Management and Branch - 1971 Words

** PLEASE KEEP IN MIND THAT THIS IS AN EXAMPLE OF THE ESSAY TO BE WRITTEN. YOU MUST NOT COPY IT VERBATUM OR ELSE YOU WILL HAVE IT HANDED BACK OR FAIL FOR CHEATING!! PLEASE USE IT AS A REFERENCE, BUT ADD YOUR OWN INFORMATION AND PERSONAL EXPERIENCES!! ** 05002200 Organizing, Researching and Illustrating your Material Page 1 of 7 â€Å"Step 1† Methods: Conduct investigation in the branch through: †¢ Request initial explanation from the branch manager regarding the issues that the branch is encountering, on the first day of branch visit. Requesting an explanation from the branch head is imperative before communication with anyone else in the company. The branch head is responsible for the overall performance of his branch and as a†¦show more content†¦5. What do you propose as the best solutions to your listed issues in question number 3? l The question will gather possible solutions to the problems as employees see them. â€Å"Clients† In a scale of 1-5 (1 I the highest and 5 is the lowest) please answer the following questions. ** PLEASE KEEP IN MIND THAT THIS IS AN EXAMPLE OF THE ESSAY TO BE WRITTEN. YOU MUST NOT COPY IT VERBATUM OR ELSE YOU WILL HAVE IT HANDED BACK OR FAIL FOR CHEATING!! PLEASE USE IT AS A REFERENCE, BUT ADD YOUR OWN INFORMATION AND PERSONAL EXPERIENCES!! ** 05002200 Organizing, Researching and Illustrating your Material Page 3 of 7 1. How do you rate the branch’s overall performance? l This question will determine how the clients assess the overall performance of the branch. In getting this, I will have the confirmation of whether the clients are satisfied or not with the service. 2. How do you rate the branch’s procedure for accepting new client account and in closing completed accounts? l This will help me in knowing how well the clients accept the branch’s procedure on new client acceptance and if not what could be the possible solutions. 3. In what way/s do you think can the branch meet your service expectations/ l This question gathers relevant client suggestions in improving the branch’s performance. ** PLEASE KEEP INShow MoreRelatedTraining And Management Development : A Branch Within An Organization2739 Words   |  11 PagesTraining and Management development is a branch within an organization that is geared towards reducing randomness as well as bringing a structured format in learning and behavioral change. The program is meant to bring measurable changes in skills, knowledge and attitude as well as improving the performance of the organization. From Malone’s journal, It is a program designed to strengthen the competencies of extension workers while they are on the job (Malone, 1984, p. 209). With the world constantlyRead MoreOperations Management Is The Branch Of Management’S Science1571 Words   |  7 PagesOperations Management is the branch of management’s science concerned in st udying how to achieve successful management with the day-by-day operations of an organization. This study is dedicated in developing and applying the methods that are necessary to achieve business and operations improvement of the company. You may find operations problems in any area of the company and production and those problems may start in buying the feedstock of the products and go from there to even the distributionRead MoreCurrent Management Issues Within The Brisbane Branch Of Guyumi1505 Words   |  7 Pages1.0 Introduction The aim of this report is to address the current management issues within the Brisbane branch of Guyumi. Within the last twelve months the diversity of the workforce has been decreasing in a number of key areas within the organisation, it is believed that the new manager that was hired twelve months ago has caused this issue to arise. Currently there is a diversity policy in place that has had a gradual process over the last five years; however, it is likely that the failure of thisRead MoreJob Trainee Intern At Enterprise Rent A Car1680 Words   |  7 PagesOver the summer, I had the opportunity to work as a Management Trainee Intern at Enterprise Rent-A-Car at the home-city branch located in Kona. Enterprise Rent-A-Car is a management career, where each employee can advance from within. The branch office is on the second floor of the building and the rental cars are lined up on the ground floor, which made it easier for employees and customers to window shop from inside. Inside th e office has tons of space for customers to rest and place their luggage(s)Read MoreHalifax - Performance of Branch 54461675 Words   |  7 Pages1.0 SUMMARY The performance of branch 5446 was evaluated against the perspectives of Human Resources, Operations, Markets, Finance and Accounting, and Information, which are associated with the Halifax’s Balanced Scorecard quadrants and theory ‘Z’. The main concerns were HR management and Information flow, although all perspectives had areas to improve. It was concluded that working with the current manager, building on his experience should improve the branches performance and build it to excelRead MoreBusiness Management1669 Words   |  7 Pages Roanoke Branch of Virginia 111 Main Street Roanoke, VA0002-0002 Phone: 1800-201-1111 Fax: 1800-222-2100 April1, 2010 Executive Team Phoenix Advertising 111 Main Street Charlotte, NC 0001-0001 Dear Executive team: Until recently, the Roanoke branch of Virginia represented Phoenix Advertising visionRead MoreUnderstanding organisational culture1329 Words   |  6 Pageshas various levels of management. There is quite a bit of interaction between departments resulting in them being interdependent. This interdependence gives rise to how the branch performs in achieving its overall objectives. Cartwright (Mullins L J: Management and Organisational Behaviour: 7th edition, 2005, page 891) sees culture as ‘’a system of management authority.’’ He states that when accepted by employees, cultural values increase the power and authority of management in 3 ways. Employees: Read MorePenn Foster Exam 05002300 Essay1091 Words   |  5 Pagespin-point problems within the Roanoke branch of Phoenix Advertising which have led to the recent resignations of an art director and an account executive, increasing client complaints about quality of work, productivity and demoralization of employees within that branch. II. Site visit to Roanoke branch was performed in order to investigate issues. A. Preformed one-on-one employee interviews in order understand the reasons behind declining morale within the branch. 1. Conducted interviews withRead MoreInformal Report 050024001399 Words   |  6 PagesIntroduction The Roanoke branch of Phoenix Advertising has been one of the company’s most successful branches in previous years, handling the company’s largest accounts and maintaining a strong human resource pool. However, recent observable difficulties have brought the branches’ current human resource practices into question, as reports of key personnel leaving or threatening to leave their jobs, sharp declines in productivity, and loss of employee morale reach the company’s headquarters. UnderRead MoreManagement: VBD Report Essay1291 Words   |  6 Pagesabsenteeism at the Manila, Philippines branch. The Manila branch is significant to Moda as it is a major product manufacturer and distributor. The output of the branch is crucial to supplying demand for Moda’s products to the global market and therefore it is imperative that this issue is addressed directly to avoid further complications. Furthermore, it will examine the planning and controlling managerial functions that are currently in place at the Manila branch and provide recommendations in order

Cell Phones Pro Vs. Con - 1025 Words

Cell Phones: Pro vs. Con Cell phones have come a long way since April 3, 1973 when the first phone was invented. The first call in history was made that day by Motorola employee Martin Cooper, as he stood next to a 900 MHz base station in New York City and phoned to the headquarters of Bell Labs in New Jersey (The Cellphone Turns 40: Remembering Martin Cooper’s Historic Call). Since that day, cell phones have evolved to become what is now a all-in-one master piece. A current cell phone removes the need for various gadgets and replaces it with the click of just one button. Cell phones were first created to be strong, durable and not for long distance calling. Now, ordinary cellphones have evolved to the point where they are called smart phones. Although this incredible invention has changed our lives, it remains in debate of whether it was for the good or bad. The usage of cell phones is becoming tremendously fashionable in today’s innovative world. With the iPhone selling over $10 million worth of product in the first 3 days of its release, it is no question that cell phone popularity in today’s society is extremely crucial because these technologically advanced devices can record and capture videos, pictures, and even connect to the Internet for easy web surfing (First Weekend iPhone Sales Top 10 Million). For instance, the easy access of internet usage can help an individual when seeking to obtain an answer to challenging questions. Also, cell phones can help a child orShow MoreRelatedPersonal and Mobile Computing Essay1454 Words   |  6 Pagesonline news cite by using his/her mobile device to read or find out different information. Furthermore, mobile computing will be discussed along with the different types of computing devices ; such as laptops , smart phones ,tablets , I pads , and E Book Readers. Likewise, the pros and cons will be deliberated as well, along with the history, and lastly why is technology currently playing a huge role in diverse people daily lifestyles? To sum it a mobile computer is efficiently any computing device thatRead MoreUnit 1 Lab 1 Physical Networking1074 Words   |  5 Pageson Fixed Line vs. Cellular Debate June 16, 2014 Debate the Pros and Cons to having a purely cellular network vs. having a purely fixed line network Pro s: Cost: Most wireline phone companies charge more than what you d pay for most alternatives, and some are taxed more as well. There are some locations where getting new wired phoneservice is prohibitively expensive or even impossible. Long Distance and extra features like Call Waiting are normally included with alternative phones. †¢ Portability:Read MoreTouch Screen Technology1494 Words   |  6 Pagescapacitive touch. As shown in Figure 1, a resistive touch screen is made up of several layers, the surface consists two electrically conductive layers separated by a narrow gap. When an object presses on the screen, it completes the circuit, telling the phone which part of the screen is being pressed. Figure 1 Resistive touch screen ELEC001 Project Report | Touch Screen Technology Group 30 Illustrated in Figure 2, capacitive touch screens consists a layer of insulator such as glass coated with a transparentRead MoreUnit 1. Activity 1. Data on Fixed Line vs. Cellular Debate Essays1234 Words   |  5 PagesPros Cons of Fixed vs. Cellular: Pros: Cost: Most wireline phone companies charge more than what youd pay for most alternatives, and some are taxed more as well. There are some locations where getting new wired phone service is prohibitively expensive or even impossible. Long Distance and extra features like Call Waiting are normally included with alternative phones. More Features: Cellular and broadband phones normally include Long Distance, Voice Mail, Caller ID, Call Forwarding andRead MoreThe Current Status of 3g and the Future of 4g Essay1237 Words   |  5 Pages3G is still in use world-wide and will probably remain so for a few more years. 4G is still relatively new and has somewhat limited coverage, but it is only going to expand and get better. Brief History of 3G 3G is the third generation of cell phone mobile communications standards and successor of the older 2G standards. 3G networks were a substantial improvement over 2G networks, offering previously unseen data transfer speeds. Although 3G has only been in the United States since 2002, itRead MoreData on Fixed Lines vs Cellular Essay examples1191 Words   |  5 PagesIn this paper I will go over the pros and cons of having a purely fixed line network vs. a purely cellular network. When making this decision there are several things to consider, the most important is what this network is going to be used for. I am going to first go over the fixed line network then follow up with the cellular network. At the end of this paper I will do a recommendation to a new company that wants to open up a Skype- style service as to whether they should use a fixed line or aRead MoreOur Distracted Culture : What Was It?1643 Words   |  7 Pagesinto depth on how our culture is addicted to devices, spe cifically cell phones, that correlates with social media and how it affects relationships and everyday life. He claims, The harsh truth is we Americans have become addicted...is taking a toll on everything from nurturing our authentic relationships to simply paying attention to what matters during our brief lifetimes† (5H). In other words, these distractions, mainly cell phones, withdrawal us from life and lead us to fail to communicate withRead More100 Essay Topics1545 Words   |  7 Pagesprostitution 43. Write an editorial to your mayor complaining about problems in your town or city 44. What the individual can do to help protect the environment Consumerism 45. The effects of fast food on your health 46. Cell phones, television, computers†¦luxuries or necessities 47. Should phone surveys and telemarketing be prohibited 48. Are brand name clothes worth the price (Abercrombie, Ralph Lauren, Nike) 49. Advantages and disadvantages of credit cards Current events 50. The im portance of the ozoneRead MoreImpact of Social Media on Relationships Essay1050 Words   |  5 Pagesfamily’s favorite Christmas tradition. Of course, the sender of the friend request is not at fault, because society struggles with â€Å"what is private vs. what is public†. 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Speaking Through the Movement of Dance. Free Essays

Speaking Through the Movement of Dance Summary: Many people think of dance as human communication at its most basic level. Some form of dance can be found in every culture, regardless of its location or stage of development. It is easy to see that dance is a natural, universal human activity. We will write a custom essay sample on Speaking Through the Movement of Dance. or any similar topic only for you Order Now But what most people overlook to see is that dance can be found as a form of writing just like any other genre out there. So this explains how and why dance is a form of writing, and goes specially into choreographed dancing and how routines are a part of writing. What’s the first thing that pops in your head when you think about dance or dancing? That its form of writing right? WRONG! When thinking about dance or dancing the first thing most people think about is shaking their butts across the dance floor while grooving to the latest jams. But what most people don’t realize is that dance is a form of writing, weird right? I would of never guessed that either, until I went on a recent trip back to Chicago, and one of my best friends invited me to a dance performance at her school, not only was the show very entertaining. I learned that dance is more than moving to the rhythm of the beat to your favorite song, but that dance tells a story. Which most people don’t realize. Dance routines are very unique and explore states of mind and feelings such as pleasure and pain. I’ve heard people who like to dance mention things like dancing is form art and writing. They say some people dance to express their feelings and emotions. Other people dance to feel better, but dance can be used to tell a story. As if it is a language or written in a book. It utilizes many of the elements that can be found in other forms of writing and genres like tattooing’, graffiti, Facebook post and many more. But what is dance really? You +1’d this publicly. UndoDance is when people move to a musical rhythm. They may be alone, or in a group. The dance may be an informal play, part of a ritual, or part of a professional performance. There are many kinds of dance, and every human society has its dances. Dances may be planned in detail, or they may be whatever dancers feel like doing. However, most dancing does follow some general style or pattern. Dance takes as its subject matter moving visual patterns, feelings, states of mind, and narrative, in various combinations. The form of the dance, the details and the parts as they work together to organize the structure, gives us insight into the subject matter. However, the details, the parts, and the structure are not as easily perceived as they are in painting, sculpture, or writing. Because when in dance you have to pay very close attention to the little details and follow and feel what the dancers are doing. In this article I want to take a closer look only on choreographed dancing and how it’s a form of writing because the word choreography literally means â€Å"dance-writing†. Choreography is not just stringing together steps and figures. That’s boring. When choreographing a dance you need to first ask yourself why the audience is there. What do they want to see? What would interest them? Why should they like your piece? Or even if they don’t like it, how will it impact them. What will hold their attention at each moment? Keep your audience in mind during every step of your design. Just like an author when writing a book or any writing you still need to follow the same kind of steps in order for people to recognize and acknowledge your work because no one wants to read a boring book nor want to see a boring dance. hat’s why practice makes perfect. Writing, obviously, is my favorite form of expression. It allows me to dance with words, spin with anecdotes and tap out my frustrations. Just like dancing, it is not always easy or a graceful performance. Sometimes I falter, fall, miss a step and tap off beat. I sweat a lot when I’m on deadline and I doubt my abilities when the task is difficult. But at other times, my words gracefully fly off the page like a ballerina mastering a leap. When I keep trying and practicing, the steps get easier and encourage me to keep dancing along. I can also express myself as a writer, expanding my repertoire with different styles. Just as dancers switch from tap and ballet to hip hop and jazz, writers also strengthen their skills and express themselves by varying the tone, organization and style. When I’m frustrated, I tap out an opinion piece to persuade my audience. When I’m happy, I compile a light-hearted narrative or anecdotal piece. When I’m feeling sassy, I throw a little attitude into a blog post and quite often, I spruce up my wording to jazz up an article. In reality, writers are dancers at heart. We sway to the words, we feel the meaning we wish to express and we type to a rhythm with every piece. And sometimes, we pop, lock and drop it just for fun. Work Cited Page: â€Å"Dance. † Wikipedia. Wikimedia Foundation, 12 Aug. 2012. Web. 5 Dec. 2012 â€Å"What Is Dance to You? † Yahoo! Answers. Yahoo! , n. d. Web. 11 Dec. 2012. â€Å"What Is Choreography? † What Is Choreography? N. p. , n. d. Web. 3 Dec. 2012. Annette Lamb and Larry Johnson,. â€Å"Dance. † Dance. N. p. , n. d. Web. 24 Nov. 2012 Unknown. â€Å"Dance Quotes. † Dance Quotes. N. p. , n. d. Web. 30 Nov. 2012 How to cite Speaking Through the Movement of Dance., Papers

Geopolitical and Contemporary Perspective

Question: Discuss about the Geopolitical and Contemporary Perspective. Answer: Introduction: As in the other areas in Europe, the Roman Empire was the ultimate power during the early AD years, against which the people outside their borders defined themselves. Most of the written facts about the history of Scandinavia start from 600AD, and that evidence collected of their history come from contemporary writers or archaeological artefacts. The lack of written evidence does not diminish the stimulating past of the Scandinavians. Swedish archaeologist Oscar Montelius named the period of Iron Age in Scandinavia, Northern Germany and the Netherlands as the Roman Iron Age. The name begins from the hold that the Roman Empire had begun to apply on the Germanic tribes of Northern Europe. Along these lines, the original bit of the Iron Age is known as the Pre-Roman Iron Age, which had turned out to be out of the Nordic Bronze Age. The age that took after the Roman Iron Age is known as the Germanic Iron Age or the Age of Migrations[1]. As an important marker in the European history,the 9 AD is remembered as being the year of the stopping of Roman expansion attempts in the north by the Teoteburg forest in North-West Germany. In 61 AD, Boudicca, the Celtic queen from Norfolk, England, successfully rebelled against the Romans and made the Roman losses legendary.The rumours of the Roman defeats successfully conveyed one crucial message: the Romans are defeatable. This situation bolstered Scandinavian migrations and military campaigns southwards, a penchant that extended from the fourth century AD onwards. Most by far of the Germanic tribes alluded to the Romans saw themselves as relatives from Scandinavia who remained in contact with their genealogical homes. In Scandinavia, there was an original import of items, for instance, coins (more than 7,000), vessels, bronze pictures, measuring glasses, enamelled catches, weapons, et cetera. Furthermore, the fashion of metal things and soil vessels were particularly Roman. Thr ough the fifth century and 6th century, gold and silver end up being progressively ordinary. This time saw the scour of the Roman Empire by the Germanic tribes, by which various Scandinavians returned with gold and silver[2]. The Scandinavian-Germanic relocations in the midst of the late Roman Iron Age were the results of poverty at home. Fossil science has refuted this totally. In fact, Scandinavia in the midst of the third and fourth several years AD was a relentlessly comfortable place, with an abnormal state of wealth, political affiliation and moved advancement particularly weapon development and with strong and starting at now, old ties to the terrain. Graves have been found showing that some Norwegian fourth century AD warriors served unyieldingly in the Roman outfitted constrain and whatnot, not out of need yet rather due to intrigue and fearless mindsets. Some got the chance to be unmistakably Roman administrators[3]. The most reliable evidence of human settlement in Scandinavia is dated back to more than ten-thousand years. These premature social orders generated a clean living in the course of pursuing and calculating, with some affirmation of agrarianism in modern Sweden. Almost none is found about the two-hundred year time traverse (c. 850 AD to 1050 AD) of the Vikings. The Viking Age (8001050 AD) was depicted by an important improvement of action, for Sweden's circumstance for the most part in the direction of east. Various Viking efforts headed out from Sweden to both loot and do business the length of the Baltic float and the conduits that augmented significantly into present-day Russia. The Vikings went like the Black and Caspian Seas, where they made trading associations with the Byzantine Empire and the Arab kingdoms[4]. Written records out of Scandinavia's history come into view with the commencement of Christianity that made its opening in the midst of the Middle Ages. The essential Scandinavian country to handle Catholicism, Denmark has chronicled records backpedalling to 829. Subsequently, of its property closeness to Western Europe, Denmark showed the way whatever is left of Scandinavia in directing its overall population in the direction of a European model. Ruler Margaret, the young lady of the King of Denmark and life partner to the King of Norway, made usage of a Norwegian claim to Sweden's regarded position in 1388. Erik, her grandnephew and recipient, got the chance to be the leader of each of the three nations. Following up on Margret's proposal, he executed a 123 year time of political solidarity that perceived Denmark as the political state place of Scandinavia. Christianity at first accomplished Sweden with a legation drove by Ansgar, who went there in the ninth century, yet the state was not changed over to Christianity till the eleventh century. The different territories of Sweden were held around 1000 AD into a lone unit; nevertheless, the crown began to increment enormous effect just in the midst of the late thirteenth century[5]. Political Developments The crowns of Denmark, Norway and Sweden were joined in 1389 under the control of Margareta, the Danish Queen. The Kalmar Union in 1397 was surrounded, with the three Scandinavian countries underneath a lone ruler. In any case, the Union (13971523) was marked by internal differences that completed in the 'Stockholm Bloodbath' in 1520, when 80 Swedish nobles were put to death at the affectation of the Danish Union ruler, Kristian II. The exhibition instigated a resistance that in 1521 provoked to the declaration of Kristian II and the attack of drive by a Swedish privileged person, Gustav Vasa, who was picked the leader of Sweden in 1523. Sweden and Norway had been joined under a comparative crown on two occasions: from 1319 to 1343, and rapidly from 1449 to 1450 in spite of Sweden and Norway had been joined under a comparative crown on two occasions: from 1319 to 1343, and rapidly from 1449 to 1450 as opposed to Christian of Oldenburg who was picked leader of the Kalmar Union by the Danes[6]. In the following decades, all the Scandinavian nations got the opportunity to be unmistakably Protestant. The Swedish and Danish rulers snatched all the Church territories and this strengthened the wealth and impact of the crown. Under their appealing ruler, Gustavus Adolphus (ruled 1611-32), and, all things considered, consequently of their triumphs in the Thirty Years War, the Swedes won key areas in the east, and on the southern shores of the Baltic. Thus as importantly, the run of Gustavus Adolphus and the techniques of his mind-boggling pastor, Oxenstierna - saw clearing changes that have remarkably fortified the nation's vitality. The equipped compel, maritime drive, normal organisation, adjacent government, law courts and preparing have all been redesigned, making Sweden the most capably run country in Europe[7]. In June 1397 the bishopric managers of Lund and Uppsala doled out the responsibility to 15-year-old Erik of Pomerania the King of Denmark, Sweden, and Norway. The made declaration out of the Kalmar Union convey that every nation was to be coordinated by its particular laws yet was to offer help to the others if any of them was assaulted. The three nations consented to be coordinated by Erik, and his successors were to be examined by his nearby relatives. On the off chance that his line vanished, the advisors from the three kingdoms were to pick a master sufficient to all. A criminal expelled by one kingdom was disallowed in like manner from the other two. Each and every past battle were to be ignored. However, the assenting required authenticity because of Norway's powerlessness to sign[8]. In January 1435 the Arboga parliament conveyed Engelbrekt Engelbrektson as the master in Sweden. Regardless, in October the Swedish Council pronounced their predictable quality at Halsted if Erik would regard Swedish rights and favorable circumstances. Krister Nilsson Vasa of Viborg was assigned Viceroy (Drots), and Karl Knutsson persuaded the chance to be Marshal. Erik then made peace with the Hanseatic League and Holstein. Karl Knutsson drove the Swedish nobles against Engelbrekt, who was executed by Magnus Bengtsson on May 4, 1436. The specialists had lost, and the parliaments quit meeting. A Norwegian restrict the King started in 1436 and was driven by Amund Sigurdsson Bolt and five unique nobles. They assaulted Oslo yet then pulled back. A truce was made on June 23, and the Council met at Tunsberg to counsel with the revolt pioneers. They assented to expel each and every remote ace by July 29[9]. In Denmark, workers challenged the respectability and the service. The Council respected Erik's nephew, Duke Kristofer of Bavaria, and guaranteed him the coronets of the three kingdoms. In March 1439 Erik named Nils Stensson Marshal and Commander of the Danish army in Sweden, and they pointed the finger at Karl Knutsson for unfairness. In 1438-39 uprisings had mollified out up Satakunta, Tavastia, and Karelia in western Finland, where a huge part of the appraisals was assembled. In 1440 Karl escaped to Finland, and he energized withdrawal from the Union. Serve Thomas of Strangnas in like manner made a piece that portrayed Erik's abuse and the adventure for flexibility drove by Engelbrekt and Karl. In July the Danes expelled Erik and picked his nephew Kristofer master of Denmark. Erik exited Denmark to reside in Gotland. For the accompanying ten years, he was at Visburg fortress dealing with assaults in opposition to the Swedes. Exactly when the Swedes barred him in 1449, he gave up t he castle to a Danish naval force summoned by Olaf Akselsen Thott and surrendered to his Rgenwald house in Pomerania. Denmark, meanwhile, has benefitted from the strong and practical keep running of one of her most absolute rulers, Christian IV (1588-1648). He has given careful thought to the economy, finished many concentrating changes, contributed his capital with various great structures and set up a couple of indispensable new towns (tallying the next city of Oslo). He has moreover given Norway impressively more critical freedom. His remote approach has been tragic, in any case, drawing on his country the outrage of essentially every one of his neighbours, provoking to two critical interruptions by undermining the military. Scandinavism Scandinavism was a nationalist improvement happening in the Scandinavian countries in the mid-nineteenth century. Like the German and Italian unification advancements, it anticipated that would join Denmark, Sweden and Norway (yet again)[10]. Some get to be companions with among Danish and Swedish scholastics had begun happening to start at now in the 1870s, moved by the musings of the season of enlightenment. This was however outstandingly compelled. In the mid-1800s there was some desire that the Danish crown sovereign could gain the Swedish position of eminence which by then did not have a recipient, yet a sudden end was passed on to it when Sweden and Denmark before long stayed on converse sides of war[11]. The scandinavist advancement is said to have started in the winter of 1838 when the school understudies at Copenhagen crossed the hardened resund to visit the Swedish understudies in Lund - and the different way. The going with summer, an understudy meeting was formed in Copenhagen. In 1843, another scandinavist understudy meeting happened in Uppsala. The first understudy scandinavism was feared and met with mind boggling doubt by the principle tip best, as it was connected with radicalism. It has been depicted as the immature resistance of the 1840s[12]. The zenith of understudy scandinavism was in 1845 when the most surely understood of the understudy social events happened. This time, understudies from the University of Christiania (Oslo) also joined the social affair (the Norwegians were the most sceptical to scandinavism, as it insistently collided with the Norwegian patriotism). In the notable "riding house talk" the Danish administrator Orla Lehmann called the all-inclusive community to ensure to shield all of Scandinavia. Following two-years, that in like manner got the chance to be unmistakably critical; Prussia and the North German Confederation attempted to assault Schleswig-Holstein, two mostly German-talking duchies under the Danish crown. Sweden-Norway did not share in the war, yet rather had ensured to intervene if Denmark authentic was assaulted. A couple of volunteers from Norway and Sweden moreover fought in the war. Finally, Denmark won the war[13]. After this, scandinavism was no longer seen as an unsafe youth advancement; the 1848 distress in Denmark inferred progressivism and vote based framework was not a hazard, and the main understudy scandinavists had now grown up and taken up important positions in the general population field. As the Danish ruler Fredrik VII had no adolescents, there were similarly new any goals for dynastic scandinavism[14]. The scandinavist advancement remained tolerably quiet for the underlying fragment of the 1850s, however, got a lift in 1856 when some dynamic attempts to touch off coordinated effort was made. Around this time, the western strengths discovered scandinavism; having as of late combat the Crimean war, they viewed it as a possible power impede against Russian augmentation. There were in same manner talks between Oscar I of Sweden-Norway and Fredrik VII of Denmark of a possible agreement, yet shockingly it came to nothing. In 1859, the relations between Norway and Sweden furthermore took a swing to the more unfortunate. Thedispute as for Schleswig-Holstein incited to war toward the day's end in 1864 when Prussia and Austria struck Denmark. Denmark had zero shot against the better arranged and greater military and was constrained to give away both Schleswig and Holstein. For the scandinavists, the refusal of Norway and Sweden to help Denmark in the war was seen as a remarkable offering out and is much of the time said to have butchered the advancement off for good. There was still some development after this, and some scandinavist affiliations were made in most of the countries[15]. Scandinavism had constantly been a confined tip best improvement, generally reinforced by the educated people. It similarly had its adversaries; the Norwegian nationalists, the respectability in Sweden, and the Danish choice tip beat (above all else). The improvement in like manner did not have a run of the mill adversary - Sweden had Russia and Denmark Germany - and the three countries had their official ties to different orientation - Sweden toward the east, Norway westwards, and Denmark toward the south. Regardless, scandinavism was not an entire frustration. The investment began by the scandinavists lead the way towards further interscandinavian joint effort later on - this time without the political reasons however fundamentally for practical purposes. The advancement has similarly been said to have gigantically improved the photos the scandinavian nations had of each other. For pretty much 300 years, Sweden and Denmark had been most extraordinary enemies, and after the self-governance of Norway in 1814, hate towards both its neighbours was creating. Nowadays, the Nordic countries work together almost and are on excellent terms with each other. Scandinavism expected a unique part in starting this change[16]. References Aronsson, P., 2013. 2 Nordic culture.The Value of Arts and Culture for Regional Development: A Scandinavian Perspective, p.15. Barton, H.A., 2009.Essays on Scandinavian history. SIU Press. Berdah, J.F., 2013. The Baltic through Foreign Eyes in the 19th century: A Contribution to Regional History.Revue d'histoire nordique/Nordic Historical Review, (15), pp.pp-217. Brink, S. and Price, N. eds., 2008.The Viking World. Routledge. Cook, C. and Broadhead, P., 2012.The Routledge Companion to Early Modern Europe, 14531763. Routledge. Ghenghea, M.C., 2014. About Pan-Scandinavianism. Reference points in the 19th century (1815-1864).Revista Romn? de Studii Baltice ?i Nordice,6(2), pp.127-145. Helle, K., 2003.The Cambridge History of Scandinavia(Vol. 1). Cambridge University Press. Kent, N, 2008. A Concise History of Sweden. Cambridge University Press. Kuldkepp, M., 2014. Swedens historical mission and World War I: a regionalist theory of Swedish activism.Scandinavian Journal of History,39(1), pp.126-146. Newby, A.G., 2013. A History of Finland, by Henrik Meinander. Schaffer, J.K., 2012. The Forgotten Revolution: Debunking Conventional Wisdom on Sweden's Transition to Democracy. Sejersted, F. and Adams, M.B., 2011.The age of social democracy: Norway and Sweden in the twentieth century. Princeton University Press. Skovgaard-Petersen, K., 2012. Historical Writing in Scandinavia.The Oxford History of Historical Writing: Volume 3: 1400-1800, p.449. Strang, J., 2016. Nordic Political and Economic Cooperation: Context, History and Outlook. Thomas, A.H., 2016.Historical dictionary of Denmark. Rowman Littlefield. WJCICKA, A., Sweden and Poland: Nordicization Versus Europeanization Processes.Regional Development and the Baltic Sea Region, p.143. Bain, R.N., 2014.Scandinavia: A Political History of Denmark, Norway and Sweden from 1513 to 1900. Cambridge University Press. Berg, R., 2014. Denmark, Norway and Sweden in 1814: a geopolitical and contemporary perspective.Scandinavian Journal of History,39(3), pp.265-286. Hrdstedt, M., 2016. Decline and Consolidation: Sweden, the Napoleonic wars and Geopolitical Restructuring in Northern Europe. InNapoleons Empire(pp. 213-226). Palgrave Macmillan UK. Kirby, D., 2014.Northern Europe in the early modern period: The Baltic world 1492-1772. Routledge. Norde, M., 2013. Tracing the origins of the Swedish group genitive.2013): The genitive. Amsterdam/Philadelphia, John Benjamins, pp.299-332. Ressel, M., 2012. Swedish Pomeranian Shipping in the Revolutionary Age (17761815). InForum Navale(Vol. 68, pp. 65-103).

Pepsi Co Strategic Management Essay Example

Pepsi Co Strategic Management Paper Background ?Established in 1965 PepsiCo created in 1965 through the merger of Pepsi-Cola and Frito-Lay ? In 1997, publicly traded company to focus PepsiCo on food and beverages. ?The world’s largest snack and beverage company in 2006 In 2006, PepsiCo has approximately $35billion net revenue ?The company is broken into four business divisions: ?Frito-lay North America Frito-Lay North America manufactures, markets, sells and distributes salty and sweet snacks. Products manufactured and sold in North America include Lay’s and Ruffles brand potato chips, Doritos and Tostitos brand tortilla chips, Cheetos brand cheese-flavored snacks, Fritos brand corn chips, a variety of branded dips and salsas and Rold Gold brand pretzels. Low-fat and no-fat versions of several brands are also manufactured and sold in North America. ?PepsiCo Beverages North America Pepsi-Cola North America manufactures concentrates of brand Pepsi, Mountain Dew, Mug, Slice, Fruitworks, Sierra Mist and other brands for sale to franchised bottlers. PCNA also sells syrups to national fountain accounts. PCNA markets and promotes its brands. PCNA also manufactures, markets and distributes ready-to-drink tea and coffee products through joint ventures with Lipton and Starbucks and licenses the processing, distribution and sale of Aquafina bottled water. In addition, PCNA manufactures and sells Dole juice drinks for distribution and sale by Pepsi-Cola bottlers. ?PepsiCo International Pepsi-Cola International manufactures concentrates of brand Pepsi, 7UP, Mirinda, KAS, Mountain Dew and other brands internationally for sale to franchised bottlers and company-owned bottlers. We will write a custom essay sample on Pepsi Co Strategic Management specifically for you for only $16.38 $13.9/page Order now We will write a custom essay sample on Pepsi Co Strategic Management specifically for you FOR ONLY $16.38 $13.9/page Hire Writer We will write a custom essay sample on Pepsi Co Strategic Management specifically for you FOR ONLY $16.38 $13.9/page Hire Writer PCI operates bottling plants and distribution facilities in various international markets for the production, distribution and sale of company-owned and licensed brands. PCI markets and promotes its brands internationally. Principal international markets include Mexico, China, Saudi Arabia, India, Argentina, Thailand, the United Kingdom, Spain, the Philippines and Brazil. ?Quaker Foods North America Frito-Lay International manufactures, markets, sells and distributes salty and sweet snacks. Products include Walkers brand snack foods in the United Kingdom, Smith’s brand snack foods in Australia, Sabritas brand snack foods and Alegro and Gamesa brand sweet snacks in Mexico. Many of our U. S. brands have been introduced internationally such as Lay’s and Ruffles brand potato chips, Doritos and Tostitos brand tortilla chips, Fritos brand corn chips and Cheetos brand cheese-flavored snacks. Principal international snack markets include Mexico, the United Kingdom, Brazil, Spain, the Netherlands, Australia and South Africa. International Channel Value Chain PepsiCo’s management team was decided to capturing strategic fit benefits within the business line-up throughout the value chain. Primary activities : †¢Supply Chain management oCombined corporate-wide procurement of product ingredients upon the acquisition of Quacker Oats †¢Producing / Manufacturing oShare marketed research information to better enable each division to develop new products likely to be hits with consumers, consolidated its purchasing to reduce costs, and manufactured similar products in common facilities whenever possible. oMaximize unutilized resources Packaging oCombined corporate-wide procurement of packaging materials upon the acquisition of Quacker Oats †¢Distribution and retailing oJoin distribution of Quacker snacks and Frito-Lay to reduce their distribution expenses oPower of One retailer alliance strategy to increase consumers tendency to purchase more than one product offered by PepsiCo during a store visit. †¢Sales and marketing oConsolidated sales and marketing functions of similar products to eliminate duplication of effort and to present one face to customers. Support Activities : †¢Human resource management PepsiCo respects individual differences in culture, ethnicity and color. PepsiCo is committed to equal opportunity for all employees and applicants. oCorporate program for training employees how to work and manage in an inclusive environment †¢Advertising oPepsi already had experiences in advertising their products internationally. If the other line business of PepsiCo wants to do advertising in some countries, they could learn and implement the advertising technique that already implemented by Pepsi and they also already have necessary information about the country. Diversification Strategy Financial Analysis SWOT Analysis Strengths †¢Broader but focused product line and outstanding brand reputation †¢Key strategies: products innovation, close relationships with distribute allies, international expansion, strategic acquisitions †¢Market leader for U. S. convenience food (21%) and liquid refreshments (26%) †¢Capturing strategic fit benefits within the business lineup throughout the value chain †¢Lack of capital constraints (High availability of FCF, projected as $15 billion between 2007-2009) Weaknesses Slow move into international bottled water market †¢Unequally distributed international sales of Quaker Oats Products (75% of international sales was accounted for by just six countries) †¢A large dependency on one business division in generating profits (Over 50 percent of the companys profits come from Frito-Lay North America) Opportunities †¢Promising international foods and beverages markets o$70 billion market for noncarbonated beverages in international market oHigh per capita consumption of snacks †¢The increase of health conscious consumers Threats †¢FTC’s 10-year prohibition on bundled beverages (Gatorade and PepsiCo soft drink products) contracts with retailers †¢The maturity of Food and Beverages industry Conclusion ?Increase the use of exclusivity agreements to boost their sales in key markets. This may make it harder to keep costs low but will ensure added revenues. ?Continue to expand with their â€Å"Human Sustainability†. PepsiCo should become more proactive in the health food/product marketplace rather than being reactive to the market trends. They need to improve their responsiveness and future projections to market trends and changes that can therefore allude to different product segments and target markets. The healthy eating market is a demographic that will continue to grow in the future, and will provide generous profits if Pepsi Co is able to obtain a large market share. ?Expand more into social benefits, especially for those in developing nations. Pepsi’s main competitor Coca Cola has implemented a water purification program for African Villages, which provides a valuable need and at the same time introducing their brand name where it was before unknown. If Pepsi followed this same ideology with food products and water purification it too would significantly increase brand recognition ? Capture more of the aging population’s market share. Pepsi is a company focused on a younger market hoping to repeat the worldwide success of Coca Cola in regards to brand loyalty with the generations born after 1980; however, there is still a large market with the Baby boomer demographic that they could break into. PepsiCo should expand into markets and market segments that they are currently not in, such as Asia, India, and South America, It will expand their market share at the global level and to increase their overall revenue. ?PepsiCo should improve their employee relations. It will create employees all over the world to promote the product both during their work day and in their personal life in order to create â€Å"word of mouth marketing†.

Legalizing drugs essays

Legalizing drugs essays Unleashing a Weed of Mass Destruction on America While scanning through a newspaper, I came across a depressing article about a teenage girl who was found dead in her apartment because of a drug overdose. Also found in her dingy apartment was a baby girl. The article went on to say that she was a prostitute who sold herself to pay for her drug habit. The baby girl was given to child services, because nobody else wanted her, she was orphaned at 3 months and HIV positive. She had contracted it from her HIV positive-drug addicted-prostitute mother. The teenage girl had not only destroyed her own life, but the life of an innocent child. Incidents such as these show how drug abusers not only affect their own lives, but also the lives of relatives and complete strangers who may fall victim to their crimes. In light of this, the recent Controlled Drugs and Substances Act passed by the Canadian government to decriminalize the possession of 15 grams of marijuana or 1 gram of hash has incensed not only the White House, but numerous parents of teenagers across America who may cross the border to take advantage of the lax drug laws. The Canadian government made the decision because they felt it was futile to waste state resources unnecessarily arresting small time offenders that only ended up crowding prisons, instead, they will now invest that time and energy in pursuing bigger fish. This decision has revived the 1970s debate about whether or not to decriminalize legalize drugs in America. Currently, American drug laws are extremely stringent and for various reasons, the pro-drug legalization/ decimalization lobby want the use, sale, import, trafficking and production of drugs such as marijuana, weed, cannabis and more lethal drugs such as heroin and cocaine to be made legitimate and people found taking them to be able to do so without fear of getting a criminal record and prosecution. America spends over $60 billion a year on its ...

Important Court Cases - 20th century american history Research Paper

Important Court Cases - 20th century american history - Research Paper Example History tells us about the things we should never forget. How civil rights in America were properly respected and enforced by both the courts and the government is something we need to understand fully. It is the cornerstone of America's greatness today and into the future. The legal history of civil rights goes back many decades, but the most important cases appear after the Second World War when increased urbanization was reshaping American demography and social situation (Marable 1984, 14). The first and most significant landmark case was Brown vs. Board of Education. Few can dispute the historical role played by this case which almost certainly is the most famous American court case of the 20th century. This case effectively ended segregation in the United States and proved very controversial at the time (Kluger 1975, 12). The case involved parents in Kansas and elsewhere who wanted to send their children to the schools closest to them, but because of their race were forced to se nd their children to black schools a great distance away. They launched a suit arguing that having separate schools for different races was unconstitutional and a violation of their rights. The Supreme Court agreed with them 9-0. A book by Myrdal showed the court that the state of black schools was inferior (Myrdal 1944). The court realized that schools were separate but not equal. A second case involving similar issues, often referred to as Brown II, led to the Court declaring that the desegregation of American schools should be done soon and quickly (Ogletree 2004, 8). This gave impetus to changes that began to happen across the country. But that was not the end of the consequences of this decision. This was not a court case decided in a vacuum. In its wake, the governor of Arkansas used the national guard to try to block black students from entering white schools (Kluger 1975, 90). He refused to accept the ruling by the Supreme Court of the United States. Instead, he wanted to pl ay to his racist base. President Eisenhower was forced to send in the army to ensure the rule of law. He nationalized the Arkansas guard and saw that the law was enforced. In Alabama, a similar event occurred involving the governor there. These dramatic confrontation set the stage for much of the civil rights movement and the rise of people like Rosa Parks and Martin Luther King Jr. Civil rights leaders saw that the Constitution could protect them even if local sheriffs and lawmakers did everything they could to prevent changes from being made. Inspired by these cases, they pressed their issues by using non-violent protests. Education was just one legal battle fought during the civil war movement. People wanted to have less government control over their personal lives. Who was the government to say who a person could marry in a free country? And yet racist laws in much of the South prevented blacks and whites from marrying. Another significant case in the history of the civil rights movement was Loving vs. Virginia (1967). This was a case involving the marriage between a black woman and a white man, which the state of Virginia held to be illegal under their anti-miscegenation laws. These laws were in place based on a biblical conception of creation and marriage. Many people at the time believed that God had placed the races on

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

Scene - Essay Example The ladies are joined by another group of ladies and they sum up to seven. They walk slowly on the pathway to the relaxing zone where they continue with their conversation. Meanwhile, the game gets sweeter and I cannot resist the temptation of joining the team. I give the idea to my friends and they do not object to the idea of joining the players. As we head for the pitch, I remember that I have a presentation to make in an afternoon class. I stop for a while and remind my friends and surprisingly, none of them remembers the assignment. Immediately we change our minds from joining the game to preparing the presentation. We head to an empty bench where we sit and take out our presentation materials and get busy with our perfection. I notice that we are sited at a bench opposite a group of finalists who are busy discussing their project. This gives me the morale to get serious with the presentation. I notice that all my group mates, despite having forgotten about the assignment, they are all ready to contribute the ideas and materials that we are supposed to use. This motivates me more and I get down to working with my team in order to better our

Career statement Essay Example | Topics and Well Written Essays - 500 words

Career statement - Essay Example I shall have to develop vast knowledge of the latest means, advanced tools, and strategies for efficient sales and marketing of products as well as of the operations involved in deriving different kinds of chemicals and byproducts from crude oil in the next five years. In addition to that, the skills and abilities I will need to develop in the next five years include presentation skills and technological skills including developing competence in the latest software employed in sales and marketing. I will have gained a lot of knowledge about my field at the point of completion of my undergraduate degree. However, I shall continue developing my knowledge by getting the Master’s degree in Marketing. Besides, I shall keep attending workshops and conferences and will also be in search of good short courses to refresh my knowledge as well as learn the latest trends in the use of steel in the industry. These workshops, conferences, and short courses will also help me acquire the need ed skills and abilities in addition to the practical experience of working I shall get through working in the field. There is a lot of margin for growth in the both steel and petrochemical industries. There is no dearth of organizations looking for professionals to fill these positions across the world. Construction and oil exploration never goes out of trend and it is safe to assume that I shall easily find job anywhere in the world any time. I would most likely go to a graduate school after completing my undergraduate degree.

Case Study: Audit Processes of a Computer Company

Case Study: Audit Processes of a Computer Company Introduction Internal auditing is a consulting activity on a company that is independent. It aims at helping a company/ form evaluate its managerial system, identify issues in the firm and control the process of governance. Therefore an internal audit helps in supporting the board in their duties of completing important businesses in the company. The main issues faced by the auditor is whether research and development costs expensed in establishing technological feasibility were properly expensed or capitalized when appropriate. A good audit plan when implemented improves business performances and increases sales in a company. Definitions An internal audit is a tool used in firms to evaluate how effective its management system is and its quality. An internal auditor is any person who is qualified enough to have a responsibility of performing the audit process Nonconformance is the situation where the practice of a company is in disagreement with the standard practices KCN Analysis of the Audit Strategies Section Purpose Audit Strategy OBJECTIVES OF THE ENGAGEMENT This lists the services to be provided by the audit firm to KCN. The aim of this process is to define Keyton Computers Networks Inks internal audit for the purpose of evaluating the companys effectiveness.This is the audit of KCNs financial statements for the year ended December 31, 2015, and the issuance of a letter of engagement. BUSINESS AND INDUSTRY CONDITIONS To evaluate KCNs business and the industry it operates in KCN sells and services micro-computers, networking hardware and software to different businesses. PLANNING MEETINGS Shows the meetings that have been made with the clients and CPA team One meeting so far held with client and one with engagement team OWNERSHIP AND MANAGEMENT Shows/ indicates who owns and manages the company. Owners: Terry Keystone, Mark Keystone, John Keystone, Keith Young, and Rita Young. Managers: Terry and Mark Keystone OBJECTIVES, STRATEGIES AND BUSINESS RISKS This establishes clients goals, how they planned to achieve it, and the commensurate risks, and how they planned to overcome these risks. The main aim is to increase revenues 110% and increase net income to112% for each of the next 3 years.   To achieve this there will be need to: (1) advertise aggressively, sell to customers with higher risk profiles, and to develop new software.    The primary risks involved are not being able to produce the desired results and exceeding increased sales with credit losses. Another possible risk is not producing products in the software development. MEASUREMENT AND REVIEW OF FINANCIAL PERFORMANCE These are the ways used for performance evaluation. The procedures include inventory and receivables turnover, aging of accounts receivable, and the total inventory balance. PROCEDURES TO ATTAIN AN UNDERSTANDING OF CLIENT AND CLIENTS OPERATING ENVIRONMENT This tells the procedures to be done so the auditors can understand the client and the clients environment. For this audit strategy, the auditor needs to 1) review the prior years audit, 2) make inquiries from management, 3) analyze KCNs minutes of its board of directors meetings, 4) evaluate performance reports, 5) analyze company website, 6) appraise industry reports, and 7) assess business newspapers including the Wall Street Journal. AUDIT APPROACH This defines the general plan to be taken. Just like last years audit, the accountants assigned to KCNs audit have to make a plan about the companys tests of controls to gauge whether its control risks are below the maximum for the identified assertions. SIGNIFICANT RISKS Primary risks identified by the auditors. The primary risks involved are not being able to produce the desired results and exceeding increased sales with credit losses. Another possible risk is not producing products in the software development, and analysis of the quarterly results showed significant bonuses awarded to officers. SIGNIFICANT ACCOUNTING AND AUDITING MATTERS This are matters of concern in accounting and auditing Two primary concerns exist: whether accounting for extended warranties is done properly and cost of software. PLANNING MATERIALITY The auditor computes the materiality threshold. Review of sales, total assets, and pretax net income, to plan for materiality, $70,000 was established as the measure. SCHEDULING AND STAFFING PLAN This is the audits schedule. It also identifies the human resources assigned to the engagement. This includes the target dates for each major section of the audit starting from the interim audit work up to the updating of the management letter.The firm budgeted 118 hours for the engagement. KCN Risks RiskImplications and Response The primary risks involved are not being able to produce the desired results and exceeding increased sales with credit lossesthrough the extension of credits to high risk customers This increases the risk of bad debt expense misstatement and the corresponding allowance. The auditors can revise their estimates on the value of an account, and ignore the procedures previously done. Bonuses for the clients officers There could be an increase in the risk of quarterly results misstatement to extract the maximum bonus for officers.Also this motivates the officers to work more for more bonuses. The auditors may respond by reducing the number of the staff as long as they can handle their duties, to reduce number of people receiving bonuses. KCN Capitalization of Software Development Costs For KCN, the auditor has to determine whether research and development costs including those expended to establish technological feasibility have been properly booked as expenses or capitalized wherever appropriate.The audit firm will then identify the point of feasibility for the software product.The primary risks involved are not being able to produce the desired results and exceeding increased sales with credit losses by selling to high risk customers. The implication of this factor is that it creates a chance for misstatement of bad debt expense and the allowance for bad debts. Moreover, auditors will either increase or decrease their evaluation of the worthiness of the accounts receivable and avoid relying on previously done procedures. KCN Ratio Analysis Keystone Computers Networks, Inc. Analytical Review of Financial Ratios For the Period Ended December 31, 20X5 Details of Computations of 2005 ratios Ratio analysis may be difficult when there are no major changes in ratios.   However, the following might be considered: Number of Sales in Accounts per day Changes in credit policy and customer mix Improved economic conditions Exaggerations of sales Understatement of purchases Turnover of Inventory Change in the policy of the inventory exaggeration of inventory Understatement of the commodities bought by the company As KCN competes with companies that are much larger than itself and some even older in the computer and software business, the economic pressure is a lot. Whether bor not the company succeeds depends on how it handles the competition, for example, being able to attain and maintain a qualified market. This may increase its growth in the software sector by up to 6%. Conclusion The audit process is an important part of a company. Using the ratios and factors above, the Keyton company auditing process was carried out.   The increased profitability level resulted to a number of ratios with significant changes.As mentioned in the first part of this discussion paper, the auditor needs to determine whether research and development costs are properly expenses or capitalized when appropriate. The auditors determined that accounting for research and development was followed and all it needs to do is to identify when the software product became technologically feasible. As stated above, implementing these policies from the auditors reports will increase the sales for example, up to 6% in software alone. This supports our thesis statement. References Chesler, L. (1981). Baseline audit plan. Santa Monica, Calif. Kagermann, H. (2008). Internal audit handbook: Management with the SAP-Audit Roadmap. Berlin: Springer. Pickett, K. H. S. (2006). Audit planning: A risk-based approach. Hoboken, N.J: Wiley. Why did the Compromise Fall in 1860? Why did the Compromise Fall in 1860? During the beginning of the nineteenth century, the relationship between North and South deteriorated over the issue of territorial expansion. In 1850, the issue of slavery was slowly dividing the North and South sections of the United States; both factions were of similar origins and had a myriad of common bonds. Frantic efforts at compromise were launched such as the Kansas-Nebraska Act of 1854 and The Missouri Compromise of 1820. However, the sectional rift only increased with the Brooks-Sumner incident and any chances of compromise were terminated with the Supreme Court decision of the Dred Scott case in 1859. The two powerful parties of the Second American Party System, the Democrats and the Whigs, were dumbfounded and could not find a solution to the slave question, which ultimately lead to their destruction. From their remains rose two new political parties, the Republican Party and a southern party devoted to the defense of slavery. Their battle in the election of 1860 would decide the future and fate of the United States. By 1860 all attempts at compromise had failed, and within a year the nation was in the midst of a bloody Civil War that would cost over 600,000 American lives and divided many families in the process. The types of economies that developed in the three regions of the United States in the first half of the nineteenth century had a powerful impact on political goals and decisions. The South grew important cash crops such as cotton, tobacco, sugar, and rice. The North was far more industrialized than the South or even the West, having shifted from mercantile capitalism. At the same time the West shifted from subsistence farming to commercial agriculture and produced more foodstuffs, such as corn and wheat, than the other two regions. The North came to rely more and more on western foodstuffs and in return, westerners became consumers of northern industrial and commercial products. By the 1850s the North and West were economically joined, and the Norths economy was rapidly evolving into a modern-day industrial and commercial system. In the South, cash crops such as rice and tobacco were grown extensively. Yet no commodity was more important to the South than cotton. One southern politi cal leader was so certain that the rest of the nation depended on the Souths cotton production that he declared, Cotton is King! Cotton was one of the most important commodities in the world in the nineteenth century; many factories in the Northern states as well as European countries such as Great Britain and France needed cotton for their important and prosperous textile industries. Yet this was all done on the backs of abused slaves who worked tirelessly night and day to pick the cotton of their masters plantations. In the early 1800s Northerners were content to allow slavery to reside in Southern states. Only when Southern leaders sought to expand slavery did many Northerners become concerned. The Missouri Compromise of 1820 was an attempt to maintain the balance in the Senate between slave and Free states. Senator Henry Clay, known as the Great Compromiser, worked out a compromise in which Maine would enter the Union as a free state while Missouri would be admitted into the Union as the northernmost slave state. As a result of the compromise, slavery was then prohibited north of the 36 °30 parallel making a clear distinction between the northern and southern states. This boundary would then later be challenged by events such as the Dred Scott case, yet it marvelously managed to avert war for forty years, and thus set it aside for a later generation to fight, but the damage to American nationalism helped to erode the so-called Era of Good Feelings in which the popular James Monroe presided as president. During 1828, Congress passed a tariff that protected Northern industries but had the unwanted consequence of driving up domestic prices. This, while beneficial to the growing industry in the North, greatly crippled the South who suffered as their economy largely depended on the import and export of domestic goods. As a result, this new bill outraged Southerners who began calling it the Tariff of Abominations. South Carolina spearheaded Southern concerns by citing the doctrine of nullification, which allowed individual states to nullify proclamations of the federal government that would be found to be unconstitutional or inhibit the states rights. The issue of nullification was taken up in the Senate in the famous Webster-Hayne debate in which Daniel Webster of Massachusetts, the Senates leading orator, responded by challenging the Souths apparent willingness to subvert the Union for regional economic gain. In doing so, he broadened the debate beyond land, tariffs, and slavery to a co nsideration of the very nature of the federal republic. In 1832 Congress modified the tariff of 1828 by retaining high duties on some goods, but lowering others to rates held before the treaty. A South Carolina convention, under the leadership of current vice-president John Calhoun, later that year adopted an Ordinance of Nullification, voiding the tariffs of 1828 and 1832 in the state. The claim was that because the South tended to export food and import manufactured goods these tariffs were abusive and unfair; this new Ordinance supported free trade and generally opposed protective tariffs. The South Carolina state legislature funded a volunteer army and threatened secession if the federal government tried to force the state to comply with the tariffs. President Jackson, though an advocate of states rights, responded forcefully and threatened to invade South Carolina if its leaders refused to participate in the collection of tariff duties. To the ambitious malcontents in South Car olina, he proclaimed emphatically, the laws of the United States must be executed. . . . The Union will be preserved and treason and rebellion promptly put down. Jacksons proclamation stimulated an outburst of patriotism all over the country, isolating South Carolina from the rest of the Union. President Andrew Jackson asked Congress to grant him the authority to use military force to collect tax revenues and to subdue South Carolina. Congress complied by passing the Force Bill of 1833; the bill gave the President the authority to close ports or harbors at his will. This in turn would require opponents to the tariff to travel a distance to carry out any threats or insurrection against federal facilities. Hostile acts against government facilities or personnel would then be considered pre-meditated and blatant. Fortunately, however, the president never had to resort to military action. The crisis was averted when Congress passed a bill that reduced the productive tariff the following year. These events were dubbed the Nullification Crisis and the Compromise of 1833. Though war was averted, South Carolina now became the hotbed of southern dissent. The crisis of 1850 may never have occurred if a more common resource was discovered in California. But since gold was so rare, and therefore very valuable, Californias population skyrocketed. By 1850 over 100,000 hoping-to-strike-it-rich settlers, also known as forty-niners, flocked to California in hopes of attaining vast wealth in the gold that was said to be so abundant there. Without waiting for federal approval, the inhabitants of California called a convention, framed a constitution that prohibited slavery, and applied to Congress for admission as a state without first becoming a territory, this was made possible due to the vast influx of people who had emigrated there from the east of the United States as well as those who had immigrated from other countries. California had become very populous. The questions of whether California should be admitted as a free state and slavery should be allowed in New Mexico and Utah, two other territories asking to be allowed into the Union a t the time, generated a great deal of controversy both within Congress and throughout the nation. President Taylor supported Californias admission. Though the slaveholding president supported the proposal, other slaveholders throughout the country did not follow suit. Many southerners quickly threatened that they would secede from the Union if California was admitted as a free state. The Great Compromiser Henry Clay then once again stepped into the fray and proposed a compromise to this problem; this would be known as the Compromise of 1850. The compromise itself was more a series of bills than an actual compromise, these bills included among other things, that California would enter the Union as a free state; a more stringent Fugitive Slave Law of 1850 was guaranteed to be rigidly enforced. The law itself was already present, but it was rarely followed due to it being so poorly enforced as well as fierce opposition from Northerners who refused to hand in runaway slaves to the ever unpopular slave hunters; a settlement of the boundary between Texas and New Mexico; an indemnity to be paid to Texas for the relinquishment of its claims to a large portion of New Mexico; the slave trade would be banned in Washington D.C. (District of Columbia) though the ownership of slaves would not be abolished in the capital. This idea arose mainly because in this time period many European nations, with which the United States of America did business with, had already abolished slavery throughout their country, and it would leave an unfavorable impression on a foreign diplomat to see slaves which were no longer allowed in their own country, still present in another with whom they were considering associating themselves with ; the Mexican Cession, or the land taken from Mexico as a result of Americas victory in the Mexican-American War, would be divided into two new territories, New Mexico and Utah. Both territories would determine the status of slavery in their areas by popular sovereignty. Popular sovereignty was a system that would determine whether the state or territory would be free or would allow slavery by mean of holding local elections in said state or territory, Democrats would advocate popular sovereignty during the election of 1860. The compromise was made official with the signing of President Millard Fillmore. This passage by Congress delayed the onset of the Civil War for more than eleven years. The Bleeding Kansas period came about due to the Kansas-Nebraska Act. Democrat and Illinois Senator Stephen Douglas introduced the Kansas-Nebraska Act to further the construction of a Transcontinental Railroad to Chicago despite being warned by Frederick Douglass that the bill was an open invitation to a fierce and bitter strife. For the Bill to pass he needed the votes of southern Democrats, who were unwilling to support him unless the new Territories needed to accomplish it were open to slavery. Douglas thought that by proposing that the status of slavery in the new territories be governed by the principle of popular sovereignty, he would satisfy both pro and anti slavery factions. However, his bill in effect, repealed the Missouri Compromise of 1820, which barred slavery north of latitude 36à ¯Ã¢â‚¬Å¡Ã‚ ° 30. This brought as consequence that the Southern Whigs voted with southern Democrats in favor of the measure, and the northern Whigs rejected it, creating an irreconcilable spl it that left Whigs unable to field a presidential candidate in 1856. In the congressional elections of 1854, the southern Democrats became the dominant voice both in congress and within the party due to the split with the northern Democrats. The Cotton Whigs, who had economic ties with southern slave owners, were convinced that the bill would encourage antislavery feelings in the north. They urged southern politicians to vote against the bill, but were utterly ignored. This convinced them that compromise with the South was impossible and the nation watched horrified as the residents of Kansas slaughtered each other in pursuit of sectional goals that increasingly seemed to represent the divisions of the country. Since popular sovereignty would decide Kansass fate, it seemed that the majority of Kansas antislavery farmers would align Kansas with the Free states. Proslavery sympathizers in neighboring Missouri were not about to stand by while their neighbor cast its lot with the free s tates on account of its land being fertile and perfect for growing and farming cotton, the white gold of the South. Soon, border ruffians crossed into Kansas with the intention of making it a slave state. Border ruffians terrorized Kansas and intimidated others to vote proslavery with vicious threats and cast fraud ballots during elections to help elect their candidates into office. In response, Northern opponents of slavery like the New England Emigrant Society began sending supporters to Kansas. Fighting soon erupted as advocates of slavery created a government in Lecompton, Kansas and their opponents established an antislavery government in Topeka. Shortly thereafter, proslavery forces massacred citizens of the antislavery town of Lawrence. In retaliation, a violent abolitionist named John Brown organized his own massacre of five suspected proslavery advocates at Pottawatomie Creek in 1856. The Democratic President Pierces decision to remain aloof from the events in Kansas furthe r damaged what was left of his partys cohesion. In the ensuing months it seemed as if Kansas would enter as a free state, but a new problem arose; enter President James Buchanan. The newly elected President Buchanan accepted the proslavery Lecompton Constitution, which would admit Kansas as a slave state. Certain democrats then agreed to unite with the young Republican Party in 1858 to oppose the Lecompton Constitution, their efforts were not in vain and Kansas was ultimately accepted into the Union as a free state. The election of 1856 attracted one of the highest voter turnouts in American history. Ordinary citizens were sharing the politicians concerns about the growing sectional rifts in the nation. The northern turnout also showed that the threat posed by expansion of slavery was greater than that posed by new immigrants. In 1856 the people of the United States heard about the looting and burning in Kansas, about John Browns massacre at Pottawatomie, and about the Sumner-Brooks incident on the senate floor, ostensibly causing the unprecedented voters outpour. In the latter incident, Senator Charles Sumner of Massachusetts suffered permanent injuries from an attack by Congressman Preston Brooks of South Carolina. Using abusive and accusatory language in his The Crime Against Kansas speech, Sumner had singled out for ridicule Senator Andrew Butler of South Carolina. Sumners rude and personal attack suggested that the senator was drooling. South Carolina, Sumner cried, had sent to the Senate a Don Quixote who had chosen a mistress who, though polluted in the sight of the world, is chaste in his sight- I mean the harlot, Slavery. Talk of sexual connection between white Southerners and slaves was always explosive. Senator Butlers nephew, Preston Brooks, did not bother to challenge Sumner to a duel. Brooks said that the Yankee would never give satisfaction and would therefore refuse or flee from the challenge. Instead, Brooks strode into the Senate chamber and, finding the Massachusetts lawmaker alone, brutally beat Sumner with his cane, nearly ending his life. In Brooks mind, he was simply avenging an intolerable affront to his uncles honor. Each man found his action perfectly justifiable and the action of the other outrageous. So far had the behavioral codes of the North and the South diverged, and their attitudes were mirrored by their respective sections. The nation lay as divided as the senators. President-elect James Buchanans support for a pro-southern decision by the Supreme Court further aggravated sectional differences. In Dred Scott vs. Sandford, a southern-dominated Supreme attempted, in vain, to solve the political controversy over slavery. Scott, a slave, had been taken by his owner to Illinois, a Free State, and Wisconsin Territory north of the Missouri Compromise line. During that time, Scott married another slave and had a daughter who was born in free territory, then returned to Missouri, a slave state. Once in Missouri Scott sued for his freedom and that of his wife and daughter on the grounds that residence in free lands had made them free. Chief Justice Roger B. Taney declared the Missouri Compromise unconstitutional asserting that the federal government had no right to interfere with the free movement of property throughout the territories. Taney dismissed the Dred Scott case on the grounds that only citizens could bring suits before federal courts and that b lack people were not citizens. The five southern members of the Supreme Court concurred with the decision along with one Northerner, Robert Grier. President-elect Buchanan had pressured Justice Grier into supporting the majority. Clearly as a sectional decision, Southerners expressed satisfaction and support for the Court, Northerners disagreed. They found themselves questioning the power of the Supreme Court to establish the law of the land. The racist attitude of the Supreme Court was a bitter blow to the free blacks in the North. The South was overjoyed with the Courts ruling. The North was outraged; Northern Democrats like Senator Steven Douglas of Illinois found it increasingly difficult to reconcile their support of popular sovereignty in the Dred Scott decision. Under Douglass definition of popular sovereignty, it was always the white majority that would make decisions about black mens freedom. Lincoln responded to this definition by stating that for a man to rule another man without his consent was tyranny. Lincoln succeeded in pressing Douglas on the issue of slavery in the territories after Chief Justice Taneys Dred Scott decision. Lincoln used this opportunity to attack Douglass popular sovereignty idea. For how could the people of a territory vote against slavery, if Chief Justice Taney said that every American had a right to carry his property with him? In response, Douglas introduced his Freeport Doctrine. The doctrine was dubbed after the Illinois town where Lincoln and Douglas had met for one of their debates. The doctrine said slavery could not exist without friendly legislation to support it. Anti-slavery voters could simply refuse to pass such laws and slavery would effectively be kept out of the territory. Douglas concluded then that popular sovereignty was entirely consistent with Chief Justice Taneys ruling. However, the Freeport Doctrine alienated many Southern Democrats. Douglas had actually stated the essence of the doctrine previous t o the debate at Freeport, but its prominent public assertion at Freeport contributed, along with other political disputes, to antagonizing those in the Southern United States who were demanding ever-increasing protections for slavery, and who subsequently insisted on the repudiation of the Freeport Doctrine in order to block Douglas presidential bid in 1860. Containing slavery became important to Northerners, who believed that as slavery expanded, Northern industrial capitalism would become limited. To fight this fear a new political party emerged in the 1850s, the Republicans, whose political goals were free labor, free soil, free men. The industrial capitalists, owners of the Norths factories and workshops had the most to gain by containing the spread of slavery and expanding capitalism. For example, as capitalism expanded, they hoped to expand the labor pool, by supporting a loose immigration policy, which in turn would drive down the wages that they would have to pay for workers. Just as the planters dominated the South, the industrial capitalists profoundly influenced the Norths political, economic and cultural system. In addition, their political and economic objectives often clashed with those of the Souths planter class. In the South, militant political leaders, referred to as fire-eaters due to their adamant nature to raise cont roversial disputes, especially with their northern counterparts. These fire-eaters chafed at the notion of containing slavery, let alone abolishing it entirely, naturally bringing about disputes between the two. These clashes were mostly due to slavery as the industrial capitalists wanted to expand the white labor pool and southern plantation owners wanted to keep their slave force. Though compromises such as the Missouri Compromise, the Kansas-Nebraska Act, and the myriad of bills proposed by Henry Clay in the Compromise of 1850, it helped to divert attention from the topic and to try and appease both sides, but conflict was inevitable. As discussed earlier, both the North and the South consisted of entirely different ideals and culture by the nineteenth century. These divisions were brought to light in both the violence of the Brooks-Sumner incident and the racist decision of the South-dominated Supreme Court during the Dred Scott case. By the time Abraham Lincoln, the sixteen pre sident of the United States of America, took office the southern had already seceded from the Union. There was no longer room for compromise, Lincoln was given two options; to allow the Union to crumble or fight to preserve it. They thought themselves to be to economically powerful, politically influential, and the North and the rest of Europe too dependent on their White Gold for slavery to be abolished. They were wrong.

Punk music in the 70s and 90s Essay -- essays research papers

Punk music has gone through an evolution ever since the punk explosion in the late seventies. Although todayà ¢Ã¢â€š ¬Ã¢â€ž ¢s punk music retains most of the ideology and sound that defines the punk genre, there are some distinct differences between Nineties and Seventies punk. Most of the punk bands to emerge and gain popularity in the nineties mostly hailed from California (Green Day, the Offspring, etc.). Punk vanguards from the seventies hailed from the East Coast and from Great Britain (the Ramones, the Clash, etc.). The Sex Pistolsà ¢Ã¢â€š ¬Ã¢â€ž ¢ "Liar" and Blink182à ¢Ã¢â€š ¬Ã¢â€ž ¢s "Whatà ¢Ã¢â€š ¬Ã¢â€ž ¢s My Age Again?" demonstrates how conditions à ¢Ã¢â€š ¬Ã¢â‚¬  social, political, and physical à ¢Ã¢â€š ¬Ã¢â‚¬  are reflected in the nature of the music produced by these punk bands. The Sex Pistols emerged in the late seventies as one of the first politically charged punk bands, advocating anarchy in most of their tunes. The band embraced and produced songs that reflected the punk ideology: rebellion and nihilism. The Sex Pistols also reacted to the stark social conditions that infected Great Britain in the late seventies à ¢Ã¢â€š ¬Ã¢â‚¬Å" rising unemployment, a hard-line, conservative government, and a depressed post-industrial economy. With a hopeless future at the horizon, the restless youth in Britain had plenty of things to get angry about. The Sex Pistols embodied the eraà ¢Ã¢â€š ¬Ã¢â€ž ¢s anger and restless ambition. Blink182 first gained popularity as a local band from San Diego. The Southern California environment was completely different from the harsh, cold urban environment of London. The environment from where Blink182 cultivated their style was sunny and suburban San Diego. The mid-nineties were economically good in the United States. The youths of Southern California did not face the same despair as the youths of Britain in the seventies. Moreover, Blink182 gained popularity by producing songs that reflected the "skater" and teen culture of Southern California. Their music is fun, carefree, rebellious, and filled with adolescent, bathroom humor. The harsh, dense noise that is the hallmark of every Sex Pistols song can be heard in "Liar." The distorted guitar is the centerpiece of most punk music. The guitarist, Steve Jones, plays with an incessant, down strumming of power chords, cre... ...rank phone calls / What the hell is caller ID? / My friends say I should act my age / Whatà ¢Ã¢â€š ¬Ã¢â€ž ¢s my age again?" Sung in the mellow style of Hoppus, the aloofness and sarcasm are evident in the lyrics. The song rejects immaturity and advises that "No one should take themselves so seriously." The themes evoked in the song reflect the carefree and mellow attitude of Southern California while at the same time reflect the rebellious attitude of traditional punk. Moreover, the themes, along with the goofy sense of humor of the band, relate to the teen/pop culture that emphasizes music that is fun to listen to. The punk revival in the Nineties retains the energy and freshness of Seventies punk. But as previously evidenced, the creative forces and inspiration that produced this music influenced and affected the message and sound of the songs. "Liar" is a song derived from the angry punk scene of Great Britain and "Whatà ¢Ã¢â€š ¬Ã¢â€ž ¢s My Age Again?" reflects the warm, mellow attitude of Southern California. The distinctions end there. Those looking for the raw sound and power of punk music can find it in both Nineties and Seventies punk.

Public School vs. Private School Essay

Are there any sentences that could be revised or restated? or anything that can make this sound a bit better? never mind the grammar and spelling. There are many reasons private schools are academically superior to public schools. There are vast differences between both public and private schools. Public school is controlled by the government. Public schools don’t charge tuition and accepts all children by law. They are financed through the federal, state and local taxes; functioning as part of the government and must adhere to the regulations by politicians. Thus, they can be greatly influenced by the political winds. Private schools are not administered by the government and are operated by private individuals. Unlike public school, they operate on student’s tuition and have different admissions requirements. Private schools accept students according to its academic standards but, generally private school students meet or exceed the standards of public school students . However, there are many advantages and disadvantages of both types of schools. Among the benefits of private school, private schools students generally have smaller class sizes and a lower student to teacher ratio. Children wil have more individualized attention and will allow more opportunities for access to instructors. Students would have better performance and brighter children can be challenged by harder lessons. They usually have more challenging curriculum. Students are also motivated to have better performance because private schooling requires tuition. Private schools also have more events and activities due to their small school sizes. Parents would have more opportunities to get involved with their children’s education. Private school students can benefit from the flexible teacher methods. Private school aren’t as tailored in rules as public schools. So, lesson teaching methods can vary greatly. Another aspect of private schools superiority is they offer specialized classes and courses beyond the basics. that students are expected. While, public schools only teach general and common studies that would be required for future life. Private schools cater specialized classes like religious teachings. Private schools are stricter in rules and behavior including a school code dress uniform. The stricter classroom rules provides a better learning environment and results in a better education. Also, private school teachers usually hold advanced degrees and tend to be  experts in their field. Typically, private schools have newer facilities and materials such as older textbooks, sports equipment. However, there are also some benefits of public schools that private students don’t have. There are disadvantages in private schools while there are benefits. Private schools are usually composed of students from very similar backgrounds and economic states Therefore, the lack of diversity and in-exposure to different people of economic backgrounds can lower their communication and social skills. Public school education also has its own advantages and disadvantages. It’s educational disadvantages compared to private school students are by far. Public schools have larger class sizes and more students. So, students would have less individualized attention. Public schools are required to follow a heavy set of rules, restricting them to different methods of teaching. The state determined teaching methods may not be the best methods in teaching students on certain subjects. Public schools can be affected by the economy and decisions made by politicians. Another big difference is that public schools are required to educate all children by law and can’t deny any student. Admitting all sorts of children into classrooms causes higher chances of disturbance. It’s diversity may also cause higher chances of bullying and violence. Public school facilities and materials are typically older. The drop out rates in public schools are usually lower than private students. But, there are social benefits of being a public school student. The public school system is diverse with people from a variety of backgrounds. The students are more exposed to people from different social economic backgrounds and can teach children to get along with one another regardless of the differences. It can improve communication and social skills. Another advantage is that they are financed through the governmental don’t charge tuition. Students are also provided with transportation and all teachers are certified educational instructors. There are upsides and downsides of both school systems. The benefits of private school education exceeds public school benefits. The lower student to teacher ratio in private schools can encourage students to learn and provide more challenging courses for the advanced students. The safer learning environments with less bullying can improve concentration.

Cardiovascular Diseases

Cardiovascular disease Introduction Heart disease is No. 1 killer disease worldwide. It causes 12 million deaths annually. Thanks to the rising health awareness and government programmes this number significantly reduce during last 30 years. Coronary heart disease and cardiovascular disease Cardiovascular diseases are diseases of the heart (cardiac muscle ) or blood vessels (vasculature).Cardiovascular disease (CVD) means all the diseases of the heart and circulation (blood vessels disease) including coronary heart disease (angina and heart attack) and stroke, as well as coronary and periphery blood vessels disease (problems with circulation). Diseases from this group are the biggest killer in Europe and USA, but developing and non-develop countries too. The final and most tragic consequence of different types of heart disease is heart attack with tragic consequences. Heart diseases are caused by atherosclerosis, a disease of arterial blood vessels resulted from atheroma i. . plaques accumulated (forming; sticking) on artery walls which makes the blood vessels nonelastic and narrowed and leads to decreased blood flow. For the atherosclerosis doctors very often use alternative name chronic cardiovascular disease. The opposite group acute heart disease made group of diseases which are dangerous for patients lives. Acute heart diseases include conditions or illnesses which usually have a rapid onset of symptoms and may resolve within days with or without treatment.A condition or illness that is sudden or severe. On the other hand a condition or illness that arises slowly over days or weeks and may or may not resolve with treatment made a group of chronic heart disease. Both of them are caused by atheroma and the most known are next: a) Acute heart disease Heart attack is caused by lack of O2 in heart muscle cells. Very often it is caused by rupture of â€Å"hard plaques† patches which result in blood clots and partially or completely block blood flow and ca use a heart attack.When a fiber cap becomes thin, these â€Å"hard plaques† can suddenly rupture, spilling their contents, resulting in blood clots that partially or completely block blood flow and cause a heart attack http://www. authorstream. com/Presentation/nitin-35423-heart-diseases-science-technology-ppt-powerpoint/ Cholesterol glossary. http://www. mybwmc. org/library/28/000225 Stroke Stroke is death of brain cells caused by obstructed blood flow to parts of the brain. Since the level of LDL cholesterol is main cause of narrowed of blood vessels, it is necessary control it. If not treated properly, high LDL cholesterol can cause a stroke.Cholesterol glossary. http://www. mybwmc. org/library/28/000225 b) Coronary heart disease Heart disease (coronary heart disease), When the plaque build up in th conorary arteries heart does not get sufficient blood, the condition is called coronary artery disease or coronary heart disease. Atherosclerosis is a disease of arterial blood vessels in which plaques form on artery walls. This is a consequence of different substances circulating in the bloodstream (inflammatory cells, proteins, cholesterol and calcium) sticking inside the vessel walls. Plaque patches influence on narrowing blood flow in the artery. ttp://www. bodybuilding. com/fun/gastelu5. htm Peripheral artery disease (reduced blood flow in the limbs, usually the legs Coronary plaque Coronary plaque is a term which use in practice as a synonym for atheroma or atherosclerosis. Patches of atheroma are formed from substances that circulate in the bloodstream. They consist of lipid, or fat, cores covered by collagen fiber caps which are sticking to the inside of the vessel walls. Over time plaque or patch of atheroma increases making an artery narrower and the blood flow through the artery is reducing.We can see the changes in blood vessels caused by plaque in the Figure 1. Figure 1 Artery with the patches of atheroma – plaque Preventing Cardiovasc ular Diseases. Patient. co. uk. emis < www. patient. co. uk/health/Preventing-Cardiovascular-Diseases. htm> (March 13, 2013) http://medicineworld. org/blogs/heart/blog/permalinks/Jan-2006/coronary-plaque-detection-by-molecular-imaging. html> (March 13, 2013) Mature plaques typically consist of two main components: soft, lipid-rich atheromatous â€Å"gruel† and hard, collagen-rich sclerotic tissue.Lipid-rich and soft plaques are more dangerous than collagen-rich and hard plaques because they are more unstable and rupture-prone and highly thrombogenic after disruption. Researchers have found that many people who have heart attacks do not have arteries narrowed by plaque. Many heart attacks are now known to be caused by soft or vulnerable plaques, located on an inflamed part of an artery. This plaque can burst, leading to the formation of a blood clot that can cause a heart attack. The 2009 issue of â€Å"The American Journal Pathology† edited explanation of those relatio ns discovered by Olga Ovchinnikova and er colleagues. They found that inflammation results in the formation of soft (vulnerable) plaque which is filled with different cell types that promote blood clotting. This leads to a reduction of mature collagen, resulting in thinner caps that are more likely to rupture, even in the cases when total level of plaque isn’t extremely high. The authors advocate different viewpoints about relations between the plaque level and structure, i. e. its influence on heart attack. The first group claims that described types of blockages cause only about 30 percent of heart attacks.On the other hand, some sources state that more than two-thirds of acute coronary events result from rupture of coronary plaques. However problems that plaque creates are extremely dangerous for people’s life and it is very important to prevent and monitor its appearance and changes. Graphs of vulnerable plaque and rupture of plaque which causes a heart attack is p resented below. Figure 2 Vulnerable atherosclerotic plaques. Vulnerable atherosclerotic plaques. A. Atherosclerosis in a chronic disease that leads to plaque rupture and vascular occlusion. B.Cross-section of a lethal coronary plaque rupture. Adapted from Heistad D. Unstable coronary-artery plaques. N Engl J Med. 2003. Atherosclerosis Modeling In-vitro. http://www. remedi. uzh. ch/research/disease. html Figure 3 Plaque Rupture and Heart attack http://hon. nucleusinc. com/generateexhibit. php? ID=30468&A=1027 Factors influencing plaque growth and stability Based on everything mentioned above and medical experience the conclusion about relations between heart attack and other cardiovascular disease and the level of plaque increasing are found.The higher the level of plaque the higher risk of heart disease will be. The level of plaque will increase as the result of high level of cholesterol, type LDL, so called â€Å"bad cholesterol† in blood. When the level of LDL is normal, bl ood can pass in and out of the blood vessels without problems, but if it significantly increase particles of the blood will accumulate and sooner or later provoke trigger (cause) heart attack. Other very important factors influencing plaque level increasing are high blood pressure and cigarette smoking.Both factors accelerate the plaque formation changing (damaging) artery walls and even more, helping cholesterol forming. Medical experience proved that plaque composition and vulnerability (hard or soft plaque) is more responsible for the conversion of a stable disease to a life-threatening condition than the plaque size. Except the plaque vulnerability the risk of plaque disruption is are consequence of rupture triggers (extrinsic forces). Soft plaque – lipid-rich one is more dangerous because of its instability and higher probability for rupture.Even (IAKO) Although â€Å"hard plaque† that one having higher level of calcium influence on the blood vessels walls and the ir â€Å"hardness† experience show that heart attacks are mostly caused by soft plaque disruption. Figure 4 Plaque rupture and its consequences in the form of heart diseases http://www. nature. com/nrg/journal/v7/n3/fig_tab/nrg1805_F2. html Risk factors of coronary heart disease Risk factors influencing cardiovascular disease we can group based on their stability into the three groups: a) Modifiable risk factorsIn this group hypertension is the most dangerous risk factor for heart attacks, but even more for stroke. It is forming as the result of abnormal blood lipid levels which means high total cholesterol, high levels of triglycerides and high levels of low-density lipoprotein or low levels of high-density lipoprotein (HDL). Smoking, physical inactivity, Type 2 diabetes, and a diet full with saturated fats are risk factors strongly influencing the heart disease. All of them are treatable and patients (individuals) belonging into the different types of risk customersâ€℠¢ groups should avoid practice them. b) Non-modifiable risk factorsThe factors from this group mostly are constant, like the case in gender or family history. Others are changing when time is passing, like age and lifestyle and personal habits. Older people have more chance to get heart attack and the man, especially those having â€Å"bad medical history†. Ration between man and woman are changing when women past the menopause. After that the level of risk is similar as the men’s one. As I’ve presented there is direct correlation between cardiovascular disease and condition and health of blood vessels, more precisely of developing atheroma, means level and structure of plaque in vessels.On the other development of plaque and its level is directly influenced by level of cholesterol and some other elements which are connected with individual person and his/her life and genetic predispositions. As with the other diseases everybody has some risk of developing ather oma, but some risk factors increase the risk level for several categories. Those risk factors include: fn 12 †¢Fixed risk factors – factors that person cannot change: oA strong family history which means close relatives who developed heart disease or a stroke before they were 55 (for males) or 65 (for female). Severe baldness in men at the top of the head. oAn early menopause in women. oAge. Older people have more risk to develop atheroma. oEthnic group. Medical data show that people from different ethnic group have different risk for heart diseases. †¢Treatable or partly treatable risk factors include different health problems caused basically by the same causes as the: oHypertension (high blood pressure). oHigh cholesterol blood level. oHigh triglyceride (fat) blood level. oDiabetes. oKidney diseases causing diminished kidney function. All factors from this group have to be controlled and monitor.Any kind of their complication probably will trigger more serious pr oblems such as heart attack or stroke. †¢Lifestyle risk factors that can be prevented or changed. Actually these factors PRETHODE precede to those belonging to the second group. Except the genetic factors way of life and daily habits are the more responsible for different kind of heart diseases. Those factors are: oSmoking (Smoking cigarette increase blood pressure, decrease HDL; damages arteries and blood cells and increases heart attacks. Passive smoking is also a risk factor for cardiovascular disease ) oLack of physical activity. Obesity (People who are overweight (10-30% more than their normal body weight) have 2 to 6 times the risk of developing heart disease. ) oAn unhealthy diet and eating too much salt. oExcess alcohol. Looking on those three groups one can easily conclude that people with â€Å"bad predisposition† having high fixed risk factors have to think about their lifestyle risk factors even more, in order to try to decrease the second group of factors (t reatable or partly treatable risk factors). On the other hand some of risks are more dangerous than the others; for example smoking increases risk for heart disease more than obesity.And of course combination of two or more risk factors increases significantly the level of risks; older man (or woman) who smokes, without physical activity and with bad eating habits has more chance to get some of previously explained disease than the one who have â€Å"just one of bad habits†. The more risk factors someone has the greater is the likelihood that he/she will develop cardiovascular disease, unless taking action to modify his/her risk factors and working to prevent them compromising his/her heart health.That doesn’t mean that people with â€Å"good genes† can be irresponsible and ZANEMARITI risk factors from other groups. With or without genetic predisposition modern life significantly increases a risk of heart disease for everybody. Hormones impact on lipids and othe r risk factors Different numbers of man and women died from heart attack initiated a lot of research about hormones' influence on the risk factor and heart disease development. Number of men died from the heart attack outnumbered the number of women in pre-menopause period, but in the post-menopause data show completely opposite situation.A percentage of women in post-menopause having heart disease and dying from heart attack increase dramatically and now outnumbered the men. The main reasons for those changes are connected to the level of hormones and their influence on level and structure of cholesterol and consequently on risk factors and heart disease. As mentioned before total cholesterol actually is made of two different types of cholesterol: LDL – low density lipoprotein (LDL), so called bad cholesterol and high density lipoprotein (HDL).High levels of LDL cholesterol lead to atherosclerosis increasing the risk of heart attack and ischemic stroke. HDL cholesterol redu ces the risk of cardiovascular disease as it carries cholesterol away from the blood stream. http://www. walgreens. com/marketing/library/careguides/careguide. jsp? docid=000225=28=High%20Cholesterol Estrogen, a female hormone, raises HDL cholesterol levels, partially explaining the lower risk of cardiovascular disease seen in premenopausal women.But after menopause (natural or surgical) when a level of estrogen significantly decreases total cholesterol rises, low density lipoprotein (LDL) cholesterol rises, and high density lipoprotein (HDL) cholesterol does not change or decreases slightly. This is the reason why negative hormones’ effect after menopause increasing more than proportionally. Some authors argue that even influence of estrogen on LDL and HDL level is proved it is yet unclear whether increase in risk is caused, at least partially, by increased level of androgen (the other of hormones belong to steroid as estrogen too), which is characteristics of menopause too. This sexual dimorphism means a lower incidence in atherosclerotic diseases in premenopausal women, which subsequently rises in postmenopausal women to eventually equal that of men. These observations point towards estrogen and progesterone playing a lifetime protective role against CAD in women. As exogenous estrogen and estrogen plus progesterone preparations produce significant reductions in low-density lipoprotein (LDL) cholesterol levels and significant increases in high-density lipoprotein (HDL) cholesterol, this should in theory lower the risk of CAD.UKLOPITI U ONO GORE Among estrogen's positive effects on the heart are: †¢Reducing the LDL (â€Å"bad†) cholesterol in the blood. †¢Increasing the HDL (â€Å"good†) cholesterol in the blood. †¢Helping to keep blood vessels open. †¢Lowering blood pressure at night. †¢Reducing blood viscosity (how sticky the blood is), a property that may cause blood clots which could result in a heart attack o r stroke. Estrogen's effects on clotting are complicated, however, since there also is an increased risk for thromboembolism (a blood clot that blocks a vessel) in women taking estrogen. Possibly enhancing fibrinolysis, which is the body's natural process for breaking down blood clots. Read more: http://ehealthmd. com/content/what-are-benefits-hrt#ixzz2NbWR3MxY http://ehealthmd. com/content/what-are-benefits-hrt#axzz2NbW1GJJN Nutrition guidelines As presented before three different groups of risk factor exist. Some of them people can change but the other are fixed, non-changeable because they caused by genetic heritage ( ) influences. Controllable factors are connected to the lifestyle of person.Lifestyle changes can prevent or slow the development of coronary plaque and heart disease. In order to prevent a disease development one have to keep track of his/her blood pressure and cholesterol levels. Choosing a heart-healthy diet is vital in controlling weight, which helps keep blood pressure and cholesterol levels down. Foods high in cholesterol and saturated fat should be avoided, and quitting smoking is imperative. Regular exercise and an increased overall activity level contribute to heart health and help reduce stress.The risk of cardiovascular disease is possible to reduce following recommendation for lifestyle changing: Cessation of smoking and avoidance of second-hand smoke. Nutrition should ensure a healthy diet wiht total diet no more than 8% of saturated + trans fatty acids of total energy intake. All people, especially ones with high risk factors should lower alcohol consumption As the prevention physical activities are recommended – at least 30 minutes of moderate intensity physical activity per day or three days week (i. e. 150 mins/week minimum). Currently practiced measures to prevent cardiovascular disease include: †¢A low-fat, high-fiber diet including whole grains and plenty of fresh fruit and vegetables (at least five portions a d ay)[29][30] †¢Tobacco cessation and avoidance of second-hand smoke;[29] †¢Limit alcohol consumption to the recommended daily limits;[29] consumption of 1-2 standard alcoholic drinks per day may reduce risk by 30%[31][32] However excessive alcohol intake increases the risk of cardiovascular disease. [33] †¢Lower blood pressures, if elevated, through the use of antihypertensive medications[citation needed]; †¢Decrease body fat (BMI) if overweight or obese;[34] Increase daily activity to 30 minutes of vigorous exercise per day at least five times per week;[29] †¢Decrease psychosocial stress. [35] Stress however plays a relatively minor role in hypertension. [36] Specific relaxation therapies are not supported by the evidence. [37] Routine counselling of adults to advise them to improve their diet and increase their physical activity has not been found to significantly alter behaviour, and thus is not recommended. [38] http://www. news-medical. net/health/What-i s-Cardiovascular-Disease. aspx http://www. barnesandnoble. om/w/prevent-halt-and-reverse-heart-disease-joseph-piscatella/1100260037 Primary and secondary prevention of heart disease It is necessary start with prevention from heart disease as early as possible. Changes in the number of people killed by heart attack in developed countries show that prevention and awareness about this group of disease help to http://circ. ahajournals. org/content/123/20/2274/F2. expansion. html health plans must continue to drive cardiovascular care further along the continuum toward primary prevention of cardiovascular disease (CVD).CVD risk factors should be managed not only after a coronary event has occurred, but also before the onset of such and event. Ideally, health lifestyles should be promoted with all patients so that risk factors for CVD never develop. In this way, CVD care can be moved from the inpatient setting to the outpatient setting. Sidney C. Smith Jr, MD. Focus on Cardiovascular Dise ase; A Word About the Quality of Care in Cardiovascular Disease. Director, Center for Cardiovascular Science and Medicine University of North Carolina at Chapel Hill. http://www. qualityprofiles. rg/leadership_series/cardiovascular_disease/cardiovascular_introduction. asp Key priorities for implementation Primary prevention of CVD †¢For the primary prevention of CVD in primary care, a systematic strategy should be used to identify people aged 40–74 who are likely to be at high risk †¢People should be prioritised on the basis of an estimate of their CVD risk before a full formal risk assessment. Their CVD risk should be estimated using CVD risk factors already recorded in primary care electronic medical records †¢Risk equations should be used to assess CVD risk People should be offered information about their absolute risk of CVD and about the absolute benefits and harms of an intervention over a 10-year period. This information should be in a form that: opresen ts individualised risk and benefit scenarios opresents the absolute risk of events numerically ouses appropriate diagrams and text (See www. npci. org. uk) †¢Before offering lipid modification therapy for primary prevention, all other modifiable CVD risk factors should be considered and their management optimised if possible.Baseline blood tests and clinical assessment should be performed, and comorbidities and secondary causes of dyslipidaemia should be treated. Assessment should include: osmoking status oalcohol consumption oblood pressure (see ‘Hypertension’, NICE clinical guideline 34) obody mass index or other measure of obesity (see ‘Obesity’, NICE clinical guideline 43) ofasting total cholesterol, LDL cholesterol, HDL cholesterol and triglycerides (if fasting levels are not already available) ofasting blood glucose orenal function oliver function (transaminases) thyroid-stimulating hormone (TSH) if dyslipidaemia is present †¢Statin therapy is recommended as part of the management strategy for the primary prevention of CVD for adults who have a 20% or greater 10-year risk of developing CVD. This level of risk should be estimated using an appropriate risk calculator, or by clinical assessment for people for whom an appropriate risk calculator is not available or appropriate (for example, older people, people with diabetes or people in high-risk ethnic groups) †¢Treatment for the primary prevention of CVD should be initiated with simvastatin 40 mg.If there are potential drug interactions, or simvastatin 40 mg is contraindicated, a lower dose or alternative preparation such as pravastatin may be chosen. Secondary prevention of CVD †¢For secondary prevention, lipid modification therapy should be offered and should not be delayed by management of modifiable risk factors. Blood tests and clinical assessment should be performed, and comorbidities and secondary causes of dyslipidaemia should be treated.Assessment sho uld include: osmoking status oalcohol consumption oblood pressure (see ‘Hypertension’, NICE clinical guideline 34) obody mass index or other measure of obesity (see ‘Obesity’, NICE clinical guideline 43) ofasting total cholesterol, LDL cholesterol, HDL cholesterol and triglycerides (if fasting levels are not already available) ofasting blood glucose orenal function oliver function (transaminases) othyroid-stimulating hormone (TSH) if dyslipidaemia is present. Statin therapy is recommended for adults with clinical evidence of CVD †¢People with acute coronary syndrome should be treated with a higher intensity statin. Any decision to offer a higher intensity statin should take into account the patient’s informed preference, comorbidities, multiple drug therapy, and the benefits and risks of treatment †¢Treatment for the secondary prevention of CVD should be initiated with simvastatin 40 mg. If there are potential drug interactions, or simvasta tin 40 mg is contraindicated, a lower dose or alternative preparation such as pravastatin ay be chosen †¢In people taking statins for secondary prevention, consider increasing to simvastatin 80 mg or a drug of similar efficacy and acquisition cost if a total cholesterol of less than 4 mmol/litre or an LDL cholesterol of less than 2 mmol/litre is not attained. Any decision to offer a higher intensity statin should take into account informed preference, comorbidities, multiple drug therapy, and the benefit and risks of treatment http://www. eguidelines. co. uk/eguidelinesmain/guidelines/summaries/cardiovascular/nice_lipid_modification. phpHow to lower the risk of cardiovascular disease The risk of cardiovascular disease is possible to reduce following recommendation for lifestyle changing: Cessation of smoking and avoidance of second-hand smoke. Nutrition should ensure a healthy diet wiht total diet no more than 8% of saturated + trans fatty acids of total energy intake. All peop le, especially ones with high risk factors should lower alcohol consumption As the prevention physical activities are recommended – at least 30 minutes of moderate intensity physical activity per day or three days week (i. . 150 mins/week minimum). Cessation of smoking The aim of this measure is complete cessation of smoking and avoidance of second-hand smoke. Patient and their families need to stop smoking. Those who are unable to quit may need professional help in form of counselling, behavioral therapy and even pharmacological therapy. Nicotine replacement therapy (NRT) is the first line choice of medication. Nutrition The aim of this measure is to ensure a healthy diet. Total diet should have no more than 8% (of total energy intake) of saturated + trans fatty acids.All patients are advised to take approximately 1g Eicosapentaenoic acid (EPA) and Docosahexaenoic acid (DHA) and more than 2g Alpha Linolenic Acid (ALA) daily. Diet should have vegetables, fruits and legumes, g rain-based foods, moderate amounts of lean meats, poultry, fish and reduced fat dairy products. EPA and DHA can be obtained from oily fish and marine n-3 (fish oil) capsule supplements. Alcohol consumption All patients should be advised to lower alcohol consumption. Men should drink no more than 2 standard drinks per day and women no more than 1 standard drink per day. Physical activityThe aim of this measure is to raise physical activity and exercise to the recommended goal of at least 30 minutes of moderate intensity physical activity on most, if not all, days of the week (i. e. 150 mins/week minimum). Maintaining a healthy body weight The aim should be to achieve a waist measure of less than or equal to 94 cm in men and less than or equal to 80 cm in women. The body mass index (BMI) should be maintained at 18. 5–24. 9 kg/m2 Lowering blood cholesterol The aim of therapy should be to maintain blood cholesterol at: †¢Low density lipoprotein (LDL) at – less than 2. mmol/L †¢HDL – more than 1. 0 mmol/L †¢Triglyceride (TG) less than 1. 5 mmol/L The blood cholesterol can be maintained with the use of pharmacotherapy. Statins are commonly used lipid lowering drugs. Those with diabetes and atherosclerosis need stringent blood cholesterol control as well. Other lipid lowering drugs include fibrates like gemfibrosil, clofibrates etc, Ezetimiber and niacin. Lowering blood pressure High blood pressure is one of the important risk factors for cardiovascular disease. Those with coronary heart disease, diabetes, kidney disease or stroke need tight blood pressure control.The aim should be a blood pressure of less than 130/80 mm of Hg. Diabetes and blood sugar control Those diagnosed with diabetes need stringent blood sugar control to prevent cardiovascular damage. HbA1c levels should be maintained at less than 7%. Other drugs to lower risk of cardiovascular disease Other drugs used to lower risk of cardiovascular diseases include: †¢ Antiplatelet agents – this includes Aspirin and Clopidogrel. These drugs when given to patients with risk of heart attacks may prevent such attacks and events. †¢ACE inhibitors like Enalapril, Captopril, Lsinopril and Cardiovascular Diseases Cardiovascular disease Introduction Heart disease is No. 1 killer disease worldwide. It causes 12 million deaths annually. Thanks to the rising health awareness and government programmes this number significantly reduce during last 30 years. Coronary heart disease and cardiovascular disease Cardiovascular diseases are diseases of the heart (cardiac muscle ) or blood vessels (vasculature).Cardiovascular disease (CVD) means all the diseases of the heart and circulation (blood vessels disease) including coronary heart disease (angina and heart attack) and stroke, as well as coronary and periphery blood vessels disease (problems with circulation). Diseases from this group are the biggest killer in Europe and USA, but developing and non-develop countries too. The final and most tragic consequence of different types of heart disease is heart attack with tragic consequences. Heart diseases are caused by atherosclerosis, a disease of arterial blood vessels resulted from atheroma i. . plaques accumulated (forming; sticking) on artery walls which makes the blood vessels nonelastic and narrowed and leads to decreased blood flow. For the atherosclerosis doctors very often use alternative name chronic cardiovascular disease. The opposite group acute heart disease made group of diseases which are dangerous for patients lives. Acute heart diseases include conditions or illnesses which usually have a rapid onset of symptoms and may resolve within days with or without treatment.A condition or illness that is sudden or severe. On the other hand a condition or illness that arises slowly over days or weeks and may or may not resolve with treatment made a group of chronic heart disease. Both of them are caused by atheroma and the most known are next: a) Acute heart disease Heart attack is caused by lack of O2 in heart muscle cells. Very often it is caused by rupture of â€Å"hard plaques† patches which result in blood clots and partially or completely block blood flow and ca use a heart attack.When a fiber cap becomes thin, these â€Å"hard plaques† can suddenly rupture, spilling their contents, resulting in blood clots that partially or completely block blood flow and cause a heart attack http://www. authorstream. com/Presentation/nitin-35423-heart-diseases-science-technology-ppt-powerpoint/ Cholesterol glossary. http://www. mybwmc. org/library/28/000225 Stroke Stroke is death of brain cells caused by obstructed blood flow to parts of the brain. Since the level of LDL cholesterol is main cause of narrowed of blood vessels, it is necessary control it. If not treated properly, high LDL cholesterol can cause a stroke.Cholesterol glossary. http://www. mybwmc. org/library/28/000225 b) Coronary heart disease Heart disease (coronary heart disease), When the plaque build up in th conorary arteries heart does not get sufficient blood, the condition is called coronary artery disease or coronary heart disease. Atherosclerosis is a disease of arterial blood vessels in which plaques form on artery walls. This is a consequence of different substances circulating in the bloodstream (inflammatory cells, proteins, cholesterol and calcium) sticking inside the vessel walls. Plaque patches influence on narrowing blood flow in the artery. ttp://www. bodybuilding. com/fun/gastelu5. htm Peripheral artery disease (reduced blood flow in the limbs, usually the legs Coronary plaque Coronary plaque is a term which use in practice as a synonym for atheroma or atherosclerosis. Patches of atheroma are formed from substances that circulate in the bloodstream. They consist of lipid, or fat, cores covered by collagen fiber caps which are sticking to the inside of the vessel walls. Over time plaque or patch of atheroma increases making an artery narrower and the blood flow through the artery is reducing.We can see the changes in blood vessels caused by plaque in the Figure 1. Figure 1 Artery with the patches of atheroma – plaque Preventing Cardiovasc ular Diseases. Patient. co. uk. emis < www. patient. co. uk/health/Preventing-Cardiovascular-Diseases. htm> (March 13, 2013) http://medicineworld. org/blogs/heart/blog/permalinks/Jan-2006/coronary-plaque-detection-by-molecular-imaging. html> (March 13, 2013) Mature plaques typically consist of two main components: soft, lipid-rich atheromatous â€Å"gruel† and hard, collagen-rich sclerotic tissue.Lipid-rich and soft plaques are more dangerous than collagen-rich and hard plaques because they are more unstable and rupture-prone and highly thrombogenic after disruption. Researchers have found that many people who have heart attacks do not have arteries narrowed by plaque. Many heart attacks are now known to be caused by soft or vulnerable plaques, located on an inflamed part of an artery. This plaque can burst, leading to the formation of a blood clot that can cause a heart attack. The 2009 issue of â€Å"The American Journal Pathology† edited explanation of those relatio ns discovered by Olga Ovchinnikova and er colleagues. They found that inflammation results in the formation of soft (vulnerable) plaque which is filled with different cell types that promote blood clotting. This leads to a reduction of mature collagen, resulting in thinner caps that are more likely to rupture, even in the cases when total level of plaque isn’t extremely high. The authors advocate different viewpoints about relations between the plaque level and structure, i. e. its influence on heart attack. The first group claims that described types of blockages cause only about 30 percent of heart attacks.On the other hand, some sources state that more than two-thirds of acute coronary events result from rupture of coronary plaques. However problems that plaque creates are extremely dangerous for people’s life and it is very important to prevent and monitor its appearance and changes. Graphs of vulnerable plaque and rupture of plaque which causes a heart attack is p resented below. Figure 2 Vulnerable atherosclerotic plaques. Vulnerable atherosclerotic plaques. A. Atherosclerosis in a chronic disease that leads to plaque rupture and vascular occlusion. B.Cross-section of a lethal coronary plaque rupture. Adapted from Heistad D. Unstable coronary-artery plaques. N Engl J Med. 2003. Atherosclerosis Modeling In-vitro. http://www. remedi. uzh. ch/research/disease. html Figure 3 Plaque Rupture and Heart attack http://hon. nucleusinc. com/generateexhibit. php? ID=30468&A=1027 Factors influencing plaque growth and stability Based on everything mentioned above and medical experience the conclusion about relations between heart attack and other cardiovascular disease and the level of plaque increasing are found.The higher the level of plaque the higher risk of heart disease will be. The level of plaque will increase as the result of high level of cholesterol, type LDL, so called â€Å"bad cholesterol† in blood. When the level of LDL is normal, bl ood can pass in and out of the blood vessels without problems, but if it significantly increase particles of the blood will accumulate and sooner or later provoke trigger (cause) heart attack. Other very important factors influencing plaque level increasing are high blood pressure and cigarette smoking.Both factors accelerate the plaque formation changing (damaging) artery walls and even more, helping cholesterol forming. Medical experience proved that plaque composition and vulnerability (hard or soft plaque) is more responsible for the conversion of a stable disease to a life-threatening condition than the plaque size. Except the plaque vulnerability the risk of plaque disruption is are consequence of rupture triggers (extrinsic forces). Soft plaque – lipid-rich one is more dangerous because of its instability and higher probability for rupture.Even (IAKO) Although â€Å"hard plaque† that one having higher level of calcium influence on the blood vessels walls and the ir â€Å"hardness† experience show that heart attacks are mostly caused by soft plaque disruption. Figure 4 Plaque rupture and its consequences in the form of heart diseases http://www. nature. com/nrg/journal/v7/n3/fig_tab/nrg1805_F2. html Risk factors of coronary heart disease Risk factors influencing cardiovascular disease we can group based on their stability into the three groups: a) Modifiable risk factorsIn this group hypertension is the most dangerous risk factor for heart attacks, but even more for stroke. It is forming as the result of abnormal blood lipid levels which means high total cholesterol, high levels of triglycerides and high levels of low-density lipoprotein or low levels of high-density lipoprotein (HDL). Smoking, physical inactivity, Type 2 diabetes, and a diet full with saturated fats are risk factors strongly influencing the heart disease. All of them are treatable and patients (individuals) belonging into the different types of risk customersâ€℠¢ groups should avoid practice them. b) Non-modifiable risk factorsThe factors from this group mostly are constant, like the case in gender or family history. Others are changing when time is passing, like age and lifestyle and personal habits. Older people have more chance to get heart attack and the man, especially those having â€Å"bad medical history†. Ration between man and woman are changing when women past the menopause. After that the level of risk is similar as the men’s one. As I’ve presented there is direct correlation between cardiovascular disease and condition and health of blood vessels, more precisely of developing atheroma, means level and structure of plaque in vessels.On the other development of plaque and its level is directly influenced by level of cholesterol and some other elements which are connected with individual person and his/her life and genetic predispositions. As with the other diseases everybody has some risk of developing ather oma, but some risk factors increase the risk level for several categories. Those risk factors include: fn 12 †¢Fixed risk factors – factors that person cannot change: oA strong family history which means close relatives who developed heart disease or a stroke before they were 55 (for males) or 65 (for female). Severe baldness in men at the top of the head. oAn early menopause in women. oAge. Older people have more risk to develop atheroma. oEthnic group. Medical data show that people from different ethnic group have different risk for heart diseases. †¢Treatable or partly treatable risk factors include different health problems caused basically by the same causes as the: oHypertension (high blood pressure). oHigh cholesterol blood level. oHigh triglyceride (fat) blood level. oDiabetes. oKidney diseases causing diminished kidney function. All factors from this group have to be controlled and monitor.Any kind of their complication probably will trigger more serious pr oblems such as heart attack or stroke. †¢Lifestyle risk factors that can be prevented or changed. Actually these factors PRETHODE precede to those belonging to the second group. Except the genetic factors way of life and daily habits are the more responsible for different kind of heart diseases. Those factors are: oSmoking (Smoking cigarette increase blood pressure, decrease HDL; damages arteries and blood cells and increases heart attacks. Passive smoking is also a risk factor for cardiovascular disease ) oLack of physical activity. Obesity (People who are overweight (10-30% more than their normal body weight) have 2 to 6 times the risk of developing heart disease. ) oAn unhealthy diet and eating too much salt. oExcess alcohol. Looking on those three groups one can easily conclude that people with â€Å"bad predisposition† having high fixed risk factors have to think about their lifestyle risk factors even more, in order to try to decrease the second group of factors (t reatable or partly treatable risk factors). On the other hand some of risks are more dangerous than the others; for example smoking increases risk for heart disease more than obesity.And of course combination of two or more risk factors increases significantly the level of risks; older man (or woman) who smokes, without physical activity and with bad eating habits has more chance to get some of previously explained disease than the one who have â€Å"just one of bad habits†. The more risk factors someone has the greater is the likelihood that he/she will develop cardiovascular disease, unless taking action to modify his/her risk factors and working to prevent them compromising his/her heart health.That doesn’t mean that people with â€Å"good genes† can be irresponsible and ZANEMARITI risk factors from other groups. With or without genetic predisposition modern life significantly increases a risk of heart disease for everybody. Hormones impact on lipids and othe r risk factors Different numbers of man and women died from heart attack initiated a lot of research about hormones' influence on the risk factor and heart disease development. Number of men died from the heart attack outnumbered the number of women in pre-menopause period, but in the post-menopause data show completely opposite situation.A percentage of women in post-menopause having heart disease and dying from heart attack increase dramatically and now outnumbered the men. The main reasons for those changes are connected to the level of hormones and their influence on level and structure of cholesterol and consequently on risk factors and heart disease. As mentioned before total cholesterol actually is made of two different types of cholesterol: LDL – low density lipoprotein (LDL), so called bad cholesterol and high density lipoprotein (HDL).High levels of LDL cholesterol lead to atherosclerosis increasing the risk of heart attack and ischemic stroke. HDL cholesterol redu ces the risk of cardiovascular disease as it carries cholesterol away from the blood stream. http://www. walgreens. com/marketing/library/careguides/careguide. jsp? docid=000225=28=High%20Cholesterol Estrogen, a female hormone, raises HDL cholesterol levels, partially explaining the lower risk of cardiovascular disease seen in premenopausal women.But after menopause (natural or surgical) when a level of estrogen significantly decreases total cholesterol rises, low density lipoprotein (LDL) cholesterol rises, and high density lipoprotein (HDL) cholesterol does not change or decreases slightly. This is the reason why negative hormones’ effect after menopause increasing more than proportionally. Some authors argue that even influence of estrogen on LDL and HDL level is proved it is yet unclear whether increase in risk is caused, at least partially, by increased level of androgen (the other of hormones belong to steroid as estrogen too), which is characteristics of menopause too. This sexual dimorphism means a lower incidence in atherosclerotic diseases in premenopausal women, which subsequently rises in postmenopausal women to eventually equal that of men. These observations point towards estrogen and progesterone playing a lifetime protective role against CAD in women. As exogenous estrogen and estrogen plus progesterone preparations produce significant reductions in low-density lipoprotein (LDL) cholesterol levels and significant increases in high-density lipoprotein (HDL) cholesterol, this should in theory lower the risk of CAD.UKLOPITI U ONO GORE Among estrogen's positive effects on the heart are: †¢Reducing the LDL (â€Å"bad†) cholesterol in the blood. †¢Increasing the HDL (â€Å"good†) cholesterol in the blood. †¢Helping to keep blood vessels open. †¢Lowering blood pressure at night. †¢Reducing blood viscosity (how sticky the blood is), a property that may cause blood clots which could result in a heart attack o r stroke. Estrogen's effects on clotting are complicated, however, since there also is an increased risk for thromboembolism (a blood clot that blocks a vessel) in women taking estrogen. Possibly enhancing fibrinolysis, which is the body's natural process for breaking down blood clots. Read more: http://ehealthmd. com/content/what-are-benefits-hrt#ixzz2NbWR3MxY http://ehealthmd. com/content/what-are-benefits-hrt#axzz2NbW1GJJN Nutrition guidelines As presented before three different groups of risk factor exist. Some of them people can change but the other are fixed, non-changeable because they caused by genetic heritage ( ) influences. Controllable factors are connected to the lifestyle of person.Lifestyle changes can prevent or slow the development of coronary plaque and heart disease. In order to prevent a disease development one have to keep track of his/her blood pressure and cholesterol levels. Choosing a heart-healthy diet is vital in controlling weight, which helps keep blood pressure and cholesterol levels down. Foods high in cholesterol and saturated fat should be avoided, and quitting smoking is imperative. Regular exercise and an increased overall activity level contribute to heart health and help reduce stress.The risk of cardiovascular disease is possible to reduce following recommendation for lifestyle changing: Cessation of smoking and avoidance of second-hand smoke. Nutrition should ensure a healthy diet wiht total diet no more than 8% of saturated + trans fatty acids of total energy intake. All people, especially ones with high risk factors should lower alcohol consumption As the prevention physical activities are recommended – at least 30 minutes of moderate intensity physical activity per day or three days week (i. e. 150 mins/week minimum). Currently practiced measures to prevent cardiovascular disease include: †¢A low-fat, high-fiber diet including whole grains and plenty of fresh fruit and vegetables (at least five portions a d ay)[29][30] †¢Tobacco cessation and avoidance of second-hand smoke;[29] †¢Limit alcohol consumption to the recommended daily limits;[29] consumption of 1-2 standard alcoholic drinks per day may reduce risk by 30%[31][32] However excessive alcohol intake increases the risk of cardiovascular disease. [33] †¢Lower blood pressures, if elevated, through the use of antihypertensive medications[citation needed]; †¢Decrease body fat (BMI) if overweight or obese;[34] Increase daily activity to 30 minutes of vigorous exercise per day at least five times per week;[29] †¢Decrease psychosocial stress. [35] Stress however plays a relatively minor role in hypertension. [36] Specific relaxation therapies are not supported by the evidence. [37] Routine counselling of adults to advise them to improve their diet and increase their physical activity has not been found to significantly alter behaviour, and thus is not recommended. [38] http://www. news-medical. net/health/What-i s-Cardiovascular-Disease. aspx http://www. barnesandnoble. om/w/prevent-halt-and-reverse-heart-disease-joseph-piscatella/1100260037 Primary and secondary prevention of heart disease It is necessary start with prevention from heart disease as early as possible. Changes in the number of people killed by heart attack in developed countries show that prevention and awareness about this group of disease help to http://circ. ahajournals. org/content/123/20/2274/F2. expansion. html health plans must continue to drive cardiovascular care further along the continuum toward primary prevention of cardiovascular disease (CVD).CVD risk factors should be managed not only after a coronary event has occurred, but also before the onset of such and event. Ideally, health lifestyles should be promoted with all patients so that risk factors for CVD never develop. In this way, CVD care can be moved from the inpatient setting to the outpatient setting. Sidney C. Smith Jr, MD. Focus on Cardiovascular Dise ase; A Word About the Quality of Care in Cardiovascular Disease. Director, Center for Cardiovascular Science and Medicine University of North Carolina at Chapel Hill. http://www. qualityprofiles. rg/leadership_series/cardiovascular_disease/cardiovascular_introduction. asp Key priorities for implementation Primary prevention of CVD †¢For the primary prevention of CVD in primary care, a systematic strategy should be used to identify people aged 40–74 who are likely to be at high risk †¢People should be prioritised on the basis of an estimate of their CVD risk before a full formal risk assessment. Their CVD risk should be estimated using CVD risk factors already recorded in primary care electronic medical records †¢Risk equations should be used to assess CVD risk People should be offered information about their absolute risk of CVD and about the absolute benefits and harms of an intervention over a 10-year period. This information should be in a form that: opresen ts individualised risk and benefit scenarios opresents the absolute risk of events numerically ouses appropriate diagrams and text (See www. npci. org. uk) †¢Before offering lipid modification therapy for primary prevention, all other modifiable CVD risk factors should be considered and their management optimised if possible.Baseline blood tests and clinical assessment should be performed, and comorbidities and secondary causes of dyslipidaemia should be treated. Assessment should include: osmoking status oalcohol consumption oblood pressure (see ‘Hypertension’, NICE clinical guideline 34) obody mass index or other measure of obesity (see ‘Obesity’, NICE clinical guideline 43) ofasting total cholesterol, LDL cholesterol, HDL cholesterol and triglycerides (if fasting levels are not already available) ofasting blood glucose orenal function oliver function (transaminases) thyroid-stimulating hormone (TSH) if dyslipidaemia is present †¢Statin therapy is recommended as part of the management strategy for the primary prevention of CVD for adults who have a 20% or greater 10-year risk of developing CVD. This level of risk should be estimated using an appropriate risk calculator, or by clinical assessment for people for whom an appropriate risk calculator is not available or appropriate (for example, older people, people with diabetes or people in high-risk ethnic groups) †¢Treatment for the primary prevention of CVD should be initiated with simvastatin 40 mg.If there are potential drug interactions, or simvastatin 40 mg is contraindicated, a lower dose or alternative preparation such as pravastatin may be chosen. Secondary prevention of CVD †¢For secondary prevention, lipid modification therapy should be offered and should not be delayed by management of modifiable risk factors. Blood tests and clinical assessment should be performed, and comorbidities and secondary causes of dyslipidaemia should be treated.Assessment sho uld include: osmoking status oalcohol consumption oblood pressure (see ‘Hypertension’, NICE clinical guideline 34) obody mass index or other measure of obesity (see ‘Obesity’, NICE clinical guideline 43) ofasting total cholesterol, LDL cholesterol, HDL cholesterol and triglycerides (if fasting levels are not already available) ofasting blood glucose orenal function oliver function (transaminases) othyroid-stimulating hormone (TSH) if dyslipidaemia is present. Statin therapy is recommended for adults with clinical evidence of CVD †¢People with acute coronary syndrome should be treated with a higher intensity statin. Any decision to offer a higher intensity statin should take into account the patient’s informed preference, comorbidities, multiple drug therapy, and the benefits and risks of treatment †¢Treatment for the secondary prevention of CVD should be initiated with simvastatin 40 mg. If there are potential drug interactions, or simvasta tin 40 mg is contraindicated, a lower dose or alternative preparation such as pravastatin ay be chosen †¢In people taking statins for secondary prevention, consider increasing to simvastatin 80 mg or a drug of similar efficacy and acquisition cost if a total cholesterol of less than 4 mmol/litre or an LDL cholesterol of less than 2 mmol/litre is not attained. Any decision to offer a higher intensity statin should take into account informed preference, comorbidities, multiple drug therapy, and the benefit and risks of treatment http://www. eguidelines. co. uk/eguidelinesmain/guidelines/summaries/cardiovascular/nice_lipid_modification. phpHow to lower the risk of cardiovascular disease The risk of cardiovascular disease is possible to reduce following recommendation for lifestyle changing: Cessation of smoking and avoidance of second-hand smoke. Nutrition should ensure a healthy diet wiht total diet no more than 8% of saturated + trans fatty acids of total energy intake. All peop le, especially ones with high risk factors should lower alcohol consumption As the prevention physical activities are recommended – at least 30 minutes of moderate intensity physical activity per day or three days week (i. . 150 mins/week minimum). Cessation of smoking The aim of this measure is complete cessation of smoking and avoidance of second-hand smoke. Patient and their families need to stop smoking. Those who are unable to quit may need professional help in form of counselling, behavioral therapy and even pharmacological therapy. Nicotine replacement therapy (NRT) is the first line choice of medication. Nutrition The aim of this measure is to ensure a healthy diet. Total diet should have no more than 8% (of total energy intake) of saturated + trans fatty acids.All patients are advised to take approximately 1g Eicosapentaenoic acid (EPA) and Docosahexaenoic acid (DHA) and more than 2g Alpha Linolenic Acid (ALA) daily. Diet should have vegetables, fruits and legumes, g rain-based foods, moderate amounts of lean meats, poultry, fish and reduced fat dairy products. EPA and DHA can be obtained from oily fish and marine n-3 (fish oil) capsule supplements. Alcohol consumption All patients should be advised to lower alcohol consumption. Men should drink no more than 2 standard drinks per day and women no more than 1 standard drink per day. Physical activityThe aim of this measure is to raise physical activity and exercise to the recommended goal of at least 30 minutes of moderate intensity physical activity on most, if not all, days of the week (i. e. 150 mins/week minimum). Maintaining a healthy body weight The aim should be to achieve a waist measure of less than or equal to 94 cm in men and less than or equal to 80 cm in women. The body mass index (BMI) should be maintained at 18. 5–24. 9 kg/m2 Lowering blood cholesterol The aim of therapy should be to maintain blood cholesterol at: †¢Low density lipoprotein (LDL) at – less than 2. mmol/L †¢HDL – more than 1. 0 mmol/L †¢Triglyceride (TG) less than 1. 5 mmol/L The blood cholesterol can be maintained with the use of pharmacotherapy. Statins are commonly used lipid lowering drugs. Those with diabetes and atherosclerosis need stringent blood cholesterol control as well. Other lipid lowering drugs include fibrates like gemfibrosil, clofibrates etc, Ezetimiber and niacin. Lowering blood pressure High blood pressure is one of the important risk factors for cardiovascular disease. Those with coronary heart disease, diabetes, kidney disease or stroke need tight blood pressure control.The aim should be a blood pressure of less than 130/80 mm of Hg. Diabetes and blood sugar control Those diagnosed with diabetes need stringent blood sugar control to prevent cardiovascular damage. HbA1c levels should be maintained at less than 7%. Other drugs to lower risk of cardiovascular disease Other drugs used to lower risk of cardiovascular diseases include: †¢ Antiplatelet agents – this includes Aspirin and Clopidogrel. These drugs when given to patients with risk of heart attacks may prevent such attacks and events. †¢ACE inhibitors like Enalapril, Captopril, Lsinopril and