yrs. old and the last group was all women irrespective of symptoms. The actual screening tool was the Polymerase chain reaction (PCR) which is a very specific and sensitive antibody based test. It was performed on either urine or direct cervical samples. (Barlow et al 2001) The study protocol then called for all positive testing patients to receive treatment with doxycycline for seven days. The analysis section of the paper is both long and complex. We shall therefore condense our examination of this part of the study into an examination of the results. The overall treatment costs of treating all of the medical complications of chlamydial infection was calculated as $676,000. Each of the positive screening strategies produced a significant reduction in the expected cost of complications that was greater than the cost of the actual screening exercise. A condensation of the tabulated results is shown here: Screening method Screening costs ($) Medical costs ($) Total cost ($) Number of PID cases PID cases prevented No screening 676,000 676,000 152 CDC criteria 55,000 390,000 446,000 88 64 Women 75,000 297,000 372,000 67 85 Universal screening 120,000 270,000 391,000 61 91 The results need little explanation, as it can be clearly seen that both the costings and the number of cases prevented argue strongly for a case for screening. The only point of contention is the decision on the population that the health care system will fund for screening. Overall, the authors state that their regime reduced the incidence and prevalence of pelvic inflammatory disease by 60% when compared to the unscreened group. The other significant factor was that, taking all groups as an average, they noted a total healthcare saving of about $50 per woman screened, and this clearly does not take any account of any associated comorbidity, pain and suffering that is caused by the chlamydia infection A further corollary can be drawn from the results. The authors went on to provide an impressive statistical analysis of the comparative costs of different community groups with different rates of prevalence. Of great importance to our considerations here was the fact that the authors concluded that the cost of screening was cost effective when the incidence of infection in a population of asymptomatic women was above 1.1%. when the incidence rose above 11% then they found that the screening of all women and their partners became the most effective strategy. To some extent, this study can be considered the â€Å"gold standard† for most of the studies in this area. It is well conceived, meticulously executed and well and thoughtfully analysed to give meaningful results which are of great practical importance. Despite such comments it should be noted that there are a number of negative points to be considered in this particular study. The universal treatment constant was the seven day doxocycline treatment. We should note (as the authors did) that there is therefore a potential for non-compliance with the whole seven day regime, and this may introduce a potential source of bias in the figures(Haddix et al.1995). We can also point to other studies that have addressed this particular problem with a one dose treatment regime (azithromycin). It is fair to note that despite the potential for bias, extrapolation to these other studies does not appear to show significant differences in the overall results (Lea et al 1997) The issue of screening, although covered reasonably comprehensively in the last paper, certainly as far as matters of cost are concerned, is examined further in the paper by (Duncan et al. 2001). This paper approaches the issues from a different perspective. It includes the issues of male screening And takes an overview of the Public Health issues from a sociological viewpoint, which makes it, (in our examination of the current literature), almost unique. We should note that we have already addressed the issues faced by the NCSP, but the other major public document in this area is the report commissioned by the Chief Medical Officer (CMO 1998). It is instructional to discuss the recommendations of this group as they differ significantly from the screening criteria used in the previous paper. The recommended groups for screening here are the following: Everyone with symptoms of chlamydia infection, All those attending genitourinary medicine clinics, Women seeking termination of pregnancy.1 Opportunistic screening of young sexually active women under 25 years Women over 25 with a new sexual partner or two or more sexual partners in the past year. In the context of our considerations here, we should note that the advisory group identified the optimum sites for screening as the primary healthcare team (family planning clinic) as well as the usual GUM clinics. (Stokes 1997) The Duncan paper is particularly well written and a major point that comes from it is in sharp contrast to that found in the Howell study. One of the criteria that they suggest for screening males in the population is that women may find that being screened has connotations of being dirty and unattractive A positive result is said to be associated with promiscuity. The authors suggest that not screening men not only fosters gender inequalities but it reduces the Public Health impact on the Man’s responsibilities for sexual health. (Pierpoint et al 2000) There is no argument that this is a valid point, but the paper does not produce any evidence to show that male screening has a positive impact on the cost-effectiveness of the screening procedure. (Stephenson et al 2000) The paper does however, contrast these statements with the accepted fact that women are actually easier to target than men, as they are generally heavier health care users than men in the major at risk age range. (Oakeshott et al 1998) The paper points to the need to tackle the issues of sexual inequality, as it could be considered that the screening programmes may have less than the desired effect if they are perceived by women to be little more than surveillance of their particular sexual habits. It draws a clear analogy between a women only screening programme for chlamydia and the well established women only cervical cytology screening clinics. The paper quotes (Holgate et al 1998) in the comment: The potentially adverse consequences of sexual intercourse a private event can be surveyed and treated through screening services a publicly based and funded system . It is women who transcend this private, public dichotomy and find their lives scrutinised in a manner alien to men . The focus is commonly upon women both as transmitters and contractors of relevant viruses as both those whose cervixes are surveyed and whose sexual activity comes under surveillance. The paper then has a long middle section which, as a critical analysis, is little more than a diatribe against women being singled out for screening. It is fair to say that all of the arguments put forward are valid, to a degree, but are presented with a strongly feminist viewpoint, which is both understandable and worthy of merit form a sociological standpoint. The arguments are not however, convincing from a scientific, financial or practical perspective. The conclusions of the paper are entirely justified in calling for a greater understanding of the woman’s point of view when organising and running screening clinics, in order to broaden their appeal to the target groups. (Santer et al 2000) With specific reference to the role of the nurse in the primary healthcare team screening for chlamydia we can now turn and examine an excellent paper by Grun (et al 1997) which looked at two different methods of screening for chlamydia in a nurse run primary healthcare setting. The study set out to try to accurately determine the prevalence of chlamydia in the North London area using the ligase chain reaction (LCR) technique which is similar to the PCR mentioned earlier. (Butt et al 2001) This particular study used the rather labour intensive cervical scrape method for sampling, which had the added benefit that cervical cytology could be assessed at the same time. The paper is quite detailed in its description of its method and appears to be rigorous in its execution. It is worthy of our consideration here because of it’s direct relevance to our prime consideration. The results and conclusions of the paper make for interesting reading One of the more significant conclusions was that, on the basis of their findings, if there was a policy of simply screening all women aged 25 and all women who had had two or more partners in the past year, they would have detected 20 out of a possible 23 positive chlamydia infections in their cohort. The authors make a salient comment that including other screening criteria such as marital status (which has been suggested by other authors [Lossick JG, et al 1996]), would have made no statistically significant impact on their detection rate. They also make the comment, in line with the other authors we have examined, that selective screening appears to be more cost effective than universal screening, although the actual cost implications were not specifically considered in this paper. In contrast to the Howell paper, it suggests that screening become a viable tool when the community prevalence rate approaches 5% The fourth paper to be reviewed is the more recent paper by Adams (et al 2004). This paper takes a more general overview of the whole issue of chlamydia in the UK. This is effectively a meta analysis of nineteen different papers (selected from 357 studies) which report the incidence of chlamydia as tested by the PCT method on urine samples. This is significant as it is the first meta analysis to be carried out on UK data. (Armitage et al 2001) The results are extremely detailed and many are only of marginal relevance to our considerations here. We shall restrict our comments to those aspects that are specifically relevant. Firstly, the authors comment on the current prevalence of 8.1% of the population testing positive in the under 20 age group, progressively diminishing to 1.4% in the over 30 group. The significance of this is that it is very much lower than other studies. For example studies set in GUM clinics put the prevalence in the under 20 age group in the region of 17% and antenatal clinics at about 12%. (Piementa et al 2003) This may therefore have relevance in targeting of specific at risk groups. It should be noted that this study gave no data with regard to the incidence of chlamydia in the male population. (Dixon et al 2002) Our comments made earlier about the asymptomatic nature of the bulk of the infections, is borne out in the fact that only 8% of those tested and found to be positive, actually volunteered that they had any genital symptoms (of any sort). Another important consequence of this study is the fact that it highlights the comparatively high detection rate to be found in attenders at primary healthcare team premises. This shows a gap in the reasoning and recommendations of the National Sexual Health and HIV Strategy for England (D of H 2002) which currently suggests targeting GUM clinics and family planning centres as prime sites for screening centres. Following on from the reasoning expounded in the last paper, we can look at a provocatively entitled article by Kufeji (et al 2003)† Who is being tested for genital chlamydia in primary care?† The paper makes the point that we already have enough evidence to clearly identify the target populations that are the most likely to give a good yield as far as screening is concerned (viz. the most â€Å"at risk† groups). The raison d’à ªtre of this paper was to compare the characteristics of the actual groups screened with the characteristics which we know to be representative of the groups most likely to be at risk. The corollary of this reasoning being that if the two groups do not match then all the calculations made about the cost effectiveness of a selective screening process do not hold water. (Kinn et al 2000) The most striking feature of this paper is the fact that we know (Adams et al 2004) that the maximum age incidence for chlamydia is in the sexually active under 20 age group and the incidence rapidly decreases with age to the over 30 age group. Kufeji and his co-workers found that the majority of the tests done (63%) were done on the over 25 yr. age group where we would expect the results to be positive only in about 1.5% of the population. Adams’ findings were confirmed with a positive rate of 13.3% found in the under 20 yr. olds tested. The paper also point to the fact that the practices studied had a comparatively high healthcare staff to patient ratio. In the practices where the ratio was lower, even less opportunistic testing was done. (Shefras et al 2002) This correlates to the finding that the Townsend score ( of social deprivation) correlated highly with both a reduction in the amount of testing and an increase in the prevalence of chlamydia. In the words of the authors the study points to the fact that screening programmes for chlamydia in primary healthcare settings suffer from â€Å"a selection bias and social desirability bias, and they do not aim to provide complete descriptive information on testing patterns across a population.† It should be noted that this particular study was not just on a small sample. The authors took as their entry cohort all of the 119 General Practices in Nottingham which collected a total of over 7,000 samples. The authors note that the number of tests done in General Practice is increasing at about 35% per year. It follows that if a significant number of these are inappropriately targeted, this has profound implications for the related costings of the exercise. One other salient point in this study was the fact that only 1 in 40 tests were done on men. (Chernesky et al 1999) The last major paper that we shall review in this section is the paper by Cassell (et al 2003) this deals with the thorny issue of partner notification when screening turns up a positive result. Hitherto contact tracing had largely been in the realms of the GUM contact tracing nurse. With the expansion of the screening role into the realms of General Practice and other clinics, the contact tracing role has also expanded and may well have lost some of it’s efficiency due to both a lack of skill, time and resources. (D of H 2002). Cassell and her colleagues have tried to investigate the extent to which this perceived reduction in contact tracing may be responsible for the relentless increase in the overall incidence of chlamydia. (Radia et al 2001). The study was done by postal questionnaire to all GPs in Nottinghamshire. They got a 56% response rate. Arguably the most significant finding of the study was the fact that 86% of respondents considered that chlamydia testing was part of the remit of the primary healthcare team, while only 40% considered that partner notification was a primary healthcare team role. The rationale for this was, that most of the non-contact tracing respondents felt that it was their role to inform the patient that they should inform their partners. Given the fact that we have evidence from the Duncan paper that women tend to equate a positive test with promiscuity and being â€Å"dirty†, it is perhaps not surprising that a substantial number of partners do not get told. If you add to this number the unknown number of chlamydia infections that may have come from clandestine or extramarital liaisons, then this number may be higher still. This is clearly both hypothesis and conjecture but it would seem to be dictated by common sense. The paper goes into considerable detail about the reasons why different primary healthcare teams have different practices, but rather worryingly a surprising 20% treat chlamydia with a dose of antibiotic which is less than the currently recommended therapeutic level recommended by the Central Audit Group for Genitourinary Medicine, (Stokes et al 1997) The difficulty of a postal questionnaire study is that there is an intrinsic bias in the study design. It is quite conceivable that the 56% of primary healthcare teams who responded were the ones who may have been sufficiently motivated to be positive about matters to do with chlamydia and may therefore have been better informed that those who did not respond. In the words of the authors â€Å"our study probably over-represents primary healthcare teams already testing for chlamydia and may exaggerate the extent of good practice.† The paradox outlined by this study is that while the majority of GPs and their teams are already willing to assume the mantle of diagnosing and managing chlamydial infection, the same majority agree that contact tracing is the main difficulty in managing these patients. The study made enquiries relating to the presence of follow up strategies which were designed to minimise the risk of further infection and found that there was â€Å"very little evidence to be found† other than by putting the onus on the patient to tell their partners. It follows from this observation, and the authors put it quite succinctly: If testing in primary care continues to increase without adequate support for partner notification, much of the resource used in testing women will be wasted. (Griffiths et al 2002) If we accept the premise that an increasing amount of chlamydia screening will be done in General Practice in the future, it is likely that an increasing proportion will fall to the practice nurse or the family planning nurse specialist. (Stokes et al 2000). If this is the case, then it is common sense to maximise the benefit of chlamydia screening by supporting the healthcare professionals with time and resources to perform proper contact tracing to minimise the risk of re-infection. (EHC 1999) Conclusions In this review we have selected six primary papers which each represent a significant contribution to the evidence base in our knowledge of the rationale for screening and treatment of chlamydia infection. (Sackett 1996) From our examinations it is clear that there is a considerable disparity in the figures pertaining to the prevalence of chlamydia infection in the community. The paper by Adams (Adams et al 2004) gives us a partial rationale for this and that is that studies done in different areas of health care practice will yield different results because they have a different clientele. It is not, perhaps, surprising that a study done in a GUM clinic will report different prevalences than a study done in a General Practice setting. The common factor that runs through all of the papers examined is the fact that it is rare to find that men are screened. Generally the figures suggest about 2-5% of men are screened when compared to the number of women. There is no evidence to suggest that they have lower infection rates than women and, according to Duncan (et al 2001), there are a number of very good sociological reasons why men should be screened as frequently as women. The fact of the matter is that women are subject to screening with much greater frequency than men and therefore bear the brunt of both the indignity and the responsibility. There is no doubt however, that the case for screening and treatment and contact tracing is made on both economic and health grounds. It is equally clear that the practice nurse has a central role in the efficient administration of all of these vectors to varying degrees. The advent of nurse prescribing (Legge 1997) will make the practice nurse as valuable in this area as they already are in both the screening and contact tracing roles. The only concern here is that according to Kufeji (et al 2003) we are collectively targeting the wrong population in terms of efficacy and efficiency. References Adams EJ , A Charlett, W J Edmunds, and G Hughes 2004 Chlamydia trachomatis in the United Kingdom: a systematic review and analysis of prevalence studies Sex. Transm. Inf., October 1, 2004; 80(5): 354 362. Armitage P, Berry G, Matthews J. 2001 Statistical methods in medical research. Malden, MA, 2001. Barlow RE, Cooke ID, Odukoya O, et al. 2001 The prevalence of Chlamydia trachomatis in fresh tissue specimens from patients with ectopic pregnancy or tubal factor infertility as determined by PCR and in-situ hybridisation. J Med Microbiol 2001;50:902–8 Berry J, Crowley T, Horner P, et al. 1995 Screening for asymptomatic Chlamydia trachomatis infection in male students by examination of first catch urine. Genitourin Med 1995;71:329–30. Butt A, McCartney R, Walker A, et al. 2001 Economic advantages of ligase chain reaction for diagnosis of genital Chlamydia trachomatis infection in GUM clinic attenders. Sex Transm Infect 2001;77:227–8. Cassell JA , M G Brook, R Slack, N James, A Hayward, and A M Johnson 2003 Partner notification in primary care Sex. Transm. Inf., June 1, 2003; 79(3): 264 265. Chernesky M, Lee H, Schachter J. 1999 Diagnosis of a Chlamydia trachomatis uretral infection in symptomatic and asymptomatic men by testing first void urine in a ligase chain reaction assay. J Infect Dis 1999;170:1308-11. CMO 1998 Chief Medical Officer. Main report of the Chief Medical Officers Expert Advisory Group on Chlamydia trachomatis. London: Department of Health , 1998. Dixon L, Pearson S, Clutterbuck DJ. 2002 Chlamydia trachomatis infection and non-gonococcal urethritis in homosexual and heterosexual men in Edinburgh. Int J STD AIDS 2002;13:425–6. D of H 2002 (I) Department of Health. The national strategy for sexual health and HIV: implementation action plan. London: DoH, 2002. D of H 2002 (II) Department of Health. Action plan for the sexual health strategy for England. London: DoH, 2002 Duncan B, Hart G. 1998 Screening for Chlamydia trachomatis: a qualitative study of womens views. Prevenir 1998; (suppl 24): 229. Duncan B, Graham Hart, Anne Scoular, and Alison Bigrigg 2001 Qualitative analysis of psychosocial impact of diagnosis of Chlamydia trachomatis: implications for screening BMJ, Jan 2001; 322: 195 – 199 EHC 1999 Effective Health Care. Getting evidence into practice. York: University of York, 1999. Fenton KA, Korovessis C, Johnson AM, et al. 2001 Sexual behaviour in Britain: reported sexually transmitted infections and prevalent genital Chlamydia trachomatis infection. Lancet 2001;358:1851–4. Griffiths C, Cuddigan A. 2002 Clinical management of chlamydia in general practice: A survey of reported practice. J Fam Plann Reprod Health Care 2002;28:149–52. Grun L Julia Tassano-Smith, Caroline Carder, Anne M Johnson, Angela Robinson, Elizabeth Murray, Judith Stephenson, Andrew Haines, Andrew Copas, and Geoffrey Ridgway 1997 Comparison of two methods of screening for genital chlamydial infection in women attending in general practice: cross sectional survey BMJ, Jul 1997; 315: 226 230 Haddix AC, SD Hillia, WJ Kassler. 1995 The cost effectiveness of azithromycin for Chlamydia trachomatis infections in women. Sexually Transmitted Diseases 1995 22:274-80. Harry T, Saravanamuttu K, Rashid S, et al. 1994 Audit evaluating the value of routine screening of Chlamydia trachomatis urethral infections in men. Int J STD AIDS 1994;5:374–5 Holgate HS, Longman C. 1998 Some peoples psychological experiences of attending a sexual health clinic and having a sexually transmitted infection. J R Soc Health 1998 Howell MR , TC Quinn, CA Gaydos. 1998 Screening for Chlamydia trachomatis in asymptomatic women attending family planning clinics. Annals of Internal Medicine 1998 128:277-84 HPA 2003 Health Protection Agency, SCIEH, ISD, National Public Health Service for Wales, CDSC Northern Ireland, UASSG. Renewing the focus. HIV and other sexually transmitted infections in the United Kingdom in 2002. London: Health Protection Agency, 2003 Kinn S, Macnaughton J, Noone A, et al. 2000 Chlamydia trachomatis in primary care: knowledge and practice in Glasgow. Br J Gen Pract 2000;50:214–15 Kufeji O, R Slack, J A Cassell, S Pugh, and A Hayward 2003 Who is being tested for genital chlamydia in primary care? Sex. Transm. Inf., June 1, 2003; 79(3): 234 236. Lea AP, HM Lamb. Azithromycin. 1997 A pharmacoeconomic review of its use as a single-dose regimen in the treatment of uncomplicated urogenital Chlamydia trachomatis infections in women. Pharmacoeconomics 1997 12:596-611. Legge. A 1997 Nurse prescribing is a success BMJ, Feb 1997; 314: 461. Lossick JG, et al. 1996 Recommendations for the prevention and management of Chlamydia trachomatis infection, 1996. MMWR 1996;42:1-37. Oakeshott P, Kerry S, Hay S, et al. 1998 Opportunistic screening for chlamydial infection at time of cervical smear testing in general practice: prevalence study. BMJ 1998;316:351–2. Pierpoint T, Thomas B, Judd A, et al. 2000 Prevalence of Chlamydia trachomatis in young men in north west London. Sex Transm Infect 2000;76:273–6. Pimenta JM, Catchpole M, Rogers PA, et al. 2003 Opportunistic screening for genital chlamydial infection. II: Prevalence among healthcare attenders, outcome, and evaluation of positive cases, Sex Transm Infect 2003;79:22–7 Radja N, Slatter E, Thin N, et al. 2001 A tale of 2 cities: a comparison of demographic details, source of referral, spectrum of infection and contraceptive practice in patients under 16 years attending genitourinary medicine clinics in London and Swansea. Int J STD AIDS 2001;12:361–4. Sackett, (1996). Doing the Right Thing Right: Is Evidence-Based Medicine the Answer? Ann Intern Med, Jul 1996; 127: 91 94. Santer M, Warner P, Wyke S, et al. 2000 Opportunistic screening for chlamydia infection in general practice: can we reach young women? J Med Screen 2000;7:175–6. Shefras J, Edmondson S, McNulty C. 2002 Countywide survey of the current practice of chlamydia detection in primary care. J Fam Plann Reprod Health Care 2002;28:145–8. Stephenson J, Carder C, Copas A, et al. 2000 Home screening for chlamydial genital infection: is it acceptable to young men and women? Sex Transm Infect 2000;76:25–7. Stokes T. 1997 Chlamydia infection in UK family planning clinics. Br J Fam Plan 1997;23:47–50. Stokes T, Bhaduri S, Schober P, et al. 1997 GPs’ management of genital chlamydia: a survey of reported practice. Fam Pract 1997;14:455–60 Stokes T, Mears J. 2000 Sexual health and the practice nurse: a survey of reported practice and attitudes. Br J Fam Plann 2000;26:89–92 Wilson JS, Honey E, Templeton A, et al. 2002 A systematic review of the prevalence of Chlamydia trachomatis among European women. Human Reproduction Upda

Human Genome Essay

Human cloning involves the creation of a copy of a human cell or tissue that is genetically identical. The major types of human cloning include reproductive cloning and therapeutic cloning (National Human Genome Research Institute, 2009). Therapeutic cloning involves the use of cells from an adult to be used in medicine while reproductive cloning involves making cloned human beings. Cloning has been done on both animals and plants. When done on plants it has been used to raise genetically modified crops. Gene therapy can occur in two forms somatic gene therapy and germline gene therapy. Somatic gene therapy involves removing cells from the patient and adding cloned genes to cells using a viral vector. The cells are amplified and those that have taken up the cloned gene are taken up. The transformed cells are then taken back into the patient (see figure 1). Some of the problems associated with this procedure include transgene integration and immune response killing the viral vector which may be marked as an intruder by the body’s immune system. The procedure has been used in many clinical trials, mainly for treating cancer. The Adeno associated virus is commonly used in this case as it does not cause an immune response, it has the ability to enter non-dividing cells and it integrates into a particular location in the genome of its host (National Human Genome Research Institute, 2009). Germline gene therapy is different from somatic therapy in that the newly introduced gene is incorporated into all of the cells in the animal’s body. This includes the germline that gives rise to gametes. The change that has occurred in the process is passed on to the next generation. To produce a transgenic animal, the embryo stem cells could be modified which is done by isolating stem cells and culturing them, adding DNA to cultured cells and selecting the transformed cells (National Human Genome Research Institute, 2009). Once selected, the transformed cells are injected into an early embryo and the embryo is implanted into the female. This produces mosaics in which some cells have different genotypes. Heterozygotes are mated to produce homozygous individuals which are in turn mated to produce a transgenic strain (National Human Genome Research Institute, 2009). A transgenic animal could also be produced by direct DNA injection where the transgene is injected directly into the male pronucleus before the male and female have fused (National Human Genome Research Institute, 2009). The injected DNA integrates into a chromosome and the injected zygote is then implanted into a foster mother (see figure 2). In the figure the baby mouse has the transgene in every cell in its body. Its expression depends on where the chromosome is integrated. Nowadays, however it is possible to have targeted gene insertion in some cases. Some of the medical applications of transgenic animals and plants include the production of model systems for the study of human disease for example where a certain gene product is lacking or where a certain gene has been over expressed or where there is a gene variant. An example of this the use of transplanted human stem cells by NIH scientists to improve the repair of bone injuries in rats (Guldberg, 2010). Standardization of such a treatment it offers a possible alternative to bone grafting operations. One of the successes of stem cell transplants has been seen in the successful attempts of new hematopoietic stem cell (HSC) in reversing sickle cell anemia in children (Rodgers et al, 2009). Other applications include the production of medically important proteins, the production of vaccines and production of tissues and organs for transplantation. Transgenic plants are also used to improve crops. In spite of these advantages, the issue of cloning still remains controversial.