Factors Affecting Fermentation of Glucose by Yeast

Fermentation is anaerobic respiration whereby food is altered into more simple compounds and energy in the form of chemicals is produced, an example being adenosine triphosphate (biology-online. org/dictionary/Fermentation). All this occurs with the lack of atmospheric oxygen. At the end of the day alcohol and carbon dioxide are the end products when yeast is used in the fermentation procedure. But end products like acetic acid or lactic acid can also be gained depending on the circumstances. The salinity, air conditions, temperature, pH of the system, the enzyme systems of microorganisms, and the type of sugars being fermented can show a variety in the type of end products produced. In this study the tube with the highest amount of chlorine is added, an increase in the rate of fermentation should be observed. Methods and Materials: 100ml of the stock solution of 10% glucose was placed into four separate beakers. Each beaker was labeled â€Å"1 (control),† â€Å"2 (5 drops),† â€Å"3 (10 drops),† and â€Å"4 (15 drops)†. Five drops of 6% sodium hypochlorite was added to beaker #2, 10 drops to beaker #3, and 15 drops to beaker #4. The contents of the yeast suspension were then stirred thoroughly to be sure the yeast cells were suspended and not settled at the bottom and to each solution 50ml of the yeast suspension was added. The contents of each beaker were stirred with a glass stirring rod to mix the solutions thoroughly. Each of the four fermentation tube bowls were filled with one of the solutions and the tubes were tilted so that the vertical arm was full, but the bowl was nearly empty. Each fermentation tube was labeled in order to indicate its contents. The tubes were placed in a warm place (in an incubator or near a heat lamp). Every 10 minutes for 90 minutes a measurement was made and the amount of gas produced in each of the four fermentation tubes was recorded and graphed. Results: Figure 1 As shown in figure 1, this study revealed that when chlorine was added there was a decline in the fermentation tubes excluding group â€Å"two,† the five drop tube. Therefore this observation concluded that when there’s a large amount of chlorine the fermentation rate slowed down. But when there was a little amount of chlorine there was increase in the rate of fermentation. An average of about 15 additional minutes were spared in order to equal the amount of fermentation in the control tube and five drop tube when large amounts of chlorine were evident. Discussion: All four beakers were evaporated by the 60 minute mark. The solution with five drops was the first to completely evaporate, following with the control group, the 10 drops and finally the 15 drops. No real conclusions could be drawn from this study because of the order in which the evaporation was completed. This lab also generates questions that could not have been asked before the lab. Why do some fermentation tubes have all their solution evaporate and not others? What would have happened if more yeast solution were added to the fermentation tubes? With the information discovered, experimenters know some of the different factors affecting fermentation of glucose by yeast. This information will help alcoholic fermentation in the wine and beer industries.

How Women Changed During the Civil War Essay

The Civil War was a defining moment in American history. It was the event which determined the fate of the nation as the American community was divided into two opposing sides. It was also a time of significant social change. The realm of war previously belonged to the men; it was the male soldiers who fought in the battlefields. However, the Civil War altered the situation. The status of women dramatically changed as they became active participants in the war effort. Indeed, the Civil War opened many opportunities for women and allowed them to be active members of society. This research paper aims to discuss how women changed during the American Civil War, as well as the advantages and disadvantages of the said changes. In the 19th Century America, men dominated society and women were regarded as inferior to them. Women lived under the authority of the opposite sex, either that of the father, husband or another relative (Massey, 1994). They were confined in the domestic sphere; their main concerns were their home and family. Women had no voice in the political arena because only the men had dealt with public affairs. Not only was it objectionable for women to fulfill men’s jobs, it was also disagreeable for them to wear men’s clothes (Eggleston, 2003). When the Civil War began, the social lines were blurred. Women suddenly were presented the chance to go beyond their realm and participate in the world of men. They were given roles and jobs that were not accessible to them before. Both the Union and the Confederacy allowed women to take part in the war effort. For the first time, the government allowed women to become doctors and nurses (Eggleston, 2003). Women also served as messengers and spies. Meanwhile, there are also those women whose contributions were domestic in nature; these include cooking, as well as mending and sewing uniforms for the soldiers (Eggleston, 2003; Silber, 2005). These activities may have been the same as those women were tasked to do in the past; however, there was a significant change. Before, women only did those jobs due to the necessity in the household. During the war, the women did those jobs due to the necessity of the nation. Their domestic activities were no longer performed for private purposes; they had become part of the public affairs. However, women were not merely passive participants. They were also directly involved in the war effort as soldiers. The battlefield was reserved for males, but the females eventually found themselves fighting the same war. Women became soldiers by concealing their real identities (Eggleston, 2003). There were many reasons why women opted to disguise themselves as male soldiers. There were those who fought in the war to either escape from their betrothal or to be with their loved ones. Some saw the war as an adventure and craved its excitement. There were others who saw fighting for its financial benefits and the opportunity to better provide for their families. Meanwhile, there were women who took part in the Civil War for more noble reasons; they went to war because they were compelled by duty and patriotism (Eggleston, 2003). Women had to resort to extreme measures to appear like male soldiers. There were women who were immediately discharged because the way they acted revealed their real identities (Eggleston, 2003). Meanwhile, there were women who dramatically changed their actions and behavior before enlistment to successfully disguise themselves. They modified the color of their complexion and learned how to chew tobacco. They used vests with pads to conceal their breasts; the pads also made them seem more bulky and masculine (Eggleston, 2003). Having women disguised as men in war had its share of difficulties. The problems arose from the different toilet habits as well as other personal routines (Eggleston, 2003). Nonetheless, the recruitment of young men in the army proved to be advantageous for the female soldiers. The army consisted mostly of boys, who were still shy and reserved around each other. Most of them were hesitant to relieve themselves in the company of other soldiers; to attend their toilet needs, they had to hide in the woods or others areas which offered privacy. The meek nature of young men was beneficial for the female soldiers because it allowed them to seek privacy without appearing unusual. In addition, the young men of the army have not yet started shaving, so it did not appear unusual for the females if they did not shave (Eggleston, 2003). It is remarkable that women have finally reached the public realm during the Civil War, even if they had to pretend as men to do so. However, that kind of participation had disadvantages. Women who had successfully kept their real identities hidden as part of the army suffered all the difficulties which came with war (Eggleston, 2003). Female soldiers were held captive by their opponents, brought to prison camps and killed in the battlefields. There were those who perished and buried without their real identities discovered. Because women soldiers were not supposed to be fighting in the war, their participation in the war was previously not acknowledged. There were even those who denied the direct involvement of women as soldiers (Blanton, n. d. ). The non-recognition of women fighters in the Civil War prevented the discovery of the total number of female soldiers who offered their services. The numbers available on record are merely estimates. This situation posited a real problem, as it undermined and ignored the contributions of women in the battlefield. During the American Civil War, women changed because they went beyond the roles that were initialed assigned to them. The war effort presented them to enter the public realm of men and participate in it. Women had indeed changed during that time, as they progressed from housewives to participants in war. Women even came in disguise to become soldiers. While it is a great thing that women became active members of the community, some of their contributions were not recognized or accurately recorded because of their secret identities. Nonetheless, this does not diminish that fact that women were a significant part of the American Civil War. References Blanton, D. (n. d. ). Women soldiers and nurses of the American civil war. American Civil War Website. Retrieved March 13, 2009, from http://americancivilwar. com/women/index. html Eggleston, L. G. (2003). Women in the Civil War: Extraordinary Stories of Soldiers, Spies, Nurses, Doctors, Crusaders and Others. North Carolina: McFarland. Massey, M. E. (1994). Women in the Civil War. Nebraska: University of Nebraska Press. Siber, N. (2005). Daughters of the Union: Northern Women Fight the Civil War. Cambridge, Massachusetts: Harvard University Press.

The business of logistics Essay Example | Topics and Well Written Essays - 1000 words

The business of logistics - Essay Example The acquisition was aimed to invest in future infrastructure, increase industriy syngeries, leverage scale of economics, improve competitive positioning and thereby reduce operational and management costs. The business of airlines being very volatile and Toll's competitor having the majority shareholding in Virgin Blue,overcapacity in the shipping business and problematic rail business it was difficult for Toll to establish a firm foothold toward leadership position in the logistics industry. Toll had only two alternatives to either to merge with some bigger international transport company to achieve its strategic goal or acquire related business of high standing to get business opportunities to expand further and consolidate its position. Toll had the vision to get advantage by acquiring Patrick but still there were several internal risk involved. Whether the acquisition would generate synergy and integrated cost saving. Whether investment in an aging infrastructure of Patrick corporation would prove productive or turn negative in future. Will the acquisition build competitive advantage for Toll's business in the logistic industry. Patrick corporation themselves needed to be reorganized and restructured with injection of massive funds of $1.1 billion to stablize. These were challenging questions for the leadership to answer. However, the oportunity in the industry after acquisition was great to hold about 15% of the market share with the revenues of both the transport giants that was about $5.1 billion in 2005. This market share would transform them to formidable position in the domestic and international transport and storage market. Toll and Patrick both had massive transport and storage assets which is likely to be over $7.3 billion after consolidation. This asset strength would put them into strategic and competitive advantage position to command leadership in the industry. Patrrick had a massive asset worth $4.6 billion. They had 14 major operating divisions to earn regular revenues: Patrick Terminal as the largest operator of container terminal to provide high technology logistics movement. Patrick Autocare- that offers an integrated service of processing, distribution and storage of motor vehicles that operates in partnership with Patrick Stevedoring. Patrick Port Services- that offer a national network of land based services to importers and exporters, shipping lines, freight forwarding agents, and customs brokers. Patrick PortLink- the interface provider between Patrick's road, rail and stevedoring services - Patrick Intermodal operates a national network of interstate transport, warehousing, distribution and wharf cartage services. - Patrick Defense Logistics provides logistics support services to the Defense sector, including commercial and government organizations with specialist project management requirements - Patrick International Freight services to Australian importers and exporters. - Patrick Air Services is the airline ground handling business of Patrick Corporation Toll Holdings will be able to utilize

Stradegies (or Barriers) Term Paper Example | Topics and Well Written Essays - 1750 words

Stradegies (or Barriers) - Term Paper Example Evidence of institutions structured racially were slavery, segregations, residential schools and Indian wars. In 20th century though, discriminations of all kinds were banned following activities of civil rights groups from all quarters who opposed these discriminations using various strategies, its fundamental to note that some like employment, housing, education and lending prejudices still happen in the present society. In this paper however, focus is on the Asian and African Americans as two of the groups that faced barriers (discrimination) in United States’ history and what strategies they used to overcome these challenges. In the first part of this paper we shall look at the African Americans and then proceed to second part of Asian Americans in order to create contrast in the strategies they deployed in fighting for their freedom. Perhaps the most prominent barrier of this group is the institution of slavery in which the African Americans were enslaved and viewed as property and treated as second class citizens, stigmatized and denied industrial jobs. It the perception of slavery that resulted in all the barriers faced by the Africans in America, it started in 1630s in prehistoric era and has been practiced for a long period of time due to sugar, tobacco and other plantations that seek more workforces. There are several issues that kept them invisible in all aspects of their lives: Their lives were incredibly difficult as slaves mostly for those who worked in the plantations, they could work from sunrise to sunset without exception of the old or the young all could work for this long period of time. It was considered to be lucky if the master gives the slave a day off from work or holidays like Christmas which was infrequent. In his free lucky time, the slave engage in his own activities of fishing or cultivating small piece of land in order to supplement what is given by the master that was poor in quality. As stated earlier it was

Evidence-Based Practice Project Research Paper Example | Topics and Well Written Essays - 3750 words

Evidence-Based Practice Project - Research Paper Example The study found that the combination of blood glucose lowering and blood pressure medication slows the progression of microvascular complications. Similarly, the Turnbull (2009) meta-analysis study found that intensive glucose control leads to a reduced risk of major cardiovascular events, showing a reduction of 9% for major cardiovascular events. Advance Collaborative (2008) found that intensive blood glucose lowering with gliclazide and other drugs resulted in a reduced incidence of combined major macrovascular and microvascular events, as well as major microvascular events, because there also was a reduction of nephropathy. Still another study suggests that any kind of benefit attained by intensive lowering of blood glucose is lost after one year. The study conducted by Hollman et al. (2008) found that the patients who were assigned intensive glucose lowering were compared to patients who were assigned the standard treatment of dietary restriction. While the immediate results were that the intensive glucose lowering showed that the patients had a lower risk of microvascular complications then the patients with conventional dietary therapy, after one year, these advantages were lost. Introduction Patients with diabetes suffer from a variety of ailments. Among these ailments are microvascular and macrovascular diseases. Therefore, therapeutic intervention should be investigated to reduce the risks of a diabetic patient suffering from these ailments. One such intervention is aggressively lowering blood glucose levels through drugs such as glicazide. Therefore, this article will examine studies that are focused around the intervention of blood glucose lowering, and will examine whether this is an intervention that is positive for diabetic patients, with regards to lessening the risk of micro and macrovascular ailments. PICO Question In patients with Type II Diabetes Mellitus (P), what is the effect of intensively lowering the blood glucose (I) as compared with s tandard treatment (C) on the incidence of major macro- and microvascular outcomes (O)? Clinical Question Selection Criteria Inclusion Criteria 1. Journals and studies featuring patients who are who are subjected to either intensive glucose lowering or standard treatment. 2. The participants in these studies had either a microvascular or macrovascular cardiac event. 3. The journals were either randomized trials or meta-analyses. 4. Were published in peer reviewed journals. 5. Were reported in English. Exclusion Criteria 1. Journals that reported on either type I diabetes, juvenile diabetes or gestational diabetes. 2. Qualitative studies. 3. Studies that focused upon patients who were under the age of 18. Search Process The process began by looking for studies that had, as their focus, type II diabetes, intensive glucose lowering therapy verses traditional therapy and micro and macrovascular outcomes. These peer-reviewed journals were ones that were written in English. The data bases that were used were Pubmed, Psychosocial Instruments, British Nursing Index, Cumulative Index to Nursing and Allied Health Library, Psychosocial Instruments, Allied and Alternative Medicine and Sociofile. These databases were searched with the initial terms of type II diabetes, intensive glucose lowering therapy and micro and macrovascular cardiac. The articles were then narrowed down to studies that were randomized or studies which were

M9 Discussion Assignment Example | Topics and Well Written Essays - 500 words

M9 Discussion - Assignment Example Everything we learned about simple linear regression is a special case of multiple regression. Multiple regression is required when a single-predictor model is inadequate to describe the true relationship between the response variable y and its potential predictors (x1, x2, x3 . . .). Adding predictors is more than a matter of â€Å"improving the fit.† A multiple regression is used to define linear relationship between a response variable y and more than one explanatory variable x. In multiple regression, more than one explanatory variable are used to explain or predict a single response variable. The multiple regression model assumes that the mean of the response variable y depends on p explanatory variables according to a linear function ‘Î ¼y = ÃŽ ²0 + ÃŽ ²1x1 + ÃŽ ²1x2 +†¦+ ÃŽ ²1xp’. In this case, the mean response is not observed, as the observed values of y vary about their means. However, we can think of subpopulations of responses, each corresponding to a particular set of values for all of the explanatory variables, and in each subpopulation, y varies normally with a mean given by the population regression equation. The regression model assumes that the standard deviation ÏÆ' of the responses is same in all subpopulations. A logistic regression is used when the response variable has only two possible values such as success or failure, live or die, acceptable or not. Logistic regressions work with odds rather than proportions. The odds are simply the ratio of the proportions for the two possible outcomes. The logistic regression model relates the log of the odds to the explanatory variable. A logistic regression models the log odds as a linear function of the explanatory variable, which is given by the equation ‘log odds = ÃŽ ²0 + ÃŽ ²1x’. A simple linear regression is a flexible way of analyzing linear relationships between two quantitative variables. A key assumption for simple linear regression model is that the deviations from the model fit

Project Management Essay Example | Topics and Well Written Essays - 1000 words

Project Management - Essay Example 8.8 2)Although senior management does not want a business case for proceeding with this project, they would like to know what some of the potential financial benefits could be from this project. Write a one- to two-page paper describing several potential financial benefits that could result from providing this system. Any technology based resource management system comes with several degrees of financial benefits that are essential to the success of any organization or company involved. Most managers have however not readily identified these benefits, which are financial because they are often embedded in other benefits that are non-fiscal. This means that the financial benefits of technology based management systems are not extrinsic but highly intrinsic (WWF, 2000). The financial benefits are always the result of the key characteristics of the systems. Three of these characteristics are known to be multi-functional, effectiveness and efficiency. The technology based resource manage ment system is said to be multi-functional because it can play several roles at a time. Unlike the orthodox system of creating different portfolios for different employees, a single system could be used to play about three to five at a time (World Conservation Union M&E Initiative, 2009). There could for instance be one system that combines the roles of recruitment, placement, orientation, salary grading and pension scheming, all at a time. In such a situation, the company benefits extensively because the amount of money that would have been spent on each of the portfolios is spared and saved in the coffers of the company. Subsequently, these monies serve as capital for starting other money making activities so as to raise and generate incomes for the company. In the case of the present system, it is even possible to advance the functions of the system so that in the nearest future, there could be several roles integrated into its work. As far as effectiveness is concerned, referenc e is being made to the fact that the technology based resource management systems are useful in generating financial returns and financial benefits by ensuring very high levels of perfection in service delivery. There is no denying the fact that no machine is 100% effective. However, studies show that most contemporary systems that have been introduced in the project management system to take care of resource management actually outweigh human perfection for close to 30% (World Conservation Union M&E Initiative, 2009 ). This means that there is a wider range of quality and perfection guarantee on the use of the technology based system as compared to using human effort. Invariably, the amount of money that would have been spent on legal litigations and other forms of inaccuracy corrections and remediation would be channeled into other profit making ventures within the organization. The effectiveness of the system is therefore another guarantee that the system is highly beneficial in terms of finances. Finally, the efficiency of the system cannot be underestimated in any way, and as

HR Audit Report Essay Example | Topics and Well Written Essays - 2000 words

HR Audit Report - Essay Example 994), â€Å"Although traditional sources of competitive advantage such as the natural resources, technology, economies of scale and so forth create value, the resource based argument is that these resources are increasingly easy to imitate, especially in comparison to a complex social structure such as an employment system. Hence, human resource strategies may be an especially important source of sustained competitive advantage†. The mission of the organization is to â€Å"provide quality bakery products at competitive prices†. The quality consciousness in reflected in the policies of the management in the production, marketing and customer service. But on the other hand the management should also try to evolve new methods to evaluate the cost of various operations more stringent. The assurance of quality should not be increasing the cost and this will tend to push the prices up and high prices will not help the bakery to achieve its mission. The vision of the bakery is â€Å"To be a leading bakery in major cities of the country†. The vision of J Co is not clear and it is very ambiguous in its definition of the exact terms. This kind of vision statement will not help in aligning the organization to wards achievement of goals. Based on the mission and vision, the management of the company has formulated the objectives. The annual objective of J Co bakery is to increase the sales by 10% in the year 2008. To achieve the target growth first an analysis of the planning activities and organizing activities is necessary. The audit of the plans show that J Co has planning done extensively for increasing the sales. But it is lagging behind in its lack of planning in the area of projection of resources required to achieve the sales. The plans do not allocate budget effectively for each retail outlet but only a general allotment of money on a whole. Hence, the personnel in each outlet do not have a clear picture about the allotment of money to carryout their operations and

International order from 1945 to 1969 Essay Example for Free

International order from 1945 to 1969 Essay Introduction By the end of Second World War in September 1945, world had seen human tragedies and devastation of civilizations on an unprecedented scale. The enormity of disaster had brought complete social, economic and political chaos in the countries involved in the war, requiring long term restoration and rebuilding projects (Cottam and Woodby, 1998). The victorious countries, with the only exception of USA, fared hardly better than the defeated Axis nations. The creation of UNO in 1945 to restore peace and order in the world brought a sense of general relief in world and people felt that after 6 years of intense violence stability and tranquility were returning back. However, almost as the War ended sharp ideological and strategic differences emerged between the two new superpowers, USSR and USA that pushed the world from World War to Cold War. The countries that fought against Axis powers during war years were now polarized against each other in communist and democratic factions pursuing political and strategic agendas against each other. The US led democratic world was wary of the dangers of totalitarian society under the communist rule, as marked in the Stalin’s USSR (Robbins, 1988). As the dangers of communism became manifest, USA realized that its status of a true world-power required it to take effective actions and develop long term plans in promoting the ideals of democracy justice , and liberty that had shaped the free world since past two centuries. The rift between these two opposing factions assumed serious proportions in the Berlin Crisis, Korean War, Cuban missile crisis, Czechoslovakian invasion of USSR and finally Vietnam war; events that defined the period ranging from 1945 to 1969. The Strategic Condition after 1945 The strategic affairs of world saw a revolutionary changeover with the atomic strike on Hiroshima and Nagasaki (Laver, 2005). Previous to the atomic age, the strategic considerations generally involved three dimensions of land, sea and air forces. However the post war strategic planning defined defense just in two dimensional terms, where air, land and sea forces were categorized as conventional system and atomic weapons, including atom bombs and atomic missiles constituted the nuclear dimension of the strategy (Laver, 2005). As Laver (2005,) points out, under the new strategic system, the approaches were apparently limited to mere identification of the more appropriate strategy between conventional and nuclear. The real strategic situation however did not unfold itself as simply as it was made to be sound on paper. There were a broad range of issues in creating an optimum strategy and policy in the deployment and use of nuclear weapons within the new international framework that required a total departure from previously established norms and tactics. According to Laver (2005) some of the major issues affecting the new strategic policies were 1. Development of new technology to effectively implement the nuclear option. 2. New defense equipments that meet the nuclear requirements. 3. Mobilizing resources for effectively equipping the armed forces with a perfect combination of conventional and nuclear weapons. 4. Evaluation and measurement of economic, political and social fallouts of nuclear strategies throughout the world. These issues occupied the US foreign and strategic completely, especially in the wake of nuclear buildup in the USSR that created a possible threat of global nuclear catastrophe between the two superpowers. The first American nuclear strategy was forwarded in 1950 that proposed that national defense strategy should be build around the concept of containment. The core of the policy was simple- halting communism through combined conventional and nuclear strength of USA. In 1953, the policy of containment was replaced by policy of deterrence where nuclear option superseded the conventional strategy. However this policy was exposed as inefficient by Henry Kissinger who argued that US lacked sufficient conventional force to check communist expansion throughout the world and that implementing nuclear option towards this end would be catastrophic for the world. The end result, as put forward by Kissinger, would be US inaction and inability to counter the growth of communism (Kissinger, 1957). Kenney recognized the utility of this idea and he established the predominance of conventional strategy over the mindless destructive potentiality of nuclear option. The Vietnam War of 1960s offered US to test its conventional strategy and the incomplete success and the delayed results brought realization that the conventional strategies required further investment of resources and technology in the way of establishing democratic ideals and principles in the world. Cold War is referred to the period from 1945 to 1990 where the strategic conflict and conflicting ideologies of US and USSR that had enveloped world under a continuous shadow of war. The terror of mutual nuclear holocaust was the only factor that prevented both countries from fledging an all out war. Cold War originated due to different political, economic and strategic standings of both USA and USSR after the end of Second World War that created a hostile world environment (Dobson and Marsh, 2001). Three reasons have been put forward to explain the origin of the Cold War. US had emerged as a colossal economic power after the War but it failed to help USSR in building up it war ravaged economy and society, whereas Western Europe received massive funding and help from the US. The second reason was contrasting economic policies and world view of USA and USSR that pitted USA’s democratic and individual ideals against totalitarian and centrally planned philosophy of Soviet Russia. The third major reason was clash of geo-political interest and ambitions of the two superpowers. Driven by the mutual misperceptions and fear of each other’s intentions, ambitions and power, USA and Soviet Russia acted in ways to ostracize each other from their exclusive zones. In 1947 Marshall Plan of USA, that aimed to provide financial assistance in preventing an immanent collapse of Europe, sought to keep USSR out of the entire project. USSR, growing deeply suspicious of USA’s expansionist policies reacted by closing Western access to Berlin, creating first major crisis of the Cold War in 1948. Events unfolded dramatically with US led forces providing airlift to Berlin through 1948 and 1949, USSR responding by closing Western’s access to most of eastern European nations and creation of NATO in 1949 (Dobson and Marsh, 2001). These events firmly sequestrated the two sides and sealed any possible chances of reconciliation. With the outbreak of Korean war in 1950 and USSR’s expansionist policies in South East Asia, USA prepared itself for an all out diplomatic, ideological and if required armed intervention to combat its sworn enemy. The Cold War essentially transformed into a battle of showdown with both the countries trying to outmatch other by trade embargos, increasing efforts of polarization, espionage and technological race to develop greater horde of nuclear weapon and space research. The second major crisis of the Cold War was precipitated in the form of Cuba missile crisis. US intelligence information reported deployment of USSR’s nuclear missile in Cuba with range and payload to strike major US cities and places of strategic importance. There was intense pressure on the then President Kennedy to respond to crisis by military intervention in Cuba. However this step involved risks that the crisis may evolve into a full fledged nuclear war between USA and USSR. Restrain from Kennedy and right diplomatic measures helped to avert a major nuclear disaster. The final episode marking the international order from 1945 to 1969 was civil war in Vietnam in 1965 and the US intervention that led to more than 50, 000 US casualties and international embarrassment for US policymakers. Reference Cottam, M. L, Woodby, S. (1988). The Changing Agenda: World Politics since 1945. Westview Press: Boulder Dobson, A. P. and Marsh, S. (2001). U. S. Foreign Policy since 1945. Routledge: London. Henry Kissinger, Nuclear Weapons and Foreign Policy New York: Harper, 1957, Laver, H. S. (2005). Preemption and the Evolution of Americas Strategic Defense: Parameters. Volume: 35. Issue: 2. Robbins, K. (1988). The World since 1945: A Concise History. Contributors: Oxford University Press: Oxford.

America in the 1920s Essay Example for Free

America in the 1920s Essay In 1919, soldiers from World War One returned back to America and were not used to society. Many Americans wished for normalcy and believed the United States should go back to the way it was before the war. President Warren Harding was most popular for his promised actions toward normalcy. After becoming President, Harding did not change much of America and also died of a heart attack eight hundred and eighty one days into office. The main objective of normalcy was to get rid of fear from WWI and fears from future wars. The act of prohibition upon Americans, the delivery of a new mass culture, and changes in social conflicts marked the 1920s, in many ways. With all of these new inventions and ideas being made, there were still some ideas like the rebirth of prohibition that did not succeed. During the 1920s, women and children created a prohibition to stop the unnecessary abuse of alcohol. The first attempt at a prohibition was the Temperance Movement of the 1800s. It was an organized effort to end alcohol abuse and all of the problems it created. Women and children were suffering because of husbands and fathers abusing alcohol. In the times of WWI, a support for prohibition grew again. Veterans who were having problems when returning home from battle began to abuse alcohol to cope. The main goal of prohibition was to cut down on drunkenness. Without alcohol, there would be fewer accidents at work because people sober people have more awareness and coordination. The first effect of prohibition was it becoming the eighteenth amendment in the U. S. The prohibition created bootleggers who would secretly make and transport the alcohol illegally. With the supply of alcohol, speakeasies began to occur where secret clubs and parties would happen illegally. The growth of organized crime developed in cities. Local gangs began to supply alcohol to speakeasies. This organization of gangs started to encourage prostitution, gambling, and fighting again. The mobs became so powerful and wealthy that they could remain free of crimes by simply paying off the police. The Amendment did not last long because in 1933, prohibition was ended in America. The stop to prohibition was known as the twenty first Amendment. Even with most people in the city still drinking, there was a reduced amount of alcoholism and related deaths overall which led to new ideas and a new mass culture. In the 1920s, several forms in culture like music, movies, radio broadcasts, art, and literature began to spread across the U. S. Soldiers were returning from WWI scared and lacking sources of happiness. There was a need for new inventions and for the American citizens to feel happy again. A type of entertainment available at the time was movies without words and would only play music in the theater. Another kind of entertainment was radios, but they did not have any broadcasting stations. The newest craze in music was Jazz. Jazz would come from African American roots with improvisation, syncopation, and usually a regular or forceful rhythm. Harlem, New York became the capitol of Jazz with over five hundred clubs. The most famous club was the Cotton Club. Movies became one of the most popular types of entertainment in the 1920s. At the time, eighty million tickets were being purchased per week. The movie industry quickly grew to the fourth largest industry in the U. S. The first talkie, or movie with words, was the â€Å"Jazz Singer,† starring Al Jolson. In 1924, the Hollywood Land sign was built to reflect on the success of the movie industry. Radios were not a new device in 1920, but had new features that would change the world forever. The first radio broadcast was KDKA in Pittsburg, Pennsylvania. Stations involved with the broadcasts were CBS and NBC. Citizens would listen to music, jokes, and shows from NBC on their radios. All the new forms of culture from African Americans is however what sparked all the racial problems and discrimination in the North and the South. During the 1920s, many changes in society like the challenge on religious beliefs, the possible truth and explanations of science, and lack of equality for all races were put into play. The prior religion of America has been closely linked to Christianity. The nation was founded itself off of Christianity. Fundamentalism is what interpreted the bible as truth, rather than science. Besides religion, inequality was a big problem in America. Slaves were African Americans in the U. S. since the 1600s. During the times after the Civil War when the South lost, the Ku Klux Klan began to terrorize the African Americans. In the 1920s, people began to question their God or Gods. The truth of the bible was also being questioned. Many Americans were still against the belief that a God does not exist. Another part of the science versus religion was the Scopes Trial. John Scopes taught the theory of evolution in a Tennessee Science class. 22 States did not allow teaching against the bible in the 1920s. The case was taken all the way to the Supreme Court and was ruled in favor of Scopes. In the 1920s, there was a rebirth of the KKK and the development of other organizations. Violence began in the North and South against African Americans; this was odd because the North was usually with the African Americans. The Africans faced discrimination, lynching, and the threats from the KKK. The National Association for the Advancement of Colored People and Marcus Garvey’s establishment of the Universal Negro Improvement Association were organizations trying to stop discrimination towards the blacks. The extreme amounts of racism and discrimination that is in American heritage during the 1920s cannot be covered up. The 1920s of America were influenced by prohibition, a new mass culture, and social conflicts. In the 1920s, Prohibition was established in an attempt to rid America of alcohol because of its unnecessary effects of gambling, prostitution, accidents, and fighting. Several new forms of entertainment came out like talking movies, new forms of art, Jazz music, and radio broadcasts. Several social conflicts in the U. S. like racism and discrimination happened in the U. S. Even though the 1920s was filled with unforgettable racism and discrimination, it still was marked as one of the most economically boosted periods of U. S. history.

Answers to questions on principles of nutrition for healthcare

Answers to questions on principles of nutrition for healthcare Omega-3 (linolenic acid) is a type of essential polyunsaturated fat. Like the omega-6 fatty acids are unsaturated because it contains in its molecule double bonds between carbon atoms and are essential (EFA) because the body can not produce it and therefore must be obtained through food. There are three omega -3 fatty acids: Alpha-linolenic, Eicosapentaenoic acid and Docosahexaenoic acid. These essential fatty acids can be obtained from the following sources: The Blue Fish, Food Plant: The purslane, lettuce, soy, spinach, strawberries, cucumbers, Brussels sprouts, cabbages, pineapples, Almonds and Walnuts. The body needs omega-3 fatty acid to work properly. The main functions of linolenic acid include: The formation of cell membranes, the formation of hormones, the immune system to functioning correctly, the correct formation of the retina, the functioning of neurons and chemical transmissions. Besides the basic functions, there is evidence that ingestion of omega-3 fatty acids represents a number of benefits for the body. Beneficial effects on the circulatory system, the intake of linolenic acid-rich foods or supplements that contain this principle lowers triglycerides, lowers cholesterol, prevents blood clots in the arteries by preventing platelet aggregation and arterial pressure decreases slightly. In general thins blood and protects against heart attacks, strokes, stroke, angina pectoris, Raynauds disease, etc. Moreover, the cardioprotective role is further enhanced by the ability of these oils to increase the transmission power of the heart muscle as rhythm regular and prevent disease and arrhythmias. This component protects against the development of certain cancers like colon, prostate and breast cancer. They can also prevent the growth of cancer cells. In breast cancer these acids inhibit the action of estrogens that are responsible for the development of breast tu mors. There is evidence that omega-3 has anti-inflammatory joint diseases. Therefore food or supplements especially can be very appropriate to reduce swelling and relieve pain in diseases such as rheumatoid arthritis, psoriasis and lupus. The use of supplements containing omega-3 may be a natural alternative to conventional treatment for rheumatoid arthritis. It appears that this component increases the levels of PG3 prostaglandins have anti-inflammatory properties. Inflammatory properties of omega-3 can be used for the treatment of inflammatory bowel disease Crohns disease or ulcerative colitis.   In the same way can help reduce the pain caused by menstruation. The intake of these acids can help maintain mental balance and avoid depression or to improve or assist in the treatment of diseases such as schizophrenia. These acids have a positive action in the maintenance of healthy skin, making them suitable for preventing or ameliorating diseases affecting this organ, such as eczema, psoriasis, etc., Intake of foods rich in omega-3 is very appropriate during pregnancy to ensure that the fetus has a right brain development. Mothers who eat foods with these components have had children with a higher learning capacity and less impaired. Similarly it has been shown that omega-3 favored the motor coordination of premature babies. 2. The client brings the results of recent cholesterol screening with him to see the nurse. The client is confused about what the results mean and asks what the total cholesterol number should be. Which of the following statements could the nurse make about interpreting the results of the cholesterol screening test? a. Total blood cholesterol should not exceed 150 mg/dl c. Total cholesterol should not exceed 150 mg/ml b. Total cholesterol should not exceed 200 mg/dl d. Total cholesterol should not exceed 200 mg/ml Answer: b) Total cholesterol should not exceed 200 mg/dl 3. The nurse is teaching a group of clients in a cardiac rehabilitation class about food sources of proteins. In what foods will the nurse say protein is found? a. in foods derived from both plant and animal foods c. only in foods derived from plants b. only in foods derived from animals d. only in fortified foods Answer: a) in food derived from both plant and animal foods. 4. The school nurse is making a presentation to parents of teenage students. One parent is concerned that their child is not getting adequate high quality dietary protein because the child has stopped eating meat. The nurse tells the parent that certain diets that do not contain meat can still provide adequate protein. Which of the following statements could the nurse make about vegetarian diets and protein? a. all vegetarian diets deliver adequate high quality dietary protein c. lacto-ovo vegetarian diets deliver adequate high quality dietary protein b. fruitarian diets deliver adequate high quality dietary protein d. vegan diets deliver adequate high quality dietary protein Answer: d) Vegan diets deliver adequate high quality dietary protein. Explain why. Get adequate protein on a vegan diet presents no problem at all. Both nuts and seeds such as legumes, whole grains and soy products provide protein. Previously it was believed that plant proteins were of lower quality than animal proteins in which amino acid content is concerned. However, this belief has become outdated and that if you follow a diet based on balanced vegetable products, will receive all the necessary amino acids in adequate amounts. The vegan diet has several incomplete proteins to make a complete one, but that should be eaten the same day, the essential amino acids can also be found in soy products and tofu. 5. A pregnant client tells the nurse that she is taking megadoses of vitamin A in the hopes that it will keep her complexion clear throughout the pregnancy. What could the nurse say about the clientà ¢Ã¢â€š ¬Ã¢â€ž ¢s use of this vitamin supplement? a. Consuming megadoses of vitamin A may cause permanent night blindness. c. Taking megadoses of vitamin A are a good idea during pregnancy because vitamin A supports a healthy immune system. b. Consuming megadoses of vitamin A may result in birth defects. d. Taking megadoses of vitamin A will neither help nor hurt her or the fetus during the pregnancy. Answer: b) Consuming megadose of vitamin A may result in birth defect. Explain your answer. Birth defects can occur if the supplement that has high doses of retinol ingested for a while, several days or weeks and especially during the first trimester of pregnancy. Vitamin A is an essential micronutrient for growth of the human body, the tissue tropism of epithelial organogenesis, epithelial differentiation and embryonic development. Intake, acute or chronic high amounts of vitamin A can cause various clinical manifestations such as headache, vomiting, diplopia, alopecia, dry mucous membranes, skin peeling, bone abnormalities and liver damage. Vitamin A and retinoids are teratogens classics. Malformations that are generated depend on the doses used and timing of organogenesis in which they are provided. During early organogenesis result in abnormalities of the central nervous and cardiovascular system, while a later provision gives rise to genetic defects in the upper and lower genitourinary tract and palate. Retinoids derived from the catabolism of vitamin A mothers diet are transferred to the embryo-fetal compartment. 6. A family member of an elderly client contacts the nurse and asks why the client is receiving B12 injections. Which of the following answers could the nurse give? a. The injections of B12 are given to prevent blindness. c. The injections of B12 are given to prevent pellagra b. The injections of B12 are given to prevent beriberi d. The injections of B12 are given to prevent pernicious anemia Answer: d the injections of B12 are given to prevent pernicious anemia Explain why. Pernicious anemia is a decrease in red blood cells that occurs when the body can not properly absorb vitamin B12 from the digestive tract. This vitamin is necessary for the proper development of red blood cells. The body needs vitamin B12 to produce red blood cells. In order to provide vitamin B12 in their cells, you should eat enough foods that contain this vitamin, such as beef, poultry, seafood, eggs and dairy products (AC Antony, 2008). To absorb vitamin B12, your body uses a special protein called intrinsic factor, secreted by cells in the stomach. The combination of vitamin B12 attached to intrinsic factor is absorbed in the latter part of the small intestine. When the stomach does not produce enough intrinsic factor, the intestine can not absorb the vitamin properly. The disease begins slowly and may take decades to fully establish. Although the congenital form occurs in children, pernicious anemia usually does not occur before age 30 in adults and the average age at diagnosis is 60 years. Monthly injections of vitamin B12 are prescribed to correct the deficiency of the vitamin. This therapy treats the anemia and may correct the neurological complications if taken soon enough. In people with a severe deficiency, injections are given more frequently at first( Medlineplus).

Greek Mythology: Metamorphosis :: essays research papers

Greek Mythology: Metamorphosis Metamorphosis is a key element in Greek mythology. This ability to change shape or form is a major development in the stories of Arachne, Zeus, and Daphne. Almost all of the gods had the power of metamorphosis. The first story was the one of Arachne. Arachne was a mortal, who was a great weaver. She was the best of all the mortals. She even thought she was as good as one of the gods. Nobody was as good as the gods at anything. She thought she was as good as the god Athene. Athene was the god of arts. When Athene heard Arachne say she was better than her, Athene challenged Arachne to a contest. The winner would chose the losers punishment. Arachne accepted and went first in the competition. Hers was very beautiful, but she was no match for Athene. Athene was weaving about things that happened to the gods. While the crowd watched Athene, Arachne new that she had lost, so she went and hung herself. She soon shriveled up and had eight legs. That is how the Greeks explained the way spiders came to be. Another example of metamorphosis is Zeus. Zeus was the king of all gods. He had probably the most changes in Greek mythology. He was always changing to get a girl to marry him. The most important change was when he got his first wife Hera. Zeus had ask Hera to marry him every year for three hundred years. One stormy night Zeus changed into a pigeon, and flew onto a window seal near Hera. She let what she thought was a helpless little pigeon in through the window. She did not know it was Zeus at the time. Hera petted the bird and told it she loved it. At that time Zeus changed into himself and Hera had to marry him. That made her the queen of all gods. The Greeks believed in having many wives. And the sneaky god Zeus was he had over one hundred wives, none of them where as important as Hera. Daphne was another example of metamorphosis. Daphne was not one of the gods of the Pantheon. One of the gods from the Pantheon loved her, his name was Apollo. Apollo liked chasing Daphne. Daphne did not like to run, so one day she cried out "please turn me into a tree". Her wish was granted. She was turned into what we know today as the laurel tree.

Judge Holden of Blood Meridian :: Blood Meridian Essays

Judge Holden of Blood Meridian Although Cormac McCarthy's novel Blood Meridian tells the story of the kid and his journey through the harshest of environments, much of the action in the novel centers around Judge Holden. Judge Holden is a mystery from his very first appearance in the novel and remains so until the very end of the novel, when he is one of the few characters surviving. The kid first comes face to face with Holden in a saloon after a riot and eventually joins with Holden and a gang of misfit scalp-hunters to roam the Mexican-American borderlands. Judge Holden has some historical foundation as a character. The Judge is mentioned in Samuel Chamberlain's My Confession, a personal narrative published in 1956. Chamberlain was a private during the war with Mexico and met Holden when he joined Glanton's gang of renegade scalp-hunters. Chamberlain describes Holden as gigantic and without hair, just as Holden is described by McCarthy (Sepich 125). One of the most mysterious qualities of Judge Holden is his ability to move from place to place and almost be in two places at once. As Tobin says, "every man in the company claims to have encountered that sootysouled rascal in some other place" (McCarthy 124). Holden's first appearance in the novel is a prime example of his ability to appear in two places simultaneously. The Judge manages to escape from the riot in Reverend Green's tent to a saloon where he is completely dry, even though it is pouring rain outside (7-8). The Judge also mysteriously appears next to the kid at the bar where the dancing bear has just been killed. He looks "little changed or none in all these years" (325). In both of these situations Judge Holden is the cause of the chaos around him. The Judge single-handedly incites the riot on Reverend Green and is the cause of the bear being slaughtered. These events are indicative of the entire novel in that there is constant chaos and violence w herever Judge Holden go es. Judge Holden's physical appearance seems unbelievable and full of contrast. Holden towers over everyone, yet he seems pre-pubescent because of his total lack of hair and his small hands and feet. Much of the imagery surrounding Judge Holden describes him in child-like terms. The features of the kid and the Judge tend to complement each other.

Average Age of First-time Homeowners Essay

The U.S. homeownership rate fell to the lowest level in 15 years in the first quarter of 2012, as borrowers lost homes to foreclosure and tighter inventory and credit kept buyers off the market. (Gittelsohn, 2012). The Census Bureau reported a rate dropped to 65.4 percent from 66 percent in the fourth quarter of 2011. According to the Census Bureau in June 2004 there was a record of 69.2 rates for homeownership. In 1960 the average age of a first-time homeowner was 24-25, according to David Berson in the journal Business Economics (Edwards, 2011). Now, the ages at which people purchase homes are higher. The average age for homeowners was 34, according to the most recent American Housing Survey data collected in 2009 (Edwards, 2011). There has been a trend toward renting among the younger generation. A study by the John Burns Real Estate Consulting firm predicts the homeownership rate for people between 25 to 34-years-olds will continue decreasing though 2015 (Walsh, 2012). According to this study the number of first-time home buyers has dropped 20 percent since 2009. There is a variety of reasons why young people are not buying homes anymore. People aged 25 to 34 is averaging 8.2 percent unemployment rate (Walsh, 2012). This generation is also getting higher-than-ever student loan debt and low wages. Many young people, who have a decent job, are trying to pay down debt instead of getting more. Federal student loans have bloated 360 percent since the beginning of the recession, with the average student debt held by someone who graduate in 2010 at $25, 250 (Walsh, 2012). Homes prices are still relative high to pay. The interest for mortgages are as low as 3.87 percent (reported in February 2012), the lowest levels in the last four decades, but due to the countless loans default in 2000s it made the banks stricter and increased the requirements for mortgages when compared to previous years. (Edwards, 2011) Also, young people don’t see buying a home as investment anymore, they are afraid that their home won’t be worth what they paid for in the future. A lot of people used to use terms such as â€Å"starter home†, to buy their first home, own it for a few years, resell it and make a profit out of it, then to move into their â€Å"dream home†. Due to the economy crash and the employment rate so high on younger ages, younger people no longer see purchasing a home as a good investment. They are afraid that they might lose their job and have to relocate or not be able to afford their home anymore. As time keeps moving on, young people are more afraid in buying, they are afraid that their property will lose its value and unable to get any type of money back if they decide to sell. According to the research done by Grace Bucchianeri, Homeowners are not happier because of financial stress. Other reasons such as the average age of marriage may influence a decision of purchasing a home. The average age of marriage is currently 26.1, according to the U. S Bureau of Census. This is a huge jump compare to 1960 which the average marriage age was 20.3. The young generation seems to be more focus in other things that making a family and settle down. The U.S. apartment vacancy rate fell to 4.9 percent in the first quarter of 2012. In 2011 the rate was 9.7 percent for vacancy rate. There has been a dramatic increase on rentals according to the Census Bureau. With this big growth in apartment rentals, the multifamily housing development in June 2012 was up 63 percent from a year earlier. The industry is expected to hit over 1 million new apartments by 2015 (Walsh, 2012). Young people opt in to do short leases because they want and like the flexibility to pick up if a job arises or in the worst case scenario move back home if their job is eliminated. Some people believe that buying a house is a waste of time and money. People think that renting a period of 30 years you might save the money you are putting down for the house and all the money for the closing cost, maintenance and so on. It could save you up to $90,000 in a 30 years lap if you only rent a property (Stoffel, 2012). For some people there is stuff that money can’t buy such as stability or emotional benefits. At the end it depends on the person and the type of life they decide to have. Some people hate commitments other people have a dream of having a house and owning a piece of territory. In a recent study done by Brian J. McCabe from New York University, shows that people that own their home are more likely to vote compare to renters. Homeowners feel stronger ties to their communities. They are willing to participate more in organizations that could benefit their community. It shows that the homeownership is mediated by both stability and income. It is possible that citizens most likely to become involved in civic affairs are also those most likely to become homeowners. According to some researchers, the market will turn around—eventually. The young people will start getting older and will settle down. They will start getting married and forming a family and would like to be part of a community. When the house buying market starts increasing the back requirements will start loosen up. Banks will be more flexible when making loans. Works Cited Bucchianeri, G. W. (2011). The American Dream of The American Dilusion? The Private and External Benefits of Homeownership , 1-38. Edwards, E. (2011, October 11). The Universe. Retrieved August 2, 2012, from http://universe.byu.edu Gittelsohn, J. (2012, April 30). Bloomberg. Retrieved June 2, 2012, from Bloomberg News: http://www.bloomberg.com McCabe, B. J. (2011). Are Homeowners Better Citizens? 1-47. Stoffel, B. (2012, March 8). DailyFinance. Retrieved June 2, 2012, from http://dailyfinance.com Walsh, M. (2012, July 16). Business Week. Retrieved July 2, 2012, from http://businessweek.com

James Hurst’s story “The Scarlet Ibis” Essay

It is said that you never really appreciate something fully until it is gone. This is shown in James Hurst’s story, â€Å"The Scarlet Ibis†. This story takes place in the Deep South after World War II, and is told through the eyes of â€Å"Brother†, one of Hurst’s fictional characters. Brother tells the story of his invalid younger brother, Doodle. In â€Å"The Scarlet Ibis† normality comes with a price. Brother’s pride both helps and hurts Doodle. Brother is ashamed of Doodle’s weaknesses. He always wished for a normal brother: â€Å"it was bad enough having an invalid brother, but having one who possibly was not all there was unbearable, so I began to make plans to kill him by smothering him with a pillow† [Pg. 317]. This sentence reveals that Brother didn’t try to put in time to shape Doodle into the brother he wanted. Instead, the only thing he did was to make plans to kill Doodle so that he wouldn’t have an in valid brother. â€Å"He was a burden in many ways. The doctor had said that he mustn’t get too excited, too hot, too cold, or too tired, and that he must always be treated gently. A long list of don’ts went with him, all of which I ignored once we got out of the house. To discourage him coming with me, I’d run with him across the ends of the cotton rows and careen him around corners on two wheels. Sometimes I accidently turned him over, but he never told Mama† [Pg. 317]. We can see from this excerpt that Doodle looks up to Brother and enjoys spending time with him, however Brother resents being burdened by Doodle and attempts to flip the go-kart Doodle is being transported in so that he will not be burdened by his company when he goes on outdoor excursions. â€Å"This is within me (and with sadness I have watched it n others) a knot of cruelty borne by the stream of love, much as our blood sometimes bears the seed of our destruction, and at times I was mean to Doodle. One day I took him up to the barn loft and showed him his casket, telling him how we all had believed he would die. It was covered with a film of paris green, sprinkled to kill the rats and screech owls, which had built a nest inside it. Doodle studied the mahogany box for a long time, then said, â€Å"It’s not mine†, â€Å"It is†, I said. â€Å"And before I’ll help you down from the loft, you’re going to have to touch it [Pg. 318]. This proves that Brother pressurizes Doodle into doing things that Doodle would otherwise not do. An example of this is how Brother uses Doodle’s fear of the attic to force him to touch the coffin, a coffin that had been made for Doodle himself, as everyone predicted he would not live very long. Brother’s sometimes bullying behavior affected doodle both physically and emotionally. Brother behavior toward Doodle is inconsistent however and he does many good things, too. He helps Doodle become normal and to be able to do things that people thought were impossible for Doodle to do. â€Å"When Doodle was five years old, I was embarrassed at having a brother of that age that couldn’t walk, so I set out to teach him† [Pg. 318]. This reveals that Brother has compassion for Doodle helping him become the best he can be. Instead of just hiding Doodle at home, which would have been more convenient for him to do, he takes him out in the community. â€Å"Once I had succeeded in teaching Doodle to walk, I began to believe in my own infallibility and I prepared a terrific development program for him, unknown to mama and Daddy, of course. I would teach him to run, to swim, to climb trees and to fight, he, too, now believed in my infallibility, so we set the deadline for these accomplishments less than a year away, when, it had been decided, Doodle would start s chool† [Pg. 320]. This teaches us that Brother wants to aid Doodle in learning and living his life to the fullest possible extent, despite not having the physical and mental abilities that we take for granted. â€Å"After we had drifted a long way, I put the oars in place and Doodle row back against the tide† [Pg. 322] Brother wants to push Doodle and make him do something, which even by normal standards, would be challenging but even more difficult for Doodle because of his disabilities. These actions show a kinder side to Brother, a side that wishes to help and nurture his brother. Brother’s actions towards doodle are conflicting. Was it better for Doodle to live a short more adventurous life, or was it better for Doodle just to stay at home and never experience life to the fullest.

Biocon †Case Assignment Questions Essay

1. Assuming Biocon receives approval for BIOMAb, should it launch the drug immediately or conduct phase 3 trials before launch? Elaborate the various elements of your action plan. If Biocon receives approval for BIOMAb, the management team will need to carefully consider what the best course of action is moving forward. If the company elects to launch the drug immediately, they will be able to have the first mover advantage, reaching the market before their closest competitor, Erbitux. BIOMAb will also be able to put themselves on the map as they would be the first ever, proprietary drug developed and marked by an Indian firm for Indian patients. The Indian regulatory authorities may also cause a lengthy Phase 3 trial due to their lack of experience with bringing a proprietary drug to market, as evidenced during BIOMAb’s Phase 2 trials. However, even with all of the above listed considerations in mind, Biocon should conduct the phase 3 trials before launching the BIOMAb. BIOMA b is a superior product to Erbitux, as shown in the 100% response rate when combined with chemo and radiotherapy. There are also fewer side affects, a more patient friendly treatment plan, and BIOMAb will be able to offer the drug at a discounted price. Even if BIOMAb is not able to be the first drug to the market, they will be able to make up for those potential loses in the long run. BIOMAb will be entering this marketplace for the first time, and the company will want to enter the market with as strong of a message as possible. BIOMAb is entering this market for the long run, and overcoming any perceptions of shortcuts, lack of quality, or anything less than cutting edge will last well beyond the life of the BIOMAb product. There are only 300 oncologists in this market Biocon cannot afford to miss. While awaiting Phase 3 approval, Biocon can roll out its direct sales force, offering its suite of generic oncology drugs. This waiting period will give the sales force an opportunity to develop roots in the marketplace and to raise awareness of BIOMAb before it is even on the market. The Phase 3 approval process will serve as an advantageous ramp up time so that Biocon is fully prepared to enter the marketplace on better footing with BIOMAb. This time will also enable Biocon to better develop the infrastructure they will need to  optimize its direct distribution channel. Biocon is a new player in bringing a new drug to the market and they will want to ensure that the quality of their product is maintained from the manufacturing floor into the doctor’s office. Assuming that BIOMAb indeed loses its first mover advantage, its value proposition will be its results, which are dependent on properly controlled product. Biocon wants to become a permanent fixture in this market and the company needs to do everything in its power to deliver its value proposition of innovation, quality, and affordability. 1. How big is the current and future market opportunity in BIOMAb? The current market opportunity that Biocon is currently targeting with BIOMAb is composed of the Head and Neck cancer patients within India. More specifically, Biocon is focused, in the short term, on those Head and Neck cancer patients that can afford to pay, estimated at 1,900 patients. These patients will be the ones officially marketed to, but given the Indian’s markets preponderance for using drugs â€Å"off the label†, the unofficial market can be target at all cancer patients in India that currently able to afford treatment, 7,114 patients. Given India’s continued economic growth rate (9% annually) and ever expanding population base (1.4%), all of the preceding numbers are certain to grow in the relatively short term. The compounded impact of these different rates will cause these India based estimates to grow exponentially year over year. In the long run, BIOMAb in India is just the tip of the iceberg. CIMAB and Biocon’s current joint venture is to develop and market the molecule on the Indian subcontinent. If Biocon is able to thoroughly manage and develop all aspects of the supply chain (manufacturing, distribution, sales, marketing, etc), Biocon would have good reason to go back to the negotiating table with CIMAB. The success of CIMAB’s other partner, YM Bioscience, is not guaranteed and there is no reason that Biocon cannot unseat them in the long run. If Biocon is able to achieve this, along with the Phase 3 trials, the worldwide Head and Cancer would be open to the company, to say nothing for the â€Å"off label† prescriptions. Given the worldwide population growth, economic expansion, and aging populations, the long-term market for BIOMAb is practically limitless. 3. Who is the buyer for BIOMAb? What is the decision making unit in this case? What are the benefits that each member of the decision making unit seeks from BIOMAb? The buyer for BIOMAb is (are) the income provider(s) of the family, whose member (s) has (have) been affected by head and neck cancer or another indication, since off-label usage is very common in India. The structure of India’s health care system is such that it is estimated that 95% of BIOMAb’s patients (end users) are going to be self-paying. Therefore, the cost of treatment will be transferred to the earning member of the family. Adult patients have the right to make treatment decisions for themselves, so patients and their families are the decision makers for BIOMAb in this case. As the case states, the oncology doctors are the main influencers, as they diagnose and make ultimate recommendations to their patients as to how extensive the treatment should be. The benefits that each member of the decision making unit (i.e. patients and their families) seeks include BIOMAb’s effectiveness in the treatment of head and neck cancer in conjunction with radio and che motherapy, minimal side-effects (immediate side effects, as well as those that might be associated with long-term use), and drug’s affordability. Should phase-2 trials be conducted by Biocon for other indications, the patients will also want to seek same benefits from the drug for other types of cancer. Based on the information provided in the case, BIOMAb’s effectiveness and minimized side effects are a given. After all, phase-2 trials proved that the tumor was killed 100% of the time when the drug was used in combination with radio and chemotherapy. Moreover, unlike competition, BIOMAb did not produce skin rashes because due to the drug’s unique formula. An important factor will be affordability. Wealth distribution is very uneven in India, and 1/4 of the nation’s population earns less than the government-specified poverty threshold of $0.40/day (Wikipedia). The patients, as well as their doctors, will want to make sure that they can afford to complete treatment to ensure best possible outcome. BIOMAb has a tremendous advantage in this category compared to Erbitux, as it calls for a definite (i.e. six-dose) treatment cycle; total treatment cost can thus be effectively quantified. Another benefit that  patients will be seeking is the ability of BIOMAb’s sales reps to educate them and their families. Although this is not one of the drug’s literal benefits, it will be a crucial factor since patients’ face time with doctors and specialists is very limited in India. Pre-educating end users and their families on the benefits, side effects, and other specifics of the drug will ensure that oncologists’ time with each patient is maximized. 4. Develop a detailed launch plan for BIOMAb. Provide your rationale for the product portfolio, pricing, channel, and communication decisions. Biocon’s launch of BIOMAb is complicated by several factors. The first of these is the lack of phase 3 clinical trials, which would theoretically provide more evidence of the drug’s efficacy and safety on a larger patient pool. This is complicated by the fact that BIOMAb’s competitor comes in the form of a drug called Erbitux, which does have phase 3 trials completed and global acclaim. Biocon’s fear is that if they do not launch before Erbitux, they will lose the first to market advantage they feel necessary to succeed. In this case Biocon should take the time to complete phase 3 clinical trials on the basis of what patients and their families expect from a cancer drug. It was already stated that Erbitux had worldwide acceptance due to having extensive trials not limited to head and neck cancer that proved it was b oth safe and effective. In the eyes of the consumer the single most important concern here is that the drugs are going to work and that death can be avoided. Being first to market has the risk of offering only a temporary advantage until Erbitux actually becomes available. At this point if phase 3 trials are finally completed and the results are not favorable there would be severe consumer backlash and possibly action from the government. Finally, Biocon mentioned being able to appeal to doctor’s via existing relationships in order to get their product sold. Realistically, doctors care more about clinical trials as a means of deciding what drugs to offer. By moving forward with phase 3 trials Biocon would have real data to give these doctor’s the â€Å"hard sell.† The strategy is not just to maximize profit, but build a sustainable brand built on trust and results in the pharmaceutical industry. Building upon that is the question of whether or not to sell generics in addition to BIOMAb and when to sell them. The argument given was that selling generics would give the sales force good experience and at the  same time build a solid revenue base. Biocon should indeed take this route for these very reasons. This will allow them to still bring in revenue while the phase 3 trials of BIOMAb take place. Once the trials are complete, selling them alongside BIOMAb will allow them to capture more of the market when in front of doctors who want to have offerings for price conscious patients. On top of the first two concerns is the issue of price and what impact it would have on both market size due to affordability and perceived quality in comparison to Erbitux. Biocon, after confirmation of the extraordinarily high effectiveness of BIOMAb should charge $6000-7000 per dose or rather whatever would be equivalent to a few steps more than Erbitux. Biocon’s CEO desires to build a brand not based on low price but rather the value provided by the products. The hindrance to this route of course is the Indian cultural perception of what the price should be and the fact that many people cannot afford such cost. However, Biocon is alread y well aware that their effective target market is small so for those people the price is potentially less important. However, Biocon can market the fact that it is a six dose treatment path rather than indefinite dosages like Erbitux so in the long term people save money. Additionally they can get creative here and offer something like Walmart’s layaway program. Patients can agree to pay in equal installments up until their dosing day. On that final day when payment is received they are administered the dose. Payments for the next dose begin and the cycle repeats until the dosage time. Additionally, Biocon is concerned about the sales methodology with regards to going through the usual channels of CFAs, wholesalers, and pharmacies or selling it directly to doctors. By going through the typical channels they have the advantage of reaching more doctors who have existing relationships with certain sellers. In this case though, it would fit more with their overarching strategy to sell direct. The higher cost of the drug would be less apparent when not being sold side by side with competitor drugs through a pharmacy or wholesaler. This would also allow Biocon to sell the generic drugs and BIOMAb side by side as a complete market solution for price conscious people. The savings from not having a middleman can be passed on to the doctors via multi-patient discounts or similar. Finally, the quality of the product could be ensured since BIOMAb requires such delicate handling. This is important for the Biocon brand image moving forward as  there can be no slip ups when it comes to delivering a product critical to treatment of cancer. The direct sales also tie in with overall marketing communication planning since Biocon would not only control distribution of the product, but also the sales communication. Biocon should take this time during sales to educate doctors on the results of the phase 3 trials and provide materials for patients that explain the availability of Biocon reps during their treatment cycles. Biocon reps, as mentioned in the case, should educate the patient on their product and provide other helpful cancer information and family services in the form of support group references, etc. 5. How has Biocon’s strategy and positioning evolved over the years? What role does BIOMAb play in Biocon’s overall strategy? Biocon’s strategy and positioning have greatly evolved over the years. The company started as an enzyme manufacturing company that exported its products from India to the United States and European food processing industry. During this time the company developed an expertise in various fermentation processes. The company soon realized that the global enzyme market was limited to about $1 billion and decided to change its strategy and position itself to compete in the biopharmaceutical market, which was a $10 billion dollar market that was rapidly approaching $80 billion. Biocon was positioned nicely to move into the space and compete in the generic drug sector. They were particularly positioned well to manufacture statins. Statins were a great fit for them because they were small molecules that were easy to manufacture and Biocon already p ossessed the technical capability to do so drawing on its strength in the fermentation process and enzyme manufacturing. This short-term strategy to enter the market focused on developing globally competitive processes that relied on their existing expertise to manufacture drugs whose patents were expiring. After successfully entering into the pharmaceutical market through statins, the company was ready to continue on a growth path and move on to their medium/long term phase by entering into larger molecules in the form of insulin. Again, Biocon identified a large and rapidly growing market where they saw their expertise in fermentation giving them an edge and ability to compete. The results were consistent with their  first direction change and they were again very successful gaining over 10% of the Indian insulin market share. During this phase of their strategy they partnered with Clinigene to conduct clinical trials comparing it to the market leaders. The current phase of Biocom’s strategy is to shift the company’s focus to the development of proprietary drugs. Management again saw that the market they were competing in would soon shrink due to the maturing of the Indian drug market and they would experience enormous price pressure as a result. Their vision for the company was to develop drugs that no other companies had yet succeeded in bringing to market, and in doing so reaping the benefits of the huge payoff. BIOMAb is the essence of the final and long-term stages of Biocon’s overall strategy. They are using their collaborative strategy to partner with CIMAB thus giving Biocon the opportunity to develop and market the molecule. This is a huge step towards the long-term goal of moving the company to a discovery and development focused biotech firm. BIOMAb is very important to this next phase of the company’s growth. In the past they have relied on their expertise and experience carrying over from the enzyme development background. However in this next phase they are entering into uncharted territory and as a result will need to prove they have the capability to adapt their expertise and continue to be successful in areas that are outside of their experience scope. The success of the BIOMAb phase of Biocon’s overall strategy will be key to the future of the company and could indicate that the strategy they have in place will continue to provide the growth and profitability they seek as a biotech firm.

BA Applied Psychology

All of us have different journeys in life. We have different hopes and dreams that we cling on to motivate us strive hard to mark the goal. As a woman, I am fond of children and different kinds of personalities. I am just amazed how God create these people with different persona. They inspire me a lot. The children’s different personalities, simplicity and innocence are truly admirable. I look at them as special gifts from God that needs to be taken care of since they are also the hopes of our tomorrow.We should train them to where they should go and when they are old, they will not depart from it. Training these children with good values and morals in an early age really help them to be better citizens of our country. Moreover, the time has come to me when it is my turn to have mine. Life would not be as happy as today when I am able to have my own child. It is a great fulfillment in my part as a woman and as a person who loves children very dearly. God gives me a son on June 1, 2006 and he is 14 months old now.His ways really brought joy to me and I can say that as small as he is, his personality is totally one of a kind. Seeing him growing everyday makes my heart grow fonder. I just love being a mother and showing care to this tiny gift totally brought joy to my life. I have many plans for him and one of these plans is to use my education in psychology to raise him well as an individual. Beforehand, I am teaching piano lessons to different age groups. I am privilege to teach many children as well as adults and I love seeing all of their different personalities.Some of them are inclined to music and some are not. Some are fast learners; some are not. In every individual I meet, while teaching piano lessons, it just proves that people have different personalities and it interest me to know more about it. This interest in knowing different personalities more motivates me to study BA in Applied Psychology. In addition to this, I strongly believe that BA i n Applied Psychology will help me more efficient and equip in my field since I am currently working on a Bachelor’s in Social Work degree.

Alcohol Use Disorder

Diagnosis The DSM-IV-TR classifies drug disorders into substance use disorders (substance dependence and abuse) and substance-induced disorders (substance intoxication, substance withdrawal, induced delirium, anxiety, depression, psychosis and mood disorders). Sometimes it is difficult assessing patient’s psychiatric complaints because heavy drinking is associated with alcoholism can co-exist with, contribute to or result from several different psychiatric syndromes. (Shivani, Goldsmith Anthenelli, 2002) In order to improve diagnostic accuracy, distinguishes among alcohol-related psychiatric symptoms and signs, alcohol-induced psychiatric syndromes and independent psychiatric disorders that are commonly associated with alcoholism emerges to be essential. Patients’ gender, family history, and course of illness over time also should be taken into account. Alcohol-related psychiatric symptoms and signs Heavy alcohol consumption directly affects brain function and brain chemical and hormonal systems known to be involved in many common mental disorders thus can manifest itself in a broad range of psychiatric symptoms and signs. (Koob, 2000) And this usually the first problem which brings the patients seek help. The symptoms vary depending on the amount of alcohol used, how long it is used and how recently it was used as well as patient’s vulnerability to experiencing psychiatric symptoms in the setting of consumption. For example, during intoxication, smaller amount alcohol may produce euphoria whereas larger amount may produce more dramatic changes in mood. Alcohol also impairs judgment and aggressive, antisocial behaviours that may mimic certain externalizing disorders such as ASPD. Alcohol-induced psychiatric syndromes The essential feature of alcohol-induced psychiatric syndromes is the presence of prominent and persistent symptoms, which are judged- based on their onset and course as well as on the patient’s history, physical exam, and laboratory findings to be the result of the direct physiological effects of alcohol. Given the broad range of effects of heavy drinking may have on psychological functioning, these alcohol-induced disorders span several categories of mental disorders, including mood, anxiety, psychotic, sleep, sexual, delirious, amnestic and dementia disorders. Alcoholism with comorbid, independent psychiatric disorders Alcoholism is also associated with several psychiatric disorders that develop independently of the alcoholism and may precede alcohol use and abuse. One of the most common of these comorbid conditions is ASPD, and axis II personality disorder marked by a longstanding pattern of irresponsibility and violating the rights of others with alcohol. (Stinson et al. , 2006) Assessment The three major purposes for a comprehensive assessment are to determine a diagnosis, devise a treatment plan and to make appropriate referrals. The assessment should provide a clinical picture of the client’s personal level of functioning, history, presenting problems, family and social context in the client’s life. It is very important that the assessment process requires the gathering of comprehensive, accurate information, for a valid diagnosis and appropriate treatment. – It is vital that the counsellor needs to collect valid and reliable information. Both formal diagnosis, as listed in the Diagnostic and Statistical Manual of Mental Disorders (APA, 1994) and informal diagnosis, if the client has had therapy in the past can be made. – Comprehensive assessment is essential in designing a treatment plan. The more information provided concerning the etiology, functioning level and prognosis of the problem, the better the treatment plan. – Comprehensive assessment also provides information in order to made appropriate referral. The counsellor may decide to provide treatment solely or in conjunction with some other drug treatment specialists. Generally there are three categories of assessment measures: subjective data and physiological data. -Subjective data To collect information of demographics, family and living situations, mployment, education, drinking history (including development of the drinking problem and current drinking) and the effects on the subject’s cognitive, psychosocial, behavioural and physiological functioning. (Aalto Seppa, 2005) For example, some questionnaires focus on problems caused by alcohol consumption, the Alcohol Use Disorder Identification Test (AUDIT) (Saunders, Aasland, Babor, de le Fuente, Grant, 1993) There are ones with diaries focussing on the quantification of alcohol consumption, such as quantity-frequency, time-period or time-line follow-back methods. Webb et al. , 1990) More recently, a low level of response (LR) to alcohol (the need for higher amounts to have an effect) is a genetically influenced characteristic that is both found in populations at high risk for future alcoholism and that predicts alcohol related life problems in future. This Self-Rating of the Effects of Alcohol (SRE) questionnaire asks for estimate of number of drinks required to produce each of four effects at different times in their lives. Miller, Thomas, Mallin, 2006) In addition, the survey included the Alcohol Use Disorders Identification Test-C (AUDIT-C), a three-question alcohol screening test adapted from the original AUDIT developed by the World Health Organization for use in primary health care. The AUDIT-C is a simple, reliable screening tool that focuses on the frequency of drinking, quantify consumed on the typical occasion and the frequency of heavy episode drinking. (Bush, Kivlahan, McDonnell, al. , 1998) Again, there is no such perfect measure that SRE was found to be biased and not able to identify high functioning middle-age women. Schuckit, Smith, Danko, Isacescu, 2003) The difficulty with these specific questionnaires is that people who drink alcohol in general tend to neglect or underestimate their alcohol consumption. (Koch et al. , 2004) The accuracy of these measures is based on the patient’s awareness of and willingness to acknowledge his or her pattern and level of alcohol use as well as negative effects of drinking. At least some individuals who drink excessively will fail to do this. (Allen Litten, 2001) – Physiological data Comparing to subjective data, physiological data can overcome the subjectivity, underestimation in particular thus provides more precise and objective information about the drinking issue. It includes general medical and psychiatric history and examination. This is conducted through screening of blood, breath or urine for alcohol used, further on laboratory tests for abnormalities that may be accompanied acute or chronic alcohol use such as gamma-glutamy-transferase (GGT) or mean corpuscular volume (MCV), a measure of the average size of red blood cells. These may also be used during treatment for potential relapse. GGT is the most commonly used biochemical measure of drinking. However, it is not clear how much drinking is actually needed to cause GGT levels to elevate. And MCV tends to miss more alcoholics than GGT as MCV may be elevated by a variety of conditions other than heavy drinking such as non-alcoholic liver disease, smoking, advanced age or use of anticonvulsants etc. Thus applying the usual cut-off points for these tests, GGT turns out to have a low specificity whereas MCV shows a low sensitivity. This may lead to a gross misunderstanding with the patient and unnecessary further testing. Carbohydrate deficient transferring (CDT) has been recently approved as a marker for identification of individuals with alcohol problems as well as an aid in recognizing if alcoholic patients in treatment have relapsed. CDT and GGT appear to validly detect somewhat different groups of people with alcohol problems. GGT may best pick up those with liver damage due to drinking, whereas CDT seems to be related to level of consumption with or without liver damage. It should be kept in mind that biomarkers do not identify women or adolescents with alcohol problems as they do for male or adults in general. (Similarly, self-report screening tests are also generally less able to detect alcohol problems) (Allen Litten, 2001) Previous studies showed that over 80% of internists and family clinicians report that they usually or always ask new outpatients whether they drink alcohol. Less than 20% of primary care physicians routinely use validated self-report alcohol screening instruments (e. g. CAGE questions or AUDIT) Fewer than half ask about maximum alcohol consumption on one occasion. Alcohol biomarker laboratory tests are rarely used. Reasons given by clinicians for not following recommended alcohol screening guidelines range from lack of time, to insufficient knowledge and skills, to pessimistic attitudes about the ultimate benefits of screening. A current study conducted by Miller, et al. , (2004), they found that approximately 60% of clinicians surveyed frequently screen patients for alcohol use with quantity/frequency and CAGE questions. This is comparable to the incidence of screening found in previous studies. (Miller, Ornstein, Nietert, Anton, 2004)Miller, et al. 2006) further found that over 90% of patients were in favour of screening and guidance about alcohol use and very positive about the use of biological alcohol markers. These findings suggest that physicians and clinicians may be convinced that patients are open to alcohol screening and would not be offended by it. Heavy drinkers may have more of a tendency to be embarrassed by such questions but there is no evidence they would be object to screening. The majority of patients would also be willing to receive alcohol biomarker blood tests, if their physicians and clinicians deemed such tests necessary. Alcohol Use Disorder Diagnosis The DSM-IV-TR classifies drug disorders into substance use disorders (substance dependence and abuse) and substance-induced disorders (substance intoxication, substance withdrawal, induced delirium, anxiety, depression, psychosis and mood disorders). Sometimes it is difficult assessing patient’s psychiatric complaints because heavy drinking is associated with alcoholism can co-exist with, contribute to or result from several different psychiatric syndromes. (Shivani, Goldsmith Anthenelli, 2002) In order to improve diagnostic accuracy, distinguishes among alcohol-related psychiatric symptoms and signs, alcohol-induced psychiatric syndromes and independent psychiatric disorders that are commonly associated with alcoholism emerges to be essential. Patients’ gender, family history, and course of illness over time also should be taken into account. Alcohol-related psychiatric symptoms and signs Heavy alcohol consumption directly affects brain function and brain chemical and hormonal systems known to be involved in many common mental disorders thus can manifest itself in a broad range of psychiatric symptoms and signs. (Koob, 2000) And this usually the first problem which brings the patients seek help. The symptoms vary depending on the amount of alcohol used, how long it is used and how recently it was used as well as patient’s vulnerability to experiencing psychiatric symptoms in the setting of consumption. For example, during intoxication, smaller amount alcohol may produce euphoria whereas larger amount may produce more dramatic changes in mood. Alcohol also impairs judgment and aggressive, antisocial behaviours that may mimic certain externalizing disorders such as ASPD. Alcohol-induced psychiatric syndromes The essential feature of alcohol-induced psychiatric syndromes is the presence of prominent and persistent symptoms, which are judged- based on their onset and course as well as on the patient’s history, physical exam, and laboratory findings to be the result of the direct physiological effects of alcohol. Given the broad range of effects of heavy drinking may have on psychological functioning, these alcohol-induced disorders span several categories of mental disorders, including mood, anxiety, psychotic, sleep, sexual, delirious, amnestic and dementia disorders. Alcoholism with comorbid, independent psychiatric disorders Alcoholism is also associated with several psychiatric disorders that develop independently of the alcoholism and may precede alcohol use and abuse. One of the most common of these comorbid conditions is ASPD, and axis II personality disorder marked by a longstanding pattern of irresponsibility and violating the rights of others with alcohol. (Stinson et al. , 2006) Assessment The three major purposes for a comprehensive assessment are to determine a diagnosis, devise a treatment plan and to make appropriate referrals. The assessment should provide a clinical picture of the client’s personal level of functioning, history, presenting problems, family and social context in the client’s life. It is very important that the assessment process requires the gathering of comprehensive, accurate information, for a valid diagnosis and appropriate treatment. – It is vital that the counsellor needs to collect valid and reliable information. Both formal diagnosis, as listed in the Diagnostic and Statistical Manual of Mental Disorders (APA, 1994) and informal diagnosis, if the client has had therapy in the past can be made. – Comprehensive assessment is essential in designing a treatment plan. The more information provided concerning the etiology, functioning level and prognosis of the problem, the better the treatment plan. – Comprehensive assessment also provides information in order to made appropriate referral. The counsellor may decide to provide treatment solely or in conjunction with some other drug treatment specialists. Generally there are three categories of assessment measures: subjective data and physiological data. -Subjective data To collect information of demographics, family and living situations, mployment, education, drinking history (including development of the drinking problem and current drinking) and the effects on the subject’s cognitive, psychosocial, behavioural and physiological functioning. (Aalto Seppa, 2005) For example, some questionnaires focus on problems caused by alcohol consumption, the Alcohol Use Disorder Identification Test (AUDIT) (Saunders, Aasland, Babor, de le Fuente, Grant, 1993) There are ones with diaries focussing on the quantification of alcohol consumption, such as quantity-frequency, time-period or time-line follow-back methods. Webb et al. , 1990) More recently, a low level of response (LR) to alcohol (the need for higher amounts to have an effect) is a genetically influenced characteristic that is both found in populations at high risk for future alcoholism and that predicts alcohol related life problems in future. This Self-Rating of the Effects of Alcohol (SRE) questionnaire asks for estimate of number of drinks required to produce each of four effects at different times in their lives. Miller, Thomas, Mallin, 2006) In addition, the survey included the Alcohol Use Disorders Identification Test-C (AUDIT-C), a three-question alcohol screening test adapted from the original AUDIT developed by the World Health Organization for use in primary health care. The AUDIT-C is a simple, reliable screening tool that focuses on the frequency of drinking, quantify consumed on the typical occasion and the frequency of heavy episode drinking. (Bush, Kivlahan, McDonnell, al. , 1998) Again, there is no such perfect measure that SRE was found to be biased and not able to identify high functioning middle-age women. Schuckit, Smith, Danko, Isacescu, 2003) The difficulty with these specific questionnaires is that people who drink alcohol in general tend to neglect or underestimate their alcohol consumption. (Koch et al. , 2004) The accuracy of these measures is based on the patient’s awareness of and willingness to acknowledge his or her pattern and level of alcohol use as well as negative effects of drinking. At least some individuals who drink excessively will fail to do this. (Allen Litten, 2001) – Physiological data Comparing to subjective data, physiological data can overcome the subjectivity, underestimation in particular thus provides more precise and objective information about the drinking issue. It includes general medical and psychiatric history and examination. This is conducted through screening of blood, breath or urine for alcohol used, further on laboratory tests for abnormalities that may be accompanied acute or chronic alcohol use such as gamma-glutamy-transferase (GGT) or mean corpuscular volume (MCV), a measure of the average size of red blood cells. These may also be used during treatment for potential relapse. GGT is the most commonly used biochemical measure of drinking. However, it is not clear how much drinking is actually needed to cause GGT levels to elevate. And MCV tends to miss more alcoholics than GGT as MCV may be elevated by a variety of conditions other than heavy drinking such as non-alcoholic liver disease, smoking, advanced age or use of anticonvulsants etc. Thus applying the usual cut-off points for these tests, GGT turns out to have a low specificity whereas MCV shows a low sensitivity. This may lead to a gross misunderstanding with the patient and unnecessary further testing. Carbohydrate deficient transferring (CDT) has been recently approved as a marker for identification of individuals with alcohol problems as well as an aid in recognizing if alcoholic patients in treatment have relapsed. CDT and GGT appear to validly detect somewhat different groups of people with alcohol problems. GGT may best pick up those with liver damage due to drinking, whereas CDT seems to be related to level of consumption with or without liver damage. It should be kept in mind that biomarkers do not identify women or adolescents with alcohol problems as they do for male or adults in general. (Similarly, self-report screening tests are also generally less able to detect alcohol problems) (Allen Litten, 2001) Previous studies showed that over 80% of internists and family clinicians report that they usually or always ask new outpatients whether they drink alcohol. Less than 20% of primary care physicians routinely use validated self-report alcohol screening instruments (e. g. CAGE questions or AUDIT) Fewer than half ask about maximum alcohol consumption on one occasion. Alcohol biomarker laboratory tests are rarely used. Reasons given by clinicians for not following recommended alcohol screening guidelines range from lack of time, to insufficient knowledge and skills, to pessimistic attitudes about the ultimate benefits of screening. A current study conducted by Miller, et al. , (2004), they found that approximately 60% of clinicians surveyed frequently screen patients for alcohol use with quantity/frequency and CAGE questions. This is comparable to the incidence of screening found in previous studies. (Miller, Ornstein, Nietert, Anton, 2004)Miller, et al. 2006) further found that over 90% of patients were in favour of screening and guidance about alcohol use and very positive about the use of biological alcohol markers. These findings suggest that physicians and clinicians may be convinced that patients are open to alcohol screening and would not be offended by it. Heavy drinkers may have more of a tendency to be embarrassed by such questions but there is no evidence they would be object to screening. The majority of patients would also be willing to receive alcohol biomarker blood tests, if their physicians and clinicians deemed such tests necessary.