Managing Products and Services Assignment Example | Topics and Well Written Essays - 2250 words

Managing Products and Services - Assignment Example banking, insurance, communications, transportation, travel and entertainment. Today, more than 60% of economy in developed countries depends upon service industry and more than 74% in United States alone. Therefore, today the experts seem to be more interested in focusing how to manage and market their services instead of products. This essay will help to understand the main features of this rapidly growing industry of present era. [1] Before the advent of service industry, the definition of product used to encompass the functionality of service as well because that service was particularly related to those products. This type of service is known as 'after-sales service'. But now due to increased interest in pure service industry, the scholars and professionals have begun to point out the differences between the two. Both product and service are offered to the customers with the aim of fulfilling their needs and demands and earning profits in return. But the literature tells us that it is the 'characteristics' of service which make it different and configurable in comparison to product. Those characteristics are explained as follows: [1] Intangibility: A service is intangible because it cannot be touched, seen, possessed, owned etc. Before using the service, a customer is unknown about its quality. And the service provider cannot assess and control the quality of service until and unless it receives the feedback of customers. It totally depends upon client expectations. So the customer is always uncertain about the value and quality of a service that he/she can experience after its use. Inseparability: A service is inseparable from its provider. That's if the provider is not present the customer cannot use the service e.g. A patient cannot be treated until and unless a physician is present to examine him/her. It also poses that often a customer wants the service to be provided in a specific way or by some specific individual __ it enhances the pressure of perfection in that particular individual that directly provides the service. Perishability: The service cannot be stored for future use or to present to someone as the specimen of quality. If the customer does not avail it, he cannot expect it to be there in the same condition, value etc in future as well e.g. if a client misses the appointment with lawyer that time can never be captured again. At one time the rooms in the most renowned hotel of the city are available but after a few days you might not get a single room vacant there. It means service greatly depends upon supply and demand. Variability: The quality and consistency of service is subject to greater change because it is delivered by 'people' and the behavior of human beings cannot be controlled. They can be in good temperament at one time and in a depressed mood the other. Thus, the quality of service greatly depends upon experience, knowledge, attitude, style, personality etc of the provider e.g. in a restaurant one waiter provides excellent service but another hardly knows how to please a customer. These characteristics show that provision of service or 'service production' is totally based upon 'personnel contact', also called 'people contact'; while a 'product manufacturing' does not need people (customers) for its completion. Both product and service are of two types in nature. [2]

Fashion Trend in 2009 Case Study Example | Topics and Well Written Essays - 750 words

Fashion Trend in 2009 - Case Study Example The study "Fashion Trend in 2009" concerns the 2009's trend. The target market segment for the new designed products is middle market. The availability of cotton products in the middle class are only nominal due to the high production cost relating to the organic cotton products. Through direct purchasing and synthesizing of raw material the production cost can be signicantly reduced. This will help to focus on the middle market through appropriate pricing policies. â€Å"The purpose for segmenting a market is to allow your marketing/sales program to focus on the subset of prospects that are "most likely" to purchase your offering. If done properly this will help to insure the highest return for your marketing/sales expenditures.† The in-store presentation of the product will be in a sophisticated manner by using attractive presentation and display tactics. There should be separate section for the Y’s Passion series in the shop. The section will be made attractive by us ing glass tubes and light presentation. The product range should be of T -shirts clothing which is suitable for both men and women category. It will be available in 5 elegant colors. Comfortably fitting and skin friendly material renders a cool effect by easily absorbing the sweat. Products with unique and attractive modern designs which are affordable even to the middle class consumers, are the main feature of ‘Y’s passion’. Overall image of the product should be differentiated by its color and trendy designs and the fact that it is made from cotton. 100% pure organic cotton. The product must carry a new brand name followed by the company name. The brand name for the product range is "Y's Passion" which is a catchy one that will evolve interest and immediate attention. Following are the images of Y's Passion range products: Product features: "100% organic cotton, Color: Jersey Crewneck, 4 plus color fastness, shrinkage is less than 4 %." (Packing Bags: Organic Cotton T-Shirts). Product features: "Avocado Green", "Size: 5.8-oz. standard weight, double-needle stitching, cover-stitched hems, durability." (Visualize World Peas Women's Organic T Shirt Avocado Green). Product feature: Made from 100 % pure organic cotton, yellow haze, size: XL (100% Organic Cotton - (eco dad) T Shirt Yellow Haze XL (Extra Large)). 5. Dominant trends: The color of the products is its main interesting factor and attractive stylish rare color combinations are used for the product design. The environment friendly, high quality, perfect fit, highly stylish, comfortable, very insignificant percentage of shrinkage, fine fabric strength, textures and color fastness are other attractive features of the product. Moreover, the increasing popularity of cotton garments is an added advantage to the product, "Sales of organic cotton are set to triple to $2.6 billion at the end of 2008 from its current $900 million level as retailers and brands make significant new commitments to sustainable textile and apparel production." (Mowbray). 6. Country of manufacture: The manufacturing country for the product is India because of the availability of organic

Blood pressure Essay Example for Free

Blood pressure Essay Blood pressure (BP), sometimes referred to as arterial blood pressure, is the pressureexerted by circulating blood upon the walls of blood vessels, and is one of the principal vital signs. When used without further specification, blood pressure usually refers to thearterial pressure of the systemic circulation. During each heartbeat, blood pressure varies between a maximum (systolic) and a minimum (diastolic) pressure.[1] The blood pressure in the circulation is principally due to the pumping action of the heart.[2] Differences in mean blood pressure are responsible for blood flow from one location to another in the circulation. The rate of mean blood flow depends on the resistance to flow presented by the blood vessels. Mean blood pressure decreases as the circulating blood moves away from the heart through arteries and capillaries due to viscous losses of energy. Mean blood pressure drops over the whole circulation, although most of the fall occurs along the small arteries and arterioles.[3] Gravity affects blood pressure via hydrostatic forces (e.g., during standing) and valves in veins, breathing, and pumping from contraction of skeletal muscles also influence blood pressure in veins.[2] The measurement blood pressure without further specification usually refers to the systemic arterial pressure measured at a persons upper arm and is a measure of the pressure in the brachial artery, major artery in the upper arm. A person’s blood pressure is usually expressed in terms of the systolic pressure over diastolic pressure and is measured in millimetres of mercury (mmHg), for example 120/80. The table on the right shows the classification of blood pressure adopted by the American Heart Association for adults who are 18 years and older.[4] It assumes the values are a result of averaging blood pressure readings measured at two or more visits to the doctor.[6][7] In the UK, blood pressures are usually categorised into three groups: low (90/60 or lower), high (140/90 or higher), and normal (values above 90/60 and below 130/80).[8][9] Normal range of blood pressure While average values for arterial pressure could be computed for any given population, there is often a large variation from person to person; arterial pressure also varies in individuals from moment to moment. Additionally, the average of any given population may have a questionable correlation with its general health; thus the relevance of such average values is equally questionable. However, in a study of 100 human subjects with no known history of hypertension, an average blood pressure of 112/64 mmHg was found,[10] which are currently classified as desirable or normal values. Normal values fluctuate through the 24-hour cycle, with highest readings in the afternoons and lowest readings at night.[11][12] Various factors, such as age and sex influence average values, influence a persons average blood pressure and variations. In children, the normal ranges are lower than for adults and depend on height.[13] As adults age, systolic pressure tends to rise and diastolic tends to fall.[14] In the elderly, blood pressure tends to be above the normal adult range,[15] largely because of reduced flexibility of the arteries. Also, an individuals blood pressure varies with exercise, emotional reactions, sleep, digestion and time of day. Differences between left and right arm blood pressure measurements tend to be random and average to nearly zero if enough measurements are taken. However, in a small percentage of cases there is a consistent difference greater than 10 mmHg which may need further investigation, e.g. for obstructive arterial disease.[16][17] The risk of cardiovascular disease increases progressively above 115/75 mmHg.[18] In the past, hypertension was only diagnosed if secondary signs of high arterial pressure were present, along with a prolonged high systolic pressure reading over several visits. Regarding hypotension, in practice blood pressure is considered too low only if noticeable symptoms are present.[5] Clinical trials demonstrate that people who maintain arterial pressures at the low end of these pressure ranges have much better long term cardiovascular health. The principal medical debate concerns the aggressiveness and relative value of methods used to lower pressures into this range for those who do not maintain such pressure on their own. Elevations, more commonly seen in older people, though often considered normal, are associated with increased morbidity and mortality. Physiology There are many physical factors that influence arterial pressure. Each of these may in turn be influenced by physiological factors, such as diet, exercise, disease, drugs or alcohol, stress, obesity, and so-forth.[20] Some physical factors are: †¢ Volume of fluid or blood volume, the amount of blood that is present in the body. The more blood present in the body, the higher the rate of blood return to the heart and the resulting cardiac output. There is some relationship between dietary salt intake and increased blood volume, potentially resulting in higher arterial pressure, though this varies with the individual and is highly dependent on autonomic nervous system response and the renin-angiotensin system.[21][22][23] †¢ Resistance. In the circulatory system, this is the resistance of the blood vessels. The higher the resistance, the higher the arterial pressure upstream from the resistance to blood flow. Resistance is related to vessel radius (the larger the radius, the lower the resistance), vessel length (the longer the vessel, the higher the resistance), blood viscosity, as well as the smoothness of the blood vessel walls. Smoothness is reduced by the build up of fatty deposits on the arterial walls. Substances called vasoconstrictors can reduce the size of blood vessels, thereby increasing blood pressure. Vasodilators (such as nitroglycerin) increase the size of blood vessels, thereby decreasing arterial pressure. Resistance, and its relation to volumetric flow rate (Q) and pressure difference between the two ends of a vessel are described by Poiseuilles Law. †¢ Viscosity, or thickness of the fluid. If the blood gets thicker, the result is an increase in arterial pressure. Certain medical conditionscan change the viscosity of the blood. For instance, anemia (low red blood cell concentration), reduces viscosity, whereas increased red blood cell concentration increases viscosity. It had been thought that aspirin and related blood thinner drugs decreased the viscosity of blood, but instead studies found[24] that they act by reducing the tendency of the blood to clot. In practice, each individuals autonomic nervous system responds to and regulates all these interacting factors so that, although the above issues are important, the actual arterial pressure response of a given individual varies widely because of both split-second and slow-moving responses of the nervous system and end organs. These responses are very effective in changing the variables and resulting blood pressure from moment to moment. Moreover, blood pressure is the result of cardiac output increased by peripheral resistance: blood pressure = cardiac output Xperipheral resistance. As a result, an abnormal change in blood pressure is often an indication of a problem affecting the hearts output, the blood vessels resistance, or both. Thus, knowing the patients blood pressure is critical to assess any pathology related to output and resistance. Mean arterial pressure The mean arterial pressure (MAP) is the average over a cardiac cycle and is determined by the cardiac output (CO), systemic vascular resistance (SVR), and central venous pressure (CVP),[25] Curve of the arterial pressure during one cardiac cycle The up and down fluctuation of the arterial pressure results from the pulsatile nature of thecardiac output, i.e. the heartbeat. The pulse pressure is determined by the interaction of thestroke volume of the heart, compliance (ability to expand) of the aorta, and the resistance to flow in the arterial tree. By expanding under pressure, the aorta absorbs some of the force of the blood surge from the heart during a heartbeat. In this way, the pulse pressure is reduced from what it would be if the aorta wasnt compliant.[26] The loss of arterial compliance that occurs with aging explains the elevated pulse pressures found in elderly patients. The pulse pressure can be simply calculated from the difference of the measured systolic and diastolic pressures,[26] Arm–leg gradient The arm–leg (blood pressure) gradient is the difference between the blood pressure measured in the arms and that measured in the legs. It is normally less than 10 mmHg,[27] but may be increased in e.g. coarctation of the aorta.[27] Vascular resistance The larger arteries, including all large enough to see without magnification, are conduits with low vascular resistance (assuming no advanced atherosclerotic changes) with high flow rates that generate only small drops in pressure. The smaller arteries and arterioles have higher resistance, and confer the main drop in blood pressure along the circulatory system. Vascular pressure wave Modern physiology developed the concept of the vascular pressure wave (VPW). This wave is created by the heart during the systoleand originates in the ascending aorta. Much faster than the stream of blood itself, it is then transported through the vessel walls to the peripheral arteries. There the pressure wave can be palpated as the peripheral pulse. As the wave is reflected at the peripheral veins, it runs back in a centripetal fashion. When the reflected wave meets the next outbound pressure wave, the pressure inside the vessel rises higher than the pressure in the aorta. This concept explains why the arterial pressure inside the peripheral arteries of the legs and arms is higher than the arterial pressure in the aorta,[28][29][30] and in turn for the higher pressures seen at the ankle compared to the arm with normal ankle brachial pressure index values. Regulation The endogenous regulation of arterial pressure is not completely understood, but the following mechanisms of regulating arterial pressure have been well-characterized: †¢ Baroreceptor reflex: Baroreceptors in the high pressure receptor zones detect changes in arterial pressure. These baroreceptors send signals ultimately to the medulla of the brain stem, specifically to the Rostral ventrolateral medulla (RVLM). The medulla, by way of the autonomic nervous system, adjusts the mean arterial pressure by altering both the force and speed of the hearts contractions, as well as the total peripheral resistance. The most important arterial baroreceptors are located in the left and rightcarotid sinuses and in the aortic arch.[31] †¢ Renin-angiotensin system (RAS): This system is generally known for its long-term adjustment of arterial pressure. This system allows the kidney to compensate for loss in blood volume or drops in arterial pressure by activating an endogenous vasoconstrictorknown as angiotensin II. †¢ Aldosterone release: This steroid hormone is released from the adrenal cortex in response to angiotensin II or high serum potassiumlevels. Aldosterone stimulates sodium retention and potassium excretion by the kidneys. Since sodium is the main ion that determines the amount of fluid in the blood vessels by osmosis, aldosterone will increase fluid retention, and indirectly, arterial pressure. †¢ Baroreceptors in low pressure receptor zones (mainly in the venae cavae and the pulmonary veins, and in the atria) result in feedback by regulating the secretion of antidiuretic hormone (ADH/Vasopressin), renin and aldosterone. The resultant increase inblood volume results an increased cardiac output by the Frank–Starling law of the heart, in turn increasing arterial blood pressure. These different mechanisms are not necessarily independent of each other, as indicated by the link between the RAS and aldosterone release. Currently, the RAS is targeted pharmacologically by ACE inhibitors and angiotensin II receptor antagonists. The aldosterone system is directly targeted by spironolactone, an aldosterone antagonist. The fluid retention may be targeted by diuretics; the antihypertensive effect of diuretics is due to its effect on blood volume. Generally, the baroreceptor reflex is not targeted in hypertensionbecause if blocked, individuals may suffer from orthostatic hypotension and fainting. Measurement A medical student checking blood pressure using a sphygmomanometer and stethoscope. Arterial pressure is most commonly measured via a sphygmomanometer, which historically used the height of a column of mercury to reflect the circulating pressure.[32] Blood pressure values are generally reported in millimetres of mercury (mmHg), though aneroid and electronic devices do not use mercury. For each heartbeat, blood pressure varies between systolic and diastolic pressures. Systolic pressure is peak pressure in the arteries, which occurs near the end of the cardiac cyclewhen the ventricles are contracting. Diastolic pressure is minimum pressure in the arteries, which occurs near the beginning of the cardiac cycle when the ventricles are filled with blood. An example of normal measured values for a resting, healthy adult human is 120 mmHgsystolic and 80 mmHg diastolic (written as 120/80 mmHg, and spoken [in the US and UK] as one-twenty over eighty). Systolic and diastolic arterial blood pressures are not static but undergo natural variations from one heartbeat to another and throughout the day (in a circadian rhythm). They also change in response to stress, nutritional factors, drugs, disease, exercise, and momentarily from standing up. Sometimes the variations are large. Hypertension refers to arterial pressure being abnormally high, as opposed to hypotension, when it is abnormally low. Along with body temperature, respiratory rate, and pulse rate, blood pressure is one of the four main vital signs routinely monitored by medical professionals and healthcare providers.[33] Measuring pressure invasively, by penetrating the arterial wall to take the measurement, is much less common and usually restricted to a hospital setting. Noninvasive The noninvasive auscultatory and oscillometric measurements are simpler and quicker than invasive measurements, require less expertise, have virtually no complications, are less unpleasant and less painful for the patient. However, noninvasive methods may yield somewhat lower accuracy and small systematic differences in numerical results. Noninvasive measurement methods are more commonly used for routine examinations and monitoring. [edit]Palpation A minimum systolic value can be roughly estimated by palpation, most often used in emergency situations, but should be used with caution.[34] It has been estimated that, using 50% percentiles, carotid, femoral and radial pulses are present in patients with a systolic blood pressure 70 mmHg, carotid and femoral pulses alone in patients with systolic blood pressure of 50 mmHg, and only a carotid pulse in patients with a systolic blood pressure of 40 mmHg.[34] A more accurate value of systolic blood pressure can be obtained with a sphygmomanometer and palpating the radial pulse.[35] The diastolic blood pressure cannot be estimated by this method.[36] The American Heart Association recommends that palpation be used to get an estimate before using the auscultatory method. Auscultatory Auscultatory method aneroid sphygmomanometer with stethoscope Mercury manometer The auscultatory method (from the Latin word for listening) uses a stethoscope and asphygmomanometer. This comprises an inflatable (Riva-Rocci) cuff placed around the upperarm at roughly the same vertical height as the heart, attached to a mercury or aneroidmanometer. The mercury manometer, considered the gold standard, measures the height of a column of mercury, giving an absolute result without need for calibration and, consequently, not subject to the errors and drift of calibration which affect other methods. The use of mercury manometers is often required in clinical trials and for the clinical measurement of hypertension in high-risk patients, such as pregnant women. A cuff of appropriate size is fitted smoothly and snugly, then inflated manually by repeatedly squeezing a rubber bulb until the artery is completely occluded. Listening with the stethoscope to the brachial artery at the elbow, the examiner slowly releases the pressure in the cuff. When blood just starts to flow in the artery, the turbulent flow creates a whooshing or pounding (first Korotkoff sound). The pressure at which this sound is first heard is the systolic blood pressure. The cuff pressure is further released until no sound can be heard (fifth Korotkoff sound), at the diastolic arterial pressure. The auscultatory method is the predominant method of clinical measurement.[37] Oscillometric The oscillometric method was first demonstrated in 1876 and involves the observation of oscillations in the sphygmomanometer cuff pressure[38] which are caused by the oscillations of blood flow, i.e., the pulse.[39] The electronic version of this method is sometimes used in long-term measurements and general practice. It uses a sphygmomanometer cuff, like the auscultatory method, but with an electronic pressure sensor (transducer) to observe cuff pressure oscillations, electronics to automatically interpret them, and automatic inflation and deflation of the cuff. The pressure sensor should be calibrated periodically to maintain accuracy. Oscillometric measurement requires less skill than the auscultatory technique and may be suitable for use by untrained staff and for automated patient home monitoring. The cuff is inflated to a pressure initially in excess of the systolic arterial pressure and then reduced to below diastolic pressure over a period of about 30 seconds. When blood flow is nil (cuff pressure exceeding systolic pressure) or unimpeded (cuff pressure below diastolic pressure), cuff pressure will be essentially constant. It is essential that the cuff size is correct: undersized cuffs may yield too high a pressure; oversized cuffs yield too low a pressure. When blood flow is present, but restricted, the cuff pressure, which is monitored by the pressure sensor, will vary periodically in synchrony with the cyclic expansion and contraction of the brachial artery, i.e., it will oscillate. The values of systolic and diastolic pressure are computed, not actually measured from the raw data, using an algorithm; the computed results are displayed. Oscillometric monitors may produce inaccurate readings in patients with heart and circulation problems, which include arterial sclerosis, arrhythmia, preeclampsia, pulsus alternans, and pulsus paradoxus. In practice the different methods do not give identical results; an algorithm and experimentally obtained coefficients are used to adjust the oscillometric results to give readings which match the auscultatory results as well as possible. Some equipment uses computer-aided analysis of the instantaneous arterial pressure waveform to determine the systolic, mean, and diastolic points. Since many oscillometric devices have not been validated, caution must be given as most are not suitable in clinical and acute care settings. The term NIBP, for non-invasive blood pressure, is often used to describe oscillometric monitoring equipment. Continuous noninvasive techniques (CNAP) Continuous Noninvasive Arterial Pressure (CNAP) is the method of measuring arterial blood pressure in real-time without any interruptions and without cannulating the human body. CNAP combines the advantages of the following two clinical â€Å"gold standards†: it measures blood pressure continuously in real-time like the invasive arterial catheter system and it is noninvasive like the standard upper arm sphygmomanometer. Latest developments in this field show promising results in terms of accuracy, ease of use and clinical acceptance. Non-occlusive techniques: the Pulse Wave Velocity (PWV) principle Since the 90s a novel family of techniques based on the so-called Pulse wave velocity (PWV) principle have been developed. These techniques rely on the fact that the velocity at which an arterial pressure pulse travels along the arterial tree depends, among others, on the underlying blood pressure.[40] Accordingly, after a calibration maneuver, these techniques provide indirect estimates of blood pressure by translating PWV values into blood pressure values.[41] The main advantage of these techniques is that it is possible to measure PWV values of a subject continuously (beat-by-beat), without medical supervision, and without the need of inflating brachial cuffs. PWV-based techniques are still in the research domain and are not adapted to clinical settings. White-coat hypertension For some patients, blood pressure measurements taken in a doctors office may not correctly characterize their typical blood pressure.[42] In up to 25% of patients, the office measurement is higher than their typical blood pressure. This type of error is calledwhite-coat hypertension (WCH) and can result from anxiety related to an examination by a health care professional.[43] The misdiagnosis of hypertension for these patients can result in needless and possibly harmful medication. WCH can be reduced (but not eliminated) with automated blood pressure measurements over 15 to 20 minutes in a quiet part of the office or clinic.[44] Debate continues regarding the significance of this effect.[citation needed] Some reactive patients will react to many other stimuli throughout their daily lives and require treatment. In some cases a lower blood pressure reading occurs at the doctors office.[45] Home monitoring Ambulatory blood pressure devices that take readings every half hour throughout the day and night have been used for identifying and mitigating measurement problems like white-coat hypertension. Except for sleep, home monitoring could be used for these purposes instead of ambulatory blood pressure monitoring.[46] Home monitoring may be used to improve hypertension management and to monitor the effects of lifestyle changes and medication related to blood pressure.[6] Compared to ambulatory blood pressure measurements, home monitoring has been found to be an effective and lower cost alternative,[46][47][48] but ambulatory monitoring is more accurate than both clinic and home monitoring in diagnosing hypertension. Ambulatory monitoring is recommended for most patients before the start of antihypertensive drugs.[49] Aside from the white-coat effect, blood pressure readings outside of a clinical setting are usually slightly lower in the majority of people. The studies that looked into the risks from hypertension and the benefits of lowering blood pressure in affected patients were based on readings in a clinical environment. When measuring blood pressure, an accurate reading requires that one not drink coffee, smoke cigarettes, or engage in strenuous exercise for 30 minutes before taking the reading. A full bladder may have a small effect on blood pressure readings; if the urge to urinate arises, one should do so before the reading. For 5 minutes before the reading, one should sit upright in a chair with ones feet flat on the floor and with limbs uncrossed. The blood pressure cuff should always be against bare skin, as readings taken over a shirt sleeve are less accurate. During the reading, the arm that is used should be relaxed and kept at heart level, for example by resting it on a table.[50] Since blood pressure varies throughout the day, measurements intended to monitor changes over longer time frames should be taken at the same time of day to ensure that the readings are comparable. Suitable times are: †¢ immediately after awakening (before washing/dressing and taking breakfast/drink), while the body is still resting, †¢ immediately after finishing work. Automatic self-contained blood pressure monitors are available at reasonable prices, some of which are capable of Korotkoffs measurement in addition to oscillometric methods, enabling irregular heartbeat patients to accurately measure their blood pressure at home. Invasive Arterial blood pressure (BP) is most accurately measured invasively through an arterial line. Invasive arterial pressure measurement with intravascular cannulae involves direct measurement of arterial pressure by placing a cannula needle in an artery (usually radial, femoral,dorsalis pedis or brachial). The cannula must be connected to a sterile, fluid-filled system, which is connected to an electronic pressure transducer. The advantage of this system is that pressure is constantly monitored beat-by-beat, and a waveform (a graph of pressure against time) can be displayed. This invasive technique is regularly employed in human and veterinary intensive care medicine, anesthesiology, and for research purposes. Cannulation for invasive vascular pressure monitoring is infrequently associated with complications such as thrombosis, infection, andbleeding. Patients with invasive arterial monitoring require very close supervision, as there is a danger of severe bleeding if the line becomes disconnected. It is generally reserved for patients where rapid variations in arterial pressure are anticipated. Invasive vascular pressure monitors are pressure monitoring systems designed to acquire pressure information for display and processing. There are a variety of invasive vascular pressure monitors for trauma, critical care, and operating room applications. These include single pressure, dual pressure, and multi-parameter (i.e. pressure / temperature). The monitors can be used for measurement and follow-up of arterial, central venous, pulmonary arterial, left atrial, right atrial, femoral arterial, umbilical venous, umbilical arterial, and intracranial pressures. Fetal blood pressure Further information: Fetal circulation#Blood pressure In pregnancy, it is the fetal heart and not the mothers heart that builds up the fetal blood pressure to drive its blood through the fetal circulation. The blood pressure in the fetal aorta is approximately 30 mmHg at 20 weeks of gestation, and increases to approximately 45 mmHg at 40 weeks of gestation.[51] The average blood pressure for full-term infants: Systolic 65–95 mm Hg Diastolic 30–60 mm Hg[52] Blood pressure is the measurement of force that is applied to the walls of the blood vessels as the heart pumps blood throughout the body.[53] The human circulatory system is 400,000 miles long, and the magnitude of blood pressure is not uniform in all the blood vessels in the human body. The blood pressure is determined by the diameter, flexibility and the amount of blood being pumped through the blood vessel.[53] Blood pressure is also affected by other factors including exercise, stress level, diet and sleep. The average normal blood pressure in the brachial artery, which is the next direct artery from the aorta after the subclavian artery, is 120mmHg/80mmHg. Blood pressure readings are measured in millimeters of mercury (mmHg) using sphygmomanometer. Two pressures are measured and recorded namely as systolic and diastolic pressures. Systolic pressure reading is the first reading, which represents the maximum exerted pressure on the vessels when the heart contracts, while the diastolic pressure, the second reading, represents the minimum pressure in the vessels when the heart relaxes.[54] Other major arteries have similar levels of blood pressure recordings indicating very low disparities among major arteries. The innominate artery, the average reading is 110/70mmHg, the right subclavian artery averages 120/80 and the abdominal aorta is 110/70mmHg.[55] The relatively uniform pressure in the arteries indicate that these blood vessels act as a pressure reservoir for fluids that are transported within them. Pressure drops gradually as blood flows from the major arteries, through the arterioles, the capillaries until blood is pushed up back into the heart via the venules, the veins through the vena cava with the help of the muscles. At any given pressure drop, the flow rate is determined by the resistance to the blood flow. In the arteries, with the absence of diseases, there is very little or no resistance to blood. The vessel diameter is the most principal determinant to control resistance. Compared to other smaller vessels in the body, the artery has a much bigger diameter (4mm), therefore the resistance is low.[55] In addition, flow rate (Q) is also the product of the cross-sectional area of the vessel and the average velocity (Q = AV). Flow rate is directly proportional to the pressure drop in a tube or in this case a vessel. ∆P ÃŽ ± Q. The relationship is further described by Poisseulle’s equation ∆P = 8 µlQ/Ï€r4.[56] As evident in the Poisseulle’s equation, although flow rate is proportional to the pressure drop, there are other factors of blood vessels that contribute towards the difference in pressure drop in bifurcations of blood vessels. These include viscosity, length of the vessel, and radius of the vessel. Factors that determine the flow’s resistance as described by Poiseuille’s relationship: †¢ ∆P: pressure drop/gradient †¢  µ: viscosity †¢ l: length of tube. In the case of vessels with infinitely long lengths, l is replaced with diameter of the vessel. †¢ Q: flow rate of the blood in the vessel †¢ r: radius of the vessel Assuming steady, laminar flow in the vessel, the blood vessels behavior is similar to that of a pipe. For instance if p1 and p2 are pressures are at the ends of the tube, the pressure drop/gradient is:[57] In the arterioles blood pressure is lower than in the major arteries. This is due to bifurcations, which cause a drop in pressure. The more bifurcations, the higher the total cross-sectional area, therefore the pressure across the surface drops. This is why the arterioles have the highest pressure-drop. The pressure drop of the arterioles is the product of flow rate and resistance: ∆P=Q xresistance. The high resistance observed in the arterioles, which factor largely in the ∆P is a result of a smaller radius of about 30  µm.[58] The smaller the radius of a tube, the larger the resistance to fluid flow. Immediately following the arterioles are the capillaries. Following the logic obvserved in the arterioles, we expect the blood pressure to be lower in the capillaries compared to the arterioles. Since pressure is a function of force per unit area, (P = F/A), the larger the surface area, the lesser the pressure when an external force acts on it. Though the radii of the capillaries are very small, the network of capillaries have the largest surface area in the vascular network. They are known to have the largest surface area (485mm) in the human vascular network. The larger the total cross-sectional area, the lower the mean velocity as well as the pressure.[55] Reynold’s number also affects the blood flow in capillaries. Due to its smaller radius and lowest velocity compared to other vessels, the Reynold’s number at the capillaries is very low, resulting in laminar instead of turbulent flow.[59] The Reynold’s number (denoted NR or Re) is a relationship that helps determine the behavior of a fluid in a tube, in this case blood in the vessel. The equation for this dimensionless relationship is written as:[56] †¢ Ï : density of the blood †¢ v: mean velocity of the blood †¢ L: characteristic dimension of the vessel, in this case diameter †¢ ÃŽ ¼: viscosity of blood The Reynold’s number is directly proportional to the velocity and diameter of the tube. Note that NR is directly proportional to the mean velocity as well as the diameter. A Reynold’s number of less than 2300 is laminar fluid flow, which is characterized by constant flow motion, whereas a value of over 4000, is represented as turbulent flow. Turbulent flow is characterized as chaotic and irregular flow.[56] Disorders Disregulation disorders of blood pressure control include high blood pressure, blood pressure that is too low, and blood pressure that shows excessive or maladaptive fluctuation. High Main article: Hypertension Overview of main complications of persistent high blood pressure. Arterial hypertension can be an indicator of other problems and may have long-term adverse effects. Sometimes it can be an acute problem, for examplehypertensive emergency. All levels of arterial pressure put mechanical stress on the arterial walls. Higher pressures increase heart workload and progression of unhealthy tissue growth (atheroma) that develops within the walls of arteries. The higher the pressure, the more stress that is present and the more atheroma tend to progress and the heart muscle tends to thicken, enlarge and become weaker over time. Persistent hypertension is one of the risk factors for strokes, heart attacks,heart failure and arterial aneurysms, and is the leading cause of chronic renal failure. Even moderate elevation of arterial pressure leads to shortened life expectancy. At severely high pressures, mean arterial pressures 50% or more above average, a person can expect to live no more than a few years unless appropriately treated.[60] In the past, most attention was paid to diastolic pressure; but nowadays it is recognised that both high systolic pressure and high pulse pressure (the numerical difference between systolic and diastolic pressures) are also risk factors. In some cases, it appears that a decrease in excessive diastolic pressure can actually increase risk, due probably to the increased difference between systolic and diastolic pressures (see the article on pulse pressure). If systolic blood pressure is elevated (140) with a normal diastolic blood pressure (

Human resource planning and development t2

Human resource planning and development t2 Q) It could be said that international recruitment is the most important HR function within LVMH. What argument would you use to support this view? Ans.) 1) Recruitment is the process of searching and attracting potential applicants to a company. All companies, at one time or another, engage in recruiting activity, though the extent to which it is carried out, vary. The increasing globalisation of the marketplace combined with an increasing shortage of skilled staff and advances in technology have resulted in large scale changes to recruitment practices throughout the world. Attracting staff from overseas remains a challenge for human resources, due to a low rate of labour market mobility. Deciding how best to publicise a vacancy is just one element of how to devise a successful international recruitment strategy. It is important to remember that most workers dont automatically think about looking for a job abroad. It is only when they see a vacancy that they might seriously consider relocating. It is therefore crucial to not just post a job somewhere and wait until candidates reply, but rather to tailor each vacancy according to the factors that motivate the potential applicants that are targeted. This research reveals that those motivations vary from country to country so any international recruitment strategy must be informed by these cultural differences. Cultural and language differences are the biggest barriers for international recruitment strategies (43%), followed by legislative problems (31%) and the difficulty in checking candidate qualifications and references (26%). Companies in mainland Europe prefer to recruit from neighbouring countries, whereas firms in the UK have no particular preference regarding the country of origin of their foreign employees. Almost 40% of British people would be amenable to working in another country for more than five years. However those from Nordic countries (Norway, Sweden and Denmark) prefer to return home within two years. 2) One of the first lessons global corporations learn is that it is far cheaper to hire competent host-country national than to send their own executives overseas, for foreign service employees typically cost two to three times the salary of comparable domestic employee, and often many more times the salary of a local national employee in the assignment country. For example, General Motors typically spends $750,000 to $100,000,0 on an executive and his or her family during a three years stint abroad. The costs of doing business are often much higher overseas than in the USA. Consider office space as an example. In USA, rent per square foot ranges from about $21 in Los Angeles to $36 in midtown Mahatteam. By contrast, rents expressed in U.S. dollar average about $49 in Paris and Frankfurt and $61 in London. In such Asian cities as Bombay, Beijing, HongKong, and Tokyo, dollar rents range from $64 to $101. Of course, these costs fluctuate with international exchange rates relative to the U.S. dollar. On top of the high costs of such items as office space are the costs incurred by a high failure rate among expatriatesbetween 16 and 40 percent of all Americans sent overseas. For all levels recruitment, relocation expenses, premium compensation, repatriation costs, replacement costs, and the tangible costs of poor job performance. When an overseas assignment does not work out, it still cost a company, on average, twice the employees base salary. Although the costs of expatriates are considerable, there are compensating benefits to MNCs. In particular, overseas postings allow managers to develop international experience outside their home countriesthe kind of experience needed to compete successfully in the global economy that we now live in. When you are sending someone abroad to work on an possible about how to do business in the country. The cost of training is inconsequential compared to the risk of sending inexperience or untrained people. Business leaders of the present-let alone the future-need to possess international business skills par excellence in order to survive the chaotic world of international business. It also goes without saying that human resource managers will face new, unforeseen obstacles. Understanding the links between people, productivity and quality is the key to understanding why some firms succeed and other dont-in exactly the same economic and social environment. It is far too easy and wrong to categorize human resource practices as being the soft science—part of the hard science of making organizations competitive. In fact, this is far from the truth. The best organizations are very focussed and hard-nosed about their human resource policies because they clearly understand HR policies and their link to productivity and quality. Human resource strategies are designed to motivate people to immerse themselves in the activity of the company, to ensure that people are valued, respected and rewarded so that they continually contribute to the success of the company and enhance their own well being. Understanding the difficulties of finding qualified executives for international companies (ICs) and the importance of foreign language knowledge. Knowledge of a peoples language is essential to understanding his or her culture and to know whats going on as every effective manager must. Compare home country, host country, and third country nationals as international companies executives. Source of IC executives may be home country, host countries, or third countries, and their differing culture, language, ability, and experience can strengthen IC management. Remember some of the complications of compensation packages for expatriate executives. Expatriate manager compensation packages can be extremely complicated. Among other sources of complication are fluctuating currency exchange rates and differing inflation rates. Basic elements of those packages are salaries, allowances, and bonuses.

Sophocles Antigone - Creons Mistakes :: Antigone essays

Creon's Mistakes in Antigone In the awe-inspiring play of Antigone, Sophocles introduces two remarkable characters, Antigone and Creon. A conflict between these two obstinate characters leads to fatal consequences for themselves and their kindred. The firm stances of Creon and Antigone stem from two great imperatives: his loyalty to the state and her dedication to her family, her religion but most of all her conscience. The identity of the tragic hero of this play is still heavily debated. This tragedy could have been prevented if it had not been for Creon's pitiful mistakes. Creon's character possesses an infinite number of glitches in his personality, but his excessive pride was the root of his problems. His pride leads him to make accusations, before he considers the wise advice of others. Creon's pride also fills him not just as a king superior to the Gods, but also a man superior to women. The issue of Antigone being condemned to die becomes more than just a person who disobeys Creon; instead, the punishment is given even more eagerly, because it is a woman who disobeys a man. Creon's intelligent son warns Creon the people of Thebes sympathize with Antigone, but Creon accuses Haemon of being a "woman's slave" (line 756). Even though he is suppose to be loyal to the state and her citizens, he defensively questions if "the town [is] to tell [him] how [he] ought to rule?"(Line 734)The Theban king is too prideful to obey even the wisest of prophets, blind Teresias, insisting that "the whole crew of seers are money-mad" (line 1055). C reon finally puts his pride aside and listens to the Chorus' wise advice. It is difficult even then, and he obeys only because he fears the punishment that he might receive. "To yield [for Creon] is terrible" (line 1095) meaning to swallow his pride and admit that he is wrong is a very difficult thing for him to do. When Creon loses his wife and son, Creon's pride disappears, and he admits that he made a terrible mistake by not listening to anyone's advice. Antigone, a resolute and heroic female protagonist, pits her individual free will against the intractable forces of fate and against the irrational and unjust laws of tyrannical man like Creon.

DOUBLE SPEAK Essay -- essays research papers

Doublespeak  Ã‚  Ã‚  Ã‚  Ã‚   Doublespeak, whether intentional or unintentional is communication that is obscure, pompous, vague, evasive and confusing.() In most instances, doublespeak tries to achieve a particular objective as is the case in President Bush’s address to the nation on September 11, after the terrorist attacks on New York and Washington. The objective of this speech is clearly to mollify the emotions of a frightened nation and at the same time set the tone for what is to come as a result of the attacks. In this speech one can find many examples of doublespeak. These examples seem to be intentional although they defy typical doublespeak in that the doublespeak is not intended for any personal gains and is not concealed with a lot of convoluted language. If one can understand some of the basic principles about making sense of media-speak then the domino effect of this type of speech can be reduced.   Ã‚  Ã‚  Ã‚  Ã‚  One of the first statements President Bush makes in his speech can be classified as doublespeak. When he say’s â€Å"Our way of life, our very freedom came under attack,† he is indirectly saying that everything Americans are accustomed to and enjoy is at stake. With these simple words and the tone chosen to deliver them President Bush is strategically taking the emotions of the American people for a ride while making it clear that the American people are his target audience. An important principle for properly deciphering this instance of doublespeak is to unload first responses and get them out in the open so the rest of the message can be received clearly and unobstructed by inner thoughts. Other examples of doublespeak that fit into the same category as the previous one are when President Bush uses the phrases, â€Å"Foundation of America† and â€Å"Steel of American Resolve.† Both of these examples attempt to evoke an emotional resp onse although, the emotions attempting to be extracted are different from those in the beginning of the speech. They differ because they set the tone for new offensive and secure feelings opposed to the original feelings of defense and endangerment. This example also illustrates how obscure doublespeak can be.   Ã‚  Ã‚  Ã‚  Ã‚  President Bush regards the attacks as despicable and evil acts. The word evil is the doublespeak in this example. The way he uses this word automati... ...nbsp;  Ã‚  Ã‚  G-d is stronger than any human on earth. Walk through the valley of the shadow of death, I fear no evil  Ã‚  Ã‚  Ã‚  Ã‚  Not fearing the terrorists because of such a tragedy in close proximity. Every walk of life  Ã‚  Ã‚  Ã‚  Ã‚  All races, genders, and cultures. Resolve for justice and peace  Ã‚  Ã‚  Ã‚  Ã‚  We are going to war. Eliminating Mediaspeak: Is it Clear Now?   Ã‚  Ã‚  Ã‚  Ã‚  Doublespeak is deceptive as are most of the examples mentioned from this speech. On the contrary, doublespeak as explored through this example is sometimes a necessary tool to address an issue in a manner that is politically correct. When the doublespeak present in this speech is eliminated the underlying themes are not entirely lost and the speech is still effective. I think given the circumstances the audience was pleased with the underlying messages delivered and probably expected them making it easier to decipher President Bush’s jargon. The speech could have been delivered without doublespeak and more directly, but the perception of the audience would likely remain the same.   Ã‚  Ã‚  Ã‚  Ã‚  

Why Did Kristallnacht Take Place?

1. Both sources appear to contradict each other in terms of content. The first, and most important, question risen form these two sources are which is correct in context of who organised the riots. Source A clearly states that it was a â€Å"mass attack, which he [Goebbels] and the SA were going to launch†. However, there is a clear contravention in Source B: â€Å"The Fuhrer, at Goebbels suggestion†¦ not to be organised by the party†. However, in looking at what had happened, it seems that Goebbels encouraged a nationwide press campaign to help â€Å"stir† trouble. Also, at a dinner to commemorate the Munich Putsch, Goebbels called for von Rath's death to be avenged. These pieces of evidence do point towards riots conducted by Goebbels. It may have been, as stated in source A, that Goebbels was out of favour with Hitler and that he was trying to win back support from his Fuhrer. In source A however, whether Hitler did â€Å"squeal with delight† and slap his thigh with â€Å"enthusiasm† at the thought of riots against the Jewish minority is contestable. This is because Hitler was surprised by the extent of the pogrom, and may have been awaiting only sporadic bursts of violence from the population and not the SA. Source A, in terms of provenance, appears not to be as accurate as it seems. This is because it is only a summary by an historian nine years after the end of the First World War, and sixteen years after the events of Kristallnacht. Thus, many incidents may have been altered slightly to suit any other evidence this historian may have. Thus, a possible reason for Hitler â€Å"squealing with delight† and slapping his thigh with â€Å"enthusiasm†. However if nothing had been changed, then the very fact that the account was from a journalist, with insight to the â€Å"political behind the scenes† makes the source a significant one. On the other hand, Source B is by the Nazi Supreme Court. However the noteworthy element about this source is the fact that it is secret. Thus, meaning it is not intentionally prepared for use in the â€Å"political outside†. Therefore, there could be some element of truth in it, making it somewhat useful. However, there are some incorrect statements in the source. Consequently, I have come to the conclusion that Source A is the more useful out of the two sources for anybody studying Kristallnacht. This is because the source is a more reliable source in terms of its content. 2. The clear impression conveyed to the reader of source C is that Kristallnacht was calculated, precise attack on the Jews. Also, Mr. Buffman conveys Kristallnacht as a horrific act of terror. Mr. Buffman has written this as a first hand account, thus, many parts are down to opinion: â€Å"all of the local crowds were obviously horrified by the Nazis' acts†. Mr. Buffman 3. All three sources convey a general meaning about the events of Kristallnacht: an event disgustingly horrific both morally and physically. Source C and E particularly support each other. Both sources mention the fact that SA/SS men in no uniform had â€Å"been provided with hammers, axes and firebombs†, destroying Jewish synagogues, homes and shops. Source C also implies a calculated, organised riot; source E also conveys this as it states that a â€Å"list of names and addresses of all Jewish shops was provided†. Source E also backs up the statement Mr. Buffman made in Source C concerning the action taken by the German population: â€Å"Most German people have nothing to do with these riots†. Source E must be a reliable source to back up Source C as it is seemingly from a civil servant, working in a day-to-day job with political administrators. Source D also talks about the horrors leading up to Kristallnacht, although not in as much detail as in Sources C and E. The German Jew talks of â€Å"acts of terror†, the ‘decrees' passed on to force Jews to sell their belongings and â€Å"go away†, the ‘decree' passed on by Hitler to encourage emigration. Thus, source D does insinuate to the calculated and efficient riots that the government did organise. All of these sources are first hand accounts of the attacks on the Jews on Kristallnacht, thus they must be at least accurate, in terms of what they have interpreted to have witnessed. In looking at the chronology of events leading up to and after Kristallnacht, it seems that the ‘decrees' made were there to expel Jews from German society. Kristallnacht seemed to be a coincidence in between these events, with the Nazi's taking full advantage of this. Examples of which are 1) the Jewish minority being forced to pay compensation after the events of Kristallnacht 2) Jews forbidden to visit theatres, cinemas or concerts and 3) expulsion of all Jewish pupils from their schools. The purpose of sources C, D and E is a united one; a need to convey the horrific events, and the truth behind the smoke-screen of newspaper headlines: â€Å"a spontaneous wave of anger†¦ cowardly Jewish murder of Von Rath in Paris†