People of Britain Essay Example for Free

People of Britain Essay The emergence of television as a mass medium of communication was the key turning point in improving leisure opportunities for the ordinary people of Britain. How far do you agree with this statement? At the beginning of the 20th century, the lives of ordinary people were not ideally suited to the world of leisure. An urbanised workforce and an economy geared toward industry saw lower-class people working long hours at a low pay rate. This style of living left hardly any free time and disposable income, both key requirements for leisure opportunities. The aristocracy had always revelled in the world of leisure; their high incomes and low maintenance professions gave them a perfect framework for pursuits such as dancing, theatre going, hunting, socialising and horse riding. Although there were popular activities of the working classes family games within the home for example, or more commonly, an evening spent in the local pub leisure was limited. I believe that television was the key form of mass communication to improve the leisure opportunities of the working classes as it was accessible, cheap, and knew how to cater for changing styles and tastes. When television was first introduced on a wide scale in 1936 only a small percentage of the British public owned a television license. Its initial emergence as a mass medium was therefore not a turning point, as the ordinary people simply did not have access to it. It was difficult for television to flourish before the fifties anyway, due to the condition of Britain prior to world war two. The earliest form of television had actually been introduced in the late twenties for a trial run, but the economic slump of the decade guaranteed an impossible environment in which to launch it. The British workers were in a poor situation, and leisure opportunities would have been at the bottom of their priorities list. Shortly afterward, the country was gearing up for war and with the emphasis on this preparation the BBC was forced by the government to shut down television broadcasting until 1945. As a result of the impracticalities of earlier decades, television was not a widespread phenomenon until the 1950s, when in 1952 the first televised coronation of Elizabeth II took place, with the BBC dedicating a whole day to the coverage. 50% of the population watched the ceremony (a figure of around 25 million people) and sales of television sets rocketed prior to the event. I would argue that it was the 1950s and onwards, in which television became a crucial part of ordinary peoples leisure time. As part of the consumer culture of the fifties, the sale of television sets increased massively more than 42,000 sets were sold every month in 1950 and this figure had more than tripled by the mid 1950s when 140,500 sets were sold per month in Britain. Television seemed to be ideally suited to the working classes; it was cheap (after the initial purchase of the set and a television license, no extra fees were needed), based in the home (travelling would have cost extra money), family orientated (working class families were usually larger than those of other classes) and a relaxing leisure pursuit after a long day at work. The environment of the 1950s was significantly different from those of the 20s, 30s and 40s. Britain was considerably wealthier due to the post-war boom shared by other countries such as America, there was full employment and the importance of leisure seemed to grow especially with the influence of 1950s American youth culture. Televisions ability to change and adapt to the interests of the ordinary classes and the youth of the decade was also something that set it aside from other forms of mass communication. Whilst BBC radio had come under criticism for being too elitist, television (especially during the 1960s) made a real effort to represent the working classes. By the late 50s ITV was producing very popular variety shows- a mix of comedy, music and other light entertainment wrapped in a family package which appealed to a mass audience. Televisions interest in the needs and wants of the majority continued into the sixties. The 1960s has been described as the decade of television revolution, with the introduction of many new programmes designed for the working classes. The new ITV channel had been very successful since its launch in 195_ and the BBC split into BBC1 and BBC2 in the early sixties, with colour being introduced in 1968.

Apple Case Study Essay Example for Free

Apple Case Study Essay Apple Inc. (previously Apple Computer, Inc. ) is an American multinational corporation that designs and markets consumer electronics, computer software and personal computers. Apple currently has 246 retail stores located in 44 states that employs over 27,000 retail employees. Apple also employs over 304,000 U. S. individuals from development to transportations. As of September 11, 2012, Apple is the largest publicly traded company ever. Apple has established a unique reputation in the consumer electronics industry. This includes a customer base that is devoted to the company and its brand, particularly in the United States. Fortune magazine named Apple the most admired company in the United States in 2008 and in the world in 2008, 2009, 2010 and2011. This case study will not only highlight Apple’s strengths, it will also discuss its weaknesses and past failures that have laid the foundation to become one the most powerful companies in the world. As the story famously goes, â€Å"two Steves† started one of the biggest computer companies ever in a garage after quitting their day jobs. Steve Jobs worked at Atari, a computer and gaming company and Steve â€Å"Woz† Wozniak worked at Hewlett-Packard. A friend introduced the two seeing their mutual interest in electronics. Woz had built a computer in his spare time as a hobby. According to Charles Hill and Gareth Jones (2012), authors of Essentials of Strategic Management, â€Å"That is what people did in 1976,† (p. C13). Jobs realized that people might want to buy such a machine and persuaded Woz to set up a company to make and market it. Headquarters: Jobs’ garage in California. Thus Apple Computers was born. A total of 200 units were sold at a price of $666 each; the product rolled out on April Fool’s Day in 1976 at a local electronics store. The company went on to see great successes and some failures, and the two Steves are heralded as revolutionizing the personal computer industry. After improving on the garage computer, named Apple I, with better graphics, more data storage and a simpler looking machine, Apple introduced the Apple II in 1977. This personal computer that was user friendly to non-computer using consumers soon made the two twenty somethings into millionaires. Throughout the years, subsequent models that improved on the speed and design of the Apple II were released. With these improvements came additional products: software, external drives and printers, to name a few. By 1983, the Apple IIe was introduced, which would become Apple’s most popular and best-selling of all models. In the ‘80s and ‘90s, Apple computers became computing standard for elementary schools. By the time the Apple II line became defunct, more than 2 million Apple IIs had been sold and home computers were gaining popularity. Apple Computers also changed its name simply to Apple to reflect its diversity of products. During this general timeframe, Woz was piloting a plane that stalled and crashed; he suffered some memory loss. He returned to Apple sporadically throughout the ensuing years but formally ended his full-time association with the company in 1987. Two new engineers were brought on board for two new project ideas: Jeff Raskin for the Macintosh computer model and Bill Atkinson for the more business-oriented Lisa computer. The Macintosh became a success; the Lisa did not. In 1991 Apple continued to build on its founders’ guiding principle—that the individual, not the mainframe, should be at the center of the computing universe (â€Å"Silicon Valley,† 2012). The company introduced a portable Mac, which was the predecessor of the modern laptop. In 1993 it launched the Newton, a personal digital assistant which let consumers compute without sitting at a desk. The end of the 1990s brought yet another breakthrough Apple computer—the iMac, which touted power, ease of use and esthetics. The iPod, a digital music player and the iPhone, a phone with Internet capabilities, are two of Apple’s newest immensely popular products. Steve Jobs died of cancer in October of 2011 after working and leading on and off at Apple throughout the years; Woz is 62 and currently spends his time as a writer, speaker, researcher and philanthropist. Tim Cook is the current CEO of Apple. On August 20, Apple officially became the most valuable company in history in terms of market capitalization (â€Å"Forbes,† 2012). Heading into the final hour of trading on the NASDAQ, the stock had risen more than two percent, giving the company a market cap of over $620 billion with shared trading over $662 apiece. The reason—speculation over its newest product release—the iPhone 5. Identification of the company’s internal strengths and weaknesses Strengths: †¢Product development. Doesnt invent the market, but its products set high standards for the market †¢Design and utility. Sleek, not clunky. For instance, the desktop computer is part of the screen, not a separate box with wires; the iPhone has very few buttons and feels nice in the hand. Products are easy to use, almost intuitive †¢Marketing. Clever and takes advantages of peoples frustrations with other hardware †¢Brand name †¢ Globally recognized †¢Rapid growth and high profits †¢ Pioneer of innovative and high-tech quality products such as iPod, iPhone and iPad †¢Strong Research Development department (9% of sales devoted to RD) †¢ Having the control of both its own hardware and software †¢ Having had a visionary, charismatic and innovative CEO like Steve Jobs †¢ Apple retail store experience allowing customers to use and experience Apple’s products †¢ Having a large segment of loyal customers †¢Sales of add-on products Highlighting of its products as the world’s greenest line-up of notebooks Weaknesses: †¢Very proprietary and controlling. Wont open the operating system to outsiders to develop hardware to work with the products, keeping hardware sales to itself. While this keeps design control inside and up to standards, it has hurt wide adaptation of its hardware, especially computers, where it has a relatively small market share. Apple has veto power over Apps sold †¢ The death of Steve Jobs and the absence of his leadership will be a weakness for Apple as they find ways to match his innovation †¢Not shareholder-friendly. Has abused option granting in the past and refuses to pay a dividend despite a huge (and growing) cash level, no debt, and plentiful free cash flow †¢The battery life of the products are seen as weak †¢ Failure of two products; First Apple TV launch and Mac Mini †¢ Decision to restrict the iPhone to a single network †¢ The lack of QWERTY keyboard in products like iPad and iPhone †¢ Low market share in comparison with HP, Dell, Acer, Lenova and Toshiba †¢ Apple products are highly priced, so it is hard to suit their target market Opportunities: †¢Loyal customer base which has expanded beyond the Mac-heads of the 1990s with the iPod and the iPhone. The iPad has had a very successful launch. This seems to be leading to more sales of computers. †¢Has a well-deserved reputation for high-quality products that work smoothly. New products are generally well-received and have a built in purchasing base. †¢Move into other computer or media product spaces that are not served well. Can continue to design the standard-setter for those spaces. †¢A new version of Apple TV could take advantage of todays more highly developed Web. Threats: †¢Big ideas are easy to copy. Microsoft copied the graphical user interface, and even Linux has a version. The touchscreen interface is being used in other phones (e. g. Android). Apps are being developed for other smart phones and devices. †¢High-priced products. Apple priced itself out of the personal computer market, and that remains a problem. Other smartphones that look and behave similarly to the iPhone are less expensive. †¢Google is moving into Apples smartphone space by giving away the operating system, and it has announced that it will also be moving into the TV space. Both companies are well-funded, so any battle between the two could be long and ugly. Nature of external environment surrounding the company The industry grows and changes at an alarming pace. Every day there are new products that flood the market. New technology changes cell phones, laptops and new products are advertised every week. The major companies in the industry are Apple, Acer, Dell, and ‘Hewlett Packard’. In order for new companies to break into this market, they need to have a high entry barrier as well as a differentiated strategy from the existing companies. There is also a high learning curve with the customers getting accustomed to the new products. The existing brand names make the entry barrier very difficult to break into. Apple seems to be financially stable and healthy with weaknesses and threats that Apple has overcome and conquered in its past. The strengths show Apple’s foundation built upon a long line of unique products and branding, powerful research and development along with commanding marketing gurus that make Apple the powerhouse it has become today. Financially, the financial papers seem to be responsible and accountable with much thought put into Apple’s strategy. According to YCharts (June 30, 2012), Apple’s current ratio is 1. 71, which is slightly above book value. When you have a current ratio of 1, it means that your current assets are exactly the same as your current liabilities. â€Å"The current ratio measures a companys ability to pay short-term debts and other current liabilities by comparing current assets to current liabilities† (YCharts, 2007-2012, para. 1). Apple’s gross profit margin (sales-cost of goods sold/revenue) is 42. 81%, gross profit margin represents the percentage of each dollar of a companys revenue that is available to cover fixed costs after paying for the goods or services that were sold. With Apple seizing new opportunities every day, Apple will continue to dominate its markets for a long time to come and will remain fiscally responsible while continuing to make large profits, making it a wise decision to invest in the Apple organization. SWOT analysis It cannot be debated that Apple has many strengths. They should not, however, become complacent with their success and in order to maintain its competitive advantage, the company must constantly evaluate their internal and external operations and address its weaknesses and threats, as well as assess its strengths and use them appropriately. One of Apple’s current strengths is its brand recognition and strong brand image. Apple has effectively used this strength through product development. As Apple took the market by storm and was gaining momentum, it expanded its product offering. With each new product such as the iPhone and the iPad, consumers expected the same quality and ease of use as Apple’s preceding products as they had already established that position in the consumer mind. Apple also has an enviable position in the market place and in the minds of the financial world. Apple’s robust financial performance is strength as the growth in capital allows for continued growth. While reviewing the strengths, one must also consider the weaknesses. For example, Apple’s weaknesses can be demonstrated with the release of the iPhone 4 and the concerns over the antenna on the product and how it could affect the performance of the device. Product recalls can result in a damaged image and reputation which will affect sales. Recalls also result in warranty and other expenses. It is clear that Apple views the iPhone as a major opportunity. The iPhone leads the company in percentage of sales, and with he new release of the 4s, combined with additional service providers supporting the device, will continue to do so. The expanding tablet market and demand for mobile technology also makes the iPad market a big opportunity for Apple. Expanding in international markets is also a big opportunity for Apple. Despite its strengths and opportunities, Apple faces many threats. One major threat to the company’s iPhone growth is the rising popularity of Google’s Android. Critics and users alike have stated that the Android is comparable, if not superior, to the iPhone technology. This fierce competitor is sure to affect Apple’s market share. In conclusion, an overview of Apple’s SWOT allows us to break down current strengths, as well as weaknesses, opportunities and threats. This allows us to further analyze the company as a whole and is imperative when devising a corporate strategy. The kind of corporate level strategy the company is pursuing Apple’s corporate strategy is to focus on making the industries’ best products. They are a company that focuses on innovation, and also improvements on their existing products. They use the focused differentiation strategy, by making products that are exclusive, and fairly expensive. Not everyone can afford an Apple product. They focus on aligning their business strategy and their marketing strategy with product development. This is something that they do much better than their competitors, and this is a huge advantage for them. Apples target market is people who are willing to pay more for products with better user experience, people who like to have fun with technology, music enthusiasts and people who work with media and design professionals. They have done a good job by finding out which customer needs to satisfy. They have found out that these customers want a nice, beautiful and simple design and user input, and they have focused on programs that help photograph and edit both pictures and videos, as well as good music programs to both listen to and make music. To make these programs, they have to have to focus on innovation, and have programmers and designers that can make programs like thisthat are easy to use, beautiful to look at, and do what you expect them to do. The nature of the company’s business-level strategy Apple’s fundamental business model has not changed since it first began business in the late 1980s. Apple’s organizational strategy â€Å"think different† is to control the development and design of the hardware and software for all of its products. The company is focused on providing innovative products and solutions to consumers. Apple has a simple strategy of providing customers with the best products and experiences possible. Another strategy is offering exclusiveness of their products to certain providers and companies. This not only builds a strong working relationship, but also builds a strong want by consumers for Apple products. I think the most important strategy is their branding strategy. This includes making new products that supports a â€Å"digital hub† strategy. This is a concept where the products that Apple produces will function as a hub for digital devices such digital cameras, cell phones, etc. Apple focuses on the lifestyle of the customer which includes imagination, hopes, dreams, and many more attributes. They are committed to the customer (Apples branding strategy, 2011). Mission Statement Apple mission statement is as follows, â€Å"Apple designs Macs, the best personal computers in the world, along with OS X, iLife, iWork, and professional software. Apple leads the digital music revolution with its iPods and iTunes online store. Apple reinvented the mobile phone with its revolutionary iPhone and App Store, and has recently introduced its magical iPad which is defining the future of mobile media and computing devices (Investor relations, 2011). † Steve Jobs stated that Apple’s â€Å"core value that the company believes, is people with passion can change the world for the better. † He stressed that value at its core is something that should never change despite the world changing around it. The company’s structure and control systems and how they match its strategy Apple’s first product, the Apple I, was vastly different from the Apple products of today. This first handmade computer kit was constructed by Apple co-founder Steve Wozniak. It lacked a graphic user interface (GUI), and buyers had to add their own keyboard and display. Co-founder Steve Jobs convinced Wozniak that it could be sold as a commercial product. In 1976 the Apple I was unveiled at the Home Brew Computer Club and put on sale for $666. 66. Jobs and Wozniak continued to create innovative products. Soon their new company, Apple Computer Inc. , had surpassed $1 million in sales. However, the mid-1980s saw some difficult times for Apple. In 1983 the company introduced the Apple Lisa for $10,000. The product flopped. In 1985 Steve Jobs was ousted after internal conflicts with the Apple CEO. Its computer products the Mac I and the Newton were not successful, and the company underwent several CEO changes. With declining stock prices, the future of Apple was in jeopardy. Steve Jobs returned to Apple in 1997 to try and save the struggling company. The return of Jobs introduced a new era for Apple. Jobs immediately began to change the company’s corporate culture. Before Jobs’ return, employees were more open about Apple projects. After he returned, Jobs instituted a â€Å"closed door† policy. Today Apple continues to remain vigilant in protecting its technology and ensuring that information remains proprietary. Jobs also created a more flattened organizational structure; rather than go through layers of management to address employees, he addressed them directly. Perhaps one of the most noticeable changes, however, was Apple’s expansion into new product lines within the electronics industry. In 2001 Apple launched the iPod—a portable music player that forever changed the music industry. The company also introduced iTunes, a type of â€Å"jukebox† software that allowed users to upload songs from CDs onto their Macs and then organize and manage their personalized song libraries. Two years later Apple introduced the iTunes Store, in which users could download millions of their favorite songs for $0. 99 each online. In 2007 Jobs announced that Apple Computer, Inc. would be re-named Apple Inc. This signified that Apple was no longer just a computer manufacturer but also a driver in consumer electronics. Some saw this as a shift away from computers toward consumer electronics such as Apple TV, iPods, iTunes, iPhones, and iPads. However, it may be more accurate to say that Apple is reinventing computers. With the introduction of tablet computers such as the iPad, Apple has begun to take market share away from its top competitors in the computer industry. Sales of desktops, laptops, and netbooks began to decline after tablet computers were introduced. Analysts believe that tablet computers will continue to grow at a rapid rate. Apple’s transition from a computer to a consumer electronics company is unprecedented—and hard to replicate. Although many can only speculate about why Apple succeeded so well, they tend to credit Steve Jobs’ remarkable leadership abilities, Apple’s highly skilled employees, and its strong corporate culture. Conclusion Today, Apple continues to lead the industry with their outstanding and ‘ award winning’ products and services. Apple is also credited with leading the digital media revolution with their iPod portable music and video players and iTunes online media store, creating the first sustainable music-downloading business model in history (Gershon, 2009, p. 367). The company has also entered the mobile phone industry with an altogether different business strategy known as† value innovation† with the iPhone. Value innovation focuses on making the competition irrelevant by opening up new and untapped markets, creating a leap in value for consumers. The iPhone is yet another product that has changed the way the industry defines new product standards and possibilities. With growing demand for high-quality, powerful, user-friendly, and cost effective products, Apple is undoubtedly the leader in terms of bringing these ideas to life. The company realizes that rather than publicly announcing product development plans years in advance, products are better received with an â€Å"awe† response if they are simply released when they’re finished as opposed to providing â€Å"beta† or â€Å"demo† versions to the public. This is an excellent strategy when the goal is to keep consumers eager for the latest products and asking, â€Å"What could they possibly improve next? †

Management of Shoulder Dystocia: A Reflective Essay

Management of Shoulder Dystocia: A Reflective Essay Title: A reflective essay on how you would manage a shoulder dystocia as an obstetric emergency in a stand alone midwife led unit.   Undergraduate Degree Level Essay 1,000 Words Essay The condition of shoulder dystocia is diagnosed when the delivery of the foetal head is prevented by the impaction of one of the foetal shoulders within the mother’s pelvis. Simple head traction or episiotomy alone will not resolve the condition Shoulder dystocia is a complication of labour which is notoriously difficult to manage. It has a high complication rate and an increased rate of mortality. A number of studies have highlighted the fact that management is not always optimal. (Crofts, et al. 2006). Two UK studies produced similar findings that avoidable factors were identifiable in 66% of the perinatal deaths associated with shoulder dystocia. The definition of â€Å"avoidable factors† being a different management would have produced a better outcome. This malpresentation occurs in about 2% of vaginal deliveries and common associated morbidities include permanent brachial plexus injury, fracture of the clavicle, foetal haematoma and hypoxic brain injury. (Draycott, et al. 2008). Because the majority of cases of shoulder dystocia occur in the absence of predictable risk factors, all healthcare professionals in charge of a delivery should have an optimal plan to resolve shoulder dystocia in the safest way possible in any given circumstance. Management The management of shoulder dystocia is a subject that has acquired a large literature in its own right. It is therefore not appropriate to discuss it in great detail. Many of the studies done on the subject have identified a number of â€Å"critical tasks† in the delivery process. These include recognizing shoulder dystocia, asking for additional help, calling for paediatricians to be attend the delivery, applying gentle downward traction on the fetal head, placing the patient in McRoberts position, and applying appropriate suprapubic pressure. (Deering, et al. 2005) A number of mechanisms have been advised in the literature and these include rotational manoeuvre (Rubins or Woodscrew), episiotomy, delivery of the posterior arm, fracture of clavicle, symphysiotomy, all-fours manoeuvre, a cephalic replacement (Zavenelli) manoeuvre if other manoeuvres were not successful. (Crofts et al. 2008) Predisposing factors. Shoulder dystocia appears to occur in cases where there are no discernable predisposing factors however, there are some conditions that appear to make it more likely. The strongest single predictor appears to be foetal macrosomia. A number of authorities have suggested that maternal obesity is an association of the condition, but the meticulous study by Robinson showed conclusively that it was only obesity in diabetic mothers (that was associated with macrosomia) that had a high incidence of shoulder dystocia. Other causes of obesity did not have this association. (Robinson, et al. 2003) Gonen was able to report that a critical weight appeared to be 4,500 g with 33% of infants over this weight having shoulder dystocia and only 2% who were under it. (Gonen, et al. 1996) Birth position There appears to be considerable controversy regarding the ideal birth position. The McRoberts position (with maternal hips in flexion), combined with suprapubic pressure, has been reported as resolving 50% of identified cases of shoulder dystocia (German, et al. 1997). It is thought to achieve its effect through a rotation of the symphysis pubis and flattening of the sacrum. This, together with fundal pressure, is believed to reduce the possibility of the anterior shoulder being impacted under the symphysis pubis. There are some reports of the possibility of increased maternal morbidity (Heath, et al. 1999) and lack of effect (Beall, et al. 2003) Reflection. On a personal note, I have reflected on my own practice in dealing with cases of shoulder dystocia. As a result of researching this essay I have resolved to further explore the evidence base for dealing with the situation, because critical analysis of some of the papers read have challenged some of the ideas that I had previously believed to be true. In particular, I note papers which have analysed the behaviour of the responsible clinician in cases of shoulder dystocia and have been concerned about the frequent lack of paediatric back up. This has been identified as a failure on the part of the lead clinician, who is often so engrossed in the management of the condition that back up is simply overlooked. I have personally experienced cases where this has occurred and believe that a high degree of assertiveness is required if I see that it has been overlooked in the future. References Beall M H, Spong C Y, Ross M G (2003) A Randomized Controlled Trial of Prophylactic Maneuvers to Reduce Head-to-Body Delivery Time in Patients at Risk for Shoulder Dystocia. Obstetrics Gynecology 2003; 102: 31 35 Crofts J F, Bartlett C, Ellis D, Hunt L P, Fox R, Draycott T J (2006) Training for Shoulder Dystocia : A Trial of Simulation Using Low-Fidelity and High-Fidelity Mannequins : Obstetrics Gynecology 2006; 108 : 1477 1485 Crofts J F, Bartlett C, Ellis D, Winter C, Donald F, Hunt L P, Draycott T J (2008) Patient-actor perception of care: a comparison of obstetric emergency training using manikins and patient-actors. Qual. Saf. Health Care, February 1, 2008; 17 (1): 20 24. Deering S, Satin A J (2005) Evaluation of Residents Delivery Notes After a Simulated Shoulder Dystocia. Obstet. Gynecol., February 1, 2005; 105 (2): 448 449. Draycott T J, Crofts J F, Ash J P, Wilson L V, Yard E, Sibanda T, Whitelaw A. (2008) Improving Neonatal Outcome Through Practical Shoulder Dystocia Training. Obstet. Gynecol., July 1, 2008; 112 (1): 14 20. German R B, Goodwin T M, Souter I, Neumann K, Ouzounian J G, Paul R H. The McRoberts’ maneuver for the alleviation of shoulder dystocia: How successful is it? Am J Obstet Gynecol 1997; 176 : 656 – 61. Gonen R, Spiegel D, Abend M. Is macrosomia predictable and are shoulder dystocia and birth trauma preventable? Obstet Gynecol 1996; 88 : 526 – 9. Heath L T, Gherman R B. Symphyseal separation, sacroiliac joint dislocation and transient lateral femoral cutaneous neuropathy associated with McRoberts’ maneuver. J Reprod Med 1999; 44 : 902 – 4 Robinson H, Tkatch S, Mayes D C, Bott N, Okun N. (2003) Is Maternal Obesity a Predictor of Shoulder Dystocia? Obstetrics Gynecology 2003; 101 : 24 27 ############################################################### 12.8.08 Word count 1,060 PDG Different Medicinal Plants: Use Of Different Medicinal Plants: Use Of MEDICINAL PLANTS This section consist a list of sub-groups that gives information about Introduction, Importance, Systems of medicine, Utilization of medicinal plants. Introduction to Medicinal plants: About 250,000 higher plant species on earth, more than 80,000 species are reported to have at least some medicinal value and around 5000 species have specific therapeutic value. Herbs are staging a comeback and herbal renaissance is happening all over the globe. The herbal products today symbolize safety in compare to the synthetics that are considered as unsafe to human and environment. Even though herbs had been priced for their medicinal, flavoring and aromatic qualities for centuries, the synthetic products of the modern age surpassed their importance, for a while. However, the blind dependence on synthetics is over and people are returning to the herbals with hope of safety and security. Over three-quarters of the world population relies mainly on plants and plant extracts for health care. More than 30% of the entire plant species were used for medicinal purposes. (Joy, P.P., 2001) Herbals in world market: It is estimated that world market for plant derived drugs may account for about Rs.2, 00,000 crores. Presently, Indian contribution is less than Rs.2000 crores. The annual production of medicinal and aromatic plants raw material is worth about Rs.200 crores. This is likely to reach US $5 trillion by 2050. It has been estimated that in developed countries such as United States, plant drugs constitute as much as 25% of the total drugs, while in fast developing countries such as China and India, the contribution is as much as 80%. Thus, the economic importance of medicinal plants is much more to countries such as India than to rest of the world. (Joy, P.P., 2001) Biodiversity of herbals in India: India is one of the worlds 12 biodiversity centers with the presence of over 45000 different plant species. Indias diversity is UN compared due to the presence of 16 different agro-climatic zones, 10 vegetation zones, 25 biotic provinces and 426 biomes (habitats of specific species). Among these, about 15000-20000 plants have good medicinal value. However, only 7000-7500 species are used for their medicinal values by traditional communities. In India, drugs of plant origin have been used in traditional systems of medicines such as Unani and Ayurveda since ancient times. The Ayurveda system of medicine uses about 700 species, Unani 700, Siddha 600, Amchi 600 and modern medicine around 30 species. About 8,000 herbal remedies have been included in Ayurveda. The Rig-Veda (5000 BC) has recorded 67 medicinal plants, Yajurveda 81 species, Atharvaveda (4500-2500 BC) 290 species, Charak Samhita (700 BC) and Sushrut Samhita (200 BC) had described properties and uses of 1100 and 1270 species respectively, in compounding of drugs and these are still used in the classical formulations, in the Ayurvedic system of medicine. (Joy, P.P., 2001) Sources of medicinal drugs: The drugs are derived either from the whole plant or from different organs, like leaves, stem, bark, root, flower, seed, etc. Some drugs are prepared from excretory plant product such as gum, resins and latex. Plants, especially used in Ayurveda can provide biologically active molecules and lead structures for the development of modified derivatives with enhanced activity and /or reduced toxicity. Some important chemical intermediates needed for manufacturing the modern drugs are also obtained from plants (Eg. ÃŽÂ ²-ionone).The forest in India is the principal(diosgenin, solasodine) repository of large number of medicinal and aromatic plants, which are largely collected as raw materials for manufacture of drugs and perfumery products. The small fraction of flowering plants that have so far been investigated have yielded about 120 therapeutic agents of known structure from about 90 species of plants. Some of the useful plant drugs include vinblastine, vincristine, taxol, podophyllo toxin, camptothecin, digitoxigenin, gitoxigenin, digoxigenin, tubocurarine, morphine, codeine, aspirin, atropine, pilocarpine, capscicine, allicin, curcumin, artemisinin and ephedrine among others. (Joy, P.P., 2001) History of herbal medicine: Ayurveda, Siddha, Unani and Folk (tribal) medicines are the major systems of indigenous medicines. Among these systems, Ayurveda is most developed and widely practiced in India. Ayurveda dating back to 1500-800 BC has been an integral part of Indian culture. The term comes from the Sanskrit root Au (life) and Veda (knowledge). As the name implies it is not only the science of treatment of the ill but covers the whole gamut of happy human life involving the physical, metaphysical and the spiritual aspects. Ayurveda is gaining prominence as the natural system of health care all over the world. Today this system of medicine is being practiced in countries like Nepal, Bhutan, Sri Lanka, Bangladesh and Pakistan, while the traditional system of medicine in the other countries like Tibet, Mongolia and Thailand appear to be derived from Ayurveda. Phytomedicines are also being used increasingly in Western Europe. Recently the US Government has established the Office of Alternative Medicine at the National Institute of Health at Bethesda and its support to alternative medicine includes basic and applied research in traditional systems of medicines such as Chinese, Ayurvedic. (Joy, P.P., 2001) Disadvantages: A major lacuna in Ayurveda is the lack of drug standardization, information and quality control. Most of the Ayurvedic medicines are in the form of crude extracts which are a mixture of several ingredients and the active principles when isolated individually fail to give desired activity. This implies that the activity of the extract is the synergistic effect of its various components. About 121 (45 tropical and 76 subtropical) major plant drugs have been identified for which no synthetic one is currently available. The scientific study of traditional medicines, derivation of drugs through bio prospecting and systematic conservation of the concerned medicinal plants is of great importance. Unfortunately, much of the ancient knowledge and many valuable plants are being lost at an alarming rate. Red Data Book of India has 427 entries of endangered species of which 28 are considered extinct, 124 endangered, 81 vulnerable, 100 rare and 34 insufficiently known species (Thomas, 1997).There are basically two scientific techniques of conservation of genetic diversity of these plants. They are the in situ and ex situ method of conservation. (Joy, P.P., 2001) In Situ conservation of medicinal plants: It is only in nature that plant diversity at the genetic, species and eco-system level can be conserved on long-term basis. (www.ggssc.net) It is necessary to conserve in distinct, representative bio geographic zones inter and intra specific genetic variation. Ex situ conservation of medicinal plants: A. Ethno-medicinal plant gardens: Creation of a network of regional and sub-regional ethno-medicinal plant gardens which should contain accessions of all the medicinal plants known to the various ethnic communities in different regions of India. This chain of gardens will act as regional repositories of our cultural and ethno medicinal history and embody the living traditions of our societys knowledge of medicinal plants. (www.ggssc.net) Current status: There are estimated to be around 50 such gardens in the country ranging from acre to 40 acres some of them were set up by an All India Health Network (AHN). More recently a network of 15 such gardens has been set up in 3 states of South India with the initiative of FRLHT. One of the gardens is located in TBGRI, (Tropical botanical garden research institute) Palode at Thiruvananthapuram. B. Gene banks: In India there is a large number of medicinal plant species are under various degrees of threat. The precautionary principles would suggest that an immediate and country-wide exercise be taken up to deposit seeds of wild medicinal plants with a first priority to known Red listed species and endemic species. Current status: The department of bio-technology, Government of India has recently taken the initiative to establish 3 gene banks in the country. One is with ICAR at the NBPGR (National Bureau of plant genetic Resources) Campus, the second is with CIMAPs, (Central Institute of Medicinal and Aromatic plants) Luck now and the third with TBFRI in Thiruvananthapuram. C. Nursery network: The most urgent and primary task in order to ensure immediate availability of plants and planting materials to various user groups is to promote a nationwide network of medicinal plant nurseries, which will multiply all the regional specific plants that are used in the current practice of traditional medicine. These nurseries should become the primary sources of supply of plants and seed material that can be subsequently multiplied by the various users. Current status: Planting material for 40 odd species of medicinal and aromatic plants is reportedly available in the ICAR and CSIR (CIMAP) network. In South India FRLHT (Foundation for Rural Revitalization of Local Health Tradition) has recently set up a network of 55 supply nurseries. D. Cultivation of medicinal plants: Figures projecting demand and trade in medicinal plant species globally indicate a step upward trend in the near future. One estimate puts the figure of world trade in medicinal plants and related products at US $ 5 trillion by A.D. 2050 (world bank report , 1996).The demand so far has been met mainly from wild sources. This cant go on for much longer; policy intervention is urgently needed to encourage and facilitate investments into commercial cultivation of medicinal plants. (Joy, P.P., 2001) Cultivation of medicinal plants is inversely linked to prevalence of easy and cheap collection from the wild, lack of regulation in trade, cornering of the profits from wild collection by a vast network of traders and middlemen and absence of industrys interest in providing buy-back guarantees to growers. Current status: In the Govt. sector agro-technology of 40 odd species has been developed by ICAR Agricultural University System and CSIR (CIMAOs RRL, Jammu and Jorhat). In recent years industries like Dabur, Zandu, Indian Herbs, Arya Vaidya Shala, and Arya Vaidya Pharmacy and others have made some symbolic efforts to initiate cultivation. Since1984 NABARD (National Bank of Agricultural and Rural Development) has formulated schemes for financing cultivation and processing of medicinal plants. E. Community based enterprises: The income generated by the traditional medicine industry benefits small section of the society. A strong case exists for promotion of community level enterprises for value addition to medicinal plants through simple, on site techniques like drying, cleaning, crushing, powdering, grading, packaging etc. This will also increase the stake of rural communities in conservation and change the skewed nature of income distribution of the industry. Current status: Three community based enterprises are known in south India, one in Gandhi gram Trust, (Dindigul), Premade development Society (Peer made) Kerala and the third by VGKK in B.R.Hills, Mysore. Importance of Herbal Medicines: Herbal medicines are prepared from a variety of plant material such as leaves, stems, roots, bark, etc. They usually contain many biologically active ingredients and are used primarily for treating mild or chronic ailments. (www.ggssc.net) Herbal remedies can also be purchased in the form of pills, capsules or powders, or in more concentrated liquid forms called extracts and tinctures. They can apply topically in creams or ointments, soaked into cloths and used as compresses, or applied directly to the skin as poultices. A combination therapy integrating ayurveda and allopathy whereby the side effects and undesirable reactions could be controlled can be thought of. Studies can show that the toxic effects of radiations and chemotherapy in cancer treatment could be reduced by Ayurvedic medications and similarly surgical wound healing could be accelerated by Ayurvedic medicines. Modern science and technology have an essential role to play in the process. Systems of Medicine: There are mainly 3 systems of medicine practiced in the world today. They are, Modern System of medicine or Allopathy: This system was developed in the Western countries. In this system drugs (tablets, capsules, injections, tonics etc.) are manufactured using synthetic chemicals and / or chemicals derived from natural products like plants, animals, minerals etc. This system also uses modern equipment for diagnosis, analysis, surgery etc. Medicines or drugs of this system is often criticized for its treatment of the symptoms rather than the cause of the disease, harmful side effects of certain drugs and for being out of reach of common / poor people due to the high cost of drugs and treatment. This system is used in all the countries of the world today. (www.ggssc.net) Alternative Medicine or Traditional System: Different countries of the world developed independently their own traditional systems of medicine using locally available materials like minerals and products of plants and animals. (www.ggssc.net) The World Health Organization (WHO) is giving importance to these alternate medicine systems to provide Primary Health Care to millions of people in the developing countries. Development of herbal medicine: China developed the Chinese system of medicine, which is practiced in China, Singapore, Taiwan, Japan and other countries. In India, Ayurveda (developed in North India), Siddha (developed in Tamil Nadu) and Nagarjuna (developed in Andhra Pradesh) systems of medicine were developed. Ayurveda is practiced in Sri Lanka, Pakistan and Bangladesh also. Herbo-mineral is another traditional system used in India and other neighbouring countries. Drugs (balms, oils, pills, tonics, paste etc) are manufactured and marketed in these systems. (Joy, P.P., 2001) Advantages of traditional medicine: Traditional systems of medicine continue to be widely practiced on many accounts. Population rise, inadequate supply of drugs, prohibitive cost of treatments, side effects of several allopathic drugs and development of resistance to currently used drugs for infectious diseases have led to increased emphasis on the use of plant materials as a source of medicines for a wide variety of human ailments. Folk Medicine or tribal medicine: The medicinal systems followed by various tribals of different countries are popularly known as folk or tribal medicine. In the system, the medicine man or the doctor of the tribe who has the knowledge of treating diseases, keeps this knowledge as a closely guarded secret and passes it to the next generation by word of mouth. No written texts on these systems are available and different tribes follow different time tested methods. The treatment is often associated with lengthy and mystic rituals, in addition to prescription of drugs (decoctions, pastes, powders, oils, ashed materials etc.). Generally speaking, folk medicine can also be regarded as a traditional system of medicine. The basic aim of all the above systems of medicine is to alleviate the sufferings of human beings and their domesticated animals. (www.ggssc.net) Other Systems of medicine: Yoga, Acupressure, Acupuncture, Reiki, Magneto therapy, Pyramid therapy, Flower therapy, Homeopathy, Nature Cure or Naturopathy etc. are some of the other systems of medicine practiced in different parts of the world today. Utilization of Herbal Plants: The utility of medicinal plants has four major segments they are, Medicinal plants utilized in indigenous or traditional systems of medicines (ISM) Ayurveda, Siddha, Unani and Homeopathy systems of medicines , OTC (over the country, non-prescription) items / products involving plant parts, extracts galenicals etc. , Essential oils , Phyto pharmaceuticals or plants used in modern systems of medicine. (www.ggssc.net) Medicinal plants used in Traditional Systems of Medicine: As its name implies, it is the part of tradition of each country which employs practices that have been handed down from generation to generation. An important feature of traditional therapy is the preference of practitioner for compound prescriptions over single substance/drug as it is being held that some constituents are effective only in the presence of others. This renders assessment of efficacy and eventually identification of active principles as required in international standards much difficult than for simple preparation. In India, earlier the medicines used in indigenous systems of medicines were generally prepared by the practicing physicians by themselves, but now this practice has been largely replaced by the establishment of organized indigenous drug industries. It is estimated that at present there are more than 1, 00,000 licensed registered practitioners of Ayurveda, Siddha, Unani medicine or Homeopathy. In fact reliable data on availability in different regions of country as well as supply and demand of medicinal plants used in production of indigenous medicines are not available. (www.ggssc.net) Plants-parts, extracts and galenicals of medicinal herbs: The direct utilization of plant material is not only a feature of ISM in the developing world but also in developed countries like USA, UK, Germany etc., the various herbal formulations are sold on health food shops. Preparation of decoctions, tinctures, galenicals and total extracts of plants also form a part of many pharmacopoeias of the world. The current trend of medicinal plants based drug industry is to procedure standard extracts of plants as raw material. (www.ggssc.net) Essential Oils from herbal plants: The essential oil industry was traditionally a cottage industry in India. Since 1947, a number of industrial companies have been established for large scale production of essential oils, oleoresins and perfumes. The essential oil from plants includes Ajowan oil, Eucalyptus oil, Geranium oil, Lavender oil, Palmarosa oil, Patchouli oil, Rose oil, Sandalwood oil, Turpentine oil and Vetiver oil. Phyto-pharmaceuticals of medicinal plants: During the past decades, bulk production of plant based drugs has become an important segment of Indian pharmaceutical industry. Some of the Phyto-pharmaceuticals which are produced in India at present include Morphine, codeine, papaverine (Papaver somniferum), quinine, quinidine, cinchonine and cinchonidine (Cinchona sp., C.calisaya, C. Hyoscine, hyoscyamine (Hyocyamus Niger and H. muticus), colchicine (Gloriosa superbad, Colchicum luteum and Iphigenia stellata), cephaeline and emetin (Cephalis ipacacuanha), sennosides A B (Cassia angustifolia and C. acutifolia), reserpine, rescinnamine, ajmalicine and ajmaline (Rauvolfia serpentina); vinblastine and vincristine, ajmalicine (raubacine) (Catharanthus roseus); guggul lipid (Commiphora wightii); taxol (Taxus baccata); artemisinin (Artemisai annua) etc. (www.ggssc.net) CLASSIFICATION OF HERBAL PLANTS: They are classified according to the part used, habit, habitat, therapeutic value etc, besides the usual botanical classification.Based on Therapeutic value they are classified as follows. Anti malarial : Cinchona officinalis, Artemisia annua ,Anticancer : Catharanthus roseus, Taxus baccata ,Antiulcer : Azadirachta indica, Glycyrrhiza glabra , Antidiabetic : Catharanthus roseus, Momordica charantia , Anticholesterol : Allium sativum Anti inflammatory : Curcuma domestica, Desmodium gangeticum , Antiviral : Acacia catechu Antibacterial : Plumbago indica , Antifungal : Allium sativum , Antiprotozoal : Ailanthus sp., Cephaelis ipacacuanha , Antidiarrhoeal : Psidium guava, Curcuma domestica , Hypotensive : Coleus forskohlii, Alium sativum , Tranquilizing : Rauvolfia serpentina , Anaesthetic : Erythroxylum coca , Spasmolytic : Atropa belladona, Hyoscyamus niger , Diuretic : Phyllanthus niruri, Centella asiatica , Astringent : Piper betel, Abrus precatorius Anthelmentic : Quisqualis indica, Punica granatum , Cardio tonic : Digitalis sp., Thevetia sp. Antiallergic : Nandina domestica, Scutellaria baicalensis ,Hepatoprotective : Silybum marianum, Andrographis paniculata. (Joy, P.P., 2001) Safety of medicinal plants: The safety and effectiveness of alternative medicines have not be been scientifically proven and remains largely unknown. A number of herbs are thought to be likely to cause adverse effects. Furthermore, adulteration, inappropriate formulation, or lack of understanding of plant and drug interactions have led to adverse reactions that are sometimes life threatening or lethal. Proper double-blind clinical trials are needed to determine the safety and efficacy of each plant before they can be recommended for medical use. Although many consumers believe that herbal medicines are safe because they are natural, herbal medicines may interact with synthetic drugs causing toxicity to the patient, may have contamination that is a safety consideration, and herbal medicines, without proven efficacy, may be used to replace medicines that have a proven efficacy. (Joy, P.P., 2001) Eg: Ephedra has been known to have numerous side effects, including severe skin reactions, irritability, nervousness, dizziness, trembling, headache, insomnia, profuse perspiration, dehydration, itchy scalp and skin, vomiting, hyperthermia, irregular heartbeat, seizures, heart attack, stroke, or death. Poisonous plants which have limited medicinal effects are often not sold in material doses in the United States or are available only to trained practitioners, these include: Aconite, Arnica, Belladonna, Bryonia, Datura, Gelsemium, Henbane, Male Fern Phytolacca, Podophyllum andVeratrum. Furthermore, herbs such as Lobelia, Ephedra and Eonymus that cause nausea, sweating, and vomiting, have been traditionally prized for this action. Plants such as Comfrey and Petasites have specific toxicity due to hepatotoxic pyrrolizidine alkaloid content. There are other plant medicines which require caution or can interact with other medications, including St. Johns wort and grapefruit. (Phytotherapy , www.wikipedia.com) INTRODUCTION TO DIABETES MELLITUS In recent years, developed nations have witnessed an explosive increase in the prevalence of diabetes mellitus (DM) predominantly related to lifestyle changes and the resulting surge in obesity. The metabolic consequences of prolonged hyperglycemia and dyslipidemia, including accelerated atherosclerosis, chronic kidney disease, and blindness, pose an enormous burden on patients with diabetes mellitus and on the public health system. (Goodman Gilmans, 2006) In 1869, a German medical student, Paul Langerhans, noted that the pancreas contains two distinct groups of cells the acinar cells, which secrete digestive enzymes, and cells that are clustered in islands, or islets, which he suggested, served a second function. Direct evidence for this function came in 1889, when Minkowski and von Mering showed that pancreatectomized dogs exhibit a syndrome similar to diabetes mellitus in humans (Goodman Gilmans,2006) In the early 1900s, Gurg Zuelzer, an internist in Berlin, attempted to treat a dying diabetic patient with extracts of pancreas. Although the patient improved temporarily, he sank back into a coma and died when the supply of extract was exhausted. E.L. Scott, a student at the University of Chicago, made another early attempt to isolate an active principle in 1911. Using alcoholic extracts of the pancreas Scott treated several diabetic dogs with encouraging results; however, he lacked clear measures of control of blood glucose concentrations, Between 1916 and 1920, the Romanian physiologist Nicolas Paulesco found that injections of pancreatic extracts reduced urinary sugar and ketones in diabetic dogs. Although he published the results of his experiments, their significance was fully appreciated only years later. (Goodman Gilmans, 2006) Banting assumed that the islets secreted insulin but that the hormone was destroyed by proteolytic digestion prior to or during extraction. Together with Charles Best, he attempted to overcome the problem by ligating the pancreatic ducts. The acinar tissue degenerated, leaving the islets undisturbed; the remaining tissue then was extracted with ethanol and acid. Banting and Best thus obtained a pancreatic extract that decreased the concentration of blood glucose in diabetic dogs. (Goodman Gilmans, 2006) Insulin was purified and crystallized by Abel within a few years of its discovery. Sanger established the amino acid sequence of insulin in 1960, the protein was synthesized in 1963, and Hodgkin and coworkers elucidated insulins three-dimensional structure in 1972. Insulin was the hormone for which Yalow and Berson first developed the radioimmunoassay (Goodman Gilmans, 2006) Insulin regulation is achieved by the coordinated interplay of various nutrients, gastrointestinal hormones, pancreatic hormones, and autonomic neurotransmitters. Glucose, amino acids, fatty acids, and ketone bodies promote the secretion of insulin. The islets of Langerhans are richly innervated by both adrenergic and cholinergic nerves. Stimulation of a2 adrenergic receptors inhibits insulin secretion, whereas b2 adrenergic receptor agonists and vagal nerve stimulation enhance release. In general, any condition that activates the sympathetic branch of the autonomic nervous system (such as hypoxia, hypoglycemia, exercise, hypothermia, surgery, or severe burns) suppresses the secretion of insulin by stimulation of ÃŽÂ ±2-adrenergic receptors. Predictably, ÃŽÂ ±2 adrenergic receptor antagonists increase basal concentrations of insulin in plasma, and ÃŽÂ ²2 adrenergic receptor antagonists decrease them. The sugar is more effective in provoking insulin secretion when taken orall y than when administered intravenously because the ingestion of glucose (or food) induces the release of gastrointestinal hormones and stimulates vagal activity. Several gastrointestinal hormones promote the secretion of insulin. The most potent of these are gastrointestinal inhibitory peptide (GIP) and glucagon like peptide 1 (GLP-1). Insulin release also is stimulated by gastrin, secretin, Cholecystokinin, vasoactive intestinal peptide, gastrin-releasing peptide, and Enteroglucagon. (Goodman Gilmans, 2006) Distribution: Insulin circulates in blood as the free monomer, and its volume of distribution approximates the volume of extracellular fluid. Under fasting conditions, the pancreas secretes about 40 mg (1 unit) of insulin per hour into the portal vein to achieve a concentration of insulin in portal blood of 2 to 4 ng/ml (50 to 100 minutes/ml) and in the peripheral circulation of 0.5 ng/ml (12 minutes/ml) or about 0.1 nM. After ingestion of a meal, there is a rapid rise in the concentration of insulin in portal blood, followed by a parallel but smaller rise in the peripheral circulation. (Goodman Gilmans, 2006) Half Life: The half-life of insulin in plasma is about 5 to 6 minutes in normal subjects and patients with uncomplicated diabetes. This value may be increased in diabetics who develop anti-insulin antibodies. (Goodman Gilmans, 2006) Metabolism: Degradation of insulin occurs primarily in liver, kidney, and muscle. About 50% of the insulin that reaches the liver via the portal vein is destroyed and never reaches the general circulation. Insulin is filtered by the renal glomeruli and is reabsorbed by the tubules, which also degrade it. Severe impairment of renal function appears to affect the rate of disappearance of circulating insulin to a greater extent than does hepatic disease. Peripheral tissues such as fat also inactivate insulin, but this is of less significance quantitatively. The important target tissues for regulation of glucose homeostasis by insulin are liver, muscle, and fat, but insulin exerts potent regulatory effects on other cell types as well. Insulin is the primary hormone responsible for controlling the uptake, use, and storage of cellular nutrients. (Goodman Gilmans, 2006) DIABETES MELLITUS: Diabetes mellitus (DM) consists of a group of syndromes characterized by hyperglycemia; altered metabolism of lipids, carbohydrates, and proteins; and an increased risk of complications from vascular disease. Most patients can be classified clinically as having either type 1 or type 2 DM. Criteria for the diagnosis of DM have been proposed by several medical organizations. The American Diabetes Association (ADA) criteria include symptoms of DM (e.g., polyuria, polydipsia, and unexplained weight loss) and a random plasma glucose concentration of greater than 200 mg/dl (11.1 mM), a fasting plasma glucose concentration of greater than 126 ml/dl (7 mM), or a plasma glucose concentration of greater than 200 mg/dl (11 mM) 2 hours after the ingestion of an oral glucose load In the United States, about 5% to 10% of all diabetic patients have type 1 DM, with an incidence of 18 per 100,000 inhabitants per year. A similar incidence is found in the United Kingdom. The incidence of type 1 DM in Europe varies with latitude. The highest rates occur in northern Europe (Finland, 43 per 100,000) and the lowest in the south (France and Italy, 8 per 100,000). The one exception to this rule is the small island of Sardinia, close to Italy, which has an incidence of 30 per 100,000. However, even the relatively low incidence rates of type 1 DM in southern Europe are far higher than the rates in Japan (1 per 100,000 inhabitants). There are more than 125 million persons with diabetes in the world today, and by 2010, this number is expected to approach 220 million. (Goodman Gilmans, 2006) Both type 1 and type 2 DM are increasing in frequency. The reason for the increase of type 1 DM is not known. The genetic basis for type 2 DM cannot change in such a short time; thus other contributing factors, including increasing age, obesity, sedentary lifestyle, and low birth weight, must account for this dramatic increase. In addition, type 2 DM is being diagnosed with remarkable frequency in preadolescents and adolescents. Up to 45% of newly diagnosed children and adolescents have type 2 DM. There are genetic and environmental components that affect the risk of developing either type 1 or type 2 DM Types: Diabetes can be divided into two groups based on their requirements for insulin includes, (Pharmainfo.net) Type I: Insulin- dependent diabetes mellitus [IDDM] Type II: Non- insulin dependent diabetes [NIDDM] Type I: Insulin dependent diabetes mellitus: A burst of insulin secretion normally occurs after ingestion of a meal in response to transient increase in the levels of circulating glucose and amino acids. In the post operative period, low, basal levels of circulating insulin are maintained through beta cell secretion. However type one diabetic has virtually no functional beta cells. Treatment: Type I diabetic must rely on exogenous (injected) insulin in order to control hyperglycemia, maintain acceptable levels of Glycosylated hemoglobin (HbA1C) and avoid ketoacidosis. The goal in administering insulin to type I diabetic is to maintain blood glucose concentrations as close to normal as possible and

Fuel for Thought Essay example -- Essays Papers

Fuel for Thought Should our government regulate the fuel economies of our automobiles or should this be left up to the market? The Corporate Average Fuel Efficiency (CAFE) standards that were implemented in the 1970s contributed to great improvements in vehicle fuel economies. While we have environmental and political reasons to want cars with better fuel efficiency, there are also costs involved. The declining fuel economies of the last fifteen years seem to reveal that many Americans are not willing to bear these costs. Still, the vehicles that we drive today may be a misrepresentation of our true values. We may value environmental quality and/or independence from foreign oil, but sometimes our individual actions misrepresent our personal or societal goals. Since people's actions can be disconnected from theirvalues and society's goals, we cannot rely solely on the market; the governmentshould take action to increase the fuel efficiency of our vehicles. The energy crisis of the 1970s led congress to pass a law requiring automakers to improve the number of miles per gallon (mpg) that U.S. automobiles used. These CAFE standards led to vast improvement in fuel efficiency ("Another Cup...", 6). In 1973 the average fuel economy of light-duty vehicles, which includes cars, SUVs, vans and pickup trucks that weigh less than 8,500 pounds, was 14mpg. By 1987 average fuel economies had reached 22.1mpg. CAFE standards were frozen in the late 1980s. Since then,fuel efficiency has declined slightly. The average fuel economy in2003 model-year cars is 20.8 mpg. This decline is mostly due to theincreased popularity of SUVs. "The SUV market share increased by morethan a factor of ten, from less tha... ...are held by people in opposition to fuel economy standards. Some people are concerned about safety implications, increased vehicle costs and/or problems within the auto industry. 7. Samaras, Zissis. "Emissions Reduction via Improvements in Engines and Fuels: The Tehran Case." Journal of Urban Technology 6 (April 1999): 63-87. In this document, Zissis Sararas looks at a two-year project done in Tehran, Iran that aimed to reduce vehicle emissions by making engine and fuel improvements. Sararas provides data on emissions in Tehran and compares that to emissions in developed countries. Sararas describes methods from around the world that are used reduce emissions and/or increase fuel economy. He discusses emissions standards, particularly in Europe, diesel engines, fuel improvements, fuel economy regulations in the U.S. and alternative technologies. Fuel for Thought Essay example -- Essays Papers Fuel for Thought Should our government regulate the fuel economies of our automobiles or should this be left up to the market? The Corporate Average Fuel Efficiency (CAFE) standards that were implemented in the 1970s contributed to great improvements in vehicle fuel economies. While we have environmental and political reasons to want cars with better fuel efficiency, there are also costs involved. The declining fuel economies of the last fifteen years seem to reveal that many Americans are not willing to bear these costs. Still, the vehicles that we drive today may be a misrepresentation of our true values. We may value environmental quality and/or independence from foreign oil, but sometimes our individual actions misrepresent our personal or societal goals. Since people's actions can be disconnected from theirvalues and society's goals, we cannot rely solely on the market; the governmentshould take action to increase the fuel efficiency of our vehicles. The energy crisis of the 1970s led congress to pass a law requiring automakers to improve the number of miles per gallon (mpg) that U.S. automobiles used. These CAFE standards led to vast improvement in fuel efficiency ("Another Cup...", 6). In 1973 the average fuel economy of light-duty vehicles, which includes cars, SUVs, vans and pickup trucks that weigh less than 8,500 pounds, was 14mpg. By 1987 average fuel economies had reached 22.1mpg. CAFE standards were frozen in the late 1980s. Since then,fuel efficiency has declined slightly. The average fuel economy in2003 model-year cars is 20.8 mpg. This decline is mostly due to theincreased popularity of SUVs. "The SUV market share increased by morethan a factor of ten, from less tha... ...are held by people in opposition to fuel economy standards. Some people are concerned about safety implications, increased vehicle costs and/or problems within the auto industry. 7. Samaras, Zissis. "Emissions Reduction via Improvements in Engines and Fuels: The Tehran Case." Journal of Urban Technology 6 (April 1999): 63-87. In this document, Zissis Sararas looks at a two-year project done in Tehran, Iran that aimed to reduce vehicle emissions by making engine and fuel improvements. Sararas provides data on emissions in Tehran and compares that to emissions in developed countries. Sararas describes methods from around the world that are used reduce emissions and/or increase fuel economy. He discusses emissions standards, particularly in Europe, diesel engines, fuel improvements, fuel economy regulations in the U.S. and alternative technologies.

The Duchess of Malfi Essay examples -- Duchess of Malfi Webster Papers

The principal characters and their roles We follow after bubbles, blown in th'air. Pleasure of life, what is't? Only the good hours of an ague The Jacobean age was one of questioning and uncertainty about many issues, such as religion, politics and law. At the same time it was rediscovering the potency of Classical texts of Rome and Greece, and reinterpreting tragic form to suit its own ends. The Duchess of Malfi is a revenge tragedy, but Webster has used the form for much more than just its entertainment value; he has used it as a vehicle for the exploration of some themes relevant to the society of his time. Webster based his plot on a true story set in Italy, and kept the Italian setting because like Shakespeare and other playwrights of his day, he had to use politically-acceptable foreign settings in which to explore ideas such as those presented in The Duchess of Malfi, (which were really commentaries on the England of their own era), to do with inequality, injustice, and corruption, without causing outrage in response to his work. Antonio and The Duchess The fact that Antonio can never have an equal relationship with the Duchess has prompted some readers to feel that his importance as a character in the play is limited, while others suggest that his main role is as a mouthpiece for Webster's own judgements and opinions. To assess the importance of his role we need to consider it relation to the Duchess, and in the context of the play as a whole. Inequalities of power associated with gender and social status are highlighted in the relationship between The Duchess and Antonio, and the reactions of others towards their relationship. In Antonio's self-deprecating dying speech, Antonio: We follow afte... ... been pointed out that The Duchess of Malfi is a flawed play. For example Ferdinand reveals to Bosola a possible motive for wanting his sister to be murdered: Ferdinand: To have gain'd an infinite mass of treasure by her death. [Act 5, Scene ii] But this sounds unconvincing, as Malfi is little more than a poor fishing village. Moments such as these in the play have led it to be criticised for its plot, and it has other flaws. For example is it plausible that the Duchess could marry Antonio and have children in secret? Webster tends to neglect the importance of The Duchess' sons, and in Act 5 we see Delio apparently with a false heir. But in spite of these flaws The Duchess of Malfi has lasted and remained popular, not just for its potent entertainment value and Webster's masterful use of language, but also for the insights it gives us into Jacobean society.

Runners High :: Definition Sports Running Papers

Runner's High Many runners have had the opportunity to experience a state of euphoria while running. While the actual state that they feel varies immensely for each individual there is a common feeling associated with the term "runner's high". When a person is asked about runner's high they typically will say that it a pleasant state that a runner might experience after a certain distance. This in fact may not be true for only runners though. Skiers, surfers, football players and wrestlers all have "highs" or moments when they feel they are working to their maximum potential and feeling on top of the world. Runner's are not the only types of athletes that experience intense emotional feelings. One must question exactly what is included in this feeling. Defining a "high" may not be all that easy, if there even is such a thing. Many people have related runner's high to the feeling of an orgasm. At this time, the body and mind are both highly stimulated and seem to elevate a person's senses. Other people have responded to the question of "What is runner's high?" by saying that when the environmental stimuli around you is near perfect and you are feeling good you are actually feeling a type of "high". We must not overlook the facts though, which include physical and physiological details to back up feelings of runner's high. Throughout time, runner's high has been debated and there is still no general definition as to what it is, or even if it exists. Looking at different personal experiences and physical evidence one can generally conclude that runner's high is a state of euphoria caused by the environmental stimuli around the runner and the biological aspects of stress associated with running. The most obvious aspects to address with runner's high are the biological and psychological aspects that can be associated with it. When the body is put under stress the mind reacts accordingly. This is why endorphins are commonly associated with runner's high. Endorphins are any of a group of opiate proteins with pain-relieving properties that are found naturally in the brain. The word "endorphine" comes from endogenous, meaning "produced within the body" and morphine, a chemical substance derived from opium that elevates mood and reduces pain. Endorphines in turn are neurotransmitters that are chemically similar to morphine.1 It has been realized that the brain responds to morphine and that morphine receptors are in the brain.

Camp Wahanowin Swot

Internal Analysis: Strengths: †¢Facilities: High end facilities which accommodate up to 450 campers at one time, located on a 150 acre plot of land with water access not too far from many of the clienteles homes while remaining in a secluded area. †¢Partnerships: Keeping a close relationship with their â€Å"sister camp,† Green Acres Day Camp allows them to offer accommodations to day campers and spread their name to the day campers segment at the same time. Their partnership with the Toronto District School Board and their music program, Music by the Lake, brings revenue and word-of-mouth advertising to the camp. Management: Wahanowin has a strong management team coming from a variety of backgrounds, the university credentials of the team along with the range of skills and work experience are a big strength for the camps team. †¢Customers: Wahanowin has customers that not only come from within the GTA area, but also internationally from USA, Mexico, Israel, Fra nce, and England, providing a large clientele basis for the camp. Weaknesses: †¢Competitors: There is many other residential summer camps within a two hour drive from Wahanowin that offer different adventures luring customers away.There are also day camps which are less expensive but also offer some of the same activities and experiences which are increasing in popularity. Not to mention that there is a larger opportunity for children to travel in the summer now instead of going to camp. †¢Finance: Most of Wahanowin’s financing has come from the retained earnings of the company which are produced from the previous year’s profits. Not having any outside investors could be seen as a weakness to Wahanowins financial future. External Analysis: Opportunities: Natural: The summers are naturally getting longer and longer in North America as time goes by which provides more time for residential camping. Camp Wahanowin can capitalize on this opportunity by extending t heir summer camp season and bringing in more revenue for a longer period of time. †¢Technological: As society become more dependable on technology and the internet it becomes a more useful marketing tactic. Since today’s generation of children have grown up with technology and spend copious amounts of time on social media and other web pages, this would be an excellent opportunity to market to the children. Threats: Economically: The market for camps in Southern Ontario is actually quite saturated which makes it difficult for Wahanowin to capture the market share that they desire. Furthermore the recession of 2008 also pushed some of the higher income families out of the higher tax bracket which shrunk the potential market for these camps. †¢Social: Some social factors such as the increasing desire to travel over the summer have affected the market for residential summer camps. Other social factors such as the increasing amount of â€Å"helicopter† parents wh ich over-protect their children and forbid them from taking part in these experiences. Cultural: As the GTA (Wahanowin’s main client pool) is becoming more multi-cultural the cultures could begin to group together and form camps specific to each culture or religion (such as Jewish camps), leaving open camps such as Wahanowin on the backburner. http://wahanowin. com/facilities http://wahanowin. com/chronology http://wahanowin. com/staff http://www. livescience. com/7124-study-summer-longer. html http://www. ourkids. net/overnight-camps-s-ontario. php http://www. time. com/time/magazine/article/0,9171,1940697,00. html