Organizational Levels

1) Using the above scenario, consider Organizational Level 1: Key Players (Stakeholders) and Business Ideas (Purpose). Which Leadership Challenge response is most appropriate: Establishing, Refining, or Monitoring? Using the theories discussed in Chapters 1-4, explain why you chose that response. In my opinion refining is the most appropriate leadership challenge for the above scenario. Developing superior graphic design products and services through Innovation, teamwork and leadership is Listo’s mission. Due to the expansion of the company teamwork and leadership have been affected most. New employees are less trained thus, they lack proper leadership quality. People in habit of working for a small company where they knew each and everyone suddenly had to work for a large company where their opinions and values were not concerned. Thus keeping in mind of these situations refining in management is required in Listo to achieve its mission. 2 )Using the above scenario, consider Organizational Level 2: Entity (Culture) and Strategy (Mission). Which Leadership Challenge response is most appropriate: Defining, Shaping, or Publicizing? Using the theories discussed in Chapters 1-4, explain why you chose that response Listo’s mission is to develop superior graphic design product through innovation, teamwork and leadership. Due to sudden change in the management, employees’ adaptation in the new environment has been difficult. So shaping the management as per the company’s mission is the appropriate leadership challenge response 3) Using the above scenario, consider Organizational Level 3: Departments (Units) and Key Results (Success Factors). Which Leadership Challenge response is most appropriate: Involving, Facilitating, or Communicating? Using the theories discussed in Chapters 1-4, explain why you chose that response. Communicating is the appropriate leadership challenge response for the above scenario. Addition of new layers to the hierarchy creates new chain of commands which results confusion. So proper communication channels should be established regarding the new management system. 4) Using the above scenario, consider Organizational Level 4: Teams (Groups) and Goals (Objectives). Which Leadership Challenge response is most appropriate: Focusing, Unifying, or Connecting? Using the theories discussed in Chapters 1-4, explain why you chose that response. Connection of new hires with the previous employees is required for the team to direct towards achieving goals. If the employees are connected with each other than by implementing motivation theories they can be made unified and focused so priority should be given in connecting people. 5) Using the above scenario, consider Organizational Level 5: Individuals (People) and Tasks (Jobs). Which Leadership Challenge response is most appropriate: Enabling, Engaging, or Empowering? Using the theories discussed in Chapters 1-4, explain why you chose that response. Empowering the employees is the best option for the above case scenario. Increase in the turnover rates and absent leaves suggests that employees have lost their energy and passion working for the company. One of the main reasons for this situation is the lack of concern management has shown towards the employees. Empowering employees makes them feel of importance and the fact company giving them an important responsibility generates a desire and passion to fulfill the task effectively.

Human Impacts on the Sustainability of Groundwater Essay

The purpose of this lab is to show the sustainability of groundwater, if human development continues, at the same rate it has been, over the last few decades. Over the last 50 years our water demand has tripled, which is causing water tables all over the world to fail, and when these aquifers are depleted, worldwide food production will fall. I have looked over the data provided, and have come to the conclusion, that if we do not control our population, we will likely experience worldwide famine, maybe even have it as the catalyst for the next world war. Data collected from the M.U.S.E. in the virtual classroom, located at cut online, also researched on the internet, from the Google search bar, Nairaland forum, and WOA. Documentation, from these resources, and research, written in the following paragraphs. Stated in a 2009 report, that if the world population reached 7.5 billion, by 2020, 1.8 billion people, would be living in regions with extreme water scarcity. In a current report  as of December 1, 2014, our global population, has already reached over 7 billion, and futuristically, Africa is the only nation that is capable of self-sustaining. The Americans, Chinese, and Europeans, aspire to live a certain life style that will ultimately end in a survival of the fittest.  Several studies show that earth is currently capable of sustaining about 2 billion, at half the recourses, we currently consume. Each American, consumes about 20 acres, of biologically productive land, so if the worlds 7 billion people, consumed that of the average American, we would need about 5 earth’s resources, to be sustained. Obviously Earths 29.6 billion acres of biologically productive land, and water, support about 1.5 billion people. So we need to reduce the population by 80 %, or reduce our consumption by over 50%, and realistically, neither one is going to happen anytime soon. Which leaves our grandchildren, and so on, in serious risk of a grave global catastrophe? Resources: Politics,Lagbaja, taken from web address http://www.nairaland.com/2022950/current-world-population-three-time, on 1/05/2015 WOA!! Taken from web address http://www.overpopulation.org/water.html on 01/06/2015

Banking Industry Analysis

Banking Industry Analysis Essay Graham MavarMgmt. 415 Sec 6Industry Analysis: BankingThe banking industry has come under increasing pessimism of late because of rising short and long-term interest rates. The banking industrys market capitalization made a substantial decline. Most investors are concerned with whether the industry can sustain continued profitability as a result of these factors. Banks have responded in recent years to these problems by diversifying away from interest sensitive products and services. But interest rates are the fundamental aspect of any financial services. Therefore, I believe the financial services industry will be deeply affected by rising interest rates. Banks have experienced good business factors over the past two years. Interest rates were low, credit quality was good, and inflation was low. These factors are usually predictive of the types of earnings banks should report. But good times cant continue because interest rate hikes cause reduced lending activity, damaged credit quality, and reduced values of bond portfolios. Porters Five Forces Analysis:1. Rivalry among competing sellers:The banking industry is continuing to restructure and position itself for our changing economy as a result, many mega-mergers have occurred in recent years. Citicorp and Travelers Insurance agreed to merge in April 1998 at a value of $70 billion. Bank of A merica and Nations Bank also agreed to merge shortly afterwards which became the largest bank in the United States. Bank mergers are usually consummated as a cost-cutting measure but also to compete with non-bank providers of financial services. Bank rivalries are very strong, and as weve seen many of the largest banks are merging to increase their power. In fact, Charlotte, NC is practically owned by Bank of America and First Union. 2. Potential entry of new competitors:There is virtually no chance of a new entrant significantly affecting the major banks market share. The only place that new entrants may have a chance in the industry is through Internet banking, because of its low cost. 3. Firms offering substitute products:This is not really an issue within the banking industry, because there arent really any legal alternatives, except buying a safe and borrowing from a loan shark4. Competitive pressures stemming from supplier and buyer bargaining power:I grouped these two categories together because in the banking industry the buyers are the suppliers and vice versa, so I might as well just discuss the situation as a whole. Interest rates are the single most important aspect of bank profitability they are the bargaining power. Most bank profits are derived from net interest income. This is interest income received on loans minus interest expense for borrowed funds. Interest rates determine the amount of money a bank can earn. Another measure is a banks net interest margin which is a banks net interest income divided by its average earning assets. This is a common measure of a banks ability to squeeze profits from its loans. When interest rates fall, they have a positive effect on a bank. First, net interest margin can expand. Second, the value of a banks fixed rate of investment portfolio is enhanced by declining rates, since a bond with a higher stated interest rate becomes more valuable as prevailing rates drop. Third, falling rates lower the cost of credit, which stimulates loan demand and reduces delinquency rates. Opportunities: 1. Because of the increasing amount of technology Internet banking will begin to replace traditional banking, thus cutting personnel costs. 2. Incorporating investment banking into the banking industry, as some major companies are doing, lets the bank increase profits and promote economic growth while improving company image. Threats:1. An increase in interest rates causing a decline in bank activity. READ: In Cold Blood: Death Penalty Essay2. A collapse of the Fed leading to bank failures, a repeat of the crash of 1929. 3. A decline in the US economy leading to a fall in the value of the dollar, thus causing an instable economy. From there the US banking system would be less secure in terms of dollar values that many people would move their money overseas into a more stable economic situation. Similar to the situation in many South American countries. (a little far-fetched, but possible)Key Success Factors:? Capability to use the internet for banking, investing, and general e-commerce? Size of company, name recognition, innovative local marketing? Best rates (loans, checking, savings, etc.)? The capability to have the fastest and simplest banking through design, innovation, and locationBusiness Reports

Oligopoly is the ideal market structure because it allows society to Essay

Oligopoly is the ideal market structure because it allows society to benefit from the efficiency gains of both competition and monopoly - Essay Example The range within which each oligopolist can independently influence prices is, however, narrower than where there is a pure monopoly, for he has to take into account not only the availability of substitutes (as does a pure monopolist as well), but also the likely actions of his principal competitors in his own market. In all circumstances price changes are likely to affect adversely the interests of certain participants in the market. Increases in price naturally are harmful to consumers, while decreases injure the interests of producers and of some traders. In monopoly and oligopoly situations the power of firms to influence prices, coupled with a high degree of dependence on these firms, tends to provoke allegations that all price changes are deliberately engineered to injure certain interests. Consumers, producers or rival traders may consider that they have been specially and deliberately injured by the actions of the monopolist or oligopolists, and may ascribe market changes to their intentional activities. Plausibility is lent to these views because in these situations the firms can undoubtedly influence the market; indeed, they cannot help doing so. It is therefore impossible conclusively or convincingly to refute allegations of profiteering, of destructive underselling to eliminate partic ular competitors, of deliberate depression of producer prices, or of wasteful inflation of costs. 1 An important and distinctive characteristic of oligopoly is the realization by each firm that its fortunes depend very closely upon the actions of the others in the same market. Their behaviour is necessarily influenced by the realization of mutual interdependence. Each firm appreciates that in initiating price changes it must expect the other firms to react to these changes, and that in assessing the net effects of a price change it must take account of the probable reaction of others. In deciding on price changes each firm considers not only the general market situation and its own financial and stock position, but also the probable conduct of its principal competitors. Firms recognizing their mutual interdependence may find it convenient and profitable to co-ordinate their policies and to act together, and co-operation is made easier because the numbers are comparatively small. An oligopolistic situation is frequently accompanied by market sharing arrangements between a number of producers or firms. This is particularly likely in the supply of standardized products or services, where these price-fixing agreements may be effective and stable even without formal market-sharing arrangements; banking and shipping provide familiar examples in the United States, in Britain and in Western Europe. Where the product is largely unstandardized, agreements are less often concluded, and, moreover, tend to be unstable; the motor industry seems to be a convenient example. Co-operation is, however, by no means the inevitable outcome of oligopoly. Individual firms may decide to try their strength and to enlarge their share in the market by active competition. Moreover, when new entry is

Nelson Mandela Speech to the UN Special Committee against Apartheid Essay

Nelson Mandela Speech to the UN Special Committee against Apartheid - Essay Example Nelson Mandela Speech to the UN Special Committee against Apartheid This paper refers to Mandela’s speech after the declaration and was a follow up regarding what was happening regarding apartheid in South Africa. Since then the UN passed many resolutions regarding apartheid. In 1976 the UN Centre against apartheid was created. Prior to Mandela’s speech in 1990, the General Assembly adopted the â€Å"Declaration on Apartheid and its Destructive Consequences in South Africa†. This declaration called for negotiations between all parties to end apartheid and create a democracy free from racial discrimination. Nelson Mandela is the person giving the speech to the Special Committee against Apartheid. He is giving the speech because even though the journey to stop apartheid had began through UN efforts, he believed that nothing much was happening in South Africa especially after the declaration by the UN General Assembly in December 1989. The speech was made to the Special Committee against Apartheid in New York in June 1990. The audience included the permanent representative and Chairman of the Special Committee against Apartheid, the President of the UN General Assembly, the Secretary General of the United Nations, Excellencies and permanent representatives of the UN and Heads and Observer Missions. The audience represented people from around the world who were member states of the United Nations. This was a forum of member states of the United Nations and a great opportunity for Nelson Mandela to explain the oppressiveness of Apartheid to the world.

The Role Of Public Relation In Crisis Management in the Oil & Gas Research Paper

The Role Of Public Relation In Crisis Management in the Oil & Gas industry - Research Paper Example Whenever a crisis happens, the management of an organization needs to proceed in a manner that would guarantee the most effective coordination of the three groups, which would ensure that public relations is used in the management of the crisis. The role of public relations in the management of crisis in oil and gas industry has been portrayed in a number of crises with some companies managing the crisis poorly and damaging the image of the company while others using public relations strategies to improve the company’s image. The oil and gas industry has experienced a number of crises with some generating good public response and others attracting a public outrage and rendering the company almost bankrupt. The response to the crisis of a toxic gas release, which happened on December 1984 at a Union Carbide Chemical Factory or Plant located in Bhopal, India killing over 2000 (3800) people formed one of the most effectively managed crisis in history. The team managing this crisis consisted of ten of the executives and managers of Carbide headed by the C.E.O and worked for several months in coordinating the management, operation, and communication response to the industrial accident. The public relation methods that were utilized in managing this crisis included crisis communication, consumer public relations, internal communication, and government relations. According to a report by Jackson Browning (1993), the then vice president of Union Carbide Corporation in charge of safety, health, and environmental programs, the team held its first press conference that took very few minutes. In the press conference, the team acknowledged that the serious disaster had happened in a factory owned by the Union Carbide where they had a 50.9% share. The team explained to the press some of the immediate measur5es that they were already undertaking in addressing the crisis. The company had daily briefings where they would answer

Public Relations Assignment Example | Topics and Well Written Essays - 250 words - 4

Public Relations - Assignment Example This is a professional organization comprising of professionals from different walks of life who are interested in developing their careers within this field. I am confident that if I jouin this organization, I will immensely benefit since I wil get an opportunity to interact with other people with a wealth of knowledge in this particular field. This will also give me exposure to other pertinent issues that often shape the profession of integrated marketing communication and public relations. Above all, networking This organization fits with my goals because it is designed to enlighten all the members about the paths they can follow in as far as their career development is concerned. This association will also help me to interact with other professionals in the same field where we can exchange information and other relevant ideas that can contribute towards the generation of knowledge in our field. The organization has upcoming events and conferences that are meant to boost our knowledge in the field of marketing communication and public relations. For instance, the association has upcoming conferecnces that include the following: Ameerican Marketing Association’s 2014 Annual Conference, Brand Manage Camp as well as the 2015 Analytics with Purpose Conference among

Economic Impact of Online Identity Theft Assignment

Economic Impact of Online Identity Theft - Assignment Example Indeed, apprehension of cyber-identity criminals, and especially multi-national organized crime rings, poses a serious challenge to law enforcement specialists deployed to tackle transnational jurisdictional measures. Cyber-theft knows no boundaries, and the tendency for such crimes to be commissioned through a network of communications is extensive. With exception of high wealth transfer operations, and those transactions connected to official terrorist organizations, cooperation between governments is far beyond normal extradition order. As a result, facilitation of consumer protections is allocated primarily to watch groups and the efforts of independent counsel hired to address client complaints. At the Sixteenth Session of the United Nations Economic and Social Council (UNESC) Commission on Crime Prevention and Criminal Justice in 2007, the Results of the study on fraud and the criminal misuse and falsification of identity in a Report of the UN Secretary General toward 'international cooperation in the prevention, investigation, prosecution and punishment of fraud, the criminal misuse and falsification of identity and related crimes' set the international platform toward legislative policies pertaining to cyber identity theft, and the economic impact of transnational fraud. Responsive to the intensifying multi-jurisdictional complications of global cyber fraud and its attendant economic impacts in the realm of cyber-terrorism, the Commission outlined priority targets within international legislation intended to stem the rapid expansion of predatory privacy invasion and usurpation of finance through identity theft toward support of organized criminal activity. Amidst the proliferation of personal data collected by internet service providers and commercial and government businesses online, the quantification of fraud has become a massive undertaking. The recent disclosure of previously undetected, large-scale securities based Ponzi schemes, informs us that significant losses of wealth can be lost over long periods of time when they involve a large portfolio of parties subject to varied national rules on securities trading. Counting the cost of identity theft is, then, one of scale. As the UNSEC Report indicates, "mass-fraud schemes tend to produce large numbers of cases if occurrences are based on counting numbers of victims or complaints but lower rates if numbers of offenders fraud schemes or prosecutions are counted." Statistical accountability of identity theft related fraud by UN member states is spotty, with underreporting of the prevalence of the different methods of commissioning those crimes has shifted rapidly as technologies induce related regulatory restrictions that push criminal activity into a vague area whereby "fraud imitates legitimate commerce, making variations of commercial practice likely to produce parallel variations in fraud over time, between countries or regions, and with respect to specific areas of commerce." Mitigating factors such as privatization of previously State-owned operations in contexts where the system of justice is weak due to parallel post-conflict or reconstruction efforts, leaves infrastructural oversight open to fraud in general. The Fair Credit Reporting Act (FCRA) was written into legislation in 1970 and has been amended almost

Air Pollution in China Research Paper Example | Topics and Well Written Essays - 2500 words

Air Pollution in China - Research Paper Example The rising emissions in China cause the increased pollution of the air within the country and internationally as compared to the reduced pollution registered in other countries such as Japan, United States, and Europe. A myriad of reports has indicated that most Chinese citizens die due to respiratory problems caused by highly polluted air that contains sulfur dioxide, nitrogen dioxide, and particulate matter. The combustion of fossil fuels to power the rapidly increasing industries and automobiles is the prime source of the outdoor air pollutants, while the burning of coal within homes produces the indoor air pollution. This air pollution has been found to trigger or at times worsen the respiratory and cardiovascular diseases and conditions amongst all age groups especially the children and the elderly. As China continues to experience phenomenal growth in its economy which is majorly driven by the industries setting base in China, so does the pollution also grow and the attendant e ffects. This has come at a greater cost due to the environmental degradation in China in the form of pollution with the most prominent being the air pollution experienced in many Chinese cities and their citizens such as in Beijing and Guangzhou as well as abroad. There have been numerous studies that have shown that the appalling quality of air within the Chinese cities and even the countryside have led to the occurrence of over a million deaths as from the year 2010 alone.  

Nursing Shortage Research Paper Example | Topics and Well Written Essays - 1750 words - 2

Nursing Shortage - Research Paper Example The nurses are decreasing in number in many countries of the world, and the number of people suffering from different diseases is increasing. A few nurses who are ready to assist people for many reasons and shortage of nurses are creating many impacts on patients as well as the healthcare industry. In general, the aim of the study was to find the impact on the shortage of the nurses in the healthcare industry concerning the quality of the service the nurses provide in comparison to the previous times when the nursing shortage was not a problem. From the findings of the research one gets to interpret that, the working nurses are under pressure due to the shortage of nurses in the hospital. Moreover, there are signs of lack job satisfaction from the premises since they have considered finding better paying jobs in the country. The facility on the other hand has not made any amends to the looming danger of losing nurses hence they lacked initiative to make the nurses stay. There is no retention plan in the hospital that can curb the prevailing trend of nurse loss in the facility. More so, the synchrony in the facility is out of line making the care vulnerable to mistakes. This implies there is little accuracy in the service rendering in the facility. The fatigue the nurses are experiencing in the hospital with little coordination from the administration leads to more trouble since the lack of direction make the daily activities in the hospital collide causing chaos in the service. However, the nurses have tried to curb the ob stacles through a series of teamwork and perseverance. The environment of the hospital is not having a good environment for the hospitals reputation in terms of the administrations mandate in the hospital. The environment may not portray the hospital in the good light citing the frustrated staff that can snap and utter inappropriate message to the stakeholders costing the hospital

Ethan Frome by Edith Wharton Essay Example for Free

Ethan Frome by Edith Wharton Essay Naturalism is commonly understood as an extension or intensification of realism. The intensification involves the introduction of characters of a kind (Baym, 1999) A perfect example of Naturalist work is Ethan Frome by Edith Wharton. Ethan, one of the main characters in the book, is a old, deformed man who is in love with his wifes cousin. Zeena is Ethans wife who occasionally has psychological illnesses. Mattie is Zeenas cousin and is in love with Ethan. There are many examples of naturalism in Ethan Frome: the characters, their deformities, and their lowly place in society, their bad luck, and distasteful environment they lived in. Ethan Frome, a significant character in the book, is very troubled. Life hasnt been pleasant for Ethan. Through his life experiences, Naturalism has been portrayed. At the beginning of the story, the reader, from the following quote, finds out that Ethan is crippled from a smash-up:The smash-up it was—I gathered from the same informant—which, besides drawing the red gash across Ethans Fromes forehead, had so shortened and warped his right side that it cost him a visible effort to take the few steps from his buggy to the post-office window. (Wharton 4)This is a characteristic of Naturalism because the smash-up was caused by Ethans emotions. If Ethan did not have any feelings for Mattie, the smash-up would have never taken place and Ethan and Mattie would not be injured and forced to spend the rest of their lives being taken care of by Zeena. Then, the novel goes into a flashback and the whole story of Ethan Frome is told to the reader. The reader then finds out that Zeena, Ethans wife, is actually his cousin who came to Starkfield to take care of Ethans mother, and she never left after his mother passed away. Ethan and Zeena get married and they have a loveless marriage that took place because of loneliness. In the novel, it says that the marriage might not have taken place if it had not been wintertime. This is also another example of Naturalism because it was decision that was controlled by their instincts that if they did not get married, then they would have a lonely winter. Zeena becomes sick, and her cousin Mattie has to come to Starkfield and take care of the house. Ethan falls in love with Mattie, but is not able to express his feelings at first because of Zeena. Later on in the story, Ethan and Mattie discover that they love each other and that they cannot be together so they decided to commit suicide. Unfortunately, the suicide attempt was futile and Mattie and Ethan both survive. In this part of the story, Ethan and Mattie are acting on their emotions because they know that they cannot runaway together, and they also know that if they commit suicide they will never have to be apart together. Ethan and Mattie would have run away together if not for their economic conditions. Because the farm was so poor, Zeena wouldnt have sold the farm for very much and she would have to suffer if Ethan and Mattie had runaway together. Although, Ethan Frome plays a very big role in this novel, Zeena also portrays examples of naturalism. Zeenas character was portrayed to the reader as being selfish and needy. Because Zeena was not required to take care of anyone, she began to show the symptoms of sickness that Ethans mother was described to have had. And within a year of their marriage she developed the sickliness which had since made her notable even in a community rich I pathological instances. When she came to take care of his mother she had seemed to Ethan like the very genius of health, but he soon saw that he skill as a nurse had been acquired by the absorbed observation of her own symptoms.(Wharton 53)This is an example of Naturalism because Zeenas need to be required by others led her to become psychologically sick and this affected her marriage with Ethan. In the middle of the novel, Ethan and Mattie walk home together after the dance and Zeena hasnt put out the key. To the reader, this seems like it was Zeenas instinct to not put out a key because she was suspicious of the relationship between Mattie and Ethan. Soon after, Zeena goes to see a new doctor in town because of her sickness. This event gives the impression that Zeena is sick only because she wants to be recognized in society, and being sick is allowing her to be noticed by others. At the very end of the novel, Zeena recognizes that Mattie and Ethan have feelings for each other, and tries to split them apart by hiring another girl to take care of the house. However, the smash-up allowed Zeena to be needed by the handicapped Mattie and Ethan, and Zeena instant got better. These are examples of naturalism, because Zeena is acting on her instincts that that Ethan and Mattie are having an affair, and the outcome is that they try to commit suicide and fail and have to live the rest of their lives together with Zeena almost in  poverty. The decisions that the characters in Ethan Frome impact the rest of their lives. These decisions are all examples of Naturalism. Ethan decisions are based on his instinct and also his emotions of love for Mattie, and his emotion of loathe for Zeena. Zeenas, on the other hand, are based on by her instinct that Ethan and Mattie are in love with each other, her lowly status in society, and also their meager economic conditions. This book shows the reader that life should not always be controlled by instinct and emotion, but rather that it should be controlled by thoughts and adapting to the environment around you. Wharton, Edith. Simon Schuster, 2004.

Causes for the french revolution Essay Example for Free

Causes for the french revolution Essay There were many causes for the French Revolution, which started in 1789. However there were three main causes that affected the decision to have a revolution the most which were the weak economy, a bad harvest, and King Louis XVI and his wife Marie Antoinette. These were the main reasons that lead to the French Revolution because these events were the ones that affected France the most during 1789. The weak economy was one of the causes of the French Revolution because at that time France was in debt. France was in debt due to helping the colonist become independent from Britain in the American Revolution. For example, in The French Revolution Begins reading it states â€Å"And he borrowed heavily in order to help the American revolutionaries in their war against Great Britain, France’s chief rival. † This is one of the reasons that started the French Revolution because due to being in debt King Louis XVI’s solution was to raise the taxes on the nobles. This was surprised the 2nd estate which consist of the nobles because they paid the least taxes of the 3 estates. Due to this action the 2nd estate called a meeting called the Estates General. In these types of meetings each estate would usually only get one vote but due to the fact that it would be unfair to the 3rd estate. So for this reason every person who was at the Estates General would be granted a vote. The Estates General was to basically approve the new tax. This meeting then caused the National Assembly, which was what the third estate was now called. The third estate pledged a tennis court oath that stated that they wouldn’t leave until a new constitution was made. They drafted a new constitution, which now made France a constitutional monarchy. In conclusion, this is how being in depth was one of the reasons that started the French Revolution. Another cause for the French revolution was the bad harvest in the 1780’s. This was one of the causes for the French revolution because people could grow their food or grain, which is the ingredient to make bread. â€Å"The price of bread doubled in 1789, and many people faced starvation† (French Revolution Begins). In my opinion, I believe that this is one of the reasons to start the revolution because the people back then were poor. They were poor due to the reason that most of their money went to taxes so, if their money went to taxes and they barley had enough to pay for how much the bread used to be hoe are they expected to pay for bread when the price is doubled. I also believe that this is inequitable due to the fact that it isn’t their fault that there was bad weather I believe that the king was just trying to get money. Doubling the bread price made people not have enough money and many people died because of starvation. In conclusion, this is how a bad harvest was another one of the major causes to the French Revolution. The last main cause to the French Revolution had to do with King Louis XVI and his wife Marie Antoinette. This I believe was the main reason for the French Revolution because the king and his wife were spending money on unnecessary things. For example â€Å"†¦she spent so much money on gowns, jewels, gambling, and gifts†¦Ã¢â‚¬ (The French Revolution Begins). Based on this evidence we could see how the money was being misused and how the queen didn’t even care about the situation happening with the people. Another example showing how Antoinette was a bad queen was â€Å"One year she lost the equivalent of $1. 5 million gambling in card games† (The French Revolution Begins). This example shows us how the queen spent money and when it came to help people put they were in depth. An example of how King Louis XVI was being a bad king was â€Å"However he lacked the ability to make decisions† (The French Revolution). In my opinion I believe that this is how King Louis XVI was a cause to the French Revolution because this quote shows how he did not know what was right for the people and did not know how to deal with all of the things that were going on in France like people wanting a revolution. This was a good thing for France because they saw that the King could not make any good decisions so they saw that it was a good idea to overthrow the monarchy and become a limited monarchy. In conclusion there were many things that lead to the French Revolution but only 3 things were the main causes. The 3 main causes were the fact that the French were in depth due to the American Revolution. The fact that there was a bad harvest in the 1780’s. Lastly the fact that King Louis XVI and his wife Marie Antoinette were spending money in a useless way and that they were making bad decisions.

Functions of the Immune System | Dengue Fever Immunity

Functions of the Immune System | Dengue Fever Immunity The function of the immune system is to keep contagious microorganisms, such as definite bacteria, viruses and fungi, out of the body, and to demolish any infectious microorganisms that do attack the body. The immune system is completed by a complex and imperative network of cells and organs that guard the body from infection (1). The organs of the immune system are called the lymphoid organs, which have an effect on growth, development, and the free of lymphocytes (a confident type of white blood cell) (2). The lymphatic vessels and blood vessels are main parts of the lymphoid organs, because they transmit the lymphocytes to different areas in the body and from different areas in the body. All lymphoid organs play a task in the making and also activation of lymphocytes. Layered Defense Organisms are protected by the immune system from infections with layered defenses of rising specificity. If these barriers were breached a pathogen, the innate immune system provides an immediate, but non-specific reaction. All plants and animals have Innate immune systems (3). If pathogens effectively evade the innate response, vertebrates have a third layer of protection, the adaptive immune system. The innate response activates the adaptive immune system. Surface Barriers The body of the human continuously faces attack from foreign invaders that can cause disease and infection. These invaders sort from living microbes , such as fungi, bacteria, parasites, and viruses, to dead toxins, drugs, and chemicals. As our luck, the body has many internal and external defenses that avoid most dangerous attackers from entering and causing damages. The physical layers that stay them at inlet commonly are referred to as the bodys 1st line of defense. The largest body organ is skin; is presents both a physical and also a chemical barrier against the outer environment. The skin makes a defensive cover that completely encloses around the body, shielding blood vessels, muscles, nerves, bones and organs. When tears or cuts in the outer surface of the skin, present an opening for infective organisms, glands under the skin, produce an enzyme that helps to destroy bacteria (4). Although areas of the body not covered with skin, do not unprotected. Mucous membranes, the wet layer of the respiratory system. They produce mucus, a sultry substance that catches irritants that enter through the nose. Innate immune system The cells that mediate immunity embody neutrophils, macrophages, and natural killer (NK) cells, giant lymphocytes that are not T cells but are cytotoxic. all these cells answer macromolecule and saccharide sequences distinctive to microorganism cell walls and to alternative substances characteristic of growth and transplant cells. They exert their effects by means of the complement and alternative systems, with the cells they attack oftentimes dying by osmotic lysis or cell death (5). Their cytokines also activate cells of the nonheritable immune system. a vital link in immunity in Drosophila melanogaster is a receptor supermolecule named toll, that binds plant life antigens and triggers activation of genes cryptography for antifungal proteins (6). Humeral and Chemical Barriers Some microbes penetrate the bodys protecting barriers and enter the interior tissues. There they encounter a variety of chemical substances which will stop their growth. These substances embody chemicals whose protecting effects are related to their primary perform within the body, chemicals whose principal perform is to harm or destroy invaders, and chemicals made by present bacterium (7). Inflammation Inflammation is one in every of the primary responses of the immune system to infection. The symptoms of inflammation are redness, swelling, heat, and pain, that are caused by augmented blood flow into tissue. Inflammation is made by eicosanoids and cytokines, that are released by livid or infected cells (6). Eicosanoids embody prostaglandins that manufacture fever and the dilation of blood vessels associated with inflammation, and leukotrienes that attract bound white blood cells (leukocytes). Common cytokines embody interleukins that are chargeable for communication between white blood cells; chemokines that promote chemo taxis; and interferons that have anti-viral effects, like motion down supermolecule synthesis within the host cell. Growth factors and cytotoxic factors may additionally be released (7). These cytokines and alternative chemicals recruit immune cells to the site of infection and promote healing of any broken tissue following the removal of pathogens. Complement System The complement system is a organic chemistry cascade that attacks the surfaces of foreign cells. It contains over twenty completely different proteins and is called for its ability to complement the killing of pathogens by antibodies. Complement is that the major humeral element of the innate response. several species have complement systems, as well as non-mammals like plants, fish, and some invertebrates (8),(9). Cellular Barriers Leukocytes (white blood cells) act like independent, acellular organisms and are the second arm of the innate immune system. The innate leukocytes embody the phagocytes (macrophages, neutrophils, and nerve fibre cells), mast cells, eosinophils, basophiles, and natural killer T cells. These cells identify and eliminate pathogens, either by attacking larger pathogens through contact or by engulfing so killing micro organisms (10). Adaptive immune system Lymphocytes are available in 2 major types: B cells and T cells. The peripheral blood contains 20-50% of current humorocytes; the rest move within the lymph system. Roughly eightieth of them are T cells, V-day B cells and remainder are null or undifferentiated cells. Lymphocytes constitute 20-40% of the bodys WBCs (6). Their total mass is concerning an equivalent as that of the brain or liver. (Heavy stuff ) B cells are made within the stem cells of the bone marrow; they manufacture protein and superintend humeral immunity. T cells are non antibody-producing lymphocytes that are also made within the bone marrow but hypersensitised within the thymus and constitute the idea of cell-mediated immunity. the assembly of these cells is diagrammed below. parts of the immune system are changeable and may adapt to raised attack the invasive matter (11). There are 2 fundamental adaptive mechanisms: cell-mediated immunity and humeral immunity. Lymphocytes A white blood cell is a style of white corpuscle present within the blood. White blood cells help defend the body against diseases and fight infections. when the overall defense systems of the body have been penetrated by dangerous invasive microorganisms, lymphocytes help give a particular response to attack the invasive organisms (12). Killer T cells A large differentiated t cell that functions in cell-mediated immunity by attacking and essential amino acid target cells that have specific surface antigens (6). also known as cytotoxic t cell, killer cell. Helper T cells Any of varied T cells that, when stirred up by a particular matter, unharness lymphokines that promote the activation and function of B cells and killer T cells (13). B Lymphocytes and Antibodies A b cell identifies pathogens when antibodies on its surface bind to a particular foreign matter. This antigen/antibody advanced is preoccupied by the b cell and processed by chemical process into peptides. The b cell then displays these substance peptides on its surface MHC category II molecules (14). this combination of MHC and matter attracts a matching helper t cell, that releases lymphokines and activates the b cell. because the activated b cell then begins to divide, its offspring (plasma cells) secrete scores of copies of the protein that recognizes this matter (12). different adaptive immune system The alternative adaptive immune systems in vertebrates have several similarities, but dissent therein Lucien-rich-repeat (LRR)-based variable white blood cell (VLR) receptors are employed by bone vertebrates versus the Ig-based TCR and BCR employed by jawed vertebrates. bone vertebrates have 2 VLR sorts, VLRA and VLRB, the various repertoires of that are expressed by separate lymphocytes populations (15). Immunological Memory the capability of the bodys immune system to recollect AN encounter with AN matter owing to the activation of B cells or T cells having specificity for the matter and to react more swiftly to the matter by means that of these activated cells during a later encounter (6). Passive memory Newborn infants have no prior exposure to microbes and are particularly prone to infection. many layers of passive protection are provided by the mother. throughout pregnancy, a selected style of protein, called IgG, is transported from mother to baby directly across the placenta, so human babies have high levels of antibodies even at birth, with an equivalent vary of matter specificities as their mother. Breast milk or colostrums also contains antibodies that are transferred to the gut of the baby and defend against microorganism infections until the newborn can synthesize its own antibodies (16). Active memory Long-term active memory is nonheritable following infection by activation of B and T cells. active immunity also can be generated by artificial means, through vaccination. The principle behind vaccination (also known as immunization) is to introduce AN matter from a microorganism in order to stimulate the immune system and develop specific immunity against that specific microorganism while not inflicting malady associated with that organism (17). Disorders of Human Immunity Some of the most devastating disorders which will affect the humanity are those that attack the very weaponry weve got against diseases, our immune system (7). These disorders can vary in severity from inflicting small rashes or a stuffy nose, to attacking important organs throughout the body, inflicting death. they can also come back from a variety of sources from the genetic passing down of traits, to infection from a malady. These immune system disorders comprise four categories: immunodeficiency, autoimmune, allergic and cancer. Immunodeficiency An immunodeficiency disorder is one in every of the many disorders that attack the immune system. In these disorders the immune system has problems that cause the system to not work correctly. again and again this can be owing to a genetic trait or congenital disorder (6). the most common immunodeficiency disorders are severe combined immunodeficiency (SCID), also known as bubble boy disorder, Di St. George syndrome, and ig A deficiency (18). Motor vehicle Immunity Autoimmune disorders attack the immune system by tricking the body into thinking its own organs are foreign invaders. when this happens, the phagocytes and lymphocytes activate healthy tissues and organs and destroy them. Common autoimmune diseases are lupus, scleroderma, juvenile dermatomyositis and juvenile rheumatism. The severity of AN disease can vary dramatically (19). Some could only cause localized swelling and inflammation by attacking the tissue within the joints, while others could cause death by attacking important organs. Hypersensitivity Hypersensitivity refers to excessive, undesirable (damaging, discomfort-producing and sometimes fatal) reactions made by the traditional immune system. Hypersensitivity reactions need a pre-sensitized (immune) state of the host. Hypersensitivity reactions is divided into four sorts: type I, type II, sort III and kind IV, based on the mechanisms involved and time taken for the reaction (20). Physiological Regulation Hormones can act as immunomodulators, sterilisation the sensitivity of the immune system. as an example, female sex hormones are famous immunostimulators of both adaptive and innate immune responses. Some autoimmune diseases like autoimmune disease strike women preferentially, and their onset typically coincides with pubescence. in contrast, male sex hormones like testosterone seem to be immunosuppressive. alternative hormones appear to control the immune system yet, most notably luteotropin, endocrine and alimentation (21),(22). Manipulation in medication The response is manipulated to suppress unwanted responses ensuing from autoimmunity, allergy, and transplant rejection, and to stimulate protecting responses against pathogens that mostly elude the immune system (see immunization). immunosuppressive drugs are used to control autoimmune disorders or inflammation when excessive tissue harm occurs, ANd to stop transplant rejection once an transplantation. anti-inflammatory drug drugs are typically used to control the effects of inflammation. Glucocorticoids are the most powerful of these drugs; but, these drugs can have several undesirable facet effects, like central obesity, symptom, osteoporosis, and their use should be tightly controlled (23). Lower doses of anti-inflammatory drug drugs are typically used in conjunction with cytotoxic or immunosuppressive drugs such asmethotrexate or Imuran. Cytotoxic drugs inhibit the response by killing dividing cells like activated T cells. However, the killing is indiscriminate and alternative p erpetually dividing cells and their organs are affected, that causes harmful facet effects. immunosuppressive drugs like cyclosporine stop T cells from responding to signals correctly by inhibiting signal transduction pathways (24). What is dengue fever? Dengue fever is a malady caused by a family of viruses that are transmitted by mosquitoes. its AN acute malady of sudden onset that typically follows a benign course with symptoms like headache, fever, exhaustion, severe muscle and joint pain, swollen glands , and rash. Signs and Symptoms Many folks, especially kids and teenagers, could expertise no signs or symptoms throughout a mild case of dengue fever. when symptoms do occur, they usually begin four to ten days once the person is bitten by AN infected dipteron (25). Signs and symptoms of dengue fever most typically include: Fever, up to 106 F (41 C) Headaches Muscle, bone and joint pain Pain behind your eyes You might also experience: Widespread rash Nausea and puking Minor trauma from your gums or nose Most people recover within per week or so. In some cases, however, symptoms worsen and may become grievous. Blood vessels typically become broken and leaky, and the number of clot-forming cells in your bloodstream falls (25). this will cause: Bleeding from the nose and mouth Severe abdominal pain Persistent puking Bleeding under the skin, which can appear as if bruising? Problems along with your lungs, liver and heart Clinical Course The characteristic symptoms of breakbone fever are sudden-onset fever, headache (typically situated behind the eyes), muscle and joint pains, and a rash (25). The alternative name for breakbone fever, break-bone fever, comes from the associated muscle and joint pains. The course of infection is split into 3 phases: febrile , critical, and recovery. The febrile part involves high fever, typically over forty ÂÂ °C (104 ÂÂ °F), and is associated with generalized pain and a headache; this sometimes lasts 2 to seven days. At this stage, a rash occurs in 50-80% of those with symptoms. It occurs within the initial or second day of symptoms as flushed skin, or later within the course of malady (days 4-7), as a measles-like rash. Some petechiae (small red spots that do not disappear when the skin is pressed, that are caused by broken capillaries) can appear at this point, as could some gentle trauma from the secretion membranes of the mouth and nose. The fever itself is classically biphasic in nature, breaking so returning for one or 2 days, though there is wide variation in however typically this pattern truly happens (26). Causes Transmission Dengue virus is primarily transmitted by Aides mosquitoes, particularly A. aegypti. These mosquitoes sometimes live between the latitudes of 35ÂÂ ° North ANd 35ÂÂ ° South below an elevation of 1,000 metres (3,300 ft). They bite primarily throughout the day. alternative genus Aedes species that transmit the malady embody A. albopictus, A. polynesiensis and A. scutellaris. Humans are the primary host of the virus, but it also circulates in anthropoid primates. AN infection is nonheritable via a single bite (27). infectious agent Replication Once inside the skin, breakbone fever virus binds to Langerhans cells . The virus enters the cells through binding between infectious agent proteins and membrane proteins on the Langerhans cell, specifically the C-type lectins known as DC-SIGN, mannose receptor and CLEC5A. DC-SIGN, a non-specific receptor for foreign material on nerve fibre cells, seems to be the main purpose of entry. The nerve fibre cell moves to the nearest node (28). Meanwhile, the virus ordination is replicated in membrane-bound vesicles on the cells endoplasmic reticulum, wherever the cells supermolecule synthesis equipment produces new infectious agent proteins, and the infectious agent RNA is traced (26). Severe malady It is not entirely clear why secondary infection with a unique strain of breakbone fever virus places folks at risk of breakbone fever hemorrhagic fever and breakbone fever shock syndrome. the most wide accepted hypothesis is that of antibody-dependent enhancement (ADE). the exact mechanism behind ade is unclear. it may be caused by poor binding of non-neutralizing antibodies and delivery into the incorrect compartment of white blood cells that have eaten the virus for destruction. there is a suspicion that ade is not the only mechanism underlying severe dengue-related complications, and various lines of analysis have implied a role for T cells and soluble factors like cytokines and the complement system (25). Diagnosis Diagnosing dengue fever is tough, as a result of its signs and symptoms is easily confused with those of alternative diseases like malaria, swamp fever and enteric fever. Your doctor can seemingly raise concerning your medical and travel history. make sure to explain international visits thoroughly, as well as the countries you visited and the dates, yet as any contact you will have had with mosquitoes. bound laboratory tests can observe proof of the breakbone fever viruses, but test results sometimes come too late to assist direct treatment selections . (25),(27) Classification The World Health Organizations 2009 classification divides dengue fever into 2 groups: uncomplicated and severe. The 1997 classification divided breakbone fever into undifferentiated fever, dengue fever, and breakbone fever hemorrhagic fever. breakbone fever hemorrhagic fever was divided additional into grades I-IV. Grade I is that the presence only of easy bruising or a positive bandage test in someone with fever, grade II is that the presence of spontaneous trauma into the skin et al, grade III is that the clinical proof of shock, and grade IV is shock so severe that pressure and pulse cannot be detected. Grades III and IV are noted as dengue shock syndrome (27). Prevention All control efforts ought to be directed against the mosquitoes. its important to take control measures to eliminate the mosquitoes and their breeding places. Efforts ought to be intense before the transmission season and through epidemics (25),(27). (1) stop dipteron bites: (a) breakbone fever Mosquitoes Bite throughout the Daytime defend Yourself from the Bite (b) Wear full-sleeve clothes and long dresses to cover the limbs. (c) Use repellents care ought to be taken in victimisation repellents on young kids and elders. (d) Use dipteron coils and electrical vapor mats throughout the daytime to stop breakbone fever. (e) Use dipteron nets to safeguard babies, old folks et al who could rest throughout the day. The effectiveness of such nets is improved by treating them with permethrin. Curtains also can be treated with insecticide and decorated at windows or doorways, to repel or kill mosquitoes. (f) Break the cycle of mosquito-human-mosquito infection. Mosquitoes become infected once they bite people that are sick with breakbone fever. dipteron nets and dipteron coils can effectively stop more mosquitoes from biting sick folks and help stop the spread of breakbone fever. (2) stop the multiplication of mosquitoes: Mosquitoes that spread breakbone fever live and breed in stagnant water in and around houses. (a) Drain out the water from desert/window air coolers (when not in use), tanks, barrels, drums, buckets, etc. (b) remove all objects containing water (e.g. plant saucers, etc.) from the house. (c) All stored water containers ought to be unbroken lined in any respect times. (d) Collect and destroy discarded containers within which water collects, Treatment There arent any specific treatments for dengue fever. Treatment depends on the symptoms, variable from oral rehydration therapy reception with shut follow-up, to hospital admission with administration of intravenous fluids and/or insertion. a decision for hospital admission is often based on the presence of the warning signs listed within the table on top of, especially in those with preexisting health conditions (27),(29). Conclusion Three immune parts interact to provide a confluence of symptoms that outline DHF/DSS. breakbone fever virus initially infects immature nerve fibre cells through the mediation of DC-SIGN. Infected nerve fibre cells contribute to pathological process through production of metalloproteases and cytokines (30). Downstream of nerve fibre cells T-cells become activated and generate the very cytokines concerned in tube-shaped structure leak and shock in addition to activating soul cells. protein enhancement is mediated by Fc receptors that are conspicuously on mature nerve fibre cells. infectious agent replication mediated by antibodies is increased 100-fold. in addition their effects on breakbone fever replication, antibodies to infectious agent epitopes cross react with cell a supermolecule that has the result of stimulating CD8 soul cells and production of cytokines and anaphylatoxins. Anaphylatoxins is generated directly through infectious agent proteins or through formation of AN antibo dy-complement advanced. Anaphylatoxins in turn can alter the reactivity of T-cells.

Psychological Effects Of Long :: essays research papers

The Psychological Effects of an Injury   Ã‚  Ã‚  Ã‚  Ã‚  With every injury it is important to remember that the athlete will be affected mentally. Not all athletes will act identically to the same injury. Although research shows there are factors that are commonly seen among athletes going through adjustment to injury and rehabilitation. There are three reactive phases of the injury and rehab process. They are reaction to injury, reaction to rehabilitation, and reaction to return to competition or career termination. The reactions fall into four time frames: short term, long term, chronic, and termination.   Ã‚  Ã‚  Ã‚  Ã‚  In the scenario the athlete was diagnosed with a second degree ankle sprain. This would fall under the category of a long term injury. A long term injury is one where the rehabilitation time is longer than four weeks and may take up to a year. Some other examples of injuries in this category would be fractures, orthopedic and general surgeries, second and third degree sprain and strains, and debilitating injuries.   Ã‚  Ã‚  Ã‚  Ã‚  In the reaction to the injury itself, there is a primary reaction followed by a secondary reaction. With this ankle sprain, a common primary reaction is that of fear. This athlete can be afraid of many things ranging from them never getting better to never getting to play again to being afraid of the unknown. In order to conquer this fear the athletic trainer needs to help reassure the athlete about their injury. This can be done by presenting the truth about the injury and rehab process in a manner they can understand and gaining the athlete’s trust in the athletic trainer.   Ã‚  Ã‚  Ã‚  Ã‚  A common secondary reaction is anger. During this time the athlete may have an angry or hostile attitude and the person around the athlete at the time often takes the force of the anger. It is usually just a release for the athlete not a personal attack on the trainer.   Ã‚  Ã‚  Ã‚  Ã‚  This athlete will also have reactions to their rehabilitation. Loss of vigor and irrational thoughts are the primary reactions to long term rehab. The thing the trainer needs to be aware of at this point in time is that the loss of vigor can be masked as depression. The athlete experiencing loss of vigor will not have the same spirit as they usually do, but they will not have the common signs and symptoms of true depression. The athlete needs to understand that these feelings are normal as long as there are no signs of clinical depression.

Essay --

Few people know but, more than half of americans own an Apple product. The huge tech company was founded on April 1, 1976 by Steve Jobs and Steve Wozniak. The company was later incorporated on January 3, 1977. Apple is known as one of the most advanced technology companies in the United States. Apple is behind the largest technological revolution in history. Apple has set itself above all other technology companies. The company has a certain way of leaving customers on the edge of their seats waiting for the latest and greatest Apple product. Steve Jobs and Steven Wozniak had been friends since high school, and they both were very interested in electronics. After they both dropped of school, both of them end up in a profession related to electronics. Jobs got a job at Atari, and Wozniak at HP. Wozniak had been the initial designer for the very first Apple computer. Jobs had an eye for the future and convinced Wozniak that they should sell the computer. Soon enough on April 1, 1976, Apple had begun. In the beginning people did not take Apple very seriously. In 1977 however Apple introduced the Apple II, that when the company took off. The introduction of the Apple II opened doors for the company. It was the first computer with a hard plastic outer shell, it also was the first computer that had color graphics. The Apple II was basically the start of the company. Another thing that boosted the company in 1978 was the Apple Disk II, which was just an easy, inexpensive floppy drive. With all the sales rising, the companies n umbers began to rise as well. In 1980 Apple had a few thousand employees. 1980 was also the year Apple released its latest computer the Apple III. It was in 1979 when Jobs and a few engineers began working on ... ...that received the licensing felt that Apple was too restrictive on their agreements. Through the years, Apples big problem was not just selling the computers, but building them. In June of 1995, Apple had over one billion dollars worth of backorders, and did not have the materials to build them. On top of the current problems Apple was facing, Windows had released its latest version of its software, Window ‘95, which was too similar to the Mac and yet more simplistic. Pretty soon Spindler was asked to resign due to major losses the company faced when Apple had posted a loss of sixty-eight million dollars due to a misjudge of the market. Spindler was replaced by Gil Amelio, who was previously the president of the National Semiconductor. Through 1996 and part of 1997 Ameilo did his best to help Apple bring back is profit, but in the end his efforts were unsuccessful.

Utopia :: essays research papers

What is â€Å"Utopia†? What does this word mean to you? What would be your â€Å"Utopia†? Think about this while it is being read to you or while you read it and hopefully by the time the you get to the end you to will know what it means to you; and what your utopia would be like. By definition from a dictionary â€Å"Utopia† means, an ideally perfect place, especially in its social, political, and moral aspects. Utopia is your perfect world or society. It is a world of your choice, a world that meets every single expectation you have of life. A utopia in my mind would be a world where all people great and small, all shapes and colors, and all creatures are treated as one or as equals. It would be a world without discrimination and racism. My utopia would never have to worry about pollution or chemical weapons. People could believe in whatever god they wish but they would not kill others just because they did not believe in their god. Artist and utopia; is there any connection or resemblance in either?   Ã‚  Ã‚  Ã‚  Ã‚  Is art not an artist’s utopia? Think about it. Isn’t utopia whatever world, society, or maybe space you want it to be? So for artist a sculpture garden could be their utopia because they put the pieces of art that they had made or bought in that area. The artist could have also designed that place of perfection or tranquility to their liking, so if that were true it would that artist’s â€Å"Utopia†. The, Nasher Sculpture Center, in Dallas, is a perfect utopia for the owner of the center because it houses everything that person wanted just to make the center. To make that utopia the owner had trees brought in from all over the world and the trees were put in certain places all around the 54,000 square foot property.

Limitations From Suffering Chronic Asthma

One of the major public health problems facing Australia today is Asthma. It is disturbing that there has been an apparent increase in its prevalence and severity, and increased rates of hospital admissions. (E.J.Comino, 1996) For the diagnosed patient, the degree to which he or she suffers is related to severity of the condition, compliance with recommendations by medical experts, the immediate environment and the effectiveness of education programs. Like other major health problems, asthma has varying degrees of symptoms. As such, the degree and frequency of the symptoms limits many aspects of the asthmatics life. To describe the main limitations suffered by those with chronic asthma, asthma must be defined. Asthma is a condition whereby the sufferer has difficulty breathing due to widespread narrowing of the airways of the lungs. This narrowing can be caused by a local inflammation of the air-ways, muscle contraction or the production of excess mucus with in bronchi. (R.Roberts, 1996) Most common is bronchial asthma. Medical definitions of asthma suggest that environmental triggers can substantially contribute to the occurrence of an asthma attack. The review of asthma in Victoria (1988) by the Asthma Foundation of Victoria outlined infection, exercise, climatic conditions, exposure to airborne irritants and emotional upsets as the main trigger factors. However, doctors use a general classification to identify a patients pattern of asthma†¦classifying people who experience some symptoms of asthma on most days as having a chronic asthma condition. The classification system also extends to the categories of children, occupational asthma and asthma in later life. Usually regular medication is required to keep the lungs functioning as normally as possible. Some chronic asthmatics have severe symptoms over a long period of time and may require long term or indefinite medication to be able to lead a normal life. (Lane, 1996) The most obvious limitations suffered relate to the asthmatics physiological dysfunction. However, physiological dysfunction can in turn contribute to greater social and psychological limitations. This area is related more specifically to quality of life and morbidity and will be discussed further on. The main physiological limitation is related to the presence of the bronchial narrowing slowing the movement of air into and out of the lungs. Thus, there is difficulty both breathing in and out. Asthmatics commonly describe the feeling – tightness of the chest, congestion and wheezing. Although these symptoms can commonly occur in other chest diseases, in asthma it is a characteristic that can occur in an aggravated attack. This may be either brief episodes of chest tightness lasting a matter of minutes or a prolonged episode of wheezing lasting up to and hour, which can merge into a full blown attack of asthma. (D.J.Lane, 1996) Other physiological limitations relate to the sufferers sensitivity to known triggers factors and the consequential effect on their daily functioning. The Global Strategy for Asthma Management and Prevention (1995) states that triggers are risk factors that cause asthma exacerbation†s by inducing inflammation or provoking bronchio-constriction. This report also describes the main triggers as allergens, air pollutants, respiratory infections, exercise and hyperventilation, weather changes, allergies to foods, additives and drugs, and emotional stress. For example it is well established that viral respiratory infections can exacerbate asthma, especially in children under the age of 10. (Busse, 1993) Because the triggers may vary from person to person and from time to time, it is important to take the sufferers natural history into account and identify each individuals triggers. Therefore, an individuals identified trigger can restrict the sufferers ability to function normally. For example – an asthmatic child may try to avoid exercise for fear that it may trigger an asthmatic attack. This may in turn limit the sufferers physiological development over the long term and hence further contribute to the problem. (Global Strategy, 1995) Some psychological and social problems can also be considered as a consequence of the interaction with physiological limitations. The Global Strategy for Asthma Management and Prevention (1995) states that â€Å"asthma is a chronic disorder that can place considerable restrictions on the physical, emotional, and social aspects of the lives of patients and may have an impact on their careers†. Chronic asthma sufferers have to live with the need for treatment and with the limitations that having asthma places on their everyday lives. It is in this context that the asthmatics life area†s are most likely to be handicapped. In general, the chronic asthmatics activity choices are particularly handicapped. †¦. especially physical education. Exercise incites airflow limitation in most children and young adults who have asthma. Exercise appears to be a specific stimulus for people with asthma because it seldom leads to airflow limitation in people without asthma. (Global Strategy, 1995) More specifically sports where sustained effort is needed over a considerable period (eg long distance running) are not recommended. From a psychological point of view, the development of a positive sense of self (ie self-esteem) can be adversely affected by asthma. In one study, nearly 41 percent of parents of children with asthma said that asthma caused their children to feel self-pity. These children also were found to have low self-esteem as well as poor relationships with their peers. (Charmaz, 1983) For an adult, occupation and social life may be handicapped. A comparative study from Edinburgh (1996) between asthmatics and people with other forms of physical disability were found to have similar levels of anxiety or neuroticism. It was found most asthmatics exhibited varying levels of anxiety in relation to their beliefs and, in particular, their constant fear of another attack and anxiety over school and work prospects. (Lane, 1996). Similarly, fear also plays a predominant role in children who suffer from asthma†¦. with one in four Victorian children fearing not being able to breathe as a result of asthma (King, 1988). Furthermore, the relationship between asthma and emotional andor severe behavior problems is documented in a 1995 study by R,Bussing et al. In particular they tend to suffer from limited school functioning, inability to attend school and need for special school or special classes. In Australia, school loss caused by asthma accounted for approximately 965,000 days annually. (Aust Bureau Statistics, 1991) In particular poor academic performance and greater risk to learning difficulties were found to be the greatest negative consequences. (Fowler, 1992) The asthma sufferer can have a limited choice of occupations, because they are exposed to an increasingly large number of potential irritants in their working lives. In particular if specific allergies are known to exist then an occupation that exposes them to the allergens must be avoided. For instance, those sensitive to pollen should not become gardeners or those who have recurrent shortness of breath, should not become marine biologists. (Lane, 1996) 3. What can an individual do to prevent the occurrence of unnecessary as asthma attacks, or to minimize the seriousness of those that do occur? In 1989 an Australian Asthma management (AMP) plan was set up as a guideline for health professionals. The guideline was set up as a common consensus among health experts to help tackle the irregular diagnosis and treatment of asthma. More particularly, to help combat the increase of asthma induced admissions to hospitals due the occurrence of unnecessary asthma attacks. This report outlined 6 important steps to aid the doctor and the sufferer as to the basis of good asthma management. They include (1) Assess the severity of asthma; (2) achieve best lung function (3) maintain best lung function by identifying and avoiding triggers; (4) maintain best lung function with optimal medication; (5) develop an action plan; and (6) educate and review regularly. (Woolcock, 1989) Current research by Beilby (1997) highlighted that having an action plan can play a vital role in preventing hospital admissions and death from asthma. An asthma action plan is a co-ordinated method of management that covers all aspects a persons asthma – medication, triggers factors, lung function measurements, etc. To ensure greater adherence, both the patient and the doctor should fill out an asthma management chart together. It encourages self management and focuses on the importance of identifying the main trigger factors and monitoring the warning signs of an asthma attack. Essentially this involves a regular check on airway function by the use of a peak flow meter and the additional measurement of lung capacity twice a day those with severe asthma. Use of symptomatic (quick working) medication such the bronchodilator ventolin aerosol type to maintain best lung function, is recommended to reduce the seriousness of an acute attack. Doctors prescribe preventative medication such as Intal (sodium cromogylcate), anti-allergy injections and inhaled steroids for people who have severe asthma. Long term use of preventative medicine is used in conjunction with bronchodilators. After several months on preventative medicine, asthmatics find they are able to reduce their use of bronchodilators dramati cally. (Prendergast, 1991) Identifying trigger factors such as allergens, infection, exercise, weather changes and emotional stress is also important. The use of a bronchodilator or Intal, before being exposed to an identified trigger factor, can reduce the likelihood of an asthmatic reaction. The asthma management chart also describes what to do if following warning signs are observed : (1) the bronchodilator doesn†t bring expected relief, (2) a decrease in the peak expiratory flow, (3) Increased breathlessness and variation in peak flow rates during the day, (4) more frequent wheezing and a persistent dry cough and (4) disturbed sleep. (Prendergast, 1991) Asthmatics who live in highly polluted areas and are surrounded by electrical appliances, high tech equipment and power lines can benefit from air ionisers and a purifiers. Individuals can also prescribe to alternative treatment (for instance the Buteyko method), various breathing exercises, physical exercise (such as swimming), a healthy diet, and natural remedies such a homeopathic and acupuncture. It has been found that these treatments should complement orthodox medication and also help reduce the reliance on it. Roberts (1996) suggest that there is evidence that the Buteyko method is effective in treating chronic asthma. Devised by professor Beteyko of Siberia, this program consists of specific relaxation techniques and shallow breathing to correct breathlessness and wheezing. For those who are prone to exercise induced asthma choosing the right type of exercise is important †¦ particularly choosing a sport that requires longer and slower breathing and/or short bursts of effort. Examples include gymnastics, cricket and basketball. Swimming with its controlled breathing pattern is also recommended as it promotes chest development, flexibility and, therefore better breathing. (Roberts, 1996) There has been extensive research into new drug treatments of asthma by pharmaceutical companies and universities over the last 20 years. One such new effective drug to emerge is a Leukotiene receptor antagonists (LTRA). It was recently introduced into Australia this year and the USA 3 years ago. In people with asthma, leukotrienes play a key role in causing the inflammation, bronchoconstriction, and mucous production that lead to coughing, wheezing, and shortness of breath. LTRA†s prevent leukotrienes from attaching to the proinflammatory receptors on circulating and lung cells, which contribute to asthma symptoms. Leukotriene research is the direct result of a Nobel Prize-winning discovery made by scientist Beng Samuelsson in 1979. (Lipworth, 1999) However, there needs to be further research into the efficacy and its side effects. 4. How effective are the educational programs undertaken by organizations such as Asthma Victoria? Current statistics indicate that there has been a reduction of asthma mortality and morbidity in Australia over the past 10 years. The fall in deaths from 964 in 1989 to 715 in 1997 may indicate that some of Australia†s strategies for asthma management have been successful. (NAC, 1998) The Australian Asthma Management Program provides a systematic and methodical approach to asthma care. Nevertheless, it was not formulated as an evidence based document. This means that its recommendations (devised in 1989) were not based on systematic reviews or had been ranked according to the strength supporting them. However, today there have been a number of studies reviewing the effectiveness of the AMP. One such report by the National Asthma Campaign (1999), commented on the crucial role of education in improving the management of asthma rather than the token gesture of handing over a leaflet at the end of a patient consultation. This was in relation to the 6th step – educate and review regularly and highlights the importance of education programs undertaken by organizations such as the Australian National Asthma Campaign, Asthma Victoria, the Thoracic society of Australia and New Zealand and other relevant educators. The 1990 and 1993 national surveys of 22,000 adults and 16,000 children conducted by the National Asthma Campaign (NAC) showed improved asthma management practices in the three year period. Although the changes are not necessary the direct result of the National Asthma Campaign, it is considered to be consistent with the campaign and other agencies having been successful in promoting awareness and optimal management of asthma. (Comino, 1996) One of the goals of the NAC was to reduce the reliance on daily medication and hence increase the use of preventative therapy (such as inhaled corcosteroids) for patients with moderate or severe asthma; together with written action plans based on symptom severity and measurements of lung function. Use of preventative medication was found to have increased among both children and adults. The study highlighted also that there was a significant decline in the use of daily inhaled bronchodilator drugs among children and also inappropriate medications such as antibiotics and oral prescriptions. In addition this study also showed that in 1993 survey, doctors measured lung function significantly more often than in 1990; with similar increases observed in the use of peak flow meters and written action plans. (Comino, 1996) These results suggest that the Australian Asthma Management Programs are relatively effective. However, the study also points to the fact that limitations still exist. In particular there is a lack of communication and joint management strategies between specialists and GP†s, hospitals and the community; whilst the use of action plans still has considerable room for further improvement. Nonetheless, not all studies on education programs show positive conclusions. A British research paper ‘Greenwich Asthma Study† of 1291 asthmatics conducted in 1993 and 1996 found that their model of service delivery was not effective in improving the outcome of asthma in the community. The intervention program used was based on the British Thoracic Society†s guidelines and was conducted by specialist nurses in community based settings. There were similarities in the methodology and intervention measurement. However, they concluded that no evidence was found for an improvement in asthma related quality of life among newly surveyed patients in intervention practices compared with control practices. (Premaratne, 1999) Altogether this highlights that the variability of the asthma educational programs undertaken by various major organisations make it difficult to comparatively evaluate. A comprehensive world wide study, ‘Objectives, methods and content of patient education programs for adults with asthma: systematic review of studies published between 1979 and 1998†³ found that there was great difficulty in identifying the most effective components of asthma educational programs. The main reason cited was that education programs for adults with asthma vary widely. Most reports did not specify the general (56%) and educational objectives (60%) of the intervention. Important training characteristics were often not available: duration of education (45%) and number of sessions (22%), who delivered education (15%), whether training was conducted in groups or was individualised (28%). (Sudre, 1999) Such variability suggests a lack of consensus on what educational components actually work. With insufficient documentation of asthma education programs for adults, replication is limited. In conclusion there is some evidence to suggest that written treatment management plans are most effective in improving the quality of life for people with asthma. In the Australian context the National Asthma Campaign has clearly documented program goals. However, the limitations lie in its lack of empirical evidence. In addition the reliability of the research documents in general has been brought into question by the Sudre (1999) study. Therefore it is difficult to demonstrate the most effective management plan for asthma sufferers. This issue is currently being addressed by the National Asthma Campaign and the Asthma Foundation of Victoria. The Asthma foundation is currently conducting a study into the effectiveness of their schools based program. Hopefully, this and other studies will help fill the gap associated with the effectiveness of asthma education programs. And hence secure the continuation and development of asthma education in the community. Limitations From Suffering Chronic Asthma One of the major public health problems facing Australia today is Asthma. It is disturbing that there has been an apparent increase in its prevalence and severity, and increased rates of hospital admissions. (E.J.Comino, 1996) For the diagnosed patient, the degree to which he or she suffers is related to severity of the condition, compliance with recommendations by medical experts, the immediate environment and the effectiveness of education programs. Like other major health problems, asthma has varying degrees of symptoms. As such, the degree and frequency of the symptoms limits many aspects of the asthmatics life. To describe the main limitations suffered by those with chronic asthma, asthma must be defined. Asthma is a condition whereby the sufferer has difficulty breathing due to widespread narrowing of the airways of the lungs. This narrowing can be caused by a local inflammation of the air-ways, muscle contraction or the production of excess mucus with in bronchi. (R.Roberts, 1996) Most common is bronchial asthma. Medical definitions of asthma suggest that environmental triggers can substantially contribute to the occurrence of an asthma attack. The review of asthma in Victoria (1988) by the Asthma Foundation of Victoria outlined infection, exercise, climatic conditions, exposure to airborne irritants and emotional upsets as the main trigger factors. However, doctors use a general classification to identify a patients pattern of asthma†¦classifying people who experience some symptoms of asthma on most days as having a chronic asthma condition. The classification system also extends to the categories of children, occupational asthma and asthma in later life. Usually regular medication is required to keep the lungs functioning as normally as possible. Some chronic asthmatics have severe symptoms over a long period of time and may require long term or indefinite medication to be able to lead a normal life. (Lane, 1996) The most obvious limitations suffered relate to the asthmatics physiological dysfunction. However, physiological dysfunction can in turn contribute to greater social and psychological limitations. This area is related more specifically to quality of life and morbidity and will be discussed further on. The main physiological limitation is related to the presence of the bronchial narrowing slowing the movement of air into and out of the lungs. Thus, there is difficulty both breathing in and out. Asthmatics commonly describe the feeling – tightness of the chest, congestion and wheezing. Although these symptoms can commonly occur in other chest diseases, in asthma it is a characteristic that can occur in an aggravated attack. This may be either brief episodes of chest tightness lasting a matter of minutes or a prolonged episode of wheezing lasting up to and hour, which can merge into a full blown attack of asthma. (D.J.Lane, 1996) Other physiological limitations relate to the sufferers sensitivity to known triggers factors and the consequential effect on their daily functioning. The Global Strategy for Asthma Management and Prevention (1995) states that triggers are risk factors that cause asthma exacerbation†s by inducing inflammation or provoking bronchio-constriction. This report also describes the main triggers as allergens, air pollutants, respiratory infections, exercise and hyperventilation, weather changes, allergies to foods, additives and drugs, and emotional stress. For example it is well established that viral respiratory infections can exacerbate asthma, especially in children under the age of 10. (Busse, 1993) Because the triggers may vary from person to person and from time to time, it is important to take the sufferers natural history into account and identify each individuals triggers. Therefore, an individuals identified trigger can restrict the sufferers ability to function normally. For example – an asthmatic child may try to avoid exercise for fear that it may trigger an asthmatic attack. This may in turn limit the sufferers physiological development over the long term and hence further contribute to the problem. (Global Strategy, 1995) Some psychological and social problems can also be considered as a consequence of the interaction with physiological limitations. The Global Strategy for Asthma Management and Prevention (1995) states that â€Å"asthma is a chronic disorder that can place considerable restrictions on the physical, emotional, and social aspects of the lives of patients and may have an impact on their careers†. Chronic asthma sufferers have to live with the need for treatment and with the limitations that having asthma places on their everyday lives. It is in this context that the asthmatics life area†s are most likely to be handicapped. In general, the chronic asthmatics activity choices are particularly handicapped. †¦. especially physical education. Exercise incites airflow limitation in most children and young adults who have asthma. Exercise appears to be a specific stimulus for people with asthma because it seldom leads to airflow limitation in people without asthma. (Global Strategy, 1995) More specifically sports where sustained effort is needed over a considerable period (eg long distance running) are not recommended. From a psychological point of view, the development of a positive sense of self (ie self-esteem) can be adversely affected by asthma. In one study, nearly 41 percent of parents of children with asthma said that asthma caused their children to feel self-pity. These children also were found to have low self-esteem as well as poor relationships with their peers. (Charmaz, 1983) For an adult, occupation and social life may be handicapped. A comparative study from Edinburgh (1996) between asthmatics and people with other forms of physical disability were found to have similar levels of anxiety or neuroticism. It was found most asthmatics exhibited varying levels of anxiety in relation to their beliefs and, in particular, their constant fear of another attack and anxiety over school and work prospects. (Lane, 1996). Similarly, fear also plays a predominant role in children who suffer from asthma†¦. with one in four Victorian children fearing not being able to breathe as a result of asthma (King, 1988). Furthermore, the relationship between asthma and emotional andor severe behavior problems is documented in a 1995 study by R,Bussing et al. In particular they tend to suffer from limited school functioning, inability to attend school and need for special school or special classes. In Australia, school loss caused by asthma accounted for approximately 965,000 days annually. (Aust Bureau Statistics, 1991) In particular poor academic performance and greater risk to learning difficulties were found to be the greatest negative consequences. (Fowler, 1992) The asthma sufferer can have a limited choice of occupations, because they are exposed to an increasingly large number of potential irritants in their working lives. In particular if specific allergies are known to exist then an occupation that exposes them to the allergens must be avoided. For instance, those sensitive to pollen should not become gardeners or those who have recurrent shortness of breath, should not become marine biologists. (Lane, 1996) 3. What can an individual do to prevent the occurrence of unnecessary as asthma attacks, or to minimize the seriousness of those that do occur? In 1989 an Australian Asthma management (AMP) plan was set up as a guideline for health professionals. The guideline was set up as a common consensus among health experts to help tackle the irregular diagnosis and treatment of asthma. More particularly, to help combat the increase of asthma induced admissions to hospitals due the occurrence of unnecessary asthma attacks. This report outlined 6 important steps to aid the doctor and the sufferer as to the basis of good asthma management. They include (1) Assess the severity of asthma; (2) achieve best lung function (3) maintain best lung function by identifying and avoiding triggers; (4) maintain best lung function with optimal medication; (5) develop an action plan; and (6) educate and review regularly. (Woolcock, 1989) Current research by Beilby (1997) highlighted that having an action plan can play a vital role in preventing hospital admissions and death from asthma. An asthma action plan is a co-ordinated method of management that covers all aspects a persons asthma – medication, triggers factors, lung function measurements, etc. To ensure greater adherence, both the patient and the doctor should fill out an asthma management chart together. It encourages self management and focuses on the importance of identifying the main trigger factors and monitoring the warning signs of an asthma attack. Essentially this involves a regular check on airway function by the use of a peak flow meter and the additional measurement of lung capacity twice a day those with severe asthma. Use of symptomatic (quick working) medication such the bronchodilator ventolin aerosol type to maintain best lung function, is recommended to reduce the seriousness of an acute attack. Doctors prescribe preventative medication such as Intal (sodium cromogylcate), anti-allergy injections and inhaled steroids for people who have severe asthma. Long term use of preventative medicine is used in conjunction with bronchodilators. After several months on preventative medicine, asthmatics find they are able to reduce their use of bronchodilators dramati cally. (Prendergast, 1991) Identifying trigger factors such as allergens, infection, exercise, weather changes and emotional stress is also important. The use of a bronchodilator or Intal, before being exposed to an identified trigger factor, can reduce the likelihood of an asthmatic reaction. The asthma management chart also describes what to do if following warning signs are observed : (1) the bronchodilator doesn†t bring expected relief, (2) a decrease in the peak expiratory flow, (3) Increased breathlessness and variation in peak flow rates during the day, (4) more frequent wheezing and a persistent dry cough and (4) disturbed sleep. (Prendergast, 1991) Asthmatics who live in highly polluted areas and are surrounded by electrical appliances, high tech equipment and power lines can benefit from air ionisers and a purifiers. Individuals can also prescribe to alternative treatment (for instance the Buteyko method), various breathing exercises, physical exercise (such as swimming), a healthy diet, and natural remedies such a homeopathic and acupuncture. It has been found that these treatments should complement orthodox medication and also help reduce the reliance on it. Roberts (1996) suggest that there is evidence that the Buteyko method is effective in treating chronic asthma. Devised by professor Beteyko of Siberia, this program consists of specific relaxation techniques and shallow breathing to correct breathlessness and wheezing. For those who are prone to exercise induced asthma choosing the right type of exercise is important †¦ particularly choosing a sport that requires longer and slower breathing and/or short bursts of effort. Examples include gymnastics, cricket and basketball. Swimming with its controlled breathing pattern is also recommended as it promotes chest development, flexibility and, therefore better breathing. (Roberts, 1996) There has been extensive research into new drug treatments of asthma by pharmaceutical companies and universities over the last 20 years. One such new effective drug to emerge is a Leukotiene receptor antagonists (LTRA). It was recently introduced into Australia this year and the USA 3 years ago. In people with asthma, leukotrienes play a key role in causing the inflammation, bronchoconstriction, and mucous production that lead to coughing, wheezing, and shortness of breath. LTRA†s prevent leukotrienes from attaching to the proinflammatory receptors on circulating and lung cells, which contribute to asthma symptoms. Leukotriene research is the direct result of a Nobel Prize-winning discovery made by scientist Beng Samuelsson in 1979. (Lipworth, 1999) However, there needs to be further research into the efficacy and its side effects. 4. How effective are the educational programs undertaken by organizations such as Asthma Victoria? Current statistics indicate that there has been a reduction of asthma mortality and morbidity in Australia over the past 10 years. The fall in deaths from 964 in 1989 to 715 in 1997 may indicate that some of Australia†s strategies for asthma management have been successful. (NAC, 1998) The Australian Asthma Management Program provides a systematic and methodical approach to asthma care. Nevertheless, it was not formulated as an evidence based document. This means that its recommendations (devised in 1989) were not based on systematic reviews or had been ranked according to the strength supporting them. However, today there have been a number of studies reviewing the effectiveness of the AMP. One such report by the National Asthma Campaign (1999), commented on the crucial role of education in improving the management of asthma rather than the token gesture of handing over a leaflet at the end of a patient consultation. This was in relation to the 6th step – educate and review regularly and highlights the importance of education programs undertaken by organizations such as the Australian National Asthma Campaign, Asthma Victoria, the Thoracic society of Australia and New Zealand and other relevant educators. The 1990 and 1993 national surveys of 22,000 adults and 16,000 children conducted by the National Asthma Campaign (NAC) showed improved asthma management practices in the three year period. Although the changes are not necessary the direct result of the National Asthma Campaign, it is considered to be consistent with the campaign and other agencies having been successful in promoting awareness and optimal management of asthma. (Comino, 1996) One of the goals of the NAC was to reduce the reliance on daily medication and hence increase the use of preventative therapy (such as inhaled corcosteroids) for patients with moderate or severe asthma; together with written action plans based on symptom severity and measurements of lung function. Use of preventative medication was found to have increased among both children and adults. The study highlighted also that there was a significant decline in the use of daily inhaled bronchodilator drugs among children and also inappropriate medications such as antibiotics and oral prescriptions. In addition this study also showed that in 1993 survey, doctors measured lung function significantly more often than in 1990; with similar increases observed in the use of peak flow meters and written action plans. (Comino, 1996) These results suggest that the Australian Asthma Management Programs are relatively effective. However, the study also points to the fact that limitations still exist. In particular there is a lack of communication and joint management strategies between specialists and GP†s, hospitals and the community; whilst the use of action plans still has considerable room for further improvement. Nonetheless, not all studies on education programs show positive conclusions. A British research paper ‘Greenwich Asthma Study† of 1291 asthmatics conducted in 1993 and 1996 found that their model of service delivery was not effective in improving the outcome of asthma in the community. The intervention program used was based on the British Thoracic Society†s guidelines and was conducted by specialist nurses in community based settings. There were similarities in the methodology and intervention measurement. However, they concluded that no evidence was found for an improvement in asthma related quality of life among newly surveyed patients in intervention practices compared with control practices. (Premaratne, 1999) Altogether this highlights that the variability of the asthma educational programs undertaken by various major organisations make it difficult to comparatively evaluate. A comprehensive world wide study, ‘Objectives, methods and content of patient education programs for adults with asthma: systematic review of studies published between 1979 and 1998†³ found that there was great difficulty in identifying the most effective components of asthma educational programs. The main reason cited was that education programs for adults with asthma vary widely. Most reports did not specify the general (56%) and educational objectives (60%) of the intervention. Important training characteristics were often not available: duration of education (45%) and number of sessions (22%), who delivered education (15%), whether training was conducted in groups or was individualised (28%). (Sudre, 1999) Such variability suggests a lack of consensus on what educational components actually work. With insufficient documentation of asthma education programs for adults, replication is limited. In conclusion there is some evidence to suggest that written treatment management plans are most effective in improving the quality of life for people with asthma. In the Australian context the National Asthma Campaign has clearly documented program goals. However, the limitations lie in its lack of empirical evidence. In addition the reliability of the research documents in general has been brought into question by the Sudre (1999) study. Therefore it is difficult to demonstrate the most effective management plan for asthma sufferers. This issue is currently being addressed by the National Asthma Campaign and the Asthma Foundation of Victoria. The Asthma foundation is currently conducting a study into the effectiveness of their schools based program. Hopefully, this and other studies will help fill the gap associated with the effectiveness of asthma education programs. And hence secure the continuation and development of asthma education in the community.