Saturday, August 31, 2019

Chinese firework industry Essay

1. Introduction—Objective and structure of this report The Chinese fireworks industry has experienced significant change since China adopted â€Å"open door policy†, moreover, it has huge market share in the world’s fireworks market. But on the other hand, the Chinese fireworks industry also has fatal weaknesses. Therefore, whether to invest in this industry is still a considerable challenge to most investors. The objective of this report is to give some suggestions to Jerry Yu on his decision of the investment on Liuyang fireworks industry. Furthermore, some proposals on how to improve the attractiveness and the competitiveness of Chinese fireworks industry at a long-run level are worked out; from personal level, there are some strategic options to Jerry Yu in terms of handling an individual fireworks firm. To achieve this objective, an industry analysis and a market audit are carried out and a gross conclusion is drawn based on the analyses and suggestions. 2. Industrial analysis The aim of this industrial analysis is to outline the situation of the Chinese fireworks industry in conjunction with analyzing the rivalry within this industry through Porter’s five forces model (please refer to Appendix). 2.1 The Chinese fireworks industry overview The general belief was that China-made fireworks actually made up about 80% to 90% of the world’s fireworks market. But although Chinese fireworks account for most of the world’s market, it can be said as a relatively messy industry in terms of its quality, packaging and timing control and distribution channels. As the most popular form in Chinese fireworks industry is family-run workshop, which is usually poorly funded and lacking of R&D and managerial input, the whole industry is basically labor-intensive and the technological innovations are also restricted. The competition is intensified by the emergence of small companies. These private workshops are flexible and quick in responding to market demand. They would copy any popular product design and sell it for much less prices than  government-owned or some collectively owned factories. This fact results in price drop which has become a serious problem for the whole industry. Besides, foreign competitors such as Japanese and Korea companies also threaten the Chinese fireworks industry. 2.2 Market trend The fireworks’ market can be divided into domestic and export market. In the past years, the demand of domestic market is declining while export sales is rising. Since China opened its door in 1979, export market has become a major market of Chinese fireworks. Figure 1 indicates the growth of export market during the period of 1994-1998. Figure 1: Export sales of Chinese fireworks industry in 1994-1998 From Figure 1, it’s clear that the demand of export market is increasing stably. Undoubtedly it’s a beneficial factor for Chinese fireworks industry. Another market trend is that the demand for display fireworks is increasing at a fast speed due to the increase of public fireworks shows, whereas the demand for consumer fireworks is expected to decline owing to the more restricted regulations. 2.3 Porter’s Five Forces Model (Appendix). Porter’s five forces model aims at examining the competitive status of the whole industry. 2.3.1 Potential entrants (High) The opportunity for potential entrants of fireworks industry is high. The capital requirement for establishing a fireworks firm is very low; the economy of scale is high and the brand identification within this industry is relatively low. All these facts provide good opportunities for firms to enter this industry. 2.3.2 Bargaining power of suppliers (Low) Because of the huge number of suppliers of fireworks and little product differentiation among fireworks products, the bargaining power of suppliers is low. 2.3.3. Bargaining power of buyers (High) Owing to the large number of choices and low even zero switching costs, the fireworks buyers have high bargaining power. 2.3.4 Substitutes (Low) The threat of substitutes of fireworks is relatively low. Although there are substitutes such as make-believe â€Å"firecrackers†, due to the heritage of tradition and culture, real fireworks are still irresistible to most consumers. 2.3.5 Rivalry (High) Rivalry of fireworks industry is high. The possibility for new entrants is high, while exit barrier is low; a bulk of existing firms that have little diversity and product differentiation are competing in this industry; buyers are more powerful than suppliers†¦Ã¢â‚¬ ¦ All these forces shape the fierce competition in fireworks industry. What is indicated through the analysis of Porter’s five forces model is that the rivalry of fireworks industry is high. Therefore, if firms were to survive in competition, they should make great effort to differentiate their strategies to achieve sustainable competitive advantages over competitors. 3. Market Audit of Liuyang fireworks industry The market audit focuses on the Liuyang fireworks market’s position through the identification of its domestic and foreign competitors and a SWOT  analysis. The goal of this market audit is to assist Jerry Yu to determine whether to invest in Liuyang fireworks industry or not. 3.1 Competitor analysis The competitors of Liuyang fireworks industry include both domestic and foreign ones. The competitors and their main competitive aspects of Liuyang fireworks industry are delivered in Table 1. Table 1: The competitors of Liuyang fireworks industry Competitors Domestic Foreign Liling Pingxiang, Wanzai Dongguan Other small establishments Japan, Korea and Spain Competitive Aspects Price competition Both price and quality, especially in low- and medium-priced markets More sophisticated management and marketing practices Copy popular design and sell much less Better quality and timing control, better packaging. From Table 1, it’s clear that the Liuyang fireworks industry has been facing fierce competition from both domestic and foreign competitors though it’s still the largest and most well known place for making fireworks in China. All of them have their own competitiveness versus Liuyang fireworks. Thus, if Liuyang fireworks industry were to sustain in the intense competition and â€Å"beat† these competitors, it’s necessary for it to modify strategy to increase its competitiveness relative to its competitors. Figure 2 shows the competitive position between Liuyang fireworks industry and its competitors on a positioning map. Figure 2: Competitive positioning map of Liuyang fireworks industry and its competitors From the positioning map, it can be demonstrated that although Liuyang fireworks industry has strong competitiveness in terms of reputation, it is seriously lacking of management capabilities compared with Dongguan and foreign competitors, which could be a disastrous factor in the future. Therefore, to improve the management of Liuyang fireworks industry is crucial for each individual investor’s success as well as the whole industry’s sustainability. 3.2 SWOT analysis of Liuyang fireworks industry Liuyang fireworks industry does share certain similar characteristics in terms of Strengths, Weaknesses, Opportunities and Threats with other Chinese fireworks manufacturers, but it also has its own features. 3.2.1 Strengths * Long reputation and product variety Liuyang has been the most well known place for making fireworks in China for a long time. It has the strongest reputation in China and even in the world market it also occupies an influential position in terms of product variety and reputation. * Huge market share As the largest manufacture community of fireworks in China, Liuyang has been enjoying huge market share in both domestic and export market. * Liuyang government’s offensive strategy In 1997, Liuyang government adopted offensive strategy responding to the  decline of its fireworks sales. This has been proven to be very useful—one year later, Liuyang fireworks sales increased. * Low labor cost Located in Hunan province, Liuyang is a relatively small and less developed city. Furthermore, most of the manufacture factories are located in rural places, where the labor cost is very low. This is a beneficial factor for manufacturers because with low cost, they could gain more profit. 3.2.2 Weaknesses * Poor management input and capabilities As identified in competitor analysis, Liuyang fireworks industry has little management input and poor management capabilities. Since most of them are family-run workshops, they have no capital to fund management. What’s more, as most workers are farmers who are not well educated, they have no intellectual resource for marketing capabilities. * Messy distribution channels The overall distribution system of fireworks industry is rather fragmented and messy. Neither the old government-run channels nor the new distribution channels are efficient and effective. On the contrary, they are rather chaotic. 3.2.3 Opportunities * Increasing revenue and demand As shown in Figure 3, the total revenue of Liuyang fireworks industry increased substantially in 1992-1996. Now the demand is still increasing especially in display fireworks category. This represents an opportunity to investors. Figure 3: The total revenue of Liuyang fireworks industry in 1992-1996 Source: Liuyang Firecrackers and Fireworks Exhibition (refer to Exhibit 1 in this case) * Technological innovation appealing to consumers Technology development triggers the technological innovations. Fireworks can be combined with modern technologies like laser beams, computerized firing and musical accompaniment to cater for customers. * Increased safety of fireworks Actually, the fireworks are not as dangerous as usually perceived by people. Technological innovation such as smokeless fireworks makes fireworks safer and as long as people can use fireworks properly, it’s not so dangerous. This can be demonstrated from Figure 4. Figure 4: The increased consumption(millions of pounds) versus decreased injuries(per 100,000 pounds) of fireworks in 1990-98 Source: American Pyrotechnics Association (please refer to Exhibit 2 in this case) What is indicated in this chart is that within 1990-98, the consumption of fireworks increased whereas the injuries decreased. The increased safety can help to build consumers’ confidence toward fireworks. 3.2.4 Threats * Intensified competition and local protectionism As illustrated in competitor analysis, more and more competitors including existing firms and new entrants are competing with Liuyang fireworks  industry. The direct consequence is the price drop which leads to the deduction of profit margin. Some small manufacturers even copy designs and purchase inferior raw materials to gain profit in competition, which worsens the quality and reputation of Liuyang fireworks industry. In addition, some local Chinese governments tend to protect local manufacturers when purchasing fireworks. * Legal restriction As fireworks has made some tragedies among users, most countries and Chinese cities more or less inhibit the sell and use of fireworks. Some places even banned the use of fireworks. This fact is undermining the fireworks industry. * Credit crisis Due to the bad debt control and lacking of respect for business contracts in China, the transaction costs are increased while cash flow are slowed down, which is a serious issue for fireworks industry. * Poor profit margin and loss of brand identities This threat exists especially in export market. The importers buy the fireworks at very low price from Chinese manufacturers and then resell at much higher prices. This is indicated in Figure 5: the comparison between FOB import prices from China and wholesale prices of four types of Chinese display fireworks in US. There is a huge gap between them. The American importers enjoy huge profit whilst Chinese manufacturers suffer from low profit margin. Furthermore, some large western fireworks manufacturers and dealers started to outsource the making of their brand-name fireworks. The Chinese fireworks manufacturers are facing the problem of losing their brand identities. Figure 5: The comparison between FOB import prices from China and wholesale prices of four types of Chinese display fireworks in US Source: China Sunsong Fireworks Corp. and Websites of fireworks wholesalers in U.S. 4. Suggestions for Jerry Yu Chinese fireworks industry is a highly competitive industry, however, it still presents opportunities for investors. Based on the analysis of Liuyang fireworks industry, the suggestion for Jerry Yu is to take the opportunities–to invest in Liuyang fireworks industry. Nonetheless, to win in the fierce competition, it’s also recommended that Jerry Yu should integrate the advantages he has into the opportunities to create competitive advantages versus his competitors. Therefore, there are some strategic options proposed for him. Furthermore, some recommendations for Chinese fireworks industry as a whole are also worked out in order to increase its competitiveness and attractiveness. 5. Proposed strategic options 5.1 Options for Chinese fireworks industry (Options 1-4) 5.1.1 Strategic option 1: Launch an industry-wide advertising campaign to change consumers’ perception and attitude toward fireworks. As interpreted before, most consumers regard fireworks as a very dangerous product, especially for youth. But in fact, it’s not as dangerous as consumers’ perception. Figure 6 shows the comparison of the dangerousness between fireworks and other products. From the treatment quantities it’s rather manifest that the treatment for youth caused by fireworks is the least among these eleven consumer products. Furthermore, as the technology of fireworks is improving, the dangerousness will be less than before. Therefore, it’s necessary for the manufacturers within this industry to launch an advertising campaign to change consumers’ perception, attitude and to build consumers’ positive belief–fireworks is much safer than what they think. Figure 6: Estimated emergency room treatment per 100,000 youth (ages 5 to 14) Source: American Pyrotechnics Association (refer to Exhibition 3 in this case) Advantages: ââ€" º To build consumers’ confidence toward fireworks can somehow prevent the decline of demand of consumer fireworks from consumers’ perspective. If consumers know fireworks are virtually much safer than their perception, probably they will purchase fireworks more actively than before in spite of the restriction of government regulations. Disadvantages: ââ€" ª To launch an industry-wide advertising campaign requires sufficient capital. But as most fireworks manufacturers are family-run small workshop, it’s hard for them to afford the cost for this advertising campaign. 5.1.2 Strategic option 2: Build TQM at an industry-wide level. Lacking of quality control is a serious weakness of Chinese fireworks industry. Therefore, it’s necessary to build TQM (Total Quality Management) industry-wide to regulate and guarantee the quality of Chinese fireworks to compete with foreign competitors and to attain trust from consumers. Advantage: ââ€" ºThe advantage is obvious–increase Chinese fireworks industry’s competitiveness with foreign competitors and in doing so, to maintain and even increase its market share in the world’s market. Disadvantage: ââ€" ª The only problem TQM might face is the messiness of Chinese fireworks manufacturers. TQM requires fund as well as regulations, but for small  workshops, it’s difficult to achieve. 5.1.3 Strategic option 3: To absorb foreign investments actively to improve both hardware (equipment, capital, etc) and software (management capabilities, etc) of Chinese fireworks industry. Advantages: ââ€" ºForeign investment can compensate one weakness of Chinese fireworks industry—lack of capital. If Chinese manufacturers have sufficient fund, they can improve their equipment, the products’ quality and packaging and their management resource such as R&D, etc. No doubt that these facets can greatly promote Chinese fireworks competitive position, through which, Chinese fireworks industry could prosper. Disadvantages: ââ€" ª There is a latent possibility that these foreign investments might finally control the Chinese fireworks industry. If this happens, Chinese fireworks industry would lose its identity. 5.1.4 Strategic option 4: Build strong brand awareness and image of Chinese fireworks industry. This can be implemented by advertising campaign or aggressive promotional activities.

Friday, August 30, 2019

Found in Translation Essay

Closing Case: Found in Translation: How to Make the Multicultural Workforce Work 1 What role does the basic communication process in Figure 11.1 play in this case? Explain. The basic communication process is vital from the Figure 11.1 in this case. The definition of communication is â€Å"the interpersonal transfer of information and understand† as stated on page 300. This is monumental for the CEO Glynn Lloyd to do with 70 percent of his 65 employees being from different places like Trinidad, Brazil, Nigeria, the Dominican Republic, and Cage Verde (p. 326). He has to have his employees carry out what he envisions for his company though understanding what is required. Which of the five communication strategies in Figure 11.3 does CEO Glynn Lloyd rely on the most at City Fresh Foods? At City Fresh Foods Glynn Lloyd relies on withhold and uphold strategy the most out of the five communication strategies in Figure 11.3. Lloyd’s also includes tell and sell strategy at City Fresh. The logistics manager, Kurt Stegenga states that the English classes was a bit much so they teach limited and key languages of City Fresh Foods such as â€Å"delivery ticket, check-out sheet and ice packs† (p. 326). â€Å"I spend a little extra time trying to help them read what they need to know (p. 326). At City Fresh Foods, the multilingual employees learn key terms such as â€Å"safe and out† and even the English alphabet by watch Sesame Street as noted in this case. Training material is visual so that at City Fresh Foods the employees can duplicate work efforts by visually looking at examples of how to do their jobs; it’s the hands on approach, â€Å"A demonstration is better than words, says Lloyd† (p. 326). How should Glynn Lloyd stimulate upward communication at City Fresh Foods? Explain. Glynn Lloyd should stimulate upward communication at City Fresh Foods by having a suggestion system. The employees that are performing the day-to-day operations are best to give suggestion on how to do something better. Just because they have a language barrier doesn’t mean that the processes cannot be Closing Case: Found in Translation: How to Make the Multicultural Workforce Work 2 achieved more efficiently or a practice from their culture could make the process better. As stated on page 312, â€Å"can be a wellspring of good ideas†. Glynn Lloyd by his openness of different cultural working together for one common purpose would benefit and seem open to the idea. Lloyd seems to have the ability to multi-task and a business sense to provide feedback if not immediate to surveys taken by his employees. How would you rate Glynn Lloyd as a listener? Explain. I would rate Glynn Lloyd as a good listener, though this case does not go into details or have examples it demonstrated through the different ways in which he communicates to the employees that all the components are there to being a good listener. Lloyd knew the 40 hour classes to teach English was not working so he adopted along with his managers of ways the multicultural employees could learn. Lloyd states, â€Å"They can talk to each other in whatever language they want† because the employees are not exclusive talking English during work. As an incentive to being in management it’s required to know English, this incentive by City Fresh to contribute up to $1,000 per person and $12,000 a year for education is huge. Lloyd makes it worthwhile for his employees to strive for success and that comes from listening to what the employees want. How comfortable would you be managing this type of multicultural organization? Explain. For me, I would not be comfortable with managing this type of multicultural organization. There are too many different languages and cultures to try to learn. I’m a person that requires immediate feedback, I would lose patients with getting a translator to encode, decode to the employees and wait to see if they understand what I need from them. I know that the future according to this case that â€Å"immigrants will account for nearly two-thirds of the country’s population growth between now and 2050† (p. 236), so in Closing Case: Found in  Translation: How to Make the Multicultural Workforce Work 3 order for me to relevant and be active in my community I better find a way to adapt and learn other languages and understand different cultures. Closing Case: Found in Translation: How to Make the Multicultural Workforce Work 4 References Kreitner, R. (2009). International Management and Cross-Cultural competence. (11th ed.). Management. Mason, Ohio: South-Western Cengage Learning.

Thursday, August 29, 2019

Crime Scene Scenario Essay

At approximately 1300 on January 31, 2012, there was a call and officers were dispatched to 125 Redbird Lane to investigate a home invasion. Upon arriving on the scene I was met by SGT Johansson to describe the scene as he saw it and the homeowners’ statements. He explained the homeowner, Cindy Pinsk told him she looked out her living room window and saw a gray sedan pull up. She heard the doorbell ring. Since she was not expecting anyone, she did not answer the door. She heard glass breaking and ran out the back door to a neighbor’s house, where she called 9-1-1. She saw broken glass on the carpet in the entry hallway and saw where the door had been pried open with some sort of tool. Pinsk told Johansson her Apple computer, a pair of diamond earrings, a sapphire ring, and three credit cards are missing. He talked to a neighbor, Steve Moyer, who told him he saw a steel gray Dodge Charger in front of Pinsk’s house. A handicap tag was hanging from the rear-view mirror. The driver was a black man with a green knit cap. The passenger was a large white man about 20 – 25 years old. He has a chinstrap beard and was wearing dark clothes. After listening to the first on call officers’ report, I looked around the front yard to see if any evidence was dropped during or after the home invasion. At first inspection of the front yard, you could see what appeared to be footprints in the mud due to the rain the previous night. Pictures with measuring markers were taken to show the position of the questioned impression, and castings (using Class I dental stone) were taken of the shoe impression to later compare to the suspects. Next I went into the house to look around and upon first entering the domain you could see where it appears that a tool of some kind had been used to pry open the door. Pictures with measuring markers were taken to show the position of the tool mark and for comparison. Liquid silicone was utilized to make an impression of the tools used on the door. During taking the impressions, I could see the smallest bit of blue fiber hanging from a piece of wood on the door frame. I removed the fiber tapping the sticky side of a post-it to the fiber. I then folded the post-it, labeled it and placed in an manila envelop for evidence. Walking a little further into the domain, you could see what caused the sound of glass breaking, a vase that appeared to be knocked over during the home invasion. The living room was in disarray with couch cushions taken out of the couch, papers on the floor and drawers pulled out of desk. On the desk was a smudge of a latent partial print that I retrieved sing black powder and sticky tape. As the victim stated in her report to the officers, I went up to the bedroom to discover the missing jewelry from the jewelry box. Once again latent fingerprints were found on the desk where the Apple computer and jewelry were taken, so again prints were taken off the desk with black powder and placed on sticky tape for evidence. After thorough investigation of the house, I exited the domain to head back to the lab. The first test that was done upon reporting back to the lab was an AFIS search for whose fingerprints were at the scene. When ran through AFIS, there was a match to a white male subject matching the description from the neighbors’ statement, John Kratz. John Kratz was brought in wearing a blue hooded sweat shirt, matching the color of the fiber found at the scene, and muddy jeans. Fibers were taken from his sweat shirt for later comparison to the fiber from the Pinsk’s’ house. When questioned on his whereabouts that afternoon. He exclaimed that he was at McDonald’s on his lunch break. Due to his inability to produce a witness to corroborate his story, he was held for further questioning. Next, tool marking were carefully examined and based on the initial examination of the pictures (the size and shape of the impressions) molds and striation marks compared with a comparison microscope determined that the tool that was used in the home invasion was that of a screwdriver. Fibers were then removed from the post-it using rubber tweezers and placed on a comparison microscope for a microscopic comparison for color and diameter to the fiber from the scene and that of John Kratz. Examination found the fiber to be cotton, a natural fiber and matching the fiber to John Kratz. When questioned again on his whereabouts that afternoon, with the help of the evidence that was already found, he finally broke and explained what happened and who was involved. Rick â€Å"Rukus† Thompson was allegedly with John Kratz was brought in for questioning. During the questioning Rick denied ever being at the Pinsk’s house saying he was at home sick. Along with John, Rick also had no one to corroborate his story. Shoe impressions were taken from both suspects and compared to those found at the scene. The shoe impression was that of Rick. With all evidence putting both at the Pinsk’s house, John Kratz and Rick â€Å"Rukus† Thompson both were charged.

Wednesday, August 28, 2019

Personal Portfolio in Business Essay Example | Topics and Well Written Essays - 1750 words

Personal Portfolio in Business - Essay Example Professional Experience: Teller, September 2004 to Present Bank of change, Wisconsin Handled diverse accounting dealings and settlement tasks. Gave status of account information and took care of phone enquiries. Customer education on a range of bank products. New hires training and supervision. Teller, August 1998 to September 2004 Lurking bank, Illinois Activated and ordered ATM cards and debit cards. Fund transfers activation. Verified endorsements. Private assistant, July 1994 to June 1998 bank of change, Wisconsin Took care of incoming and out coming mail. Customer handling at the reception and undertook cash drawer reconciliation duties. Education: April 1990 to July 1994 University of Excellence Bachelor in Business Administration: Finance Technical Skills: MS Word literate, data entry skills and bank computer software literate, competent in operation of cash registers Core Competencies: Eye for detail, self motivated, works unsupervised, straight forward and keen listener, har d worker and accountable. References Allan knight, Human resource manager, Bank of change, 854, uptown, Wisconsin, 6752, (445)9974521 Sharleen Shore, Assistant manager, Lurking bank, 75, chase, Illinois, 99754, (064) 2064509 Cover letter March 3, 2011    John Sanders 45, West Street, LA, 65928,    Dear Mr. Burch, in response to your today's ad in the church town newspaper, I would like to apply for a bank teller position at People’s Bank. ... In addition, I activated and ordered ATM cards and debit cards, and verified endorsements. I will bring my accurateness and dependability, my excellent customer service, and experience to my work at People’s Bank. My other work experience includes 4 years as a private assistant at the chase bank, where my responsibilities were taking care of incoming and out coming mail, and handling of customers at the reception and undertook cash drawer reconciliation duties. My resume is attached and references are present upon demand. Am looking forward to working with you in the near future. Thank you in advance. Sincerely yours,   John Sanders. Section 2 Social media is a web-based medium for people to interact socially or makes communication to be a dialogue that is interactive. With time, it has changed communication in organizations, among people and communities (Jantsch, 2007, 5). Social media has been used to detain a broad array of client’s attention this is through advert ising. Advertisement through social media is cheap compared to the old trend of advertisement that would cost millions of dollars (IAB media committee, 2010, 9) As an essential decision-support tool, it has provided a base for customer rapport building. This is by them using the gear and mediums available them to make their decision-making process (Evans and Mcken, 2010, 135& 136). Decision-making social nature has improved with extraordinary force by linking professionals from different generations to each other (Jue et. Al, 2009, 85). In a social networking website, there is potential of one creating useful and meaningful relations with one’s readers (carol, 2011, 187)social network provides a structure of communicating individuals and firms

A study of Relationship Among Visitor's Experience, Travelling Dissertation

A study of Relationship Among Visitor's Experience, Travelling Motivation, Destination Image, Service Quality, Satisfaction an - Dissertation Example Hence, it has become a great concern for parents to spend quality time with their children and undertake meaningful cooperative activities. In addition, proper leisure time management and conveniences of air and sea transport, family tours have become more popular in recent times. According to the World Travel and Tourism Council, WTTC, Asia Pacific Economic Cooperation and APEC data, tourism travelling encompasses activities such as restaurants, leisure entertainment, transportation, accommodation and travelling service, implying that tourism is indeed made up of big enterprises, which bring about a lot of economic effects (Kotler & Keller, 2011) Evidently, in modern times, people spend quite huge portions of their income and time traveling to destination and undertake activities such as sightseeing with their preschool age children, whose parents always take to theme parks around the world. According to World Travel and Tourism Council’s 2013 Annual Statistical Repost on Tou rism, the average number of trips per person during the year 2012 was 5.12, an increase of 0.66 trips from the 4.46 average of 2011 and 2012 respectively (Kotler & Keller, 2011 ). ... inment, education, unanticipated and happy whole-family experiences for children, parents and grandparents, which make entire families to have a good time at the park. In addition, Janfusun Fancyworld’s establishment, history, environment and activities therein also offer unique services for each person and for each special festival such as Halloween, Christmas, New Year, Father’s Day, Mother’s Day and Easter Day among other holidays and occasions. These are some of the reasons parents, preschool children and other members of families opt for Janfusun Fancyworld as their first-choice destination. In addition to these factors, the rapid increase in internet accessibility and use and emerging marketing concepts and applications have, consumer-oriented and customer-centered markets have also worked in favour Janfusun Fancyworld. To this effect, Janfusun Fancyworld, places emphasis on customer experience, customer value and satisfaction and high quality in its market ing strategies. Janfusun Fancyworld has also exploited the current advances in information technology to improve on creativity, aesthetics, sensibility, intellectuality and participative entertainment and recreational activities. Like other tourism destinations, Janfusun Fancyworld must prioritise strategies to establish and retain consumer satisfaction through quality and diverse services since a thorough understanding of customer service provision and satisfaction have profound effects on consumers’ perceptions on quality, value and satisfaction level is rather integral to modern tourism. Customers’ satisfaction and their intention to revisit are perhaps the most important cornerstones in the tourism industry that any tourist destination intending to remain viable ought not to overlook (Peppers &

Tuesday, August 27, 2019

Analysis Assignment Example | Topics and Well Written Essays - 250 words

Analysis - Assignment Example Rest of the paragraph is built on the topic sentence and every sentence further builds the reader’s thought on the subject. Sentences are structured beautifully and cohesively. The paragraph is so tightly structured that the exclusion of even a sentence can damage the comprehension of the topic. Contrary to this paragraph # 1 rather starts with a slack sentence. Reader finds it hard to get into the theme of the paragraph. This cause a jerky start and reader jumps to next sentence in order to get to the bottom of the idea being presented. But one can only find the topic sentence in the last line of the paragraph. Rest of the paragraph is a product of loosely knitted sentences with least or no cohesion among ideas and elements of the paragraph. Most of the sentences are structured in a complex manner which decreases the readability of the paragraph. The sentence structure irritates the reader and he finds it hard to focus on the idea being presented. Redundant vocabulary and loo se connection between ideas and sentences also cause boredom. The relentless use of punctuation further destructs the continuity of the paragraph.

Monday, August 26, 2019

Outsourcing to Foreign Countries Essay Example | Topics and Well Written Essays - 1750 words

Outsourcing to Foreign Countries - Essay Example Changes in the way in which organizations conduct business have been rapid and wide-spread as the concept of outsourcing has been introduced. It is the inherent nature of the marketplace to increase efficiency within the workplace by constantly striving to produce the most products with the least expenditure of resources. It is this concept that has driven many corporations to join in the globalization process, frequently outsourcing many of their activities and production processes to less developed countries in which this process is less expensive and requires fewer restrictions, licensing, and/or controls. â€Å"Global markets offer greater opportunity for people to tap into more and larger markets around the world. It means that they can have access to more capital flows, technology, cheaper imports and larger export markets†. Although the idea of a global market and outsourcing sounds like an ideal situation for the increased flow of goods and currencies throughout the world, as well as a possible solution for the redistribution of wealth into some of the world’s most destitute countries, â€Å"in practice, this has meant that the governments of the advanced capitalist countries, along with the I.M.F., the World Bank, and the W.T.O., have increasingly sought to force other nations to adopt market economies, privatize public companies and resources, abandon labor and environmental regulations, reduce social services, and embrace ‘free trade’ and the free movement of transnational capital†.

Sunday, August 25, 2019

MANAGEMENT Essay Example | Topics and Well Written Essays - 250 words

MANAGEMENT - Essay Example Students are multi-dimensional and understand all facets of what the program entails. Additionally, this programs offers interactive learning. One of the best methods for learning is interactive learning that is reached via collaboration. Conducive research shows that interactive learning is one of the best methods to engage students in a simulative learning. As a matter of fact, this new type of learning of application has allowed students to truly be more engaging. It breaks away from the traditional scope of learning in a conventional classroom that extends beyond writing boring notes, engaging in useless writing drills and discussion. The interactive learning has harnessed learning because it allows students to engage in a learning environment. For instance, the application has a feature of an ACT test flashcards. If the student gets a question wrong, the APP will prompt the student to justify why they picked that certain answer. A weakness in the program is that Miami Dade College does not have a vast network of corporations that seek the potential candidates out of universities. This can be problematic because students, who may not have the adequate resources to seek other resources to find One of the major opportunities is the program is the fact that online program can be embedded to attract longer distance students. Technology and media has drastically facilitated this cause. One of the greatest benefits of E-learning that it provides dynamic technology it provides to learning. Undoubtedly, E-learning has been the pinnacle and focal point of learning. Conventional school learning relies on endless drills, homework and lecture notes. Online or virtual learning also has been gained a lot of the importance due to the technological revolution. Some teachers in many times complain that the steady use of technology is hampering the real growth of the students with many side effects. In my paper will tries to discuss the cause

Saturday, August 24, 2019

Bus 234 Quail P1 Essay Example | Topics and Well Written Essays - 250 words

Bus 234 Quail P1 - Essay Example All field agents have an educational background in environmental science while the accountant has an educational background in accounting. The mission of the business is to provide quality services in terms of advising clients on the best approach to designing and putting up infrastructure to allow minimization of environmental pollution in order to make the immediate surrounding healthier and friendlier. The business anticipates to add the number of clients through the field agents. The field agents interact with clients on site and may attract new clients from their code of conduct and interaction with existing clients on the ground. The company wishes to conduct a needs assessment to determine the necessity of training its field agents on the best strategies for winning prospective customers to utilize the business` services. As discussed in Altschuld and David (57), in order to determine the training needs, all the field agents were given questionnaires, which contained open-ended questions on a Likert scale. From the results obtained from the short survey, the field agents` rate of interaction with prospective clients is average since their interaction skills and convincing are also rated average. It is thus imperative for the Earthcare group to train its field agents on best skills and strategies of developing and sustaining good customer relationships in order to increase the customer base for Earthcare

Friday, August 23, 2019

Marketing in Ecommerce Assignment Example | Topics and Well Written Essays - 500 words

Marketing in Ecommerce - Assignment Example Similarly, if such economic forces practice monopoly over some products and services in the internet, they may lock out many prospective players of ecommerce hence slowing the growth and expansion of ecommerce. Certainly, online merchants incur huge losses when prospective buyers use their online business platforms for research purposes. This is because no matter the huge internet traffic that flock their websites, few actually make orders for the products and services that entice them. The best remedy in this case would be to disallow free viewing of products and to offer products that are more competitive and services in the internet so that potential buyers have no better alternative. Definitely, the phenomenon of doing online research particularly for electronic products before purchasing such items from the store fronts has become the norm in many parts of the world. When it comes to food items, people do not normally do online research in order to purchase. This is mainly because such items as electronics and other products have specifications that a potential buyer ought to know prior to purchase. Besides, there are so many counterfeits out in the market and the only way to escape being swindled is by doing own research and the internet provides loads of information for such purposes. Without doubt, there are certain common themes about the use of mass media that the internet provides. These media services can indeed be adapted to an individual’s mass marketing efforts with the Internet. Such internet platforms as the social media for example Facebook and Twitter offer an excellent internet marketing platforms for ecommerce entities. This is especially so because such social media sites offer real-time connection with the customers and updating hence can be more beneficial to e-businesses than the mainstream media in terms of customer

Thursday, August 22, 2019

Technology Integration In Learning Essay Example for Free

Technology Integration In Learning Essay There is almost no place that you can go where technology hasn’t been used. Technology affects our daily lives in everything that we do; it saves time, creates a world of endless learning, and makes traveling to halfway around the world effortless. Technology greatly reduces the time it takes to perform lives everyday tasks. Daily chores such as mowing the grass or doing the dishes have been reduced from hours to twenty minutes with the invention of the automatic dishwasher and gas powered lawn mower. New technologies have even eliminated the time it takes to read books when you can download the audio book off of iTunes to listen to on your iPod. In the work place machines have eliminated many of the hand labors of molding parts and assembling products creating a great surplus of extra hours to finish other works and increasing production. Technology also helps student in their studies. In an article published by Technology and Learning magazine, interviews were conducted with some leading research experts on how they felt about technologys impact on education. The first way that technology can benefit students is that it can accelerate, enrich and deepen basic skills. Under the right conditions, students learn faster with more depth of understanding using technology (Salpeter, 1999). Students who use the technology for real communication with a real audience are much more capable of talking to adults because they are getting used to ittechnology facilitates cooperative learning, encourages new roles for learners and the ability to work independently. said Judy Salpeter , who is the editor of the Technology and Learning magazine. The impact of technology on society is deep. It is both positive and negative. Technology has largely influenced every aspect of living. It has made life easy, but so easy that it may lose its charm one day. One can cherish an accomplishment only if it comes after effort. But everything has become so easily available due to technology that it has lost its value. There is a certain kind of enjoyment in achieving things after striving for them. STATEMENT OF THE PROBLEM This research generally aimed to analyze the importance of technology in learning. Specifically, it sought to answer the following questions: 1. What are the effects of technology in our lives? What are the negative effects of technology in our lives? How does the technology effects our environment? How does the technology effects the process of learning? SCOPE AND DELIMITATION OF THE STUDY This study consists of the importance of technology in our lives, in our studies and the effects of this.

Wednesday, August 21, 2019

Kite Runner response text analyses Essay Example for Free

Kite Runner response text analyses Essay The Kite Runner tells us, through Rahkim Khan that, True redemption is when guilt leads to good again Rahkim Khan states. Throughout the course of The Kite Runner there are many characters that have committed sins and subsequently attempted to redeem themselves. The Kite Runner structured around main characters, Amir and Baba and their acts of betrayal. The impact of these acts continues to be felt throughout the novel manifesting itself in Amirs guilt ridden narrative. However, guilt is not enough. The need for redemption and atonement is what these characters seek. There is away to be good again the kite runner shows that this is along painful but ultimately positive journey. Amirs feelings of guilt spring from incidents of betrayal throughout his childhood. Since 1975 when Amir watched as Hassan was raped in an alleyway by Assef, I ran because I was coward. I was afraid of Assef and what he would do to me Amir feels guilty for his cowardice s but it was not fear that drove him away the real reason Amir ran was Baba. Amir was so envious of Baba and Hassans friendship that he thought Assef was right. Maybe Hassan was the price I had to pay the lamb I had to slay to win Baba. He was just a Hazara wasnt he? This event not only affected Hassan and Amirs friend ship but still made Amir highly jealous of Babas concern for Hassan, I havent seen much of Hassan in the last few days Baba said I couldnt help hating the way his brow furrowed with worry Amirs selfish personality handy caps his chance to be good again and redeem himself for the past. Amir places Hassan in the position to be framed and sets him up for theft of Amirs birthday presents, this incident clearly shows that Amir approaches atonement the wrong way. I lifted Hassans mattress and planted my new watch and a handful of afghani bills under it then I knocked on babas door and told what I hoped would be the last in a long line of shameful lies. Hassans loyalty leads to Ali and his departure to grant Amirs wish, I wanted Baba all to myself Amirs actions changed his and Babas life forever. Amir has stolen his fathers right to a best friend, his relationship with his hidden son and taken away Ali and Hassans job and security within their family. In many respects, Amirs adult personality is now the direct result of this childhood, feelings of guilt and betrayal. Amir attempts to redeem himself by planting money in Fahibs family house I did something I had done 26 years earlier: I planted a fistful of crumpled money under a mattress. He also tries to ally his feelings of guilt by taking Sohrab out of Afghanistan and back to America, the way he should have done with Hassan. In All Amirs efforts, he does become a better person once he is situated in America however he doesnt redeem himself for what he did as a child. Nothing will, It didnt make everything all right, it didnt make everything all right. Amir is not all to blame for his insecurity and lack of self-esteem, this personality is the result of Babas bad parenting. If I hadnt seen the doctor pull him out of my wife with my own eyes, Id never believe hes my son. Baba is not a supporting father towards Amir or Hassan. Throughout the book, Baba tries to redeem and atone himself for neglecting a secret child. He attempts to achieve this by raising Hassan equality to Amir however by doing this it disallows Baba to be close to Amir as feelings of guilt towards Hassan arise; hence taking the right to a loving family away from Amir and Hassan, for not speaking the truth. Babas betrayal is directed at Ali for sleeping with his wife. Theres only one sin and that is theft. Every other sin is a variation of theft Baba illustrates his deduction to atone for his actions using his wealth he builds and orphanage for illegitimate or orphaned children. Baba feeds the poor with his ceremonial lamb money. Baba also using his courage and urge to fight for what is right this is evident when he protects the afghani women in chapter ten from the Russian soldier, ill take a thousand of his bullets before I let this indecency take place. Babas decision to abandon home and his country are a evident sign of sacrifice to secure Amirs long-term welfare and happiness. His attempts of redemption and atonement to be good again result in his feelings of achievement the day that he dies. Tonight I am much too happy If The Kite Runner tells us anything it is that redemption is a life long task, through which a person seeks to become Good Again. A person needs to forgive themselves of their sins and absolve them of guilt in order to go on living their lives. Throughout the corse of The kite Runner, we learn that guilt is not enough. To be good again is more than the journey of redemption and atonement it is the destination.

Winston Churchill As A Leader History Essay

Winston Churchill As A Leader History Essay Sir Winston Leonard Spencer Churchill is an English statesman, orator and writer, the British prime minister in 1940-1945 and 1951-1955 respectively, is a part of the Big Three in many ways by which the modern world is as it really is. Winston Churchill was born November 30, 1874 in the family estate of the Dukes of Marlborough Blenheim Palace.  Churchills father was the Lord Randolph Spencer Churchill, the third son of the 7th Duke of Marlborough, he was a famous politician, member of House of Commons from the Conservative Party, and served as Chancellor of the Exchequer. Mother was a Lady Randolph Churchill, she was the daughter of a wealthy American businessman, as described in A Life.   Churchills father was busy with his political career and his mother, absorbed in secular life, paid little attention to his son.  Since 1875, child care was given to the nurse Elizabeth Ann Everest.  She sincerely loved him and was one of the closest people to Winston Churchill. According to Sir Winston (Leonard Spencer) Churchill Biography, when Churchill was eight years old, he was sent to prep school St. Georges.  The school practiced corporal punishment and Winston, constantly violated discipline, as it was often subjected.  After regular visits to his nanny, there were found on the body of the boy traces of vice, she immediately told his mother and he was transferred to the school of Nurses Thomson in Brighton.  Academic success, especially after the transfer, was satisfactory, but the certification of the behavior of reads: Number of students per class 13.  Place the 13th In 1889, he was transferred to the army class, where, besides teaching general subjects, students were preparing for a military career.   He graduated from school among the total of 12 students, who were able to withstand the tests in all subjects, and highlights the advances in the study of history.  At Harrow, he was engaged in fencing and achieved notable success, becoming the champion of the school in 1892.   June 28, 1893 Churchill on the third attempt passed the exams to the Royal Military Academy Sandhurst (the difficulties were with the writing in Latin), one of the most prestigious military schools of the United Kingdom.  Because of low ratings (92 of 102 results), he becomes a cavalry cadet and gets transferred into a more prestigious infantry class due to the fact that several candidates showed the best results, refused admission. On the February 20, 1895 Winston Churchill was awarded with the rank of second lieutenant, as stated in Sir Winston (Leonard Spencer) Churchill Biography. In the same year he suffered two heavy losses: in January, his father dies, and in July his favorite sitter died of peritonitis. After obtaining military rank, Churchill was enrolled in the Fourth Hussars of Her Majesty. Perhaps, at that moment he realized that his military career was not very attractive: The longer I serve, the more I like to serve, but the more I am convinced that its not for me, he wrote to Lady Randolph in August 16, 1895, as stated in Churchill by Himself: The Life, Times and Opinions of Winston S. Churchill in his Own Words. In 1895, thanks to extensive links to his mother, Churchill was sent to Cuba as a military correspondent for the Daily Schedule newspaper to cover an uprising of local people against the Spaniards, but continued with the number on active duty. Seconded to the Spanish troops, he first was visited by the fire.  The newspaper has published five of his articles, some of which were reprinted by The New York Times. Articles were met favorably by readers, and the fee was 25 guineas, at that time was for Churchills quite a substantial sum.  The Spanish government awarded him with the Medal of the Red Cross, it has given the popularity of Churchills controversial nature, since he led the British press to question the neutrality of the correspondent.  In addition to the awards and literary fame, he has acquired in Cuba two habits that accompanied him throughout his life: smoking Cuban cigars and afternoon breaks siesta.  On the way back to England, Churchill first time visited the Uni ted States, as stated in An Officer and a Bulldog. In October 1896, the regiment was sent to India and houses in Bangalore.  Churchill read a lot, thus attempting to compensate studies for the lack of university education, and became one of the best players on the team regimental polo.  According to the memoirs of subordinates, he conscientiously regarded officers duties and a lot of time to exercises with the soldiers and sergeants, but routine service burden to him twice, he went on vacation in England (including the celebration of the 60th anniversary of the reign of Queen Victoria), he traveled  in India, visiting Calcutta and Hyderabad.   In the autumn of 1897, empty again in the course of his personal connections and the possibilities of his mother, he seeks the secondment to the Expeditionary Corps, to suppress the uprising Pushtun tribes in the mountain area of Malakand in north-west of the country.  This campaign was far more cruel and dangerous than the Cuban.  During the operation, Churchill showed absolute courage, though often the risk was unnecessary, caused by the bravado and not a necessity.  He wrote to his mother: I seek the reputation for courage more than anything else in this world, as described in Churchill by Himself: The Life, Times and Opinions of Winston S. Churchill in his Own Words. Letters from the front line have been published in the Daily Telegraph newspaper and after the campaign had a circulation of 8,500 copies of his book The Story of the Malakand Field Force. Because of the hurried preparations for the printing of the book, were crept into a huge number of typographical errors, Churchill had counted more than 200 spelling errors and since then has always demanded personal rule proofs publishers.   The desire to go to another journalistic assignment has not met the understanding of the command, and he wrote to the Prime Minister, Lord Salisbury, frankly admitting that travelling is motivated as a desire to illuminate a historic moment and opportunity to retrieve personal, including financial benefits from the publication of a book.  As a result, the Military Department approved a request by appointing him to the supernumerary post of lieutenant in the order of the appointment. It was stressed that in case of injury or death, he cannot rely on payments from the funds of the Ministry of Defense. In the pitched battle at Omdurman, Churchill took part in the last cavalry charge of the British Army.  He has described this episode by himself:  I pulled to a trot and rode up to individuals firing my pistol in their faces and killing several three for certain two doubtful one very doubtful, as stated in Churchill by Himself: The Life, Times and Opinions of Winston S. Churchill in his Own Words.   Hes a great general, but nobody has accused him that he was a great gentleman Churchill said about himself in private conversation, apt description, however, quickly became publicly known.  Although the criticism was largely fair, public reaction to it was ambiguous; the position of publicist and ill accuser was combined with official duty junior officer.   After the end of the campaign Churchill returned to India to take part in national polo tournament.  During a brief stop in England on several occasions he speaks at a rally conservatives.  Almost immediately after the tournament, which his team won, defeating the stubborn final match, In March 1899 he resigned.   By the time Churchills resignation became known in some circles as a journalist, and his book was about the Sudan campaign The River War, became a bestseller. The first attempt to take a seat in the House of Commons had not been successful; there were no fault of Churchill himself: county was dominated by nonconformists. Churchill during the campaign expressed his disagreement with the law, but it had no effect, and both mandates from Oldham have got the liberals, as stated in A Life.     Second English-Boer War (1899-1902). By the autumn of 1899, relations with the Boer republics became worse, and when in September the Transvaal and the Orange Republic rejected the British proposal to grant voting rights of British workers in the gold mines, it became apparent that war was inevitable.   In September 1899, owners of the Daily Mail asked Churchill to go to South Africa as a military correspondent.  Without giving any answer, he reported it to the editor of the Morning Post, for which he worked during the Sudan campaign, and he was offered a monthly salary of 250 pounds plus reimbursement of all expenses.  It was a very significant amount (about 8,000 pounds today) more than ever a journalist was offered and Churchill agreed immediately.  He departed from England on October 14, two days after the war started, as described in Winston Churchill: Soldier, Statesman, Artist. On November 15 1899, Churchill went on a reconnaissance raid on an armored train, which was commanded by Captain Haldane, his friend in Malakand.  Soon an armored train was fired upon by Boers artillery.  When a person tried to escape from the fire at a high speed, reverse composition crashed into boulders, that blocked the path of the enemy to cut off the retreat.  The repair platform and two armored wagons derailed, the only instrument which has become immobile armored train was incapacitated by a direct hit. Churchill volunteered to command the clearing of paths; Haldane tried to establish a defense and to cover workers.  According to eyewitnesses, Churchill acted courageously under fire, but when the road was cleared, it turned out that the coupling of the remaining wagons on the track was killed off by a shell, and the only thing left Haldane Immerse in the engine severely injured to send them to the rear.  Around 50 Britons still face many times superior enemy forces .  As Churchill himself wrote, the Boers attacked with a courage equal to humanity, urging the enemy to surrender. Haldane and the soldiers were taken as prisoners.  Churchill attempted to flee but was detained in cavalry drills, and placed in a prisoners camp, hosted by the State exemplary school in Pretoria, as stated in An Officer and a Bulldog. On December 12, 1899 Churchill escaped from the camp.  Two other members of the escape Haldane and Sergeant Major Brookie did not manage to get across the fence unnoticed by the guards, and Churchill, while waiting for them in the bushes on the opposite side of the wall.  He was subsequently charged with the fact that he left his comrades, but there is no evidence for this. He jumped on the freight train, he got to Uitbank, where he was within a few days hiding in the mine, and then helped smuggle a train across the front line, said a mining engineer Daniel Devsnap.  For the capture of Winston Churchill Boers was offered reward of 25 pounds.   Escape from captivity made him famous, he received several offers to run for parliament, including a telegram from Oldhams voters, promising to give him his vote regardless of political affiliation, but Churchill chose to stay in the army, he was promoted to lieutenant of the Light Brigade  without pay, while continuing to work as a special correspondent of the Morning Post.  He had been in many battles, for his courage during the battle of Diamond Hill, the last operation, in which he participated, General Hamilton introduced him to the Victoria Cross, but progress in this representation was not received, as Churchill at the time resigned, as stated in Winston Churchill: Soldier, Statesman, Artist. In July 1900, Churchill returned to England again soon, and announced his candidacy from Oldham. He had a reputation of the hero and easily  beat a candidate from the Liberals and in 26 years, first became a member of the House of Commons.  In the elections the Conservatives won the majority and became the ruling party.   On February 18, 1901 he delivered his first speech in the House of Commons on the postwar settlement in South Africa.  He called for clemency to help Boer accept defeat.   On this conflict, young parliamentarians from Churchills own party werent agreeing.  In 1902-1903 years he has repeatedly expressed its disagreement on the issues of free trade (Churchill opposed the introduction of import duties on grain) and colonial policies. Against this background, his transition into the Liberal Party on the 31 of May 1904 looked quite a logical step.  On December 12, 1905 Winston Churchill was appointed Deputy Minister for the Colonies in Campbell-Bannermans government; in this capacity he was involved in the elaboration of a constitution for the defeated Boer republics, as described in Sir Winston (Leonard Spencer) Churchill Biography. In April 1908, in connection with the sharply deteriorating health of Campbell-Bannerman becomes unable to perform the duties of prime minister and cabinet had a number of permutations: Herbert Asquith, who served as Chancellor of the Exchequer becomes Prime Minister, then his place is taken by David Lloyd George, former Minister of Trade and  industry, and this post on April 12, receives Churchill.  Ã‚  Lloyd George and Churchill advocated a reduction in public and in particular in military spending.  Their efforts do not always lead to success. Churchill was a staunch supporter of social reform undertaken by the Asquith Cabinet. In 1908, he became the initiator of the law on minimum wage.  The law was adopted by an overwhelming majority for the first time in England with the sets of the rules of the hours and wages.   On February 14, 1910 at the age of 35 Churchill became Minister of Internal Affairs, occupying one of the most influential posts in the country.  Ministerial salary was 5000 pounds (about $200 thousand in the modern equivalent). He left a literary career, returning to that occupation only in 1923.   Tenure as minister has been one of the most difficult and controversial steps in the political career of Winston Churchill.  This period was marked by massive demonstrations of workers.  Churchills actions on taming disorder repeatedly subjected to severe criticism from all sides of the political spectrum, moreover, as interior minister he was responsible, even in cases where the person does not interfere.   In summer 1911, there was a strike of seafarers and port workers.  In August there were riots in Liverpool.  August 14 Marines from the warship Antrim, arrived in town on the orders of Winston Churchill, soldiers opened fire on the crowd and eight people were wounded.  On the 15th, he was able to meet with leaders of the striking Dockers and defuse the situation in London, but on August 19, the strike threatened to join the railway.  In a situation where in the cities, paralyzed by strikes and riots have a shortage of food, and the probability of rebellion is threatening, Churchill mobilized 50 thousand soldiers and repealed a provision under which the army can only be imposed at the request of the local civil authorities.  By August 20, through the intermediary of Lloyd Georges threat of a general strike was averted.  Churchill said in a telephone conversation with Lloyd George: I am very sorry to learn about it.  It would be better to continue and give them a good thr ashing, as described in Churchill by Himself: The Life, Times and Opinions of Winston S. Churchill in his Own Words. However, relations with Germany were worsening. Churchill was persuaded to address the issues of foreign policy.  Of ideas and information obtained from military professionals, Churchill drew up a memorandum on the military aspects of the continental problem and handed it to the Prime Minister.  This document has been a success.  He testified that Churchill, having a modest military education, which gave him a school of cavalry officers, was able to quickly and professionally investigate a number of important military issues.  In October 1911, Prime Minister Asquith invited Churchill as First Lord of the Admiralty, and on October 23, he was officially appointed to the  position.   Formally, the transition to the Admiralty has been decreasing Minister of Internal Affairs  was considered one of the three most important government agencies.  Nevertheless, Churchill accepted the offer without hesitation. Navy has always been one of the most important instruments of British geopolitics, in this period it had one of the major upgrades in its history.   Naval arms race that began at the turn of the XIX-XX centuries, accelerated after the launching of the first dreadnought in 1906. First time there was a situation where the superiority of the British Navy, both quantitatively and qualitatively, began to threaten not only the traditional rivals Germany  and France, but also the United States.   The cost of the naval forces was the largest cost-article of British budget.  Churchill was asked to carry out reforms while improving cost effectiveness.  Changes initiated by them were very ambitious: organized Chief of Naval Staff established a naval air force, designed and built warships of new types.  Thus, according to initial plans, shipbuilding program in 1912 was supposed to build 4 improved types the battleship class Iron Duke.  However, the new First Lord of the Admiralty ordered the redraft of the main fire less than 15 inches, despite the fact that the design work to create such weapons has not even been completed.  The result was the very successful type of battleships Queen Elizabeth, which served Britain until 1948.   One of the most important decisions was the transfer of the navy from coal to liquid fuel.  Despite the obvious advantages, navy for a long time opposed the move, for strategic reasons quite rich in coal Britain had no oil reserves.  In order to transfer the fleet of oil was possible for Churchill to initiate the allocation of 2.2 million pounds to acquire 51% of English-Iranian Oil Company.  Apart from the purely technical aspects, the decision had far-reaching political consequences the Persian Gulf regions have become a zone of strategic interests of Britain.   Britain has officially entered the First World War on August 3. Churchill ordered the fleet to run for their positions off the coast of England. On October 5 Churchill arrived in Antwerp, where personally led the defense of the city, which the Belgian government offered to surrender to Germans.  Despite all efforts, the city fell on October 10, and 2,500 soldiers were killed.  Churchill was accused of undue waste of resources and lives, although many noted that the defense of Antwerp helped to keep Calais and Dunkirk, as stated in Churchill and War. As chair of the Commission on land ships (English Landships Committee) Churchill took part in the development of the first tank and the creation of tank forces.   In 1915, he became one of the initiators of the Dardanelles operation, which ended disastrously for the Allied forces and caused a government crisis.  Responsibility for the fiasco Churchill largely took over, and when he was forming a new coalition government, the Conservatives demanded his resignation from his post as First Lord of the Admiralty.   On November 15 1915, he resigned and went to the Western Front, where as a colonel commanded the 6th Battalion of the Royal Scottish Fusiliers.  In December 1915, Major Churchill arrived in Flanders.  He became the biggest attraction of the front.  People everywhere flocked to see the former Minister of soiled clay helmet.  But Churchill was carrying his service as all.  The only luxury he allowed himself hiking bath at the command post. Subordinates loved him.  The Times quoted one of Corporal: Churchill moved among his troops on the front line as if walking on the sidelines of the lower house of parliament. We have often discussed his composure, and everyone admired him.  However, the long Churchill in the trenches not sat through and not because of the danger: his concern was their own isolation from London, as stated in An Officer and a Bulldog. In May 1916, he handed over the command and finally returned to England.  In July 1917, he was appointed a Minister of weapons and in January 1919 a Minister of War and Minister of Aviation.  He became one of the architects of Ten Year Rule the doctrine that the military construction and military budget should plan on the basis of the installation that England will not engage in major conflicts within ten years after the war.   Churchill was one of the main supporters and the main initiators of the intervention in Russia, stating the need to strangle communism in its cradle.  Although the intervention was not approved by the support of Prime Minister Churchill, due to the tactics of political maneuvering among the various factions in the government and prolong the time, managed to delay the withdrawal of British troops from Russia until 1920. At the end of World War I, Churchill was in the status of Secretary of State for Military Affairs, held a series of reforms in 1918-21, respectively.  Catching up in the years 1921-22 issue of the colonies of Great Britain, he was directly involved in the creation of some Arab countries in solving the issue of establishing a Jewish state in the Middle East (as part of the mandate given by the League of Nations, Britain for Palestine). During these years Churchills political leanings were strongly anti-socialist, he nevertheless maintained Liberal party platform.  His proposal to use troops against the Soviet Union led to a cooling of relations with Lloyd George, who appointed lord-treasurer, Robert Horn, by passing Churchill. However, in 1923, Churchill returned to the bosom of the Conservative Party, followed by instant his appointment to this post, as described in Winston Churchills War Leadership. Since 1930, Winston Churchill was out of politics, but in September 1939, with the start of World War II, under the pressure of public opinion, he was again appointed the First Lord of the Admiralty.  Chamberlains resignation in May 1940, as Prime Minister of Great Britain, led the appointing place to Churchill.  In his first speech in the status of prime minister in the House of Commons, which was held immediately after the French surrender to Nazi Germany, Churchill made it clear that Britain does not intend to compromise: You ask, what is our aim? My answer is simple victory victory at any  price, victory over terror, victory, a long and painful it may be.  For Churchill did not exist even the possibility of negotiating with Hitler. Until the United States entered the war, Churchill was going to fight alone. The basis of his strategy was in bombing Germany and the concentration of British forces in the Mediterranean and the Middle East regions.  Both positions were supported by the U.S. after the Japanese bombing of a military base at Pearl Harbor. Churchill was needed in the U.S. aid both economically and military.  Lend-Lease program significantly supported Britain, however, total U.S. control of the British economy has deprived Britain during the war of some economic independence.  Nevertheless, Churchill was interested in close cooperation with U.S. and even dreamed of the closest in history alliance.  This cooperation was confirmed by the Atlantic Charter in August 1941.  Later the Soviet Union joined the alliance completing the creation of the Big Three.  After the war, close relationship of Allied anti-Hitler coalition came to naught.  Moreover, Churchill is the author of the term Iron Curtain, as described in Churchill and War. After Germanys surrender, England began to prepare for the elections, which passed in July 1945.  Election campaign was won by Labor, Churchill resigned.  For six years he was the leader of the opposition, calling on European leaders not to be influenced by the Soviet Union. In 1951, Churchill returned to 10 Downing Street, the official residence of British Prime Minister.  In this capacity, he pursued a policy of support for NATO and the European Union.  Churchill did not neglect the social sphere, conducted through the Parliament laws, such as the nationalization of the railways, the Royal Bank of Scotland etc, as described in Winston Churchills War Leadership. In 1953, Winston Churchill was knighted and received the Nobel Prize for literature, and ten years later he was made an honorary U.S. citizen. In 1955, Churchill moved away from high politics, and had lived in peace for ten years. On January 24, 1965, the greatest man of the century was gone.  Winston Churchill was buried in his native Oxfordshire. Winston Churchill entered the history of Britain as the most brilliant English politician of the twentieth century, who was in power during the reign of six monarchs from Queen Victoria to her great-great-granddaughter Elizabeth II.  He was present during testing of the nuclear bomb, has become a major threat to postwar peace.  With his bowler hat and cane unchanged Churchill was a brilliant diplomat, artist and even a gardener in his estate at Chartwell.  Ã‚  Churchill was one of the best orators of his time. He was the author of the term Iron Curtain, which became characteristic of the capacious postwar political situation.  Churchill also was one of the most ingenious in his time.  Lady Astor once told him: If you were my husband, I would poison your coffee, to which Churchill replied: If you were my wife, I would drink it. It is very difficult to estimate the scale of such person as Winston Churchill. There is no one in the world whose fate he did not indirectly affect, such a large scale is Winston Churchills identity. According to a survey conducted in 2002, the broadcaster BBC has been named Churchill the greatest Briton in history. During all his life he always showed incredible courage and indomitable will-power. When it seemed that the situation was hopeless he believed in and was going to win in spite of all difficulties, moreover, he successfully led the people and the whole nation to victory. He was a leader, a real leader and patriot of his country. His country can be proud for such son, who was named Winston Spencer Churchill.

Tuesday, August 20, 2019

Comparing the Tragic Hero in Things Fall Apart and Heart of Darkness Es

The Tragic Hero in Things Fall Apart and Heart of Darkness A tragic hero could be considered a "noble person with a fatal flaw" or "an opponent of society who is willing to take action that 'sensible people' might applaud but never perform themselves". In Chinua Achebe's Things Fall Apart and Joseph Conrads's Heart of Darkness, two characters, Okonkwo and Kurtz, have some qualities which could categorize them as tragic heroes. However, only the reader's interpretation of the characters' actions will determine if they are tragic heroes or not. In his Ibo society, Okonkwo would certainly be considered a "noble person". Not only has he worked his way up from poverty to become one of the leading men of Umuofia, but he has also been deemed one of the greatest warriors and wrestlers in the land. "Okonkwo was well known throughout the nine villages and even beyond. His fame rested on solid personal achievements", (Achebe 3). Due to the exemplary actions, Okonkwo has gained respect from his fellow tribesmen. Okonkwo has also taken two titles in his clan and he is a member of the egwugwu, which demonstrates his leadership capabilities and the power and "nobility" he holds in Umuofia. Despite his skills in those areas, Okonkwo does have a "fatal flaw". "His whole life was dominated by fear, the fear of failure and of weakness", (Achebe 13). Unoka, Okonkwo's father, was considered an "agbala", or a woman, because he was soft and not masculine enough. Okonkwo had also hated his father because he was em- barrassed by him, so his life's passion is to be the polar opposite of him. Due to this fear, Okonkwo held in his emotions and acted hard, which ultimately made him weak, because a s... ...o appears to have more qualities of a tragic hero than Kurtz. Achebe had created Okonkwo with some nobility, and he definitely had a fatal flaw; his fear of weakness ultimately culminated into his death. Also, Okonkwo had opposed the white society and some of his fellow tribesmen. However, his clan did not approve of his final action: suicide. Due to this fact, Okonkwo can never be a true tragic he- ro. Now, Kurtz never was considered to be a noble man by society's standards and he didn't really have a flaw; instead, he had the ability to persuade and manipulate people to his advantage, which would not be a flaw for his sake. Kurtz was a mixed man of society; he opposed some parts while accepting others. Despite this, both characters have exhibited some characteristics of a tragic hero and only the reader's response can determine their roles. Â  

Monday, August 19, 2019

Gary Sotos Like Mexicans: Personal Experiences :: essays research papers

Gary Soto's Like Mexicans: Personal Experiences My decision to write in response to Gary Soto's work, â€Å"Like Mexicans† was influenced for the most part because of the similarities between myself and Gary Soto, and our families included. Gary Soto is a Mexican American male, who grew up in the San Joaquin Valley in the industrial part of a town called Fresno. His grandparents came to this Great Valley in search of creating a better life for themselves and their families. I am also a Mexican American male who was born and raised in the San Joaquin Valley in a small town called Porterville. My grandparents migrated with their children, my mother, father, and their brothers and sisters in hopes of creating a better life for themselves as well. At the time economic betterment meant working as a hired slave for minimal income and keeping your mouth shut. After all, you were nothing more than a wetback who came to America to reap her benefits.(This ludicrous ideology is still present today) Gary Soto's grandparents and my grandparents, although they ma y be a generation behind one another, I am sure were exposed to many of the same hardships and or social barriers. It was not uncommon back then as it is not uncommon today for Mexican families with minimal work skills to be forced into the fields to work with their children alongside in hopes of escaping poverty. For the most part such families remained poverty stricken due to unfair and illegal wages and work conditions. However irrelevant this all may sound, facing similar hardships or obstacles will often create a sense of unity among those who are affected by such conditions. In short, I feel that not only do Gary Soto and I share a common ethnic origin, but all that comes with our origin, be it pride, shame, or ideology. "Like Mexicans" is a short story in which Gary Soto is constantly being reminded that he should marry his own kind. His own kind being one of Mexican descent, and of poverty and refraining from others, especially â€Å"Okies† as his grandmother used to always say. Soto ends up marrying a Japanese woman, not a Mexican. But he still has to deal with his internal struggle and acceptance of this choice. One cannot be looked down upon for questioning oneself and the decisions one makes, especially when it comes to marrying after being raised in a household that reinforced the belief , â€Å"Marry Your Own†. My mother and my father never told me that I should marry one of my own.

Sunday, August 18, 2019

Hard Tmes Essay -- Papers

Hard Tmes Snakes....specialists of deception. They enter our lives unnoticed and set out to accomplish evil plans. Snakes are twisters. Like a rattle snake, it attracts your attention with its tail then at the last moment strikes a venomous blow only to see you fall from the point you have risen. Snakes challenge your choice with sneaky tricks and can even lure you to disobey God. If that isn't enough I have to also cope with the stress of school, the racism in the community and the obsession that a young man gets for the opposite sex. My problems may seem little, but even the smallest thing can be a factor of what has caused a scared and frightened teenager to hate the world. I've always seen myself as me. Steve Marshall. An averaged height, not really popular, sixteen year old Afro-Caribbean who's often discriminated against by narrow minded child like people because of his race, a boy who likes to take good pride in himself because there is no-one else to do it for him. I mean my father has never been there for me, nothing but broken promises and lies which hurts me so much, but not even the pain that I bare could ever deny me loving him. The only thing that may seem unusual about me is the fact that I am often sick and I have to take three pills a day to keep me healthy. Ms Ramstad a.k.a Peaches or mum, well step-mum; after all she is married to my dad. She tries her hardest to look after me but I think she believes that she doesn't have the same authority over me like my real mother would. My dad abandoned us when I was young and ever since Peaches has struggled and tried her best to cope on minimum wages with the responsib... ...car me with those huge needles. No way, that would have never happened, but I do give it to Steve the disease he was successful in his mission. He was the toughest snake my life has ever handled, and the biggest factor to my demise. Yes that's right my demise. He has knocked me off my Pedestal and climbed right up. That can only mean that he has successfully taken my place. He should be me. Well everything I ever wanted to be. Now I have realized that the world is full of lying cheating and backstabbing people, so who can blame a broken teenager for hating the world. Even though he isn't here now Steve the disease belongs in this world not me. So this is the last chapter in the diary of my life. The life of Steve Marshall before I commit the tragic event called suicide. I really can't go on through all these HARDTIMES.

Saturday, August 17, 2019

Causes of World War II Essay

World War II was the biggest, deadliest, and scariest war of all time. It was obvious that it was coming to. Hitler was taking over Germany. He was sentencing Jews to concentration camps. He was plotting to rid the world of Jews and eventually take over the world. War was coming and everyone knew it. Everyone wanted to do something to stop it, but it was no use. As stated in Document 9, â€Å"neither the people nor the government of Britain and France were conditioned to the idea of war. † Keith Eubank said that in the Origins of World War II. Britain knew war was coming, France knew war was coming, and Germany even knew war was coming. World War II was inevitable. Many things built up to the eventual outcome; war. As stated in Document 5, British Prime Minister Neville Chamberlain explains why he favored peace, but he knew eventually it would end up as war. He says, â€Å" If we have to fight, it must be on larger issues than that. . . . I am a man of peace. . . . Yet if I were sure that any nation had made up its mind to dominate the world by fear of its force, I should feel that it must be resisted. . . . But war is a fearful thing. Hitler was trying to take over the world, and that is exactly what Chamberlain feared. It is also a reason why World War II began. In 1939, the world was plunged into World War II. Nobody wanted it to happen. But nobody could prevent it from happening. Hitler was continuing with his dream of taking over the world while at the same time ridding the world of Jews. Hitler was taking over one country at a time with the help of Italy. As stated in Document 2, Haile Selassie, emperor of Ethiopia, asked the League of Nations for help during Italy’s invasion of their country. The League of Nation’s response was ineffective. Selassie then said these words, â€Å"God and history will remember your judgement. . . . . It is us today. It will be you tomorrow. † What he means by that is that Hitler will not stop there. He will keep pushing and pushing until he has what he wants. He is saying that the League of Nations will to lose control to the Nazis. Different nations had different ways to handle the Nazis though. There were two responses to the aggression caused: collective security and appeasement. Collective Security is a system by which states have attempted to prevent or stop wars. Under a collective security arrangement, an aggressor against any one state is considered an aggressor against all other states, which act together to repel the aggressor. Appeasement was basically giving Germany whatever they wanted to not start a war. Appeasement did not work because Hitler agreed to take the Sudetenland, and Hitler promised to recognize Czech’s new boundary lines, but six months later, he took over all of Czech. As stated in Document 4, â€Å"There is to be no European war. . . . the price of the peace is. . . the ceding by the Czechoslovakia of the Sudeten territory to Herr Hitler’s Germany. † Hitler was not a man of his word because a very short time later, he took over Czech. World War II was undoubtedly, the biggest and costliest war of all time. People were dying all the time. Hitler had enslaved the Jews in concentration camps. Everything was falling apart. If the U. S. hadn’t stepped in to help, who knows where we would have been right now. Europe could all be Germany. There might be no Jewish people left. We are lucky because this entire war could have gone a completely different way.

Friday, August 16, 2019

Dividend Growth Model Essay

1. Dividend Growth ModelThe basic assumption in the Dividend Growth Model is that the dividend is expected to grow at a constant rate. That this growth rate will not change for the duration of the evaluated period. As a result, this may skew the resultant for companies that are experiencing rapid growth. The Dividend Growth Model is better suited for those stable companies that fit the model. Those that are growing quickly or that don’t pay dividends do not fit the assumption parameters, and thus this model cannot be used. In this model, a company may not exceed the market growth rate. In addition, since the dividend growth rate is expected to remain constant indefinitely, the other measures of performance within the company are also expected to maintain the same growth rate. If in the current state, the dividend rate is greater that earnings, in time this model will show a dividend payout greater than the earnings of the company. Conversely, if earnings are growing faster than dividends, the payout rate will converge towards zero. In summary, the Dividend Growth Model works well for those companies growing at a rate equal to or lower than that of the economy and have an established and stable dividend payout. In order to estimate the cost of equity using the Dividend Growth Model, we simply adjust the model’s equation for estimating the price of a stock, given as such:P = D1 / (r – g)Where P = the price of the stockD1 = the expected Dividend in one yearr = the required rate of returng = the expected Growth ConstantBy solving the equation for k we get the following:P(r – g) = D1r – g = D1 / Pr = (D1 / P) + gTherefore in order to estimate the cost of equity through the Dividend Growth Model, we simply add the constant growth rate and the projected dividend yield in one year. 2. Capital Asset Pricing ModelThe assumptions used in the Capital Asset Pricing Model (CAPM) are similar in that they assume an almost â€Å"perfect world† scenario. Initially, CAPM assumes that all investors have the same rational expectations of returns, and that these returns are in line with the best prediction for future returns as based on the available information. It also makes the assumption that the dividends are paid normally, that assets are fixed, and that the market is efficient and in equilibrium with no inflation or change in the interest rate. CAPM additionally makes the important assumption that the evaluated stock is properly priced and that the risk level has been properly assessed. Another major assumption is that there are no taxes, transaction fees, or arbitrage opportunities during the evaluation period. This is a huge assumption which is generally incorrect. Almost all transactions within the market have some sort of tax or fee associated with it. Within CAPM, the required rate of return is found in the following equation:r = rf + B (rm – rf)Where r = the required rate of returnrf = the risk free rateB = the stock’s Beta valuerm = The Market returnIn essence CAPM evaluates a stock based on its risk and potential return compared to a risk-free market portfolio. 3. CAPM and the Modern Portfolio TheoryModern Portfolio Theory is an attempt to balance the risks and rewards of investment portfolios through the use of diversification to lower the risk of the entire portfolio while maintaining high returns. The use of Beta is a key concept in Modern Portfolio Theory. It uses CAPM as its basis to select investments within a portfolio; seeking to mix stocks with both positive and negative Betas to construct a portfolio with a minimal Beta for the group of stocks as a whole. Theoretically, the returns from stocks with both positive and negative betas do not cancel each other out, but rather the portfolio is constructed that the returns are independent of the other stocks held, yet complimentary in accumulation of returns. 4. Estimation of Untraded Stocks. The general standard for estimating the cost of equity of a non-traded  company is through the Market Approach. The basis of this approach is that the stocks of publicly traded companies, engaged in the same of comparable business, are a valid indicator of performance for a non-traded company. Under the Market Approach, there are two commonly used valuation methods; the Guideline Public Company method, and the Merger and Acquisition Method. The Guideline Public Company method consists of finding a comparable company and applying that companies financial data to the non-traded company. A company chosen to provide a reasonable basis for comparison should ideally be in the same industry as the non-traded company. However, if there are no companies with sufficient data available, as company in a similar industry may be selected. A similar industry should be one that had identical investment characteristics such as markets, growth, and product lines. The difficulty in using this method lies in identifying a public company that is sufficiently comparable. According to the American Institute of Certified Public Accountants Statement onStandards for Valuation Services, the following should be considered when using guideline companies:†A. Price information of the guideline company must be related to the appropriate underlying financial data of the company evaluatedB. The valuation ratios for the guideline company and the comparative analysis of qualitative and quantitative factors should be used together to determine appropriate valuation ratios to be applied to the subject company. C. Several valuation ratios may be selected for application to the subject company, and several value indications may be obtained. The appraiser should consider the relative importance accorded to each of the value indications used in arriving at the opinion or conclusion of value. D. To the extent that adjustments for dissimilarities with respect to minority and control, or marketability, have not been made earlier, appropriate adjustments for these factors must be made, if applicable.†The key to obtaining the most accurate results when using the Guideline Company  Method is to use the most comparable company as the guideline company. The closer to the evaluated company in all areas, the more accurate the result. The merger and acquisition method evaluates a company based on actual merger and acquisition transactions that involve entire companies or controlling interests in companies. This method may include companies that were either public or private prior to the control transaction. When using this method, all of the underlying information relating to a particular merger or acquisition may not be known. The motives of the buyer or seller may cause the transaction amounts to be skewed; this will be transparent to the evaluator and can cause an inaccurate evaluation. By using either of the Market Approach methods, it is still a â€Å"best guess† based on the best available information. The more accurate and comparable the comparison study is, the better the resulting evaluation. REFERENCES 1. Booth, Laurence. Time to Pass the Old Maid? http://www.investmentreview.com/archives/1999/spring/oldmaid.html2. Damodaran, Aswath. Dividend Discount Models. New York University, Leonard N. Stern School of Businesshttp://pages.stern.nyu.edu/~adamodar/pdfiles/valn2ed/ch13.pdf3. Citizendium.org. Cost of equity. http://en.citizendium.org/wiki/Cost_of_equity4. Ivkovic, Inya. CAPM – Where Market Theories Converge and Clash. suite101.com. Sep 29, 2007http://investment.suite101.com/article.cfm/capm_assumptions_and_limitations5. Investopedia.com. Financial Concepts: Capital Asset Pricing Model. August 2007http://www.investopedia.com/university/concepts/concepts8.asp6. Wallener, Damir. What is Modern Portfolio Theory?http://www.investopedia.com/university/concepts/concepts8.asp7. The American Institute of Certified Public Accountants (AICPA). Statement on Standards for Valuation Services. http://bvfls.aicpa.org/NR/rdonlyres/672E1DD4-2304-47CA-8F34-8C5AA64CB008/0/SSVS_Full_Version.pdf8. Wise, Richard M. Caveats in Using Guideline Company Transactional Data in Valuing a Business. Quarterly Journal of the Business Valuation Committee of the American Society of Appraisers. Vol. 22, No. 1, March 2003http://www.wbbusval.com/english/pdf/BVR4-Caveats-Guideline-Cos-March03.pdf9. Pratt, Shannon P. Business Valuation Body of Knowledge Workbook, 2nd Edition. ISBN: 978-0-471-27066-9. Paperback. 192 pages. January 2003

Thursday, August 15, 2019

Postmenopausal Hormone Replacement Therapy Health And Social Care Essay

In the United Kingdom, about one million post-menopausal adult females use oestrogen entirely or in combination with progestogen, as portion of endocrine replacing therapy ( HRT ) , to handle the symptoms of the climacteric ( WHC, 2010 ) . HRT first became available to adult females in the United Kingdom in 1965 ( Patient UK, 2010 ) , and was traditionally prescribed for its ability to cut down vasomotor symptoms, and its preventive effects against the development of postmenopausal osteoporosis and cardiovascular bosom disease ( WHC, 2010 ) . During 2002 and 2003, two of the biggest epidemiological surveies on HRT, Million Women Study ( an experimental questionnaire ) in the UK and Women ‘s Health Initiative survey ( a clinical randomised test ) in the USA were published. Their consequences presented concerns sing the safety of traditional HRT ; peculiarly in respects to its associated hazards to the cardiovascular system and chest malignant neoplastic disease as a consequence of drawn-out use ( WHI, 2002 ; MWS, 2003 ) . The complicated image presented of the hazards and benefits of HRT has received a considerable sum of scientific and public attending, fuelling wellness anxiousness amongst medical professionals and HRT users likewise. During the period of 2003 and 2007 the figure of adult females utilizing HRT fell by 66 % ( WHC, 2010 ) . This paper presents a reappraisal of scientific literature on the efficaciousness of HRT in the direction of menopausal symptoms and assesses the proficiency of its non-hormonal options.Why a Menopause?At birth, the human ovary contains 1 to 3 – 106 Graafian follicles, with no new gametes formed after this clip ( Kim et al, 1997 ) . This figure regresses to less than 1 – 104 at the clip of climacteric ( physiology text book ) . Menopause is described as a province of oestrogen lack that is brought approximately by the loss of aboriginal follicles in the ovaries doing a failure in oestrogenic end product ( Greendale and Sowers, 1997 ) . Throughout the generative lifetime, ovarian follicles become bit by bit desensitized to gonadtrophin exposure ( physiology text book ) . This leads to the loss of progestin production and a pronounced diminution in endogenous oestrogen degrees ( Greendale and Sowers, 1997 ) .EpidemiologyHarmonizing to the office of National Statistics 2009 figures, there are about 37.8 million adult females in the UK, of whom 13.6 million are aged 45 or over ( ONS, 2010a ) . Statistics indicates that 52 is the mean age of menopausal onset ( NHS Choices, 2010 ) , and so most of these adult females will be in or shortly come ining the post-menopausal province. The current life-expectancy for a new-born miss is 81.9 old ages ( ONS, 2010b ) . Womans can therefore anticipate to populate a 3rd of their lives in a possible oestrogen deficient province ( Howard et al, 1981 ) . Womans are considered to hold reached the climacteric, after a 12 month period of amenorrhoea ( Green dale and Sowers, 1997 ) . The concluding menstruations is so retrospectively designated as the clip of climacteric ; the clip predating this is post-maturity ( Greendale and Sowers, 1997 ) . The climacteric is associated with a assortment of physical and psychological symptoms ( Porter et al, 1996 ) , where vasomotor instability and urogenital wasting are the most normally documented short-run post-menopausal symptoms. Approximately, 75 % to 80 % of all adult females normally experience their first symptoms of the climacteric during the peri-menopausal period ( Bachmann, 1999 ) ; of whom 45 % of adult females will happen the symptoms straitening ( RCPE, 2003 ) .The climacteric in the long-run increases the hazard for the development of cardiovascular diseases and osteoporosis ( Iqbal and Zaidi ) ; this is due to the physiological effects caused by the worsening degrees of estrogens in the bosom, liver, encephalon and bone ( Katzenellenbogen, 1996 ) .Vasomotor SymptomsThe vasomotor s ymptoms of the climacteric, ( for illustration hot flowers, dark workout suits, insomnia and palpitations ) ( Howard et al, 1981 ) are the most common ground why menopausal adult females seek medical aid ( Howard et al, 1981 ) . Three quarters of peri-menopausal adult females will see hot flowers ( Howard et al, 1981 ) , where symptoms are normally observed within the first twelvemonth after the concluding menstruations ( Rees and Purdie, 2006 ) . Hot flushes characteristically last between 0.5 and 5.0 old ages after natural climacteric ( Bachmann, 1999 ) , but in 25 % to 50 % of instances can last longer than 5 old ages ( Howard et al, 1981 ) . The frequence of hot flash happenings and its continuance can change from less than daily to several per hr with continuances between a few seconds to 10 proceedingss long ; nevertheless on mean hot flower episodes lasts for around four proceedingss ( Patient UK, 2010 ) . The etiology behind vasomotor symptoms is ill-defined, but it is thoug ht to be due to a combination of hormonal, metabolic, and psychogenetic factors which occur as a consequence of oestrogen backdown ( Bachmann, 1999 ) . In 1986, Sliva et al conducted a survey on rats and established the action of oestrogen in the preoptic country of the hypothalamus, here it was found to modulate the firing rate of thermosensitive nerve cells in response to stimulation. Surveies have shown that oestrogen appears to heighten ?2-adrenergic inhibitory activity ( Bachmann, 1999 ) .Women with hot flowers have higher arteriole sensitiveness to catecholamines ( Bachmann, 1999 ) .The decrease in ?2-adrenergic receptor activity leads to sudden, transient and fickle peripheral vasodilatation in the tegument blood vass, which produces the hot flower ( Bachmann, 1999 ) . Night workout suits ( sleep hyperidrosis ) , is a common job accompaniment with day-time hot flowers ( Porter et al, 1996 ) . Hot flowers and sleep hyperhidrosus can hold a Domino consequence on a patient ‘s overall quality of life ( Bachmann, 1999 ) , as a consequence of weariness, crossness, hapless concentration, and impaired memory ( Porter et al, 1996 ) .Vasomotor TherapyNumerous surveies have documented the effectivity of short-run oestrogen therapy in handling the frequence and badness of hot flowers and dark workout suits caused by climacteric. For illustration, Haas et Al ‘s 2003 double-blinded, randomized, placebo-controlled survey on 18 menopausal adult females reported that there was no immediate decrease in vasomotor symptoms after induction of oestrogen therapy ( Figure 2 ) . At first both placebo and oestradiol reduced the figure of hot flowers by 27 % and 35 % , severally. The initial placebo consequence, nevertheless, was non sustained throughout the surv ey. In contrast, those patients treated with oestradiol continued to detect a lessening in the figure of hot flowers per hebdomad, until a 74 % maximum decrease was reached after 4 hebdomads of therapy. The frequence of hot flowers fluctuated somewhat at that degree until the terminal 2 hebdomads when the placebo-only period was initiated ( see figure 2 ) . These findings were reiterated in MacLennan at Al ‘s 2004 scientific reappraisal of 24 double-blinded, randomized, placebo-controlled tests, which assessed unwritten HRT therapy. Consequences demonstrated in nine RCTs, showed a average per centum decrease of about 75 % comparative to placebo in hebdomadal hot flower frequence ( p & A ; lt ; 0.0001 ) correlating to Hass at al earlier 74 % decrease for hebdomadal hot flower episodes for HRT. In adult females randomised to have placebo intervention, a 57.7 % decrease in hot flush frequence was observed by the terminal of the survey. Eight RCTs, found that symptom badness of th ose treated with HRT was besides significantly reduced compared to placebo ( P & A ; lt ; 0.0001 ) . A direct comparing of the effectivity of combined HRT versus oestrogen merely HRT was attempted but did non make statistical significance ( p value = 0.085 ) . There is a little sum of dependable grounds available to rede the continuance of usage for the intervention of vasomotor symptoms. Clinical Knowledge Summaries ( 2010 ) recommend the prescription of uninterrupted combined unwritten or transdermic HRT, for the direction of hot flowers. Treatment for vasomotor symptoms should be continued for at least one twelvemonth ; otherwise, symptoms may repeat ( Rees and Purdie, 2006 ) . This was observed in Haas et Al survey where, during the 2 hebdomad placebo merely period ; the frequence of hot flowers began to return to baseline degrees in the group having oestradiol ( see figure 1 ) . A progressive backdown from intervention therefore is advisable. This is achieved by bit by bit cut downing uninterrupted combined HRT dosage to the lowest strength of tablets or spots, whereby half a tablet day-to-day or half a spot should be used for a farther 1-2 months ( Rees and Purdie, 2006 ) . Menopausal symptoms normally decide within 2-5 old ages ( RC PE, 2003 ) ; the consequence of uninterrupted combined HRT can be sustained for up to three old ages during disposal where, apart from shed blooding, side-effects are non normally reported ( Maclennan et al, 2004 ; Henriksson et Al, 1996 ) . Current research has confirmed the efficaciousness of oestrogen, combined or entirely, in bettering hot flowers and dark workout suits, as its effects are strong. However, farther research is required to distinguish whether combinations of low dose oestrogen and progestin may accomplish the tantamount consequence of a higher dosage of oestrogen when used entirely.Figure 1: Summarises the entire figure of Hot flowers recorded by patients on transdermic estradiol ( N = 10 ) and placebo ( N = 8, foremost seven hebdomad ; N=7, last five hebdomads ) each hebdomad ( adapted from Haas et Al, 1988 ; Bachmann, 1999 )Pre-treatment stage: A 4-week pre-treatment period during which capable eligibility of menopausal position was confirmed. Treatment stage: An active 6 hebdomad survey stage, during which the happenings of Hot flowers between 0.05 mg/ dm3 transdermic estradiol was compared against placebo. Estradiol showed to be well more effectual than placebo in cut downing vasomotor flowers during hebdomads 6 to 10. Placebo stage: Two hebdomad period where patients continued to supervise symptoms while single-blindedly utilizing a placebo spot. An addition in vasomotor flushing towards baseline was observed in estradiol-treated patients.Urogenital AtrophyThe surcease of the catamenial rhythm, consequences non merely in the conventional hot flowers observed in diagnostic menopausal adult females but besides causes alterations to the functional capacity of the urogenital piece of land ( Samsioe, 1995 ) . Urinary incontinency, recurrent lower piece of land infections, vaginal uncomfortableness, dyspareunia, and shed blooding are all symptoms of atrophic vaginitis ( Howard et al, 1981 ; Bachmann and Nevadunsky, 2000 ) . These symptoms occur as a consequence of atrophic alterations caused as a effect of a gradual diminution in go arounding estrogens ( See figure 3a ) . Once degrees fall below the threshold where endometrial proliferation is possible, the vaginal canal begins shortening and there is a loss of rugae in the vaginal wall ( DeMasters J, 2000 ) . The urinary piece of land symptoms observed is a consequence of the urethra and vagina sharing the same embryologic beginning ( Howard et al, 1981 ) . Vaginal symptoms, unlike hot flowers often persist and can worsen with age ( Grady, 2006 ) . In a 2006 survey of the Management of menopausal symptoms, Grady reported up to 30 % prevalence of atrophic vaginitis symptoms amongst adult females during the early postmenopausal period with an in addition to 47 % prevalence during the ulterior postmenopausal period ( Grady, 2006 ) . During the climacteric, the vaginal wall musculuss deteriorate to bring forth a thin, unsmooth, inflamed mucous membrane susceptible both to bacterial infections and petechial hemorrhage caused by mechanical emphasis ( Samsioe, 1995 ) . The destructive effects caused by the diminution in oestrogen degrees are most outstanding in the fundal part of the vagina ( Samsioe, 1995 ) . Hormonal alterations induced by the climacteric, actuate metabolism in the bacterial vegetation and pH of the vagina ( Samsioe, 1995 ) . Before the climacteric the vagina is colonized by lactobacilli which maintain a low vaginal pH, by and large 4.5 or less ( Brizzolara et al, 1999 ) , bring forthing a protective environment aga inst the colonisation of the vagina and urethral tissue by Gram-negative bacteriums ( Samsioe, 1995 ) . After the climacteric lactobilli becomes replaced by faecal-type vegetations which cause postmenopausal adult females to go prone to urinary piece of land infection ( see figure 3b ) . The symptoms of urogenital degeneracy can be categorised into two groups: 1 ) Lower urinary piece of land – for symptoms affecting the urethra and bladder 2 ) Vaginal – for those confined to the vagina and the vulva such as vaginal waterlessness, combustion and itchiness ( Samsioe, 1995 ) . The prevalence of urologic symptoms ‘ ( including urgency, frequence, dysuria, and incontinency ) is a job which increases in badness with age ( Grady, 2006 ) ; this nevertheless can be farther insinuated by the wasting of the urethral mucous membrane caused during the menopausal passage ( Molander, 1990 ) . In postmenopausal adult females, the control of urination becomes progressively reliant on the support of the urogential musculuss to urethrovesical junction, due to widening of the urethra ( Samsioe, 1995 ) . The decrease in oestrogen degrees consequences in the deficient blood supply to the urogenital tissues and hence impedes full muscular functionality ( Molander, 1990 ) . Poor anatomical support to the urethra consequences in the uneffective control of urination ; which consequences in pelvic laxness and emphasis incontinency ( Samsioe, 1995 ) . The diminution in go arounding blood in urogential tissues means there will besides be an damage in the immune system antibod y response to foreign organic structures ( Molander, 1990 ) ; this in add-on to the broadening of the urethra, facilitates the migration of bacteriums into the lower urinary piece of land ( Samsioe, 1995 ) .Pre-menopauseFigure 3a and 3b: Summaries the alterations in the vaginal and urethra observed as the influence of oestrogen lessenings ( adapted from Samsioe, 2005 ; Brizzolara et Al, 1999 )Figure 3a: The diminution in serum oestrogen degree causes a lessening in vaginal blood flow and secernments. As a consequence, lactic acid degrees and animal starch content of the vaginal wall decreases, this causes the hyalinisation of collagen and the impairment of elastic tissue. Atrophy of the vaginal tissues nevertheless, does non get down until endogenously produced estrogens have fallen below the threshold required for endometrial proliferative activity. Therefore the clip period between the start of climacteric and the start of wasting opens a curative window. This has allowed the poss ibility for drugs to be able to aim urogenital wasting without put on the lining endometrial proliferation which can ensue in malignant neoplastic disease, extinguishing the demand for progestin co-medicationFigure 3b: The conventional drawings represent the pre and post-menopausal urethral opening and vaginal wall. The pH of vaginal fluid in postmenopausal adult females elevates to between 6 and 7 ; this facilitates the replacing of lactobacillae with gram negative source vegetations associated with urinary piece of land infection. In healthy vaginal epithelial tissue, parabasal cells are rare and normally represent less than 5 % of the epithelial cell population, this per centum increases to around 20 % after the climacteric.Post-maturityUrogential TreatmentSurveies have shown that estrogens, administered as systemic ( unwritten or transdermic ) or intravaginal estrogens, are extremely effectual at handling vaginal wasting. It is recommended that estrogens, when prescribed with th e purpose of pull offing urogenital symptoms, are given as low-dose readyings to assist understate systemic soaking up ( Grady, 2006 ) : this prevents the additions in oestrogen endogenous degrees that could potentially do estrogenic side effects. When HRT is used at the recommended low-dose and frequence, the add-on of a progestogen for endometrial protection is non necessary ( Figure 3a ) . The physiological alterations that consequences in the decrease of urogenital symptoms observed in oestrogen therapy, suggest that oestrogen lack may lend to this pathogenesis ( Samsioe, 1995 ) . The clinical efficaciousness of low-dose HRT readyings have been demonstrated in a figure of clinical tests. Barnabei et Al followed the menopausal symptoms and the effects of oestrogen and progestogen in the postmenopausal adult females, involved in the Women ‘s Health Initiative for a mean of 5.6 old ages. The consequences from the survey showed a 74 % decrease in vaginal wasting in adult femal es who had received oestrogen plus progestin and 55 % in those who had received placebo entirely. Intravaginal estrogens are besides extremely effectual at handling vaginal wasting ; Suckling et al Cochrane reappraisal found that all intravaginal readyings ( that were administered as picks, diaphragms, intravaginal tablets or the estradiol-releasing vaginal ring ) were every bit effectual and significantly reduced the symptoms of vaginal wasting. It is for this ground and that they by and large have small consequence on the serum oestrogen degrees that intravaginal oestrogens readyings are preferred to systemic oestrogen ( Suckling et al, 2006 ) . Surveies have besides shown that HRT is effectual in forestalling urinary piece of land infections. Cardozo et Al ‘s 1998 survey found that there was a important decrease in the incidences of urinary piece of land infection in adult females who had been treated with systemic oestrogen than those given placebo. Although several positi ons have compared many of the interventions for vaginal wasting, the long-run effects of intervention have non yet been expeditiously examined. Recommendations by regulative governments will hence be more accurate if intervention was assessed over a drawn-out period, such as one to five old ages, so that the unwanted responses to intervention can be farther examined.Menopause induced OsteoporosisOsteoporosis, the most damaging side-effect to wellness associated with the climacteric ( Samsioe, 1995 ) , is a skeletal disease characterised by a lessening in bone denseness and mass ( Howard et al, 1981 ) . The skeleton comprises compact and trabeculate bone ( Kanis, 1996 ) . In the healthy grownup, bone mass is comparatively changeless, this is despite there being considerable bone turnover, of which about 95 % of this is accounted for by the remodelling of bone ( Kanis, 1996 ) . This procedure is altered after the climacteric, where there is a period of rapid bone loss that lasts betwe en 5 to 10 old ages ( Kanis, 1996 ) . This consequences in a negative remodelling instability ( Kanis, 1996 ) . Bone mass reaches its extremum between the ages 30 and 35, after this extremum, bone mass declines at a rate of 1 % per twelvemonth ( Samsioe, 1995 ) . The rate of diminution can lift up to 6 % at the climacteric and history for a loss of a 3rd of bone mass ( Samsioe, 1995 ) , after the perimenopausal period the one-year rate of bone loss returns to the 1 % ( Samsioe, 1995 ) . There is besides grounds that there is an addition in osteoclastic activity ( Kanis, 1996 ) , where high circulating FSH induces increases osteoclast-mediated bone reabsorption which exceeds the formation of new bone ( Samsioe, 1995 ) . Both of these factors in concurrence consequences in the addition bone turnover and porousness that causes the loss of the trabeculate bone model and the cutting of the cerebral mantles ( Kanis, 1996 ; Samsioe, 1995 ) . This pathological procedure finally concludes wi th the break in the bone micro-architecture, which leads to the brickle castanetss that are more susceptible to break ( Kanis, 1996 ) . Womans have a higher cumulative life-time hazard for enduring from osteoporotic breaks about three times greater than in work forces ( Kanis, 1996 ) ; with 50 % of adult females and 20 % of work forces, over the age of 50, enduring from a break. The three most common sites of osteoporotic breaks are the distal radius, the vertebral organic structure and the upper thighbone ( Howard et al, 1981 ; Samsioe, 1995 ) . Hip break is a important cause of mortality and morbidity, where one in four adult females will non last the first twelvemonth following this break ( Samsioe, 1995 ) . Several surveies indicate that early oestrogen therapy intercession can detain or forestall bone loss at the climacteric, nevertheless, grounds back uping the continuation of the good effects after discontinuance remain debatable. A reappraisal by Bagger et Al in 2004, found there was a 4-fold increased hazard of breaks in adult females having placebo than HRT. From this consequence it was concluded that short-run oestrogen replacing therapy initiated in the early postmenopausal phases, can accomplish durable benefits to the skeletal system, in footings of the saving of bone mass and important decreases in the hazard osteoporotic breaks. However another survey by Yates et Al, found grounds that postmenopausal adult females who have discontinued HRT within the past 5 old ages have a hazard for hip break that was similar to adult females who have ne'er used HRT. The latter survey nevertheless has restrictions and is hence non conclusive. Womans who responded to the study tended to be y ounger and better educated about the importance of good wellness than the non-responders ( WHC, 2010 ) . Furthermore, it must besides be taken into consideration that the hazard of osteoporosis additions with increasing age and weight. HRT as a consequence would hold a greater decrease potency in the incidences of hip break in older adult females than in younger adult females. Therefore future surveies will necessitate to be adjusted to take into history these act uponing factors.The findings from the WHI and MWSThe possible relationship between the loss of ovarian map and development of Cardiovascular Disease ( CVD ) has been substantiated by legion case-controlled and laboratory surveies carried out since the 1980s ( Iqbal and Zaidi 2009 ) . These surveies demonstrated the protective effects of estrogens on the cardiovascular system ( Mendelsohn and Karas, 2002 ) ; which encourage the production of lipid profiles that cause vascular distension, prevents coronary artery disease and augmentation of endothelial fix after harm ( Mendelsohn and Karas, 2002 ) . After the oncoming of climacteric, degrees of estrogens begin to equilibrate to that of age-matched work forces ( Iqbal and Zaidi 2009 ) . Up until 2002, HRT was established as the most effectual signifier of intervention when bettering menopausal symptoms. However this was challenged by the publication of the preliminary findings of the WHI and MWS survey, which found the benefits of HRT on CVD to no longer be important when the other possible wellness jeopardies were taken into consideration ( WHI, 2002 ; MWS, 2003 ) . For illustration that the usage of oestrogen, with or without Lipo-Lutin, was found to be associated with an increased hazard for the development of certain signifiers of malignant neoplastic disease ( such as chest, ovarian and uterine malignant neoplastic disease ) ; this hazard was substantiated farther by drawn-out use ( WHI, 2002 ; MWS, 2003 ) . Findingss from the WHI, oestrogen plus p rogestin, test besides indicated that HRT could increase the hazard of CVD, which can take to shots and venous thromboemoblism ( WHI, 2002 ) . The WHI, oestrogen plus progestin, test published in 2002 monitored and compared the HRT related consequence on CVD and other facets of adult females ‘s wellness to that of placebo, in 16, 608 adult females in the United States aged 50 to 79 from 1993 to 2002. Around 50 % of the take parting adult females were randomised to take combined oestrogen and 50 % to take a placebo. The survey ended three old ages premature after the antecedently specified bound for chest malignant neoplastic disease instances, set by the WHI Data and Safety Monitoring Board was exceeded and overall hazards were considered to outweigh benefits. The preliminary findings showed a decreased in the hazard of osteoporotic breaks and colorectal malignant neoplastic disease ( Nelson et al, 2002 ; WHI, 2002 ) , but besides found a little addition in the incidences of coronary events, shot, chest malignant neoplastic disease and venous thromboembolism ( Nelson et al, 2002 ; WHI, 2002 ) . A subsequent reappraisa l of the findings from the WHI Study in 2004, adjusted for other act uponing factors, found different consequences where the apparent higher hazard for chest malignant neoplastic disease appear to be caused by natural factors instead than to HRT ( WHC, 2010 ) . When age was taken into history analysis showed that younger adult females get downing HRT may really be protected in some wellness facets ( WHC, 2010 ) . However those get downing on HRT over 70 did non hold the same benefits and alternatively were vulnerable to certain wellness hazards, nevertheless, this may be due to the associated hazard factors increasing with age.The Million Women Study was conducted from 1996 to 2001, analysed the hazard of chest malignant neoplastic disease and other adult females wellness issues in one million adult females taking HRT in the UK, and compared findings with that received from a sum of 828,923 adult females who were non-users: All take parting adult females were over 50 old ages old. F indingss published in 2003 found a little addition in the hazard of chest, endometrial and ovarian malignant neoplastic disease when oestrogen-only HRT was used. Combined HRT was found to hold a greater addition in the hazard of chest malignant neoplastic disease but was able to cut down the hazard of endometrial malignant neoplastic disease, when compared with oestrogen-only HRT. It was besides established that the hazard of chest malignant neoplastic disease is increased the longer HRT is used ; where the extra hazard for chest malignant neoplastic disease declined to that of ne'er users when intervention ended.Restriction of the surveiesWomen ‘s Health InitiativeThe WHI survey, merely considered the dosage of 0.625 milligram of conjugated equid estrogens and 2.5 milligram Provera acetate each twenty-four hours ; whilst this dose was appropriate for younger menopausal adult females get downing HRT, it was considered by many experts to transcend the sum required for older adu lt females ( Howard et al, 1981 ) . The specification for the adult females in the WHI survey differs from adult females in the MWS. Women in the WHI survey tended to be older ( mean age 63.2 ) than the adult females in MWS ( mean age 56 ) ( MWS, 2003 ) . Therefore two-thirds of adult females in WHI were over the age of 60 and hence had a higher absolute hazard of bosom disease, shot and chest malignant neoplastic disease ( all of which increases with age ) . The mean BMI for adult females in the survey is 28.5, therefore a big proportion of adult females in the survey are overweight and were hence predisposed to bosom disease and certain malignant neoplastic diseases.Million Women StudyThe methodological analysis of MWS has been criticised: Unlike the survey by the WHI, the MWS was non a randomised controlled test. The consequences were based on a self-reporting study where adult females chose whether or non to take HRT. Furthermore the adult females in the MWS were already holding a mammogram so may already hold been at a higher hazard for malignant neoplastic disease e.g. they may hold already suspected a ball. The adult females were followed-up by studies from national malignant neoplastic disease registers, non by subsequent questionnaires, so alternations in HRT usage after initial enrollment were non recorded. Both the surveies analysed the hazard of ovarian malignant neoplastic disease in the long-run surveies and were non meant to turn to the shorter-term usage of HT. Thus, the information from these surveies should be used by adult females sing usage of HT for longer than 3 or 4 old ages.Options to HRTTibolone is a selective oestrogen receptor modulator ( SERM ) , which possesses oestrogenic, progestogenic and androgenic features ( Nelson, 2008 ) . Tibolone is effectual at handling vasomotor symptoms and bettering sexual operation and may be used as an option to combined HRT in post-menopausal adult females ( Nelson, 2008 ; Roberts, 2007 ) . In adult females under 60, the hazards of taking tibolone are tantamount to that of combined HRT ( NHS Choices, 2009 ) . For adult females over 60, the associated hazards begin to outweigh the benefits, due to the increased hazard of chest malignant neoplastic disease, shot and endometrial malignant neoplastic disease ( NHS Choices, 2009 ) . Morris et Al ( 2006 ) conducted a clinical grounds reappraisal of seven RCTs, on the effects of tibolone on vasomotor and urogential symptoms. One test found that after 16 hebdomads of intervention, tibolone reduced vasomotor symptoms by 39 % compared with placebo ( p = 0.001 ) . However, two RCTs produced questionable consequences in respects to its efficaciousness when compared against traditional combined HRT. One test ( n=437 ) found that combined HRT when compared with tibolone, well reduced the frequence of hot flowers over 48 hebdomads ( p = 0.01 ) . However contradictory findings were found in another test of a smaller population ( n=235 ) , whe re no important difference in vasomotor symptoms between combined HRT and Tibolone was established at 52 hebdomads. Due to the rawness of findings another larger adjusted RCT should be conducted to clear up the effectivity of tibolone against combined HRT. Three tests were used to measure the efficaciousness of tibolone in the direction of urogenital symptoms. All of which concluded, with the understanding that tibolone significantly improved vaginal waterlessness, sexual desire and copulatory frequence compared to both placebo and combined HRT interventions. There is besides limited grounds to back up the usage of Catapres, Neurontin, paroxetine, Prozac, citalopram, and venlafaxine as effectual interventions hot flowers ( Nelson et al, 2006 ; Anderson and Redman, 2010 ) . The latest analysis of the hazards based on the findings from the MWS and WHI survey, has concluded with the following revised hazard estimations to help health care professionals appraisal of the hazards and benefits associated with HRT for single adult females:Cardiovascular Disease hazard:There is no addition in the hazard for CHD in adult females less than 10 old ages postmenopausal when given combined HRT ( Currie and Guttinger, 2007 ; Roberts, 2007 ) . Hysterectomised adult females taking oestrogen merely HRT besides showed no increased CHD hazard during the WHI test, alternatively the hazard for both appeared to worsen ( Currie and Guttinger, 2007 ) . However there us a little addition in hazard for adult females who were more than 10 old ages postmenopausal ( Currie and Guttinger, 2007 ) . The grounds to propose a cardiovascular benefit with oestrogen-only or combined HRT is hence weak ( CSM, 2004 ; MHRA and CHM, 2007 ) .Stroke hazardWHI found oestrogen-only and combined HRT increase the hazard of shot compared with placebo ( CSM, 200 ; MHRA and CHM, 2007 ) .Breast Cancer hazard:MWS indicated that a higher hazard of chest malignant neoplastic disease is associated with drawn-out usage ( CSM, 2004 ; MHRA and CHM, 2007 ) . For oestrogen entirely, the hazard is lower than combined HRT ( MHRA and CHM, 2007 ) . Some surveies on the other manus have non shown increased hazard when compared to those who had ne'er antecedently taken HRT ( MHRA and CHM, 2007 ) .Endometrial malignant neoplastic disease hazard:There is a little addition in the hazard of endometrial hyperplasia and carcinoma with oestrogen-only HRT ; due proliferated effects of oestrogen ( Howard et al, 1981 ) . Oestrogen-only HRT is hence merely recommended for usage by adult females with a womb ( MHRA and CHM, 2007 ) . The add-on of a progestin every twenty-four hours significantly reduces the hazard ( CSM, 2004 ; MHRA and CHM, 2007 ) ; due to its endothelial protective belongings. So when used i n combination with oestrogen it can cut down the hazard of this malignant neoplastic disease to the baseline ( MHRA and CHM, 2007 ) .Ovarian malignant neoplastic disease hazard:Experimental surveies indicate that extended usage of HRT may correlate with a little increased hazard of ovarian malignant neoplastic disease ( CSM, 2004 ) , which returns to baseline a few old ages after halting intervention ( MHRA and CHM, 2007 ) .DecisionDespite the legion contraindications for HRT, they are still by and large regarded as the most effectual short-run intervention for patients enduring from menopausal symptoms, and are recognised for their preventive effects in the development of osteoporosis. The benefits nevertheless from long-run use remain debatable ; research suggests that the potency for inauspicious effects happening additions with age and drawn-out use. Clinical reappraisals hence recommend that HRT should be given cyclically ; utilizing the lowest effectual dosage for its indicate d symptom for the shortest possible clip. A reappraisal and appraisal of any alteration in the balance of hazards and benefits should be done yearly. Womans with moderate hot flowers, particularly those with contraindications or concerns about HRT may take to seek alternate therapies. Tibolone has proven good in the intervention of menopausal symptoms in younger adult females, although its usage in older adult females remains questionable due to the increased hazards to wellness. Surveies of climacteric are vast in figure, but deficient in what they discover. Nevertheless, their consequences inform the recommendations of medical professional administrations and influence criterions of pattern. Therefore an improved apprehension of the menopausal passage, its symptoms, and therapies is needed in order to unknot this epidemiological quandary and license a better conformity from patients towards intervention. This can be achieved by the reevaluating the hazards and benefits of HRT in d ouble blinded tests against a placebo or a validated therapy because of the ample placebo consequence observed in randomized controlled tests.