Sony strategic management and leadership Essay Example | Topics and Well Written Essays - 2750 words

Sony strategic management and leadership - Essay Example According to Sony’s C.E.O, the company’s mission is to challenge the designers, producers and engineers in order to improve their software and hardware and eventually advance its differentiation process towards its competition (Badawy, 2009). Sony has renowned heritage of creativeness and innovativeness. Sony boasts of having products in the electronic, games, entertainment, and still participate in the provision of financial service sectors (Flugge, 2008). In this regard, this essay will delve on a critical analysis of Sony’s strategic management and leadership. More so, it will analyze Sony’s marketing advantage with supportive evidence. (1) - Sony corporation success Traditionally, Sony was known as a great innovator that managed to transform the entire categories of electronics with unique products like the PlayStation game console and Walkman music player. More so, Sony was in a position to command premium prices for its top-quality products (Gao, Men g, Steve, 2008). Therefore, Sony did not only the electronic industry but it also changed the world because Sony brought about smaller portable devices to the market, which is contrary to the old electronic devices that were bulky and inefficient. Sony has tremendously grown in market share and profitability (Ajami, 2006). Numerous evidence portrays this growth, for instance in the year 2006, Sony topped a Harris poll as the best brand which was the seventh time consecutively, while dell and coca- cola took the second and third positions. In 2004, Forbes ranked Sony as the 72nd largest company in the world. Recently, in January 2013, Sony scooped the So-net Entertainment Corporation award. According to Interbrand Top 100 Global Brand 2011, Sony emerged position thirty-six among other a hundred brands (Anonymous 2012). Prior to successful market share, Sony boasts of diverse and effective employees who in the year 2011 they were ranging at 168,200. On February 25, 2013, Sony sold a 6 .0% stake of a 55.8%-owned subsidiary (Minato-Ku, 2013). Factors that have contributed to Sony’s success Sony’s main contributor to its success is its unique variety of brands that match up the latest modern world. The company manufactures television screens and projector, cameras, home theatre systems, computer hardware, mobile phones, and car entertainment devices (Plunkett, 2008). Additionally, Sony manufactures home recording devices, storage media, and charging devices (Nargundkar, 2006). Ideally, Sony has further divided some of its products into other sub categories especially for the television products. This has made the company able to service its market through the innovation of tailor made products that suit their various clients. These customers include households, offices, and public gatherings. Hence, Sony’s success comes from due to the ability of the company to produce products that are able to meet the needs of their customers without financial constraints as their quality dictates the price (Ferrell & Hartline, 2011). Moreover, Sony also uses strategic marketing skills to the improvement in sales capacity. These marketing strategies include market mix, online marketing among many others. Ideally, Sony has managed to use its favorable public rapport to maintain significant relations with its employees, consumers and other relevant stakeholders (Shajahan, 2004). The use of its

Political Aspects of Wireless Electricity Essay Example for Free

Political Aspects of Wireless Electricity Essay It is no secret that politics plays a big role when it comes to the introduction of the wireless electricity. Some parties are for it, as it can allow for slightly greener ways of powering devices, new jobs, and easier access. But others are against it, seeing the change as a threat to old ways of doing things, as well as a way for people to access electricity for free. Though wireless transmissions and the idea of wireless electricity have existed for quite some time, the actual possibility of creating usable, accessible wireless electricity is just now starting to become a reality. With wireless electricity looming on the horizon, more and more politicians, civilians, and companies are beginning to stand behind the idea; but that has not always been the case. Politics first began working their way into wireless electricity in 1905, when J. P. Morgan pulled all of his funding from Nikola Tesla’s Wardenclyffe Tower project when he erroneously began to believe that it could lead to free electricity for all (Haliburton, 2006). It is that same type of thinking that has helped to keep wireless electricity out of the mainstream for so long. However, information and general knowledge about wireless electricity has come far, and that type of thinking is quickly disappearing. With the recent surge of environmental and financial awareness, people are quickly beginning to gravitate towards the idea of wireless electricity. Even power companies are getting behind the idea, seeing a way to expand their business. Though the idea of wireless electricity has just begun to reemerge, it will quickly become a hot political topic, just as other forms of alternative energy have. The question is this: Will the general public and politicians continue to gravitate towards this new concept? And if they do, how long will it be until wireless electricity becomes the norm?

Free Rider Problem Essay -- essays research papers

The Free Rider Problem   Ã‚  Ã‚  Ã‚  Ã‚  The free rider issue has become one of the most serious economic issues today. The free rider is a lazy type person who wants the benefits that others bring in without having to do the work. The free rider typically takes advantage of a public good. Living in a civilized society presents many opportunities for free riding, which we have yet to find a way to control. Economists regard the possibility for free riding as a problem for the free market, which usually leads to government intervention. Government intervention is not generally needed in a free market society but in this case if there were no government intervention this problem would not find a solution.   Ã‚  Ã‚  Ã‚  Ã‚  The free-rider issue is often seen as a serious problem because of the assumption that a free rider's best self-interest is that they interact with others by force and fraud. If they can get away with the fraud and begin to gain the benefits of others they have reached their first goal. Their next goal is to make some good money or get credit for someone else's hard work before they get caught. Then they get out and are long gone by the time anyone notices. Life in a civilized society allows each of us the opportunity to enjoy the benefits of the work of people with productive ability far greater than our own, but what happens when people begin doing this? They get used to not having to do much work and become lazy. In some cases people look at welfare in this way. If a person is able to get a good job and chooses not to, but instead, to live on our government, this would be considered free riding. This causes a fluctuation in our market and it can have a negative effect. When the benefits go away people do not want to go back to work and eventually will loose their jobs or quit and become a true free rider. Clearly there is an essential difference between cases in which one can't contribute to the benefits one enjoys and cases in which one chooses not to make a contribution that is within one's power. But apart from this distinction, we can differentiate between harmless free riding and the worthless free riding. The free rider wants anything he can get for free and will think nothing of it if he can get away with it. Free riders take advantage of public goods without having to contribute to them. For example, if s... ...o make up the difference. This difference we have to make up is usually a higher tax. In raising the tax the price of the good goes up and when price goes up demand tends to go down. As the demand keeps falling and the price keeps rising the product usually ends up off the market and filing a chapter eleven. It typically does not go that far but this is an example of what could happen. A free market is a privilege to have and it is a shame people have to take advantage of it because they do not feel the need to work hard or to go out of their way to do something for someone else.   Ã‚  Ã‚  Ã‚  Ã‚  The free rider is a menace in our society and we do not need to let him take our money and put it to his use. We have found ways such as government intervention and price lids to help control the problem but we have yet to find a solution. Once a solution is found we will have fewer worries and possibly a true free market. These are very difficult problems to stop and may never be stopped. It will take a long period of time to begin the process to bring it to an end, but it will be nice to maybe some day have a true free market without the problem of a free rider.

A Futile Task- the Catcher in the Rye Essay

The teenager stands on a hill in complete solitude, watching the nearby football game, and contemplating if he should say a final farewell to the school. Ambivalent, the melancholy teenager leaves himself in a confused and vulnerable position to the lonely and corrupt reality of the world. In an attempt to endure the vices that alter the blissful spirit, he feels the need to make things right by saving what little recognizable evidence of purity that the world has not already desecrated. All throughout the novel The Catcher in the Rye, author J. D. Salinger establishes Holden’s bizarre attraction toward particular places, objects, and experiences, past and present. The author concurrently sets out the subtle, tender concern that Holden has for the preservation of innocence and where life will ultimately end up. At essential points in the plot, Salinger embodies these two motifs, which metaphorically represent each other, in order to uncover the true sadness that lurks in an abandoned Holden. By doing this, the author reveals the greater theme that unlike artifacts of history, constrained the human spirit would severely stunt any opportunity of development for people. Salinger constantly highlights the motif of Holden’s endeavors to preserve innocence from being tainted by corruption. The author first presents this through the objects that Holden develops a bond with. To demonstrate that bond, Salinger produces a scene in which Holden visits his old teacher, Mr. Spencer, one of the few concerned about the boy. The teacher asks Holden to read his paper about Egyptian mummifying aloud. Salinger first demonstrates Holden’s obsession for the preservation of life when Holden divulges that â€Å"Modern science would still like to know what the secret ingredients were that the Egyptians used when they wrapped up dead people so that their faces would not rot for innumerable centuries† (Salinger 16). Implying the deep interest that Holden possesses for this subject, Salinger underscores that the teenager may have experienced a harrowing event relating to the matter. Because Holden would still dearly like to know the â€Å"secret† of maintaining life in such a state, the author also exposes Holden’s unawareness of the topic altogether. Leaving Holden in an unaware state, the author then inserts the minor motif of Holden’s younger brother’s baseball mitt to clear the confusion. When asked to write a composition for a classmate, of all the topics Holden decides to write about, the nostalgic adolescent distinguishes his younger brother’s baseball mitt. With this sacred object, Salinger links it to Holden’s goal for conserving the unharmed and the aesthetic, as the glove had poems scribed all over it in ink. The author represents the ink as the permanence in which the item endures. Similar to the beloved baseball mitt, Holden finds solidity in a Little Shirley Beans record that he purchases. Identifying the song eternally preserved on the record, the writer elucidates that Holden still preserves things in the state that they are left, never allowing them to change. Salinger also represents Holden’s remembrance of the innocence of childhood, the record reminding him of that period. In addition to the revered objects, the author exhibits a pattern in Holden’s experiences and anecdotes that motivate Holden in the direction of making events like those last for an eternity. One of Holden’s recollections that Salinger touches on briefly involves Holden playing checkers with a childhood friend, Jane Gallagher. At one point in the game, Jane cries, and sensing this, Holden drives his efforts to console with her, kissing her all over her face, avoiding her mouth. Symbolizing the need to protect Jane and her virginity, the author portrays Holden comforting her instead of violating her, revealing the tender empathy that Holden possesses. Prior to reflecting this memory, Holden underwent an instance of rejection at a bar, and seeing what little empathy people have, Holden tries to remember a positive memory to keep his motivation alive. One of Holden’s fondest memories stems from the remembrance of his younger brother. When given time to ruminate upon his past, Allie stands out as the ideal brother that Holden would never find in any other person. Salinger distinguishes Allie as â€Å"terrifically intelligent† and that â€Å"he was also the nicest†¦ he never got mad at anybody. People with red hair are supposed to get mad very easily, but Allie never did, and he had very red hair† (Salinger 50). Portraying Allie as the epitome of childhood innocence, the author juxtaposes this to Holden’s thoughts of preserving purity. Because his sibling passed away at an extremely young age, Holden’s sole coping strategy involves the thought of bringing back his brother, thinking that someone as magnanimous as Allie deserves to live on. Despite Holden’s naive point of view toward what troubles him, he finally begins to subtly realize something about his brother. Salinger weaves a scene of Holden conversing with Phoebe, his younger sister, and the teenager mentions that he loves Allie, thinking that he still exists. Following Phoebe’s comment that Allie is dead, Holden refuses to accept and reveals that â€Å"Just because somebody’s dead, you don’t just stop liking them, for God’s sake—especially if they were about a thousand times nicer than the people you know that’re alive an all† (Salinger 223). Salinger highlights a rare moment: someone offering guidance to Holden, accepting that he is stuck. By displaying Holden touching upon Allie, Salinger expresses the adolescent beginning to address the connection with Allie. However, Holden still possesses the unawareness to come to terms with this. Salinger effectively amplifies the essence of Holden’s being in a thought of the teenager. The author illustrates a dream of Holden desiring to catch children who accidentally fall off the ledge of a cliff in the rye field, the adolescent defining himself as a catcher in the rye. The author resembles Holden as a selfless martyr in this thought, leaving Holden in bliss that he can save people if they fall; the author makes clear that, for Holden, danger should be avoided by all means and at all costs. Salinger stems the implication from Holden’s own dealings with losses Perhaps the most important category that Holden associates with conservation and longing consists of the places that he visits. One of the first locations that Salinger introduces pertains to the museum, a site of never changing exhibits. The boy favors that all the displays stay the way they are and that things are kept in fixed positions. By symbolizing the museum as a place where nothing changes, Salinger mirrors the setting to Holden’s opposition to growing up and change. Salinger initiates the beginning of a epiphany for Holden when the teenager travels to his old elementary school to meet with Phoebe. The writer describes the school as familiar to Holden While appearing to give up hope on the world, Holden sees yet another instance of chicanery. The author depicts an obscenity on the wall that appalls Holden, and in the act he makes of rubbing it out, Salinger reiterates Holden as a savior figure and that combating all of evil can be accomplished. The author furthers the learning experience for Holden when the teenager returns to the museum. Although feeling tranquil while all alone in one of the showcases, Holden observes yet another contemptible obscenity, defacing one of the glass cases. By repeating the obscenity for Holden, Salinger starts to affirm in Holden that he cannot keep everything clean and pure but must accept events like these once in a while. Finally pivoting Holden’s vague realization to the last crucial place, Salinger fleshes out the epiphany. Accompanied by phoebe, Holden views one of the carousels nearby, his attraction to it brought on by the fact that the ride always plays the same song. Holden again clings to a familiar tangent and what comforts him. Yet, the teenager watches Phoebe go around on the carousel and sees her and other children trying to grab for the gold ring. Salinger depicts Holden as â€Å"afraid that she’d fall off† but he does not react, as Holden realizes that â€Å"If they fall off, they fall off, but it’s bad if you say anything to them† (Salinger 274). Paralleling and directing opportunity and danger close together, Salinger enables acceptance in Holden that if people stay the same way, there leaves no room for development, thus rendering them static, strayed from the dynamics of change, and this time, Holden does not deny Phoebe or himself the opportunity to mature.

Organizational Communications Analysis Women’s Resource Center at Norman, Oklahoma

The Women’s Resource Center was originally started in 1973 and 1974 during the winter. It was originally started by a graduate student who wanted to assist women who were in transition points in the life. This organization could not function without effective communication and to analyze the communication strategies of the organization can provide helpful information that could further improve them. This included those women who were looking for employment as well as women who wanted to return to school. Since its opening the center has developed many programs and services (â€Å"History.. † 1). There are many programs available at the Women’s Resource Center and these include WRC Victims of Domestic Violence Shelter (providing safe temporary housing to victims of domestic violence and their children); Rape Response Team (trained volunteers who are available to meet with rape victims at the ER); counseling (specialized for victims of sexual assault or domestic abuse); WRC Education Program (offers staff that speak in a variety of places for about topics having to deal with domestic violence, date rape, healthy relationships and other topics); Children’s Program (groups that focus on letting children express their emotions and feelings); Court Advocacy (court advocates to help women through the legal system); and WRC Cells (a program to offer victims cell phones at no cost in case of an emergency) (â€Å"Programs.. † 1-2). There are also some training workshops. The main one is SANE (Sexual Assault Nurse Examiner) Volunteer Training, a specialized trainin g for nurses to learn how to do forensic rape test kits (â€Å"Training†¦Ã¢â‚¬  1). Effective communication is one of those things that are important to how well an organization is run. The Women’s Resource Center in Norman, Oklahoma has a lot of strengths in their communications. They do a good job of training both their staff and their volunteers. They work with their staff on issues about communications and knowing when to talk and when to be able to allow others to talk as they are dealing with people in very difficult situations. They learn how to effectively communicate for the situations that they are in where there is a high risk to the women that they are talking to. This means that there is a lot of training put into the idea of communications for this organization. Their main strength in communication is the overall ability to communicate effectively with those who are in a tough situation. The reason that this works so well is that there is a great deal of things in the communication process (Lee 2). Knowing the communication process can greatly help how communications are for people. According to Lass well’s model of communication there needs to be an effect for the communication to take place. What this is saying is that what is being communicated needs to have a point and a direction. In this communication process the organization is trying to point out that women deserve respect and self assurance (Lee 3). The idea of effective communication for change is something that this organization does well. The organization has made a lot of changes in the past both the long term past and the recent past. These changes are effectively communicated if three major components are available in the strategy. This study by Larkin and Larkin stated: â€Å"Communicate only facts; stop communicating values. Communicate face to face; do not rely on videos, publications or large scale meetings. And target front line supervisors; do not let executives introduce the change to frontline employees. † This is an example of the effective things that Women’s Resource Center communicates as they use a strategy that shows that each level learns new things (Cheney 330). Some of the negative things that are done at the Women’s Resource Center with communications are that the trainings are not available to the public for information. They do offer some training seminars but in the end the trainings are not available as a program on the intense level. The communication process is not as well done in advertisement or getting the word out about the programs that are available. Another area that shows weakness in communication is the organization. There is not a strong organization in this company and there are many different people volunteering and/or working for the agency. Some of the areas that could use improvement include the areas of communication about the organization and throughout the organizations volunteers and employees. This meaning that they all could use better communication to communicate between one another. The idea as stated in the same study as above is that there is sometimes little credibility to the values could be one of the communication problems in this area as it would be a problem in communicating and that the upper management and board of directors have not had a very clear vision with the Women’s Resource Center as many things have changed about their main values and ideas since the creation of the center which could cause some confusion (Cheney 330-333). A second area that has caused some problems with communications in the organization has been a lack of employed resources. This means that there are a lot of volunteers who might not have the same standards to communicating needs as regular full time or even part time employees would have. In order to effectively improve these areas there would have to be a system set up which would give both volunteers and employees a chance to express their feelings and ideas without the fear of being persecuted and with the idea that anyone who is involved has an opinion that matters. The idea that communication is a big part of leadership and how well leadership runs is based on the leader’s ability to communicate effectively. In this case this would be an area for needed improvement (Cheney 205-206). There are many areas where improvements could be made in the communication processes with the Women’s Resource Center. Some of these areas are that the management could be give better support to all of the volunteers and employees alike. Another thing that could happen is that those who are involved would be able to voice their opinions and give a case for care. They would be able to effectively communicate their needs in a process that would be pre-developed by management as it would be something that they could use on a regular basis. This means that they would be able to better manage their communications needs by effectively learning how to resolve issues and discuss issues with proper communications. The theory of Schramm on communication and the idea that overlapping boundaries and experiences make for easier communications is key in the field and services that the Women’s Resource Center is providing. It is in this process that these workers and volunteers would be able to communicate better with the clientele based on whether or not they had shared the same or similar experiences in their past (Lee 3-4). The strengths and weaknesses for this organization were apparent when reading over the press releases and other information available about the organization. Also the writer observed the communication aspects while working for the organization prior to returning to graduate school. This was observed through being a part of the organization’s training and programs. It was also observed through understanding information about the programs and how they are communicated to the public. Being able to effectively communicate is very important in the field of social work and for social service agencies. The one area where communication is well done is between the staff and the victims that come in for services as the training programs in this area are very good. Therefore their main strength is being able to communicate well to women in tough situations. The Women’s Resource Center is an organization that needs to have superior communication skills in order to deal with the problems that are being affected on a regular basis through their organization as they readily do not know what is going on and sometimes are in need of being able to communicate in a more effective manner. One of the main problems has been a lack of communications through the numerous volunteers and employees and in the end it has been a cause for some communication gaps. The main thing that can be done to improve the status of these things is for there to be a better communications system in place in general for the organization. This means that the organization would have better communication between the management and the employees and volunteers. Some of these communication gaps are what are causing the down fall for this organization and are some of the leading causes of the overall conflict that is experienced within the organization. There are always going to be â€Å"inherent challenges† when discussing communication and workplace environments (Messersmith 1). In the end communication is very important in all areas of life and when there is effective communications in some areas it lends hope to the idea that there could be effective communications in all areas of an organization. While analyzing communications for the Women’s Resource Center it is no wonder that there are many different types of communication used and it is no wonder that there are some needs for improvement. Most of the need for improvement falls on the overall board of directors and their ability to create a clear plan for what they want and what is going on within the organization. Without this they are not able to give back to the organization what is needed in order to be effective in their management and other skills. So what is needed is for the organization to work on their being able to communicate better within the organization through a set system in place for communications. This would mean that no matter when the individual was seen and whom she was seen by the whole organization would be able to help her in the future. Preparing basic short case studies and sharing them during a team meeting would be one way that this could be possible. Part of this is also being open about the organization’s needs. â€Å"Employees need to be aware of the challenges the company is facing so that they can do their part to help. † A second thing that needs to be done better is the communications that are given between the organization and the community, meaning that the community would be better informed in the future (Basili 2).

Measuring the specific heat capacity of water Essays

Measuring the specific heat capacity of water Essays Measuring the specific heat capacity of water Paper Measuring the specific heat capacity of water Paper Introduction The Specific Heat Capacity of any substance can be defined as the amount of energy needed to raise 1kg of the substance by 1i c. Its found by using the following formula: C = Q / (M x ? ?) Where (C) represents the SPHC; (Q) the energy needed or given out in joules; (M) is the mass of the substance calculated in kilograms and ? ? represents the change in temperature in either i C or Kelvin. Aim The aim of the experiment is to determine the Specific Heat Capacity of any liquid, but in our case Water. Hypothesis I think that we will obtain a close number to the exact Specific Heat Capacity known as 4200 J/Kgi C. , though it will not be 100 accurate because some heat will be lost, leading to possible errors in data. I dont think we can insulate 100% with the following calorimeter at school, thus it might gain or release energy causing in-accuracy. Additionally I think that the change of temperature will be constant throughout the experiment, because the amount of energy given will always stay the same. I also believe the temperature will rise proportional to time, this is because as more time is expanded, the molecules receive more heat, according to the Kinetic Theory, the molecules become more active, and start to move rapidly increasing collision rate. Thus more the time, the higher the temperature will be until a certain point. This is the boiling point, and this is when the molecules have reached the maximum point, and are on the point of transforming into another state of form gaseous. Apparatus A Calorimeter A Thermometer A Electric Weighing Scale. A Power Pack d 1. An empty calorimeter is weighed. The liquid under test is then poured in the calorimeter and reweighed. The Mass m of the liquid is found. 2. An immersion heater and a thermometer are placed in the calorimeter 3. The initial temperature ? ? 1 of the liquid is recorded. 4. The liquid is heated for a time t seconds. The stirrer is used to maintain a uniform temperature throughout the liquid. The lid minimizes heat losses by convection. 5. Record the temperature after every two minutes and plot it in the table below. 6. The final temperature ? ? 2 is noted and the changed in temperature ? ? after time t is found7. Record the results in the table below Precautions 1. To properly place the lid, otherwise heat lose might increase, to minimize heat loss as much possible using insulation. 2. To maintain uniform temperature make sure to keep stirring the calorimeter. 3. Make sure to keep constant energy supply by heater 12V. Variables Independent Is the power heating the up the water. This is because if you change the power, then the change in temperature will also change proportionally. So you have to keep it constant throughout, otherwise this might lead to un-reliable data. To manipulate you could change the power, by increasing the current or the volts. So you could change the current from 12V, to 16V, which would change the power. But this has to be done at the start of the experiment, and then kept constant throughout. Dependent This is the change in temperature, as this is dependent on the power supplied to the heater, if changed then the change in temperature will also change. To manipulate, you will have to change the Independent variable. Controlled This is the mass of the water, the time intervals and the power. These have to be kept constant, or otherwise it wont be a fair test. The mass of the water is kept at 0. 425 kg, 120 second time intervals and 12W power supply. To manipulate you could increase the mass by 0. 010 kg, or increase the power supply to 16W, or even increase or decrease the time intervals to either 300 second or 30 seconds. But the changes have to be kept constant otherwise. Results Time / Seconds Temperature / (? ) Change in temperature. E = the power in watts Q = the energy in joules T = time in seconds 12 x 0. joules Now to find the Specific Heat capacity we have to go back to the original formula, and deduce these finding into it. Re-arrange the formula C Conclusion From my calculation and results I have obtained the Specific Heat Capacity of water to be 4320 j/kgi C for this practical. Now I can argue that this is not a 100% accurate experiment as the scientifically defined Specific Heat Capacity of water is found to be 4200 j/kgi C. There is a difference of 1320 j/kgi C, from my results and the initial value; but I used two different ways to calculate the answer. I used the formula, which gives 4320 j/kgi C, but then I also used the gradient which in result gave me a more accurate answer of 4235 j/kgi C. As you can see the gradient gives a much more accurate answer, this is because when you use the method of calculating the sphc, by subtracting the final temperature by the initial temperature, you only base your calculation of two sets of data. This is unreliable, because if one of them proves to be inaccurate, then this impacts the answer proportionally. The gradient method is more accurate, because you are taking the data from the line of best fit, which allows you to predict the value of one variable based on a value of the other; avoiding erroneous sets of data. Using the gradient method I got an answer of 4235j/kgi C, which is very close to the initial value of Specific Heat Capacity of Water. There is a difference of only 35j/kgi C, and a difference of 85j/kgi C from the calculations using the other method. So why isnt my answer identical to the genuine calculation? Well this can be caused by many reasons, one is that the calorimeter partially absorbed some of the heat which in turn meant, that it needed more energy to raise the temperature of the water, as the particles had less energy due to heat loss. Another reason could be because it was insulated 100%, which meant that it lost some heat to the air, which again meant that the particles didnt have as much energy so it needed more. Though this reasons will only slightly affect the answer, as we didnt not perform the experiment at a very high temperature. In my hypothesis I stated that my answer for the specific heat capacity will differ slightly from the original, and I was right, but I also stated that the change in temperature will be constant, and that the temperature will rise uniformly. Theoretically I should be right, but from my results you can see that the change in temperature wasnt constant. This is because I didnt stir, the calorimeter enough and persistently. This would have made the particles in the water move more so the temperature would have then increased. The more stirring that was done could have allowed the temperature to increase at a fully uniform level. And I think that the main reason why my results of the specific heat capacity doesnt exactly equal 4200 j/kgi C. Evaluation I think that I was very close to the precise specific heat capacity of water. With a difference of only 35j/kgi C I think that there are variables, which cannot be controlled 100%. But I think I could have improved this experiment. I think next time I could take a wider range of data, for the temperatures. This means to repeat the experiment numerous times. This will allow me to have more accurate data. Also I think I should keep the stirring of the water more persistent next time. I could either, have a plan of something like, stirring for 2 minutes, and then stopping for an minute etc. Or I could persistently keep on stirring through the whole experiment; this will allow the particles to move around the beaker more, making it a fairer test. Also I could increase the power supplied to the calorimeter, which would allow me to analyze the relationship at higher temperatures, and also more modern equipment. All these factors could be improved next time, hopefully giving me even accurate results. 1 Appendix 1 2 See Graph Show preview only The above preview is unformatted text This student written piece of work is one of many that can be found in our GCSE Electricity and Magnetism section.

Why the Confederacy Lost essays

Why the Confederacy Lost essays Throughout history many historians have tried to put their finger on the exact reason for the Confederacy losing the war. Some historians blame the head of the confederacy Jefferson Davis, however others believe that it was the shear numbers of the Northern army that won out. Yet others have blamed almost every general that the Confederacy had, according to James M. McPherson: Among them Robert E. Lee himself for mismanagement, overconfidence, and poor judgment; Jeb Stuart for riding off an a raid around the Union army and losing contact with his own army, leaving Lee blind in the enemys country; Richard Ewell and Jubal Early for failing to attack Cemetery Hill on the afternoon of July 1st and again for tardiness in attacking on the 2nd; and above all, James Longstreet for lack of cooperation, promptness, and vigor in the assaults of July 2nd and 3rd.(P.19). Hopefully, this paper will shed some light on the true reasons for the Confederacy losing the war. There are two categories that interpretations can fall under, one is internal- internal is looking only at the south, what they did right and what they did wrong. The next one is external-external is looking at both the North and the South, seeing the problems and the successes of both sides. For and example of an external explanation, when Pickett was asked what he thought was the reason for the Confederacy losing the Battle of Gettysburg he said, Ive always thought the Yankees had something to do with it (19). The idea that the Yankees had way too many resources, has long been an explanation for the reason of the Confederacy losing the war. When Robert E. Lee gave his farewell address at Appomattox he said to his soldiers, The Army of Northern Virginia has been compelled to yield to overwhelming numbers and resources (20). That statement was very important to the South because, it allowed them, and s ...

Business Algebra Discussion - Smart Custom Writing Samples

Business Algebra Discussion - Smart Custom Writing Industrial ecologyIntroduction Industrial ecology or what is currently referred to as green design seeks to address the waste management problem from within the processes of production that are responsible for generating hazardous waste rather than the character and location of the wastes and facilities as is the case in justice research and environmental equity.   This paper will look at the description of industrial ecology and argue about the concept’s strength in contributing to pollution prevention efforts and waste management as well as explore its political feasibility in the United States. INDUSTRIAL ECOLOGY Industry ecology was convened as a colloquium in 1991 by the United States National Academy of Science. The aim of this colloquium was to exploit the new approaches emerging in industrial design of products and the processes involved and the implementation of manufacturing strategies that are sustainable.   This colloquium identified, the need for research as well as development to work in tandem with advances in technology in an effort to reduce the pollution perpetuated by industries’ production design which has also in the years been re-emphasized by engineering and scientific communities. This is in an effort to emulate the industrial ecology described in Type III. Both the government of America and that of Canada have in recent years been encouraging industries to engage in voluntary programs aimed at pollution preventing in an effort to reduce the hazardous waste as well as other contaminants that might harm the environment in the production stage rather than after the waste is generated consistent with industrial ecology. This is a management hierarchy that considers source reduction, alternative materials to phase out toxins, recycling and reuse as opposed to treatment and disposal. This view is also held by several other industry groups. The concept draws its structural analogy from the natural ecosystem in its effort to define the relationship between products by the industries, residue generation as well as the treatment of waste and disposal of the same. In this concept, internalization of pollution within the process of production is viewed as being a more effective method of production because of the environmental implications presented by uncontrolled emission as well as the economical inefficiencies presented by waste material disposal (Fletcher). The strength of Industry ecology in aspects of waste management is that it emphasizes on a more fundamental rethinking about the six elements of manufacturing. This includes the utilization of materials of desired properties during the formulation or extraction stages that are of the which contributing to overall industry environmental friendliness; adopting this concept also eliminates the need for storage and the long-term degradation of nonhazardous or hazardous feedstock materials by utilizing the philosophy of just-in-time raw materials; the process substitution employed also eliminates feedstock that may be toxic in nature; the engineering processes are controlled so as to assure a reliable and robust process: and also the considerations are made about the end-life of produced products to ensure their recyclability (Fletcher). The processing and manufacturing industries are always keen on improving their efficient use of economic resources. It therefore goes without saying that most industries are likely to adopt techniques and technologies that will enable it to conserve materials and also minimizes or avoid completely the need for waste management. Pollution control usually has many hidden costs associated with it. Prevention of pollution ultimately reduces or prevents these. Industry ecology identifies four incentives that would drive industries towards pollution prevention that the American and Canadian regulatory aspects apply. This includes the increase in the disposal costs; the prospect of incurring financial liabilities in implementing clean-up activities even in situations where the generator of waste might not be directly responsible for disposing waste improperly; waste disposal also presents liabilities by third-parties; there is also the risk of being adversely opposed by the public which is often unpredictable (Fletcher). Although measures of ensuring pollution preventions have always occupied center stage in politics especially around election periods, legislature passing to make some of the identified standards law, have often been missing. As it is, there has been a lack of regulation aimed in minimizing waste in the production process. The existing regulations allow most industries to rely on land-disposal as means of pollution control. This is attractive to industries as it presents a cheaper alternative of waste disposal. Unfortunately this method presents severe long-term environmental impacts than any other. In addition to this, production technologies that have been proven in the past are more likely to be adopted by industries as opposed to new alternatives aimed at reducing pollution. This problem is exacerbated as the adopted production processes mature, as many firms are less likely then to abandon them. Confidentiality presents an addition problem in that companies which develop ways of efficiently reducing waste are always reluctant to share this development with others. This is because such methods enable it to maintain a competitive advantage over its competitors. Confidentiality however still dogs the efforts of pollution prevention programs aimed at facilitating exchange of at least information on waste reduction at a generic level between corporate (Fletcher). Many groups including government environmental strategies as well as industry have in recent parts enthusiastically taken to pollution prevention debate.   The government of America In conjunction with the Canadian government has since 1972 showed their commitment to the virtual elimination of toxic substances that have persistently plagued the great lakes region. This bilateral agreement was amended in 1987 with the International Joint Commission (IJC) being mandates to support efforts to wipe out toxic substance use, manufacture and disposal.   Political will in pollution prevention policies in the United States can be traced to the â€Å"Pollution Prevention Act passed by Congress in 1990† (114). However, the Environmental Protection Agency is not empowered by the law to address the issue only providing legislative basis that provides for preferred environmental management hierarchy that is aimed at minimizing waste production as the priority and the disposal of product ion waste as a last result. A pollution prevention ethic is emphasized at the EPA especially when considering actions of enforcement.   However the federal government has not as yet initiated any program for waste exchange although a national private network, two programs that are state run as well as four private regional programs. Most industries still push for their companies to be recognized for conducting recycling off-site a trend referred to as green-washing by organizations such as Green Peace. On their part, environmentalists as well as relevant government officials are advocating adaption of industrial ecology concepts by companies by implementing recycling measures on-site in addition to source reduction of emissions as the key in prevention of pollution (Fletcher).   Conclusion Industrial ecology presents methods that are environmentally sound and contribute to waste management through the elimination or reduction of waste in the production process itself. This presents an economically and environmentally sensible method of pollution prevention. The government has been an advocate of this concept for a while now. However, it has lacked in regulation implementation to emphasis its views. As it is, the concept has not fully received the political backing it requires to be adopted on a holistic level relying instead on industry goodwill for its implementation in production processes. Works cited Fletcher, Thomas Hobbs. From Love Canal to environmental justice: the politics of hazardous waste on the Canada-U.S. border. Toronto: University of Toronto Press, 2003.

Process writing <How to Prepare for going abroad> Essay

Process writing - Essay Example s possible because when one compares the same with the old days, various transportation mechanisms were not there which have now been developed such as cars, aircrafts and vessels. Besides, there’s a saying ‘the world is one.’ So, in this sense, going to another place has become more convenient than ever. Thus, there are a lot more chances to travel or to go on a business. However, we do not go to new places without preparation. Before leaving, preparation is the most important thing to do. Without it, the travel or the business would be ruined. There are a few things to be prepared beforehand. First is to gather up the information about the destination, second is to make reservation, third is to pack and then all good to go. Initially, looking up for the destination is a must and the most basic thing to do before one leaves. There is a Korean saying ‘you know it more, you see it more’. This means if you are knowledgeable about something there are more chances to appreciate what you are seeing and you get to know deeper about it. In order to gather information about the destination, you can either look up on the internet or the tour guide book. Then, what you need to do is to choose the exact destination. Even for the smaller areas it gets different from one another. For instance, the weather in Seoul and Gyoungi is different even though they are close to each other. Moreover, you have to know about the people there. People are all different with one another but usually people can be different due to where they live. For example, Americans seem to be more open-minded than people in other cultures but at the same time Americans tend to be more conservative too. On the other hand, people in British are conservative yet more open-minded. So, knowing how the people are in the area is important to appreciate it. In the end, it is always appropriate to understand that going abroad could both be risky and beneficial in the long run. Since it involves

How does Hobbes believe that a science of politics is possible Essay

How does Hobbes believe that a science of politics is possible - Essay Example The same would apply in ensuring maintenance of peace and avoiding civil conflict. Hobbes’ science of politics carries scientific proofs leading to such a conclusion. It is not possible to exaggerate the philosophical importance of Hobbes because of the geometric proof entailed in his political argument. Francis Bacon appears to influence the process followed by Thomas Hobbes in formulating his science of politics. The geometric methodology is pronounced in the political philosophy compared to how he treats the laws of nature. Following the provision of quick definitions and conclusions that come in a series, an unfathomable logical consistency emerges relating to prudential results. The author defines the laws of nature as realistic precepts guiding people to the state of peace. To begin with, each person needs to seek peace with other people in the world. The only exemption is when the others do not have an interest in peace. However, the peace seeker should invoke helps of war. According to Hobbes, the first law of nature of seeking peace has two subdivisions. The first category supports a state of peace by making it mandatory for people to fulfil the desire for self-preservation. On the other hand, the law appreciates the fact that coexisting peacefully calls for reciprocity. Chances of establishing peace become slim if only one party takes the responsibility. This aspect led t the formulation of the second part of the first law. The aim was to have an all-round law accommodating possible situations. Te second part asks the peace seeker to use violent means to survive if others do not want to cooperate. Already, people retain personal rights to determine what can help them survive. Continued existence of the right is the main source of war and other forms of conflict (Sorell 53). Therefore, attainment of peace requires people to

The study of sociology and its applications Essay

The study of sociology and its applications - Essay Example However, in order to be successful, I know that I need to get an in-depth knowledge of how sociology is efficiently done. Thus, in recognition of the availability of various resources in the World Wide Web, this paper will include mostly articles from the internet together with books and magazines where doing sociology can be easily understood and efficiently taught. The best starting point in undertaking the research in doing sociology is Lee Harvey and Morag McDonald's Doing Sociology: A Practical Introduction which is published by Palgrave and McMillan in 1993. Though the edition is quite old, the book is still valuable in the sense that it encourages readers to learn by doing "combining sociological theory with research methods and social philosophy in an accessible way." Being focused on first-year degree students, this book is a must for starters. On the other hand, Sociology: The Core with PowerWeb written by Michael Hughes and Carolyn Kroeler provides a more recent discussion of sociological issues. After a straightforward presentation of what sociological imagination is, the book specializes in applying the functionalist, interactionist, and conflict perspective to the various sociological debates and issues. The best feature of this book is its ability to relate real world examples to the theories and concepts presented inside the classroom. Recognizing the popularity of internet in the provision of data and information used in understanding the happenings and situations of an individual nation and the world as a whole, visiting the Virtual Explorations in Sociology created by Prof. Robert E. Wood of the State University of New Jersey also proves very helpful. This virtual tour is designed to introduce students to the resources for sociology in the internet. T is broken down in areas most discussed in sociology like deviance, race and ethnicity, and the field where I am most interested at-economics. The websites presented in the tour comprises "official U.S. and U.N. sites, academic sites, advocacy sites, personal sites, and others" which are very important for data mining. The virtual tour also tests the progress of students by giving quizzes. This is a fun way of interactive learning. Focusing on the relation of business and sociology, much information can be gathered in the websites where recent business news and ideologies are presented like Times online and Financial Times. These websites contain the most recent news in the global arena and is also organized in a way that readers and users can choose the geographic region the news comes from. It should be noted though that these articles do not directly relate sociology to real world cases but stimulates the readers by making them think how sociological imagination explains the recent trends in the business arena. I find searching the archive for specific news and articles about human interaction, behavior, and global trends as an exciting way to learn and explore how sociology is imprinted on business activities. For example, I am amused at how business organizations are increasingly turning to use of social corporate responsibility in order to enhance their image and increase their bottom line. For me, this is a new trend that sociology can explain through its theory of social contract and social

International Tax Case Study Example | Topics and Well Written Essays - 2500 words

International Tax - Case Study Example Major art work galleries are increasingly maintaining an international presence such as New York based Gagosian Gallery which has branches in Rome, Paris, Hong Kong and many other cities around the world2. On the other hand, there are recognised auction houses that have had an international presence for some time but globalisation seems to have ramped up considerably in this segment of the art world in the recent decade as well. News media including television, newspapers, magazines and internet sites have been offering regular coverage for this market where the most evident feature is the regular skyrocketing of the prices of art work pieces3. The are other academic interests that involve the collection behaviour where the market for fine and decorative arts is slowly but steadily on the rise due to the favourable amounts of revenue generated from them. Art historians tend to focus on the history of collecting, while scholars in this field as diverse anthropology, sociology and economics who are interested in the multi-billion dollar international market for art4. The fine arts experience has gone even to undergraduate schools where it is common for students to pursue double majors in history and majors in art history and economics in preparation for a career in this field5. This shows that Eyemax Group has potential for numerous labour market employment opportunities for the necessary expertise to generate enough skills; this burgeoning field of art business had engendered specialised graduate-level programs, whose graduates seek opportunity in the rapidly expanding market for art. For an excellent experience in this industry, Eyemax Group will need to not only adhere to tax and other regulations of the law but also to generate potential useful alliances with the artists, dealers, auctioneers and others whose interests have a significant monetary component in the larger arts world6. These are the

Research Paper Example | Topics and Well Written Essays - 1250 words - 1

Research Paper Example SAS did not look back from then onwards. Continuous research and development helped the software achieve new milestones in the industry with the ability of the software to run on different platforms and across multivendor system architecture, which it is still famous for. One interesting point worth mentioning here is that the company kept on expanding and becoming more and more global each day, the internal corporate cultures and values have remained the same throughout. It is a privately help company. The solutions provided by the company have helped client organizations innovate and improve their performance. The company motto is ‘The power to know’ and this is what they do for their customers, they help the customers make better, informed decisions. The company proudly states that they impact every single person every day they believe that they have role in the daily lives of everyone. SAS has been able to help organizations utilize the greatest and most powerful ass et they possess, the data and has helped them in turning it into useful information. SAS is uses at more than 50,000 sites in more than 100 countries around the globe including the 93 out of the top 100 Companies on the Fortune 500 Global list of 2010 (About SAS, 2011). Right from its birth, the company had a unique organizational culture. They had instilled a unique value within the employees of the organizations that the business of doing business is everyone’s job. An example of this approach is back in the early days, when a shipment of user manuals came, everyone stopped whatever they were doing and formed a human chain to ship those manuals to the storage space on the second floor. The company always maintained their focus on the customers right from the start. They had employees listened to the customers and tried to answer their queries and take their suggestions into consideration. Emphasis on the satisfaction of employees was as important as customer satisfaction. T he company offered a flexible work environment and a employee-friendly culture and it did so right from its start and has maintained its trademark up till now. They have also gained continuous recognition from FORTUNE, Working Mother, BusinessWeek, and Mother Jones Magazines for their great work place environment. Not only the company managed to maintain a great work culture at its head office, it has also managed to do the same while earning recognition for it at the same time. In 1999, SAS Australia was the first office outside USA to be recognized as a great place to work. Other offices around the world also started getting recognition for the same reason later on. In USA, SAS has been consistently in the list of â€Å"100 Best Companies to Work for† since 1998 and it was named no. 1 in the same list during 2010 and 2011. The above-mentioned statistics and information highlight the success of the company from the time it came into being. Several factors are responsible for making a corporation successful. SAS has emphasized and implemented certain strategies and indulged into a work culture that has made it largest privately held software company and the no. 1 employer in the United States. Critical Success Factors SAS CEO, Jim Goodnight regards employees as their most valuable assets and this has clearly been one of the main reason behind their exceptional success in the past 35 years of their existence (Culture, 2011). Several changes have evolved in the business model as well as the employee

International Tax Case Study Example | Topics and Well Written Essays - 2500 words

International Tax - Case Study Example Major art work galleries are increasingly maintaining an international presence such as New York based Gagosian Gallery which has branches in Rome, Paris, Hong Kong and many other cities around the world2. On the other hand, there are recognised auction houses that have had an international presence for some time but globalisation seems to have ramped up considerably in this segment of the art world in the recent decade as well. News media including television, newspapers, magazines and internet sites have been offering regular coverage for this market where the most evident feature is the regular skyrocketing of the prices of art work pieces3. The are other academic interests that involve the collection behaviour where the market for fine and decorative arts is slowly but steadily on the rise due to the favourable amounts of revenue generated from them. Art historians tend to focus on the history of collecting, while scholars in this field as diverse anthropology, sociology and economics who are interested in the multi-billion dollar international market for art4. The fine arts experience has gone even to undergraduate schools where it is common for students to pursue double majors in history and majors in art history and economics in preparation for a career in this field5. This shows that Eyemax Group has potential for numerous labour market employment opportunities for the necessary expertise to generate enough skills; this burgeoning field of art business had engendered specialised graduate-level programs, whose graduates seek opportunity in the rapidly expanding market for art. For an excellent experience in this industry, Eyemax Group will need to not only adhere to tax and other regulations of the law but also to generate potential useful alliances with the artists, dealers, auctioneers and others whose interests have a significant monetary component in the larger arts world6. These are the

Economic impact on Crime Literature review Example | Topics and Well Written Essays - 3750 words

Economic impact on Crime - Literature review Example Unfortunately, illegitimate ways of seeking basic resources and of ensuring human survival have also been used. This may account for the fact that crimes are prevalent in areas with depressed economic conditions. The studies below shall present a literature review on the relationship between the economy and crime, how they impact on each other and mostly how depressed economic conditions lead to the high incidence of crime and how high crime rates can impact negatively on the economy. Review of related literature Before reviewing the studies discussing the relationship of crime and economic conditions, it is important to first establish global conditions relating the economy and crime. Based on the United Nations Global Pulse (2010), their analysis was based on a cross-national assessment which sought to investigate the possible impact of economic stress on crime. The UN report established that in times of economic crisis and non-crisis, economic conditions have a crucial role to pla y in the manifestation of crimes. Based on statistics and analysis from 15 countries, there are general associations which can be made between crime and economic conditions. ... s seem to support the criminal motivation theory which indicates how economic stress may further increase the motivation for individuals to participate in illegal activities (UNGP, 2010). For the different countries compared by the UN, the combination of crime and economic predictors were evaluated and a major association between these elements was identified. The UN assessment cites issues seen during economic crisis like youth gangs, weapons availability, drugs and alcohol abuse, and the low visibility of law enforcement officers as factors which all impact on criminality during economic hardships. In the study by Aiginger (2010), the author compared the recent economic recession with the Great Depression which was seen following the First World War. The authors utilized new data set in order to evaluate the decrease in activity in the industrialized countries using seven activity indicators. Their data indicated that the recent crisis had the possibility of being another Great Dep ression, especially with the speed and decline seen within the first nine months of the recession. However, if it is to be assumed that another greater impact can be avoided, the decrease in the indicators would have to be smaller when compared to the Great Depression. This is true for the GDP, the employment rates, and for manufacturing profits. Differences in the degree of the crisis are expected in terms of differences in the policy reaction. In the Great Depression, fiscal policies were applied in order to manage budgets. However, the lower nominal interest rates led to higher and actual rates. Aiginger (2010) also indicates how the economic policy implemented during the recent crisis prevented the crisis from causing another period of depression. Baron (2008) discusses the importance

Canadian Solar Essay Example for Free

Canadian Solar Essay However, with the global economic downturn in the recent years as well as changes in the government incentives in certain countries, the company has been struggling to stay on top in this competitive market, and needs to keep a competitive advantage against companies such as Sharp and Kyocera. This is a big problem to the company since it threatens their strategy and might put them out of competition. Which brings us to the question: What should Canadian Solar do to best compete in the increasingly â€Å"global† photovoltaic industry? Analysis External Analysis General Environment Most of the general aspects influence the PV industry relies on government incentive programs. Programs for green energy such as the FIT program, has a positive effect on the industry since it guarantees rates on certain projects. Other government laws such as the placement of a cap can have a negative effect on the industry. Therefore, since income levels vary for every country, this will affect the usage of PV technology. Moreover, society has a desire to â€Å"go green† and they highly value PV technology, although the implementation of PV technology can cause society financial harm such as in Spain, where the unanticipated installations caused taxpayers $26. 4 billion. Threat of new Entrants Barriers to entry are considered low since the PV industry requires low capital and medium to low technological knowledge to make PV module. The low barriers to entry are also due to

Effect of Organisational Culture on Customer Satisfaction

Effect of Organisational Culture on Customer Satisfaction Researches by some academics have made it known that a companys culture is closely linked to its effectiveness and efficiency (Kotter Heskett, 1992). In addition, according to (Morgeson, Krishnan, 2006) customer satisfaction is an increasingly significant factor of an effective organization in todays competitive business setting. Prospects arising from increase in globalization by companies, advancement in technology, and outsourcing have meant that companies are increasingly turning their attention to laying greater emphasis on customer service across national borders in order to reduce costs, while at the same time trying to increase customer user-friendliness through day-to-day activities of the firm. ORGANISATIONAL CULTURE (Shein 1996), defined culture as: a pattern of basic assumptions that a group has invented, discovered or developed in learning to cope with its problems of external adaptation and internal integration, and that have worked well enough to be considered valid, and therefore, to be taught to new members as the correct way to perceive, think, and feel in relation to those problems. Other shared definitions by learned scholars refer to organisational culture as pattern of shared values and beliefs that help individuals understand organizational functioning and thus provide them with the norms for behavior in the organization(Deshpande and Webster 1989), a set of cognitions shared by members of a social unit (OReilly et al., 1991). According to (Laurie 2008), organisational culture is a combination of traditions, values, policies, beliefs, and attitude that establishes a general framework for everything done in an organisation. It can also refer to the form of beliefs, values, and ways of managing experience that have developed during the course of the organisations history, and becomes noticeable in its material arrangements and the behaviour of its members. (Brown 1998). (Gupta 2009), in his write up, opined that organisational culture is a set of unwritten rules meant to guide the employees towards an standardardised and rewarding behaviour. TYPES AND MODELS OF ORGANISATIONAL CULTURE In order to appreciate the incorporation of organisational culture, it is very important to examine and search for different models to improve the understanding of the concept of organizational culture. I. Scheins Three Layer Organizational Model These three layers as explained by (Shein 1996) below are stages of organisational culture that should be categorized carefully with the purpose of avoiding any theoretical misperception. Artefacts and Creations the Artefact and Creation layer is the observable stage of corporate culture, it includes the social environment. Usually researchers study the artistic productions, technological output, physical space in the artefacts and Creations stage. Values usually values symbolize the significant things for individuals, they are affective wants or needs and conscious. The existence of values is very important for the organization in order to function competently and share ideals among staff. Basic Assumptions a specific group of individuals study how to manage and handle the difficulties of internal integration and external adaptation through developing and discovering the assumptions. II. Denisons Effectiveness and Culture Model The effectiveness and culture model for (Denison 1990) represents the relationship between management, corporate culture, effectiveness and finally the performance of the organization. This model is equipped to stress the important association in management practices with the beliefs and principles when examining the effectiveness and culture of the organization and its performance. Involvement this feature includes constructing the individual ability, responsibility, duty and ownership. Corporate culture is described as highly involved strongly support participation and generate a sense of responsibility. Adaptability the adaptability feature means translating the environmental business demands into action. Consistency is the vital source of power, course, formation and integration. Mission -is the long-term trend for the corporation. According to (Laurie 2008) organisational culture can be grouped into four main classes namely power culture, role culture, task culture, and person culture. Power Culture- entirely dependent on central power source and control is excercised by key individuals. Role Culture this type of culture is characretised by bureacracy and is based on rationalisation of all aspects of the organisation with role and job description more important than the individual. Emphasis is laid on position as the main source of power. Task Culture job or project oriented. Person Culture here, the individual is the central focus and every resource available is there to serve the individuals within it. (Laurie 2008). The type of culture inherent in an organisation may be decisive for organisations ability to serve its customers effectively. For example, organisations with a culture with respect for the interest of people value their members by displaying concern for their well-being, growth, and development and lay emphasis on the need for cooperation. Such a culture is more effective than one that emphasizes power, control. (Gupta 2009) went further by suggest the existence of two levels in organisational culture; The visible aspect of the organization which he said is reflected in artifacts, symbols and visible behavior of employees, and the hidden aspect which is related to fundamental values and assumptions that employees make regarding the acceptable and unacceptable behaviors in the organisation. Organisational culture in its entirety consists of traditions, values, norms and physical signs (artefacts) of organisation members and their activities. Practically speaking, the members of an organisation will eventually come to understand the particular culture of their organisation. Then, although the culture is one of those factors that are difficult to express definitely, nevertheless everyone knows it when they sense it. Hidden rules and assumptions become an organisational culture as these rules are implemented over time. A strong culture shapes the behaviour pattern members of the organisation in the absence of policies, procedures or advice from supervisors and managers. CUSTOMER SATISFACTION Satisfaction is a general customer attitude by a consumer towards a service provider and an emotional reaction to the difference between what customers anticipate and what they receive in terms of service and or product. When customers are satisfied, they are more likely to return, while dissatisfied customers are more likely to go elsewhere (Levesque and McDougall, 1996, Zineldin, 2000). Customer satisfaction is an important constituent of a successful and thriving organization and can be directly associated to increased profit margins and greater employee satisfaction, customer retention, and repeat purchases to organisations that consider customer satisfaction a key factor in its marketing strategy. An organizations social setting-whether it is called culture or climate-is an important driver of customer satisfaction. As stated by, (Ferris et al., 1998) organizational climate can facilitate a positive relationship between human resource practices and customer satisfaction, support ing a social context model for predicting customer satisfaction. Against this background, this paper aims to explore the way organisational culture affects customer satisfaction in the automobile industry setting, based on the general perceptions of front-line employees. However, according to Darby et al.s (1997) the customer service positioning show a positive relationship with different procedures of measuring customer satisfaction, and consequently it is assumed in this paper that the degree to which front-line employees are oriented towards customer satisfaction is an revealing measure of customer satisfaction. (Schneider et al., 1998) reiterated that there are different dimensions to employees understanding of the appropriate form of organisational culture, based on whether they are managers or not. Such differences in perception are linked to their different positions within the organisation. In addition, since the front-line employees (managers) deal with more pressure, managerial demands, and are responsible for their subordinates, they will be more likely able to understand the possible effects of organisational culture on customers. RESEARCH AIMS AND OBJECTIVES After a critical analysis of the research, the following aims and objectives established for this research are: To analyse the effect of organisational culture on the effectiveness of the organisation. To study the organisational culture of Ford Motors. To understand the relationship between Ford Motors organisational culture and customer satisfaction. RESEARCH QUESTIONS Does organisational culture have any effect on customer satisfaction? What sort of corporate culture does Ford Motors possess? What is the effect of Ford Motors organisational culture on customer satisfaction? LITERATURE REVIEW: A number of academic researchers have studied various elements of organizational culture and customers satisfaction. However, only a few experimental studies have studied the link between the characteristics of an organizations work environment (organisational culture) and this important aspect of organizational effectiveness (customer satisfaction) e.g., Conrad, Brown, Harmon, 1997. Most of the studies that have observed this impact have focused on the relationship between service-oriented climates and customer satisfaction. These studies, while making a very important contribution, have lean towards emphasising on the impact of a climate for service or service climate on customer satisfaction. In doing so, they may run the risk of neglecting some general organizational characteristics that can affect a wider range of organizational outcomes. Starkey and Woodcock (2002) opined that organizations that are less customer oriented are more likely to perform poorly in terms of sales output as against those that are customer oriented. To survive in the highly competitive automobile markets, organisations need to provide products and services that will produce highly satisfied and loyal customers (Westbrook and Oliver, 1991). According to (Asif and Sargeant, 2000), several benefits accrue to the organisation via customer loyalty such as generation of profit, costs related to promotions, advertising, start-up costs are limited. More so, chances of increase in customers will be high, as satisfied customers will recommend the organisations products and services to others. As a result, customer satisfaction can be the key factor to the growth of the business, in term of market share and profit. A popular supposition about the role of organizational culture as it relates to customer satisfaction is that if an organization possesses a strong culture by demonstrating that it has a well-integrated and effective set of defined values, beliefs, and behaviors, then it will achieve a higher level of efficiency. Curry and Kkolou (2004) identify customer focus, participation, and teamwork as important cultural issues influencing customer relations outcomes. They suggested that empowering employees to excel at customer service and ensuring their job security also contribute to customer relation success. According to (Deshpandà © 1999), investigation into market orientation suggests that the existence of an innovative and entrepreneurial culture is strongly associated with exceptional business performance. Collectively, these reports suggest that an organizational culture that puts more importance on customer-oriented behaviours, cross-functional teams, performance-based rewards, adjustment and reactive attitudes to change, and a higher degree of risk taking and improvement, is likely to contribute to have successful customer relations management system implementations. Every organisation has to face the task of ascertaining the critical factors in their organisational culture that will ensure customer satisfaction and loyalty (McDougall and Levesque, 1992). For all these reasons, customers perception of the service experience is frequently the only way accurately to estimate quality level of services and product provided. Within many organizations, identifying these issues may be easy or complex depending on the type of culture involved. In either case, the development of a fitting solution is difficult and the application and maintenance on a long run complex, time-consuming and costly. However, an effective organizational culture is one of the key components influencing an organizations capacity to elicit customer satisfaction and to thrive in the long term. RESEARCH METHODOLOGY: Research methodology is basically the procedures and processes of collecting and analysing data. There are two types of research methodology positivist and interpretive. In this study, we would use positivist approach in order to collect and analyse data. According to Comte (1971), researchers that demonstrate the use of real life, data is known as positivist approach. Conversely, when researchers have a set of assumption about the outcome of the research, it is known to use interpretive approach (Malhotra 2003). As mentioned in the objectives, we aim to find the effect of organisational culture on the effectiveness of the organization and to do so, we would have to use factual data from Ford motors, and therefore, positivist approach will be used in this study. Research Strategy According to Brymen and Bell (2007:135), a researcher can follow five research strategies in conducting his research. They are: 1) longitudinal 2) experimental 3) cross sectional 4) case study and 5) comparative. For this study, case study approach will be used in order to accomplish the research objective. This is because the effect of organisational culture would be analysed in this research in order to figure out its effect on the customer relations of the company. Research Approach A set of methods researchers use in order to achieve the concluding remark on the research objective of the subject matter is known as research approach. According to Saunders (2003), there are two types of research approaches available to conduct a research and they are Inductive and deductive approach Deductive approach is mostly used when researchers needs to find a causal relationship between the variables while inductive approach is a widely used method for qualitative researches. Since the primary aim of this research is to find out the effect of organisational culture on customer satisfaction, the researcher will employ inductive approach for the research. RESEARCH METHOD: Different types of primary and secondary sources would be used in order to collect data regarding organizational culture and customer satisfaction. Primary Data is the vital data gathered by researchers via interviews, surveys or questionnaires (Anderson 2005). In this report, interviews and questionnaire will be used to provide the study a better understanding of corporate culture and the financial performance from all level of employees. The source that will be used in primary data is a survey and separate interview sessions with managers, executives and even temporary employees in Ford Motors. Secondary Data: Secondary data will be collected through researchers who are conducting the research. This data will be sourced from many departments and the web site in Zain Company, along with published and academic journals, articles, books, online resources and many other data from previous authors. Interviews: Interview is one of the most effective ways of conducting qualitative research. In this study, interviewing method will acquire a clear knowledge about the organisational culture of Ford Motors. There are many types of interviews such as structured, semi structured, focused group, in depth and so on. In this study, semi structured interview will be used since it is well known method to clear the doubts and misunderstandings that might arise from the interviews. It should be mentioned here that the primary feature of semi structured interview is flexibility from both interviewees and interviewers side. ANTICIPATED METHOD OF ANALYSIS AND FINDINGS: Data Analyses This study will involve both qualitative and quantitative data analysis techniques in order to establish its objectives. A qualitative approach will be used while in order to demonstrate the relationship between organisational culture and overall performance of the company. Conversely, quantitative approach will be adopted to create a relationship between organisational culture and customer satisfaction. CONCLUSION: This research will focus on the organisational culture factors inherent in Ford Motors and the individual effects these factors have on customer satisfaction.

Juvenile Recidivism Essay -- delinquency, rehabilitation, Risks Assess

Introduction: Recidivism or, habitual relapses into crime, has time and time again proven to be an issue among delinquents, which thereby increases the overall juvenile prison population. This issue has become more prevalent than what we realize. Unless a unit for measuring a juvenile’s risk of recidivism is enacted and used to determine a system to promote effective prevention, than the juvenile prison population will continue to increase. Our court system should not only focus on punishing the said juvenile but also enforce a program or policy that will allow for prevention of recidivism. So the question remains, how can recidivism in the juvenile prison population be prevented so that it is no longer the central cause for increased juvenile delinquency? Simply put, we must create a means of measuring juvenile’s level of risk and in turn, form an effective rehabilitation program that will decrease their risk level for future recidivism. Show the problem exists: â€Å"Critics of the juvenile justice system claim that approximately 500,000 youths who move through to the nation’s pretrial detention centers each year—70 percent of them nonviolent offenders—are thousands too many and that this experience may even increase the chances that they will commit more crimes and go â€Å"deeper† into the system† (Hardy 2007). These numbers are staggering. Of these half a million youths 350,000 of them will be re-incarcerated in just a matter of 12 months or less. This is an epidemic that can no longer be avoided. The arrest rates for juvenile violent offenses have also significantly increased over the past few decades with a 61% rise in arrests for violent offenses, even despite the fact that violent offenders are a relatively small proportion... ...OF THE EDUCATIONAL PROGRAMS HELD FOR JUVENILE DELINQUENTS IN TURKEY. Education, 130(3), 384-398. Furniss, J. (2009). Fighting for the Futures of Young Offenders. Corrections Today, 71(3), 36. LU, A. (2011, October 30). Jailing Fewer Would Trim County Costs, Official Says. New York Times. p. 25B. Tulman, J. B. (2008). Time to Reverse the School-to-Prison Pipeline. (Cover story). Policy & Practice (19426828), 66(1), 22-27. Mulder, E., Brand, E., Bullens, R., & Van Marle, H. (2010). A classification of risk factors in serious juvenile offenders and the relation between patterns of risk factors and recidivism. Criminal Behaviour & Mental Health, 20(1), 23-38. doi:10.1002/cbm.754 Teitelman, R. B., & Linhares, G. J. (2013). JUVENILE DETENTION REFORM IN MISSOURI: IMPROVING LIVES, IMPROVING PUBLIC SAFETY, AND SAVING MONEY. Albany Law Review, 76(4), 2011-2017.

Nursing: Epidemiology and Health

U N I T Concepts of Health and Disease arly peoples were considered long-lived if they reached 30 years of age—that is, if they survived infancy. For many centuries, infant mortality was so great that large families became the tradition; many children in a family ensured that at least some would survive. Life expectancy has increased over the centuries, and today an individual in a developed country can expect to live about 71 to 79 years. Although life expectancy has increased radically since ancient times, human longevity has remained fundamentally unchanged.The quest to solve the mystery of human longevity, which appears to be genetically programmed, began with Gregor Mendel (1822–1884), an Augustinian monk. Mendel laid the foundation of modern genetics with the pea experiments he performed in a monastery garden. Today, geneticists search for the determinant, or determinants, of the human life span. Up to this time, scientists have failed to identify an aging gene th at would account for a limited life span. However, they have found that cells have a ? nite reproductive capacity. As they age, genes are increasingly unable to perform their functions.The cells become poorer and poorer at making the substances they need for their own special tasks or even for their own maintenance. Free radicals, mutation in a cell’s DNA, and the process of programmed cell death are some of the factors that work together to affect a cell’s functioning. I E CHAPTER Concepts of Health and Disease Georgianne H. Heymann Carol M. Porth 1 ogy. There has been an increased knowledge of immune mechanisms; the discovery of antibiotics to cure infections; and the development of vaccines to prevent disease, chemotherapy to attack cancers, and drugs to control the manifestations of mental illness.The introduction of the birth control pill and improved prenatal care have led to decreased birth rates and declines in infant and child mortality. The bene? ts of scienc e and technology also have increased the survival of infants born prematurely and of children with previously untreatable illnesses, such as immunode? ciency states and leukemia. There also has been an increase in the survival of very seriously ill and critically injured persons of all age groups.Consequently, there has been an increase in longevity, a shift in the age distribution of the population, and an increase in age-related diseases. Coronary heart disease, stroke, and cancer have now replaced pneumonia, tuberculosis, and diarrhea and enteritis—the leading causes of death in the 1900s. This chapter, which is intended to serve as an introduction to the book, is organized into four sections: health and society, historical perspectives on health and disease, perspectives on health and disease in individuals, and perspectives on health and disease in populations.The chapter is intended to provide the reader with the ability to view within a larger framework the historical aspects of health and disease and the relationship of health and disease to individuals and populations, and to introduce the reader to terms, such as etiology and pathogenesis, that are used throughout this text. HEALTH AND SOCIETY HEALTH AND DISEASE: A HISTORICAL PERSPECTIVE The In? ence of Early Scholars The Nineteenth Century The Twentieth Century The Twenty-First Century PERSPECTIVES ON HEALTH AND DISEASE IN INDIVIDUALS Health Health and Disease as States of Adaptation Disease Etiology Pathogenesis Morphology Clinical Manifestations Diagnosis Clinical Course PERSPECTIVES ON HEALTH AND DISEASE IN POPULATIONS Epidemiology and Patterns of Disease Prevalence and Incidence Morbidity and Mortality Determination of Risk Factors The Framingham Study The Nurses’ Health Study Natural History Levels of Prevention Evidence-Based Practice and Practice Guidelines e concepts of what constituted health and disease at the beginning of the last century were far different from those of thi s century. In most of the industrialized nations of the world, people now are living longer and enjoying a healthier lifestyle. Much of this has been made possible by recent advances in science and technol- T Health and Society Everyone who is born holds dual citizenship in the kingdom of the well and in the kingdom of the sick. Although we all prefer to use only the good passport, sooner or later each of us is obligated, at least for a spell, to identify ourselves as citizens of that other place. 3 4 UNIT I Concepts of Health and Disease After completing this section of the chapter, you should be able to meet the following objectives: ? Describe the concepts used to establish belief systems within a community and the effects on its health care practices ? Identify a disease believed to be generated by speci? c emotions and the characteristics ascribed to it ? Explain how mythologizing disease can be detrimental to individuals in a society There is a long history that documents the concern of humans for their own health and well-being and that of their community.It is not always evident what particular beliefs were held by early humans concerning health and disease. Still, there is evidence that whenever humans have formed social groups, some individuals have taken the role of the healer, responsible for the health of the community by preventing disease and curing the sick. In prehistoric times, people believed that angry gods or evil spirits caused ill health and disease. To cure the sick, the gods had to be paci? ed or the evil spirits driven from the body. In time, this task became the job of the ealers, or tribal priests. They tried to pacify the gods or drive out the evil spirits using magic charms, spells, and incantations. There also is evidence of surgical treatment. Trephining involved the use of a stone instrument to cut a hole in the skull of the sick person. It is believed that this was done to release spirits responsible for illness. Prehistoric h ealers probably also discovered that many plants can be used as drugs. The community as a whole also was involved in securing the health of its members.It was the community that often functioned to take care of those considered ill or disabled. The earliest evidence of this comes from an Old Stone Age cave site, Riparo del Romio, in southern Italy. There the remains of an adolescent dwarf were found. Despite his severe condition, which must have greatly limited his ability to contribute to either hunting or gathering, the young man survived to the age of 17 years. He must have been supported throughout his life by the rest of the community, which had incorporated compassion for its members into its belief system. Communities such as this probably existed throughout prehistory; separated from each other and without any formal routes of communication, they relied on herbal medicines and group activity to maintain health. Throughout history, peoples and cultures have developed their he alth practices based on their belief systems. Many traditions construed sickness and health primarily in the context of an understanding of the relations of human beings to the planets, stars, mountains, rivers, spirits, and ancestors, gods and demons, the heavens and underworld.Some traditions, such as those re? ected in Chinese and Indian cultures, although concerned with a cosmic scope, do not pay great attention to the supernatural. Over time, modern Western thinking has shed its adherence to all such elements. Originating with the Greek tradition—which dismissed supernatural powers, although not environmental in? uences—and further shaped by the In? uences of zodiac signs on the human body. (Courtesy of the National Library of Medicine) ourishing anatomic and physiologic programs of the Renaissance, the Western tradition was created based on the belief that everything that needed to be known essentially could be discovered by probing more deeply and ever more minu tely into the ? esh, its systems, tissues, cells, and DNA. 3 Through Western political and economic domination, these health beliefs now have powerful in? uence worldwide. Every society has its own ideas and beliefs about life, death, and disease. It is these perceptions that shape the concept of health in a society.Although some customs and beliefs tend to safeguard human communities from disease, others invite and provoke disease outbreaks. The beliefs that people have concerning health and disease can change the destiny of nations. The conquering of the Aztec empire may be one example. Historians have speculated how Hernando Cortez, starting off with fewer than 600 men, could conquer the Aztec empire, whose subjects numbered millions. Historian William H. McNeill suggests a sequence of events that may explain how a tiny handful of men could subjugate a nation of millions.Although the Aztecs ? rst thought the mounted, gunpowered Spaniards were gods, experience soon showed CHAPTER 1 Concepts of Health and Disease 5 otherwise. Armed clashes revealed the limitations of horse? esh and of primitive guns, and the Aztecs were able to drive Cortez and his men from their city. Unbeknownst to the Aztecs, the Spaniards had a more devastating weapon than any ? rearm: smallpox. An epidemic of smallpox broke out among the Aztecs after their skirmishes with the Spaniards.Because the population lacked inherited or acquired immunity, the results were catastrophic. It is presumed that a quarter to a third of the population died from the initial onslaught. Even more devastating were the psychological implications of the disease: it killed only American Indians and left Spaniards unharmed. A way of life built around the old Indian gods could not survive such a demonstration of the superior power of the God the Spaniards worshipped. It is not hard to imagine then that the Indians accepted Christianity and submitted meekly to Spanish control. Although we live in an age of science , science has not eliminated fantasies about health; the stigmas of sickness and the moral meanings that they carry continue. Whereas people in previous centuries wove stories around leprosy, plague, and tuberculosis to create fear and guilt, the modern age has created similar taboos and mythologies about cancer and acquired immunode? ciency syndrome (AIDS). The myth of tuberculosis (TB) was that a person who suffered from it was of a melancholy, superior character— sensitive, creative, a being apart.Melancholy, or sadness, made one â€Å"interesting† or romantic. The general perception of TB as â€Å"romantic† was not just a literary device. It was a way of thinking that insinuated itself into the sensibilities and made it possible to ignore the social conditions, such as overcrowding and poor sanitation and nutrition, that helped breed tuberculosis. The infusion of beliefs into public awareness often is surreptitious. Just as tuberculosis often had been regard ed sentimentally, as an enhancement of identity, cancer was regarded with irrational revulsion, as a diminution of the self. Current accounts of the psychological aspects of cancer often cite old authorities, starting with the Greek physician Galen, who observed that â€Å"melancholy women† are more likely to get breast cancer than â€Å"sanguine women. † Grief and anxiety were cited as causes of cancer, as well as personal losses. Public ? gures such as Napoleon, Ulysses S. Grant, Robert A. Taft, and Hubert Humphrey have all had their cancers diagnosed as the reaction to political defeat and the end to their political ambitions. Although distress can affect immunologic responsiveness, there is no scienti? evidence to support the view that speci? c emotions, or emotions in general, can produce speci? c diseases—or that cancer is the result of a â€Å"cancer personality,† described as emotionally withdrawn, lacking self-con? dence, and depressive. These di sease mythologies contribute to the stigmatizing of certain illnesses and, by extension, of those who are ill. The beliefs about health and disease have the power to trap or empower people. They may inhibit people from seeking early treatment, diminish personal responsibility for practicing healthful behaviors, or encourage fear and social isolation.Conversely, they also can be the impetus for compassion to those who are ill, for commitment to improving one’s own health, and for support of efforts to improve the health status of others. In summary, what constitutes health and disease changes over time. Prehistoric times were marked by beliefs that angry gods or evil spirits caused ill health and disease. To cure the sick, the gods had to be paci? ed or the evil spirits driven from the body. Tribal healers, or priests, emerged to accomplish this task. Prehistoric healers used a myriad of treatments, including magic charms, spells, and incantations; surgical treatment; and plan t medicines.Throughout history, the concept of health in a society has been shaped by its beliefs about life, death, and disease. Some beliefs and customs, such as exhibiting compassion for disabled community members, tend to safeguard human communities and increase the quality of life for all community members. Others invite and provoke disease outbreaks, such as myths about the causes of disease. Even though science and technology have advanced the understanding and treatment of disease, misconceptions and fantasies about disease still arise.In previous centuries, diseases such as leprosy, plague, and tuberculosis were fodder for taboos and mythologies; today, it is cancer and AIDS. The psychological effects of disease mythologies can be positive or negative. At their worst, they can stigmatize and isolate those who are ill; at their best, they can educate the community and improve the health of its members. Health and Disease: A Historical Perspective After completing this sectio n of the chapter, you should be able to meet the following objectives: Describe the contributions of the early Greek, Italian, and English scholars to the understanding of anatomy, physiology, and pathology ? State two important advances of the nineteenth century that helped to pave the way for prevention of disease ? State three signi? cant advances of the twentieth century that have revolutionized diagnosis and treatment of disease ? Propose developments that will both hamper and contribute to the promotion of health and the elimination of disease in the twenty-? rst century It has been said that those who do not know history are condemned to repeat it.There are many contributors to the understanding of how the body is constructed and how it works, and what disease is and how it can be treated, which in turn leads to an understanding of what health is and how can it be maintained. Much of what we take for granted in terms of treating the diseases that af? ict humankind has had its origin in the past. Although they are seemingly small contributions in terms of today’s scienti? c advances, it is the knowledge 6 UNIT I Concepts of Health and Disease produced by the great thinkers of the past that has made possible the many things we now take for granted.THE INFLUENCE OF EARLY SCHOLARS Knowledge of anatomy, physiology, and pathology as we now know it began to emerge with the ancient Greeks. They were the ? rst to recognize the distinction between internal and external causes of illness. To Hippocrates and his followers, we owe the foundations of the clinical principles and the ethics that grew into modern medical science. Hippocrates (460–377 BC) was a blend of scientist and artist. He believed that disease occurred when the four humors—blood from the heart, yellow bile from the liver, black bile from the spleen, and phlegm from the brain—became out of balance.These humors were said to govern character as well as health, producing phl egmatic, sanguine, choleric, and melancholic personalities. This belief paralleled the even older Chinese tradition, which was founded on the complementary principles of yin (female principle) and yang (male), whose correct proportions were essential for health. Hippocrates is identi? ed with an approach to health that dictated plenty of healthy exercise, rest in illness, and a moderate, sober diet. It was Aristotle (384–322 BC) who, through his dissection of small animals and description of their internal Hippocrates: A blend of scientist and scholar. Courtesy of the National Library of Medicine) anatomy, laid the foundations for the later scrutiny of the human body. For Aristotle, the heart was the most important organ. He believed it to be the center of the blood system as well as the center of the emotions. However, Aristotle’s main contributions were made to science in general. The person who took the next major step was Galen (AD 129–199), a physician to t he emperors and gladiators of ancient Rome. Galen expanded on the Hippocratic doctrines and introduced experimentation into the study of healing. His work came to be regarded as the encyclopedia of anatomy and physiology.He demoted the heart—in his view, the liver was primary for venous blood, whereas the seat of all thought was the brain. He described the arteries and veins and even revealed the working of the nervous system by severing a pig’s spinal cord at different points and demonstrating that corresponding parts of the body became paralyzed. According to Galen, the body carried three kinds of blood that contained spirits charged by various organs: the veins carried â€Å"natural spirit† from the liver; the arteries, â€Å"vital spirit† from the lungs; the nerves, â€Å"animal spirit† from the brain. The heart merely warmed the blood.After Galen’s death, however, anatomic research ceased, and his work was considered infallible for almo st 1400 years. As the great medical schools of universities reformed the teaching of anatomy in the early 1500s and integrated it into medical studies, it became apparent to anatomists that Galen’s data—taken from dogs, pigs, and apes—often were riddled with error. It was only with the work of Andreas Vesalius (1514–1564) that Galen’s ideas truly were challenged. Vesalius, professor of anatomy and surgery at Padua, Italy, dedicated a lifetime to the study of the human body.Vesalius carried out some unprecedentedly scrupulous dissections and used the latest in artistic techniques and printing for the more than 200 woodcuts in his De Humani Corporis Fabrica (â€Å"On the Fabric [Structure] of the Human Body†). He showed not only what bodily parts looked like but also how they worked. The book, published in 1543, set a new standard for the understanding of human anatomy. With this work, Vesalius became a leading ? gure in the revolt against Gal en’s teachings. One of the most historically significant discoveries was made by William Harvey (1578–1657), an English physician and physiologist.He established that the blood circulates in a closed system impelled mechanically by a â€Å"pumplike† heart. He also measured the amount of blood in the circulatory system in any given unit of time—one of the ? rst applications of quantitative methods in biology. Harvey’s work, published in On the Motion of the Heart and Blood in Animals (1628), provided a foundation of physiologic principles that led to an understanding of blood pressure and set the stage for innovative techniques such as cardiac catheterization. With the re? ement of the microscope by the Dutch lens maker Anton van Leeuwenhoek (1632–1723), the stage was set for the era of cellular biology. Another early user of the microscope, English scientist Robert Hooke (1635–1703), published his Micrographia in 1665 in which CHAPTER 1 Concepts of Health and Disease 7 William Harvey’s most eminent patient, King Charles I, and the future King Charles II look on as Harvey displays a dissected deer heart. (Courtesy of the National Library of Medicine) he formally described the plant cells in cork and presented his theories of light and combustion and his studies of insect anatomy.His book presented the great potential of the microscope for biologic investigation. In it, he inaugurated the modern biologic usage of the word cell. A century later, German-born botanist Mathias Schleiden (1804–1881) and physiologist Theodor Schwann (1810–1882) observed that animal tissues also were composed of cells. Although Harvey contributed greatly to the understanding of anatomy and physiology, he was not interested in the chemistry of life. It was not until French chemist Antoine Lavoisier (1743–1794), who was schooled as a lawyer but devoted to scienti? pursuits, overturned 100year-old theories of che mistry and established the basis of modern chemistry that new paths to examine body processes, such as metabolism, opened up. His restructured chemistry also gave scientists, including Louis Pasteur, the tools to develop organic chemistry. In 1796, Edward Jenner (1749–1823) conducted the ? rst vaccination by injecting the ? uid from a dairymaid’s cowpox lesion into a young boy’s arm. The vaccination by this English country doctor successfully protected the child from smallpox. Jenner’s discovery led to the development of vaccines to prevent many other diseases as well.Jenner’s classic experiment was the ? rst of? cially recorded vaccination. Painting by Georges-Gaston Melingue (1894). The ? rst vaccination. Here Dr. Jenner introduces cowpox taken from dairymaid Sarah Nelmes (right) and introduces it into two incisions on the arm of James Phipps, a healthy 8-year-old boy. The boy developed cowpox, but not smallpox, when Jenner introduced the organis m into his arm 48 days later. (Courtesy of the National Library of Medicine) THE NINETEENTH CENTURY The nineteenth century was a time of spectacular leaps forward in the understanding of infectious diseases.For many centuries, rival epidemiologic theories associated disease and epidemics like cholera with poisonous fumes given off from dung heaps and decaying matter (poisons in the air, exuded from rotting animal and vegetable material, the soil, and standing water) or with contagion (person-to-person contact). In 1865, English surgeon Joseph Lister (1827–1912) concluded that microbes caused wound infections. He began to use carbolic acid on wounds to kill microbes and reduce infection after surgery. However, Lister was not alone in identifying hazards in the immediate environment as detrimental to health.English nurse Florence Nightingale (1820–1910) was a leading proponent of sanitation and hygiene as weapons against disease. It was at the English base at Scutari dur ing the Crimean War (1854–1856) that Nightingale waged her battle. Arriving at the army hospital with a party of 38 nurses, Nightingale found nearly 2000 wounded and sick inhabiting foul, rat-infested wards. The war raged on, deluging the hospital with wounded as Nightingale not only organized the nursing care of the wounded but also provided meals, supplied bedding, and saw to the laundry.Within 6 months, she had brought about a transformation and slashed the death rate from approximately 40% to 2%. 3 8 UNIT I Concepts of Health and Disease Florence Nightingale caring for wounded at Scutari, Turkey, during the Crimean War. (Courtesy of the National Library of Medicine) From the 1860s, the rise of bacteriology, associated especially with chemist and microbiologist Louis Pasteur in France and bacteriologist Robert Koch in Germany, established the role of microorganismal pathogens. Almost for the ? rst time in medicine, bacteriology led directly to dramatic new cures.The techni que of pasteurization is named after Louis Pasteur (1822–1895). He introduced the method in 1865 to prevent the souring of wine. Pasteur’s studies of fermentation convinced him that it depended on the presence of microscopic forms of life, with each fermenting medium serving as a unique food for a speci? c microorganism. He developed techniques for culturing microbes in liquid broths. Through his work, he was able to dispel the disease theory that predominated in the mid-nineteenth century, attributing fevers to â€Å"miasmas,† or fumes, and laid the foundation for the germ theory of disease.The anthrax bacillus, discovered by Robert Koch (1843–1910), was the ? rst microorganism identi? ed as a cause of illness. Koch’s trailblazing work also included identifying the organism responsible for tuberculosis and the discovery of a tuberculosis skin-testing material. In 1895, German physicist Wilhelm Rontgen (1845– 1923) discovered X rays. For the ? rst time without a catastrophic event, the most hidden parts of a human body were revealed. Even though he understood that it was a signi? cant discovery, Rontgen did not initially recognize the amazing diagnostic potential of the process he had discovered.THE TWENTIETH CENTURY The twentieth century was a period of revolutionary industry in the science and politics of health. Concerns about the care of infants and children and the spread of infectious disease became prevailing themes in public and political arenas alike. It was during this time that private duty and public health nursing emerged as the means of delivering health care to people in their homes and in their communities. Social service agencies like the Henry Street Settlement in New York, founded by Lillian Wald, sent nurses into tenements to care for the sick. The placement of nurses in schools began in New York City in 1902 at the urging of Wald, who offered to supply a Henry Street nurse for 1 month without charg e. 5 Efforts to broaden the delivery of health care from the city to rural areas also were initiated during the early 1900s. The American Red Cross, which was reorganized and granted a new charter by Congress in 1905, established a nursing service for the rural poor that eventually expanded to serve the small town poor as well. 5 Scienti? c discoveries and innovations abounded in the twentieth century.In the early 1900s, German bacteriologist Paul Ehrlich (1854–1915) theorized that certain substances could act as â€Å"magic bullets,† attacking disease-causing microbes but leaving the rest of the body undamaged. In 1910, he introduced his discovery: using the arsenic compound Salvarsan, he had found an effective weapon against syphilis. Through his work, Ehrlich launched the science of chemotherapy. CHAPTER 1 Concepts of Health and Disease 9 The operating room. With the advent of anesthesia, knowledge of how microbes cause disease, and availability of incandescent ligh ting in the operating room, surgery became an option for treating disease.Rubber gloves had not yet been invented and the surgical team worked with bare hands to perform surgery. (Hahnemann Hospital, Chicago, IL. Courtesy Bette Clemons, Phoenix, AZ) The ? rst antibiotic was discovered in 1928 by English bacteriologist Sir Alexander Fleming (1881–1955). As he studied the relationship between bacteria and the mold Penicillium, he discovered its ability to kill staphylococci. However, it was not until the 1940s that later researchers, who were searching for substances produced by one microorganism that might kill other microorganisms, produced penicillin as a clinically useful antibiotic.By the 1930s, innovative researchers had produced a cornucopia of new drugs that could be used to treat many of the most common illnesses that left their victims either severely disabled or dead. The medical community now had at its disposal medications such as digoxin to treat heart failure; su lfa drugs, which produced near-miraculous cures for infections such as scarlet fever; and insulin to treat diabetes. At the turn of the century, social service agencies like Henry Street Settlement in New York sent nurses into tenements to care for the sick. (Schorr T. M. , Kennedy S.M. [1999]. 100 years of American nursing [p. 12]. Philadelphia: Lippincott Williams & Wilkins) 10 UNIT I Concepts of Health and Disease With the discovery of insulin, a once-fatal disease known from antiquity no longer carried a death sentence. Working together, Canadian physician Sir Frederick Banting (1891–1941) and physiologist Charles Best (1899–1978) isolated insulin from the pancreas of a dog in 1921. The extract, when given to diabetic dogs, restored their health. In January 1922, they successfully treated a young boy dying of diabetes with their pancreatic extracts.Although still incurable, it became possible to live with diabetes. One disease that remained not only incurable but u ntreatable through much of the twentieth century was tuberculosis. With no cure or preventive vaccine forthcoming, efforts at the turn of the century were dedicated to controlling the spread of tuberculosis. It was then that an alliance between organized medicine and the public resulted in the formation of voluntary local organizations to battle the disease. These organizations focused on education to counteract the fear of tuberculosis; at the same time, they warned against the disease.In 1904, the local organizations joined together to form a national organization, the National Association for the Study and Prevention of Tuberculosis. In 1918, the name was changed to the National Tuberculosis Association, which was renamed the American Lung Association in 1973. 6 The national and local tuberculosis associations played a vital role in educating the public by running campaigns urging people to have skin tests and chest x-rays as a means of diagnosing tuberculosis. Once tuberculosis was diagnosed, an individual was likely to be sent to a sanatorium or tuberculosis hospital.There, good nourishment, fresh air, and bed rest were prescribed in the belief that if the body’s natural defenses were strengthened, they would be able to overcome the tuberculosis bacillus. For almost half a century, this would be the prevailing treatment. It was not until 1945, with the introduction of chemotherapy, that streptomycin was used to treat tuberculosis. Outbreaks of poliomyelitis, which had increased in the early decades of the 1900s, served as the impetus for the work of American microbiologist Jonas Salk (1914–1995).At its peak, the virus was claiming 50,000 victims annually in the United States. 3 Test trials of Salk’s vaccine with inactivated virus began in 1953, and it proved to prevent the development of polio. By 1955, the massive testing was complete, and the vaccine was quickly put into wide use. Surgical techniques also flourished during this time . A single technical innovation was responsible for opening up the last surgical frontier—the heart. Up to this time, the heart had been out of bounds; surgeons did not have the means to take over the function of the heart for long enough to get inside and operate. American surgeon John Gibbon (1903–1973) addressed this problem when he developed the heart-lung machine. Dramatic advances followed its successful use in 1953—probably none more so than the ? rst successful heart transplantation performed in 1967 by South African surgeon Christiaan Barnard (1922–2001). For centuries, the inheritance of traits had been explained in religious or philosophical terms. Although English naturalist Charles Darwin’s (1809–1882) work dispelled long-held beliefs about inherited traits, it was Austrian bo-A tuberculosis skin testing clinic. (Schorr T. M. , Kennedy S. M. [1999]. 100 years of American nursing [p. 49]. Philadelphia: Lippincott Williams & Wilki ns) CHAPTER 1 Concepts of Health and Disease 11 The â€Å"iron lung,† which used negative pressure to draw air into the lungs, was used to provide ventilatory support for persons with â€Å"bulbar polio. † (Schorr T. M. , Kennedy S. M. [1999]. 100 years of American nursing [p. 91]. Philadelphia: Lippincott Williams & Wilkins) anist Gregor Mendel’s (1822–1884) revolutionary theories on the segregation of traits, largely ignored until 1902, that laid the groundwork for establishing the chromosome as the structural unit of heredity. Many other scientists and researchers contributed to the storehouse of genetic knowledge. With the work by American geneticist James Watson (1928–) and British biophysicists Francis Crick (1916–) and Maurice Wilkins (1916–) in the early 1950s, which established the double-helical structure of DNA, the way to investigating and understanding our genetic heritage was opened.It is dif? cult, if not impossible, to single out all the landmark events of the twentieth century that contributed to the health of humankind. Among the other notable achievements are the development of kidney dialysis, oral contraceptives, transplant surgery, the computed axial tomography (CAT) scanner, and coronary angioplasty. Not all of the important advances in modern medicine are as dramatic as open-heart surgery. Often, they are the result of dogged work by many people and yield results only after a number of years, and then they frequently go unheralded.For example, vaccination programs, control of infectious diseases through improvements in sanitation of water and waste disposal, safer and healthier foods free from microbial contamination, identi? cation of health risks from behaviors such as smoking, and improved prenatal care all have saved many lives in the twentieth century. THE TWENTY-FIRST CENTURY The twenty-? rst century reveals new horizons, but also new problems. In greater numbers than ever, goods an d people travel the world. There is unprecedented physical mobility—travel and migration from villages to cities and country to country—and interconnectedness.However, the bene? ts of physical mobility and interconnectedness are accompanied by risks. Diseases such as AIDS remind us that nothing is regional, local, or limited in its reach: contagious illness has a worldwide arena. The challenges of maintaining health and well-being in this global community are increasingly apparent. The inadvertent introduction of pathogens poses an unrelenting threat to public health, as does the deliberate use of microorganisms as weapons (see Chapter 18 for a discussion of bioterrorism and emerging global infectious diseases).In February 2003, the viral respiratory illness named severe acute respiratory syndrome (SARS) by the World Health Organization was ? rst recognized in China. 8 In the next few months, the illness swept through parts of Asia and spread to more than two dozen cou ntries in North America, South America, and Europe. The disease was characterized by rapid onset and variable severity, ranging from mild illness to death. The prevention of SARS was a particular challenge because preventive interventions (e. g. , vaccines and antibiotics) were unavailable.Containment became a global collaboration, with public health authorities utilizing isolation and quarantine to focus delivery of health care to people who were ill and to protect healthy people from getting sick. During the February to July outbreak, more than 8000 people worldwide became infected, and more than 900 died. Commerce also is an integral part of the growing world community, bringing goods and services once unobtainable into the global marketplace. Expanded international trade also provides the vehicle for the unwitting introduction or transmission of disease. One such instance occurred in the spring of 2003 in the United States. A multistate outbreak of human monkeypox, ? rst identi? ed in the Democratic Republic of the Congo in 1970, was traced by investigators to pet prairie dogs. The prairie dogs became infected when they were housed or transported along with infected Gambian giant rats, dormice, and rope squirrels that were part of a shipment of small mammals from Ghana. Spread of nonindigenous zoonotic pathogens to indigenous susceptible animal populations can be rapid and deadly. With such outbreaks lurks an additional danger—the potential for interspecies exchange, including between humans and animals such as pets.The widespread distribution of infected and potentially infected animals allowed epizootic spread of monkeypox through several states before effective interventions could be put into place. One of the challenges to the world health community will be to study the role of international travel and commerce in the emergence of infectious diseases through the dissemination of pathogens and their vectors throughout the world and then to develo p long-term strategies of surveillance and intervention with the ultimate goal of curtailing their occurrence.In 1976, the World Health Organization (WHO) actually succeeded in eliminating smallpox from the face of the earth. 10 This triumph gave substance to the idea that other infections, like measles, also might disappear if suf? cient efforts were directed at worldwide campaigns to isolate and cure them. However, new infectious diseases, such as Lyme disease and Legionnaire’s disease, and new forms of old diseases, such as resistant strains of tuberculosis and malaria, have emerged and are readily spread 12 UNIT I Concepts of Health and Disease ing on Hippocratic doctrines and introducing experimentation into the study of healing.His work, gleaned through his role as physician to the emperors and gladiators of Rome and animal dissections, came to be regarded as the encyclopedia of anatomy and physiology and was considered infallible for almost 1400 years. Signi? cant chal lenges to long-held beliefs began with the work of Andreas Vesalius (1514–1564), professor of anatomy and surgery at Padua, Italy. His published work, On the Fabric [Structure] of the Human Body, showing how the parts of the body looked and worked, set a new standard for the understanding of human anatomy.Other significant early contributions were made by scholars such as William Harvey (1578–1657), the English physician and physiologist, who in his book, On the Motion of the Heart and Blood in Animals, provided a physiologic framework for the circulation of blood; Anton van Leeuwenhoek (1632–1723), the Dutch lens maker who refined the microscope and set the stage for the era of cellular biology; and Edward Jenner (1749–1823), the English country physician who conducted the first successful vaccination. The nineteenth century was a time of major discoveries that paved the way for understanding infectious diseases.Signi? cant contributions were made by suc h scientists as Joseph Lister, the English surgeon who concluded that microbes caused wound infections; German bacteriologist Robert Koch, who discovered the anthrax bacillus, thus identifying for the ? rst time a microorganism and the illness it caused; and French chemist and microbiologist Louis Pasteur, who developed the technique of pasteurization. Perhaps the most notable technical innovation of the century was the discovery of X rays by German physicist Wilhelm Rontgen. The scienti? undertakings and discoveries of the twentieth century were revolutionary. In 1910, Paul Ehrlich introduced chemotherapy, and in 1928, Sir Alexander Fleming discovered the ? rst antibiotic as he studied the relationship between bacteria and the mold Penicillium. Diseases that had once been fatal or crippling were managed or prevented by new advances, such as the discovery of insulin by Sir Frederick Banting and Charles Best in 1922 and the development of the polio vaccine by Jonas Salk in 1953. Tech nical innovations set the stage for new surgical techniques.The creation of the heartlung machine by American surgeon John Gibbon paved the way for coronary bypass surgery and the ? rst successful heart transplantation in 1967, which was performed by Christiaan Barnard, a South African surgeon. Other important advances included kidney dialysis, oral contraceptives, the CAT scanner, and coronary angioplasty. Public health programs also were responsible for greatly affecting the health of populations, such as those dedicated to increasing vaccination, improving sanitation of water and waste disposal, and identifying health risks.Knowledge about the in? uence of heredity on health and disease originated with Charles Darwin’s (1809–1882) evolutionary theories about inherited traits and with Gregor Mendel’s (1822–1884) theories on the segregation of traits, which laid the groundwork for establishing the chromosome as the structural unit of heredity. In the ear ly 1950s, geneticist James Watson of the United States and British biophysicists Francis Crick and Maurice Wilkins presented their ? ndings on the double-helical structure of DNA. worldwide.The powerful interventions used to ? ght these infections have had the unexpected effect of accelerating their biologic evolution and making them impervious to one after another form of chemical attack. Pathogens also can be introduced into the food chain and travel worldwide. The discovery that beef from cattle infected with bovine spongiform encephalopathy (BSE) may be the source of Creutzfeldt-Jakob disease led many countries to ban beef products from the United Kingdom when BSE was found to be prevalent in English herds.The introduction of such pathogens can be the result of ignorance, carelessness, or greed. Tobacco is a product that serves as a pathogen. In a quest for ever-increasing pro? ts, the tobacco industry created a demand for its product by arti? cially raising the nicotine content of cigarettes so as to increase their addictive potential. This was done with the knowledge of the health risks of tobacco products, thanks to experiments conducted by the tobacco companies’ own medical scientists, but kept secret.If there is a blueprint for future advances, it is in the genes. The twenty-? rst century is destined to be dominated by advances in genetics. With the mapping of the human genome comes hope of cure for some of the most dreaded crippling and fatal diseases. The mapping of the human genome also has posed new ethical dilemmas, for with it comes the potential to predict the future health of persons based on their genes. It soon may be possible to differentiate between persons who will develop certain debilitating diseases and those who will not.Although advances in science and technology will continue to provide new treatments for many diseases, it has become apparent that there are more impressive rewards to be had by preventing diseases from becomin g established in the ? rst place. Ultimately, maintaining health is more resource conservative and cost effective than relying on the treatment of disease. Many decades ago, we learned that even though the â€Å"magic bullets† such as antibiotics had the ability to cure what was once considered incurable, much of our freedom from communicable disease is due to clean water, ef? ient sanitation, and good nutrition. We have become increasingly aware of the importance of preventive measures against noninfectious conditions, especially cancer and coronary heart disease. There is no better way to prevent disease and maintain health than by leading a healthy life, and increasingly, it will be the individual who is responsible for ensuring a healthy passage through life. In summary, Greek scholars were responsible for establishing the fundamentals of anatomy, physiology, and pathology that served as the earliest knowledge base for understanding health and disease.It was Hippocrates ( 460–377 BC) and his followers who laid the foundations of the clinical principles and ethics that grew into modern science. Although his belief that disease occurred when the four humors—blood, yellow and black bile, and phlegm—became out of balance was disproved, his approach to health that dictated plenty of healthy exercise, rest in illness, and a moderate, sober diet remains valid. Galen (AD 129–199) took the next major step, expand- CHAPTER 1 The twenty-? rst century is predicted to be a time of great advances in the ? ld of genetics, already evidenced by the substantial mapping of the human genome that has taken place. Scientists look to genetic research to provide advances that not only will predict who may develop disease but also will provide new treatments for those diseases. However promising future advances may appear, it is readily apparent that prevention is an equally important tool in maintaining health. Concepts of Health and Disease 13 P erspectives on Health and Disease in IndividualsAfter completing this section of the chapter, you should be able to meet the following objectives: ? State the World Health Organization de? nition of health ? Describe the function of adaptation as it relates to health and disease ? State a de? nition of pathophysiology ? Characterize the disease process in terms of etiology, pathogenesis, morphology, clinical manifestations, and prognosis ? Explain the meanings of reliability, validity, sensitivity, speci? city, and predictive value as they relate to observations and tests used in the diagnosis of diseaseWhat constitutes health and disease often is dif? cult to determine because of the way different people view the topic. What is de? ned as health is determined by many factors, including heredity, age and sex, cultural and ethnic differences, as well as individual, group, and governmental expectations. HEALTH The World Health Organization (WHO) in 1948 de? ned health as a â€Å"stat e of complete physical, mental, and social well-being and not merely the absence of disease and in? rmity. †10 Although ideal for many people, this was an unrealistic goal.At the World Health Assembly in 1977, representatives of the member governments of WHO agreed that their goal was to have all citizens of the world reach a level of health by the year 2000 that allows them to live a socially and economically productive life. 10 The U. S. Department of Health and Human Services in Healthy People 2010 described the determinants of health as an interaction between an individual’s biology and behavior, physical and social environments, government policies and interventions, and access to quality health care. 1 with which the need to adapt occurs (see Chapter 9). Generally speaking, adaptation affects the whole person. When adapting to stresses that are threats to health, the body uses those behaviors that are the most ef? cient and effective. It does not use long-term mec hanisms when short-term adaptation is suf? cient. The increase in heart rate that accompanies a febrile illness is a temporary response designed to deliver additional oxygen to tissues during the short period that the elevated temperature increases metabolic needs.On the other hand, hypertrophy of the left ventricle is a long-term adaptive response that occurs in persons with chronic hypertension. Adaptation is further affected by the availability of adaptive responses and the ability of the body to select the most appropriate response. The ability to adapt is dependent on the availability of adaptive responses—the greater number of available responses, the more effective the capacity to adapt. Adaptive capacity is decreased with extremes of age and with disease conditions that limit the availability of adaptive responses.The immaturity of the infant impairs the ability to adapt, as does the decline in functional reserve that occurs in the elderly. For example, infants have d if? culty concentrating urine because of the immaturity of their renal tubular structures and therefore are less able than an older child or adult to cope with decreased water intake or exaggerated water losses. Similarly, persons with preexisting heart disease are less able to adapt to health problems that require recruitment of cardiovascular responses. Adaptation also is less effective when changes in health status occur suddenly rather than gradually.For instance, it is possible to lose a liter of blood through chronic gastrointestinal bleeding without developing signs of shock. On the other hand, a sudden hemorrhage that causes the loss of an equal amount of blood is apt to produce hypotension and circulatory shock. Even in advanced disease states, the body retains much of its adaptive capacity and is able to maintain the internal environment within relatively normal limits. DISEASE The term pathophysiology, which is the focus of this book, may be de? ned as the physiology of a ltered health. The term combines the words pathology and physiology.Pathology (from the Greek pathos, meaning â€Å"disease†) deals with the study of the structural and functional changes in cells, tissues, and organs of the body that cause or are caused by disease. Physiology deals with the functions of the human body. Thus, pathophysiology deals not only with the cellular and organ changes that occur with disease but also with the effects that these changes have on total body function. Pathophysiology also focuses on the mechanisms of the underlying disease and provides the background for preventive as well as therapeutic health care measures and practices.A disease has been de? ned as any deviation from or interruption of the normal structure or function of a part, organ, or system of the body that is manifested by a characteristic set of symptoms or signs; the etiology, pathology, and prognosis may be known or unknown. 12 The aspects HEALTH AND DISEASE AS STATES OF ADAPTA TION The ability of the body to adapt both physically and psychologically to the many stresses that occur in both health and disease is affected by a number of factors, including age, health status, psychosocial resources, and the rapidity 14 UNIT I Concepts of Health and Disease f the disease process include the etiology, pathogenesis, morphologic changes, clinical manifestations, diagnosis, and clinical course. ity, the progression from fatty streak to the occlusive vessel lesion seen in persons with coronary heart disease represents the pathogenesis of the disorder. The true etiology of atherosclerosis remains largely uncertain. Etiology The causes of disease are known as etiologic factors. Among the recognized etiologic agents are biologic agents (e. g. , bacteria, viruses), physical forces (e. g. , trauma, burns, radiation), chemical agents (e. g. , poisons, alcohol), and nutritional excesses or de? its. At the molecular level, it is important to distinguish between sick molecu les and molecules that cause disease. 13 This is true of diseases such as cystic ? brosis, sickle cell anemia, and familial hypercholesterolemia, in which genetic abnormality of a single amino acid, transporter molecule, or receptor protein produces widespread effects on health. Most disease-causing agents are nonspeci? c, and many different agents can cause disease of a single organ. For example, lung disease can result from trauma, infection, exposure to physical and chemical agents, or neoplasia.With severe lung involvement, each of these agents has the potential to cause respiratory failure. On the other hand, a single agent or traumatic event can lead to disease of a number of organs or systems. For example, severe circulatory shock can cause multiorgan failure. Although a disease agent can affect more than a single organ, and a number of disease agents can affect the same organ, most disease states do not have a single cause. Instead, most diseases are multifactorial in origin . This is particularly true of diseases such as cancer, heart disease, and diabetes.The multiple factors that predispose to a particular disease often are referred to as risk factors. One way to view the factors that cause disease is to group them into categories according to whether they were present at birth or acquired later in life. Congenital conditions are defects that are present at birth, although they may not be evident until later in life. Congenital malformation may be caused by genetic in? uences, environmental factors (e. g. , viral infections in the mother, maternal drug use, irradiation, or intrauterine crowding), or a combination of genetic and environmental factors.Not all genetic disorders are evident at birth. Many genetic disorders, such as familial hypercholesterolemia and polycystic kidney disease, take years to develop. Acquired defects are those that are caused by events that occur after birth. These include injury, exposure to infectious agents, inadequate n utrition, lack of oxygen, inappropriate immune responses, and neoplasia. Many diseases are thought to be the result of a genetic predisposition and an environmental event or events that serve as a trigger to initiate disease development. MorphologyMorphology refers to the fundamental structure or form of cells or tissues. Morphologic changes are concerned with both the gross anatomic and microscopic changes that are characteristic of a disease. Histology deals with the study of the cells and extracellular matrix of body tissues. The most common method used in the study of tissues is the preparation of histologic sections that can be studied with the aid of a microscope. Because tissues and organs usually are too thick to be examined under a microscope, they must be sectioned to obtain thin, translucent sections.Histologic sections play an important role in the diagnosis of many types of cancer. A lesion represents a pathologic or traumatic discontinuity of a body organ or tissue. De scriptions of lesion size and characteristics often can be obtained through the use of radiographs, ultrasonography, and other imaging methods. Lesions also may be sampled by biopsy and the tissue samples subjected to histologic study. Clinical Manifestations Disease can be manifest in a number of ways. Sometimes, the condition produces manifestations, such as fever, that make it evident that the person is sick.Other diseases are silent at the onset and are detected during examination for other purposes or after the disease is far advanced. Signs and symptoms are terms used to describe the structural and functional changes that accompany a disease. A symptom is a subjective complaint that is noted by the person with a disorder, whereas a sign is a manifestation that is noted by an observer. Pain, dif? culty in breathing, and dizziness are symptoms of a disease. An elevated temperature, a swollen extremity, and changes in pupil size are objective signs that can be observed by someone other than the person with the disease.Signs and symptoms may be related to the primary disorder, or they may represent the body’s attempt to compensate for the altered function caused by the pathologic condition. Many pathologic states are not observed directly—one cannot see a sick heart or a failing kidney. Instead, what can be observed is the body’s attempt to compensate for changes in function brought about by the disease, such as the tachycardia that accompanies blood loss or the increased respiratory rate that occurs with pneumonia. It is important to recognize that a single sign or symptom may be associated with a number of different disease states.For example, an elevated temperature can indicate the presence of an infection, heat stroke, brain tumor, or any number of other disorders. A differential diagnosis that describes the origin of a disorder usually requires information regarding a number of signs and symptoms. For example, the presence of fever , a reddened sore throat, and positive throat culture describe a â€Å"strep throat† infection. A syndrome is a compilation of signs and symptoms (e. g. , chronic fatigue syndrome) that are characteristic of a speci? c disease state. Complications are possible adverse ex-Pathogenesis Pathogenesis is the sequence of cellular and tissue events that take place from the time of initial contact with an etiologic agent until the ultimate expression of a disease. Etiology describes what sets the disease process in motion, and pathogenesis, how the disease process evolves. Although the two terms often are used interchangeably, their meanings are quite different. For example, atherosclerosis often is cited as the cause or etiology of coronary heart disease. In real- CHAPTER 1 Concepts of Health and Disease 15 ensions of a disease or outcomes from treatment. Sequelae are lesions or impairments that follow or are caused by a disease. Diagnosis A diagnosis is the designation as to the na ture or cause of a health problem (e. g. , bacterial pneumonia or hemorrhagic stroke). The diagnostic process usually requires a careful history and physical examination. The history is used to obtain a person’s account of his or her symptoms, their progression, and the factors that contribute to a diagnosis. The physical examination is done to observe for signs of altered body structure or function.The development of a diagnosis involves weighing competing possibilities and selecting the most likely one from among the conditions that might be responsible for the person’s clinical presentation. The clinical probability of a given disease in a person of a given age, sex, race, lifestyle, and locality often is in? uential in arriving at a presumptive diagnosis. Laboratory tests, radiologic studies, CT scans, and other tests often are used to con? rm a diagnosis. Normality. An important factor when interpreting diagnostic test results is the determination of whether they are normal or abnormal.Is a blood count above normal, within the normal range, or below normal? Normality usually determines whether further tests are needed or if interventions are necessary. What is termed a normal value for a laboratory test is established statistically from test results obtained from a selected sample of people. The normal values refer to the 95% distribution (mean plus or minus two standard deviations [mean  ± 2 SD]) of test results for the reference population. 14 Thus, the normal levels for serum sodium (135 to 145 mEq/L) represent the mean serum level for the reference population  ± 2 SD.The normal values for some laboratory tests are adjusted for sex or age. For example, the normal hemoglobin range for women is 12. 0 to 16. 0 g/dL and for men, 14. 0 to 17. 4 g/dL. 15 Serum creatinine level often is adjusted for age in the elderly (see Chapter 36), and normal values for serum phosphate differ between adults and children. Reliability, Validity, Sensitivit y, Speci? city, and Predictive Value. The quality of data on which a diagnosis is based may be judged for its reliability, validity, sensitivity, speci? city, and predictive value. 6,17 Reliability refers to the extent to which an observation, if repeated, gives the same result. A poorly calibrated blood pressure machine may give inconsistent measurements of blood pressure, particularly of pressures in either the high or low range. Reliability also depends on the persons making the measurements. For example, blood pressure measurements may vary from one observer to another because of the technique that is used (e. g. , different observers may de? ate the cuff at a different rate, thus obtaining different values), the way the numbers on the manometer are read, or differences in hearing acuity.Validity refers to the extent to which a measurement tool measures what it is intended to measure. This often is assessed by comparing a measurement method with the best possible method of measu re that is available. For example, the validity of blood pressure measurements ob- tained by a sphygmomanometer might be compared with those obtained by intraarterial measurements. Measures of sensitivity and speci? city are concerned with determining how well the test or observation identi? es people with the disease and people without the disease.Sensitivity refers to the proportion of people with a disease who are positive for that disease on a given test or observation (called a true-positive result). Speci? city refers to the proportion of people without the disease who are negative on a given test or observation (called a true-negative result). A test that is 95% speci? c correctly identi? es 95 of 100 normal people. The other 5% are false-positive results. A false-positive test result, particularly for conditions such as human immunodeficiency virus (HIV) infection, can be unduly stressful for the person being tested (see Chapter 22).In the case of HIV testing, a positive res ult on the initial antibody test is followed up with a more sensitive test. On the other hand, false-negative test results in conditions such as cancer can delay diagnosis and jeopardize the outcome of treatment. Predictive value is the extent to which an observation or test result is able to predict the presence of a given disease or condition. A positive predictive value refers to the proportion of true-positive results that occurs in a given population.In a group of women found to have â€Å"suspect breast nodules† in a cancer-screening program, the proportion later determined to have breast cancer would constitute the positive predictive value. A negative predictive value refers to the true-negative observations in a population. In a screening test for breast cancer, the negative predictive value represents the proportion of women without suspect nodules who do not have breast cancer. Although predictive values rely in part on sensitivity and speci? city, they depend more heavily on the prevalence of the condition in the population. Despite unchanging sensitivity and speci? ity, the positive predictive value of an observation rises with prevalence, whereas the negative predictive value falls. Clinical Course The clinical course describes the evolution of a disease. A disease can have an acute, subacute, or chronic course. An acute disorder is one that is relatively severe, but selflimiting. Chronic disease implies a continuous, long-term process. A chronic disease can run a continuous course, or it can present with exacerbations (aggravation of symptoms and severity of the disease) and remissions (a period during which there is a lessening of severity and a decrease in symptoms).Subacute disease is intermediate or between acute and chronic: it is not as severe as an acute disease and not as prolonged as a chronic disease. The spectrum of disease severity for infectious diseases such as hepatitis B can range from preclinical to persistent chronic inf ection. During the preclinical stage, the disease is not clinically evident but is destined to progress to clinical disease. As with hepatitis B, it is possible to