Is the Emphasis on a Color-Blind Society an Answer to Racism

Racism is a word that sparks a nerve in many individuals today. As hard as it is to believe, racism is still a big factor in what we as a society know as a unified America. Although, it is not as obvious as it was in the past, it still goes on, just in ways that are less noticeable. We ask the question, is the emphasis on a color-blind society an answer to racism. Ward Connerly claims it is a way to stop the segregation and make America a whole as it has been striving to be for the longest. Eduardo Bonilla-Silva believes color-blind racism is the new racial ideology and still brings about racial inequality. As the solution to the question progresses, we ask ourselves, will a color-blind society change the way whites view blacks and minorities? Will it change the discrimination that is brought about everyday from individualistic opinions? Those that say they are not biased against other races are the main ones that are judgmental to how certain ethnicities act. Regardless of a color-blind society, there is still going to be racial inequality. Color-blind racism is basically racism that acts as if color doesn’t matter, when in actuality, it really does. Whites believe that if they use color-blind racism, they aren’t racist. They bypass the word â€Å"black† and use other words to substitute it for. They bypass the word â€Å"race† and instead use words such as â€Å"ethnicity,† â€Å"culture† or â€Å"background† to make their statements not sound so harsh. Despite the fact that they believe they may not sound prejudiced at the time that does not stop them from thinking it. As Eduardo Bonilla-Silva believes, color-blind racism may not be as crude as the Jim Crow era, but it resembles it in a more minor way. For example, whites will vote for a black man for President of the United States, but they still look down on the black society, most likely hoping that the â€Å"black President† will help those stereotypes. Ward Connerly attended the American River Junior College and earned a Bachelor of Arts Degree in political science with honors at Sacramento State College. He is the founder of the American Civil Rights Institute and an outspoken supporter of equal opportunities for all Americans. He expressed his views on racism by discussing an encounter he had with a woman. While explaining his desire to succeed at having a color-blind government, the woman commented by replying what he was doing was going to be best for his people. Although, she may not have realized her remark offended him, situations similar to that occur all the time especially with blacks and minorities. Persons may do it without the intention to insult, but that just proves that everyone is viewed more so by color than by characteristics and personality. Many minorities will always be judged by their color because whites believe that they will never have higher power. Even though Ward Connerly went through rough obstacles growing up involving race, rather than focusing on the bad experiences he had, he claimed that if you â€Å"take people at face value and give them an opportunity, race is irrelevant. † He supports the emphasis on a color-blind society so people won’t use discrimination based on the color of one’s skin. He used examples such as classifications and how there was no need to classify people by race. After the Civil War, with having separation for bathrooms, poll taxes and water fountains, distinguishing differences between people should have been stopped. He decided to place the Racial Privacy Initiative in California, to prevent governments from categorizing individuals by race, color, ethnicity and origin. That may help to some degree, but there’s still going to be physical appearances by all people and no one is going to worry about classifications, because whites are still going to have their assumptions about blacks, even if they don’t completely say so. Eduardo Bonilla-Silva received his Ph. D. from the University of Wisconsin. He has authored two books called White Supremacy and Racism in the Post-Civil Rights Era and Racism without Racists. He currently teaches sociology at Duke University focusing on race relations. Professor Bonilla-Silva proved his points with adequate examples shown in daily life. He uses the theory that blacks and most minorities are â€Å"at the bottom of the well. † He brought up that steering highly successful and educated blacks towards the poor, less paying jobs in the worst conditions are ways to keep minorities away from the upscale white society. According to Bonilla-Silva, the U. S. has scarcely moved beyond the era of segregation. He argues that all whites today rely more on cultural rather than biological analogies to explain blacks’ position in this country. I concur with his support because he has more supporting evidence than Connerly. Based on his interpretations, I’ve come to the conclusion that whites do come up with explanations to prove that they are so-called non-racial but as Bonilla-Silva said, â€Å"regardless of whites’ sincere fictions, racial consideration shade almost everything in America and black and dark skinned minorities lag behind in every area of social life. † An emphasis on a color-blind society is not the answer to racism. It’s just an excuse for whites to say that racism is not part of everyday life; that it simply just doesn’t exist. Ward Connerly had good claims, but his evidence did not support his conclusion enough to make me feel this topic would change the state of race in the U. S. Him describing his encounter made me feel that racism was never going to cease or for that matter, get better. Eduardo Bonilla-Silva brought out great support. By reviewing his examples and opinions, it is true that color-blindness is a front. Most whites will always have animosity towards those that don’t â€Å"resemble them. † Both authors did focus on the matter of race and how it is seen in the country. Race is seen differently throughout all individuals. Some find it just a word that has no meaning and is only involved with the past, but others find it an exaggeration of the word hatred. A word that brings out the worst in people’s personalities. Regardless of how much emphasis is even involved in having a color-blind society, racism still and always will exist.

Compare and Contrast of the The Shang-Zhou River Valley and Egypt

Egypt and the Shang-Zhou Dynasty were both powerful and influential civilization who faced similar ideas in their government, and defense strategies, but differed when it came to cultural rituals, and the use of natural resources.A solid form of government is essential to any civilization, and although Egypt and Shang-Zhou were both successful, they both used different and similar methods to conform to their religious and social standards.Egypt used a Pharaoh as their king, which they claim the pharaoh was sent from a god in order to maintain ma’at, the distinctive order of the universe. On the contrary, the Shang- Zhou Dynasty followed their own theory of the Mandate of Heaven. The Mandate of Heaven served as a foundation for the Chinese government for three thousand years, and was used when a ruler had neglected his duties such as dishonoring gods, expressing tyranny, or ignoring warning signs of disasters; heaven could remover this â€Å"mandate† and put it in the po ssession of a more worthy ruler or family.After a ruler has fulfilled their duties and depart the physical world, both Egypt and the Shang-Zhou dynasty honor them in every way possible, however both have separate rituals and beliefs in how they should be honored. In Egypt, the Pharaoh is built a remarkable pyramid in which their body is mummified, and buried deep down in the structure. During the Shang-Zhou Dynasty, the royal family and the elite families were not buried in a pyramid, but rather in tombs with many of possessions they might need in the afterlife.To run a successful government, there has to be order and record keeping to keep from conflict and having all property, belongings, etc. needs to be officially stated. The Egyptians developed their own writing, known as hieroglyphics, on papyrus to records all their statements. Instead of hieroglyphics and papyrus, the Shang-Zhou also developed their own writing of symbols which they wrote on oracle bones to keep order in the ir society. A significant connection between the two is that both civilizations were a theocracy because they both believed that their leader was divine and the closest to God. Both Egypt and the Shang-Zhou Dynasty shared the idea of charging taxes in exchange for landowning and service in the military.Charging taxes influenced many civilizations because in order to be a resident, some sort of service or duty had to be given in exchange. In retrospect, Egypt and the Shang-Zhou dynasty both shared similarities in their government which helped them grow as a large, powerful society, but also varied in some methods mostly because of religion beliefs.Environment plays an intense role in any region of the world because it determines the lifestyle for how that civilization will prosper over time. Being located in Africa, near the equator, Egypt has the consistent face of a hot, dry, and sunny climate. The Shang-Zhou dynasty territory is located  east of Africa and slightly towards the n orth. Therefore, Southern China gets heavy rainfall due to the monsoons in India and surrounding areas, and the northern part of China gets rainfall as well, but is inconsistent. Being that China gets a fair amount of rain, most of their agriculture is dependent on that rainfall. Instead of depending on rainfall, Egypt is primarily dependent on the Nile River which is the longest river and provides the best source of irrigation.A benefit to both the Shang-Zhou Dynasty and Egypt is that they both are in some way surrounded by natural barriers which serve as a mechanism for defense. Egypt has the Nile River which makes it difficult for invaders to get across to attack. The Shang-Zhou area has the Himalaya mountain range to the southwest, the Pamir and Tian Mountains and the Takla Makan Desert to the west, as well as the major rivers, the Yellow and the Yangtze, to also help to protect their society. Natural barriers are a huge advantage and blessing because they can distinctively mark territories as well as serve each civilization in a way as to help them advanced and develop while lowering the likelihood of getting attacked and weakening a civilization.The natural elements are what make a society capable of flourishing and both Egypt and the Shang-Zhou Dynasty used all of their resources to their advantage to prosgress into a sophisticated and highly respected culture and society.

You Suck: A Love Story Chapter 1

For my readers, by request ACKNOWLEDGMENTS Thanks, again, to the usual suspects: my agent, Nick Ellison, and Sarah Dickman, Arija Weddle, and Marissa Matteo at Nicholas Ellison, Inc.; Jennifer Brehl, Kate Nintzel, Lisa Gallagher, Michael Morrison, Mike Spradlin, Jack Womack, Debbie Stier, Lynn Grady, and all my friends at William Morrow; and, of course, to Charlee Rodgers, for putting up with the frozen turkey bowling. Chapter One Get Over It, a Lot of People Are Dead â€Å"You bitch, you killed me! You suck!† Tommy had just awakened for the first time as a vampire. He was nineteen, thin, and had spent his entire life between states of amazement and confusion. â€Å"I wanted us to be together.† Jody: pale, pretty, long red hair hanging in her face, cute swoop of a nose in search of a lost spray of freckles, a big lipstick-smeared grin. She'd only been undead herself for a couple of months, and was still learning to be spooky. â€Å"Yeah, that's why you spent the night with him.† Tommy pointed across the loft to the life-sized bronze statue of a man in a tattered suit. Inside the bronze shell was the ancient vampire who had turned Jody. Another bronze of Jody stood next to him. When the two of them had gone out at sunrise, into the sleep of the dead, Tommy had taken them to the sculptors who lived on the ground floor of his building and had the vampires bronzed. He'd thought it would give him time to think of what to do, and keep Jody from running off with the old vampire. Tommy's mistake had been drilling ear holes in Jody's sculpture so she could hear him. Somehow, during the night, before the bronzing, the old vampire had taught her to turn to mist, and she'd streamed out of the ear holes into the room, and – well – here they were: dead, in love, and angry. â€Å"I needed to know about what I am, Tommy. Who else was going to tell me if not him?† â€Å"Yeah, but you should have asked me before you did this,† Tommy said. â€Å"You shouldn't just kill a guy without asking. It's inconsiderate.† Tommy was from Indiana, and his mother had raised him to have good manners and to be considerate of other people's feelings. â€Å"You had sex with me while I was unconscious,† Jody said. â€Å"That's not the same,† Tommy said. â€Å"I was just being friendly, like when you put a quarter in someone else's parking meter when they aren't there – you know they appreciate it later, even if they don't thank you personally.† â€Å"Yeah, wait until you go out in your jammies and wake up all sticky in a cheerleader outfit and see how grateful you are. You know, Tommy, when I'm out, technically, I'm dead. Guess what that makes you?† â€Å"Well – uh – yeah, but you're not even human. You're just some foul dead thing.† Tommy immediately regretted saying it. It was hurtful and mean, and although Jody was, indeed, dead, he didn't find her foul at all – in fact, he was pretty sure he was in love with her, he was just a little embarrassed about the whole necrophilia/cheerleader thing. Back in the Midwest people didn't mention that sort of thing unless a dog dug up a pom-pom in some guy's backyard and the police eventually discovered the whole human pyramid buried under the swing set. Jody sniffled, completely for effect. Actually she was relieved that Tommy was now on the defensive. â€Å"Well, welcome to the Foul, Dead Thing Club, Mr. Flood.† â€Å"Yeah, you drank my blood,† Tommy said. â€Å"A lot.† Damn, she should have pretended to cry. â€Å"You let me.† â€Å"Again, being considerate,† Tommy said. He stood up and shrugged. â€Å"You just let me because of the sex.† â€Å"That's not true, it was because you needed me.† He was lying, it was because of the sex. â€Å"Yes, I did,† Jody said. â€Å"I still do.† She held her arms out to him. â€Å"I really do.† He walked into her arms and held her. She felt amazing to him, even more amazing than she had before. It was as if his nerves had been dialed up to eleven. â€Å"Okay, it was because of the sex.† Great, she thought, in control once again. She kissed his neck. â€Å"How do you feel about it now?† â€Å"Maybe in a minute, I'm starving.† He let go of her and stormed across the loft to the kitchen, where he pulled a burrito out of the freezer, threw it into the microwave, and hit the button, all in one smooth motion. â€Å"You don't want to eat that,† Jody said. â€Å"Nonsense, it smells great. It's like every little bean and pork piece is sending out its own delicious miasma of flavor vapor.† Tommy used words like ;miasma; because he wanted to be a writer. That's why he'd come to San Francisco in the first place – to take life in big bites and write about it. Oh, and to find a girlfriend. â€Å"Put the burrito down, and back away, Tommy,† Jody said. â€Å"I don't want you to get hurt.† â€Å"Ha, that's cute.† He took a big bite and grinned at her as he chewed. Five minutes later, because she felt responsible, Jody was helping him clean bits of masticated burrito off the kitchen wall and the front of the refrigerator. â€Å"It's like every bean was storming the gates of repressive digestion to escape.† â€Å"Yeah, well, being refried will do that to you,† Jody said, stroking his hair. â€Å"You okay?† â€Å"I'm starving. I need to eat.† â€Å"Not so much eat,† Jody said. â€Å"Oh my God! It's the hunger. I feel like my insides are caving in on themselves. You should have told me about this.† She knew how he felt – actually, she had felt worse when it happened to her. At least he knew what was happening to him. â€Å"Yeah, sweetie, we're going to have to make a few adjustments.† â€Å"Well, what do I do? What did you do?† â€Å"I mostly fed off of you, remember?† â€Å"You should have thought this through before you killed me. I'm fucked.† â€Å"We're fucked. Together. Like Romeo and Juliet, only we get to be in a sequel. Very literary, Tommy.† â€Å"Oh, that's a comfort. I can't believe you just killed me like that.† â€Å"And turned you into a superbeing, thank you very much.† â€Å"Oh, crap, there's burrito spooge all over my new sneakers.† â€Å"You can see in the dark, now,† Jody said cheerfully. â€Å"Wanna try it? I'll get naked. You can look at me in the dark. Naked. You'll like it.† â€Å"Jody, I'm starving over here.† She couldn't believe that he didn't respond to the naked persuasion. What kind of monster had she created? â€Å"Okay, I'll find you a bug or something.† â€Å"A bug?! A bug!? I'm not eating a bug.† â€Å"I said there'd have to be some adjustments.† Tommy had been dealing with more than a few adjustments since he'd come west from his hometown of Incontinence, Indiana – not the least of which had been finding a girlfriend, who, while smart, sexy, and quick-witted, drank his blood and tended to fall unconscious at the exact moment of sunrise. He'd always suspected that she might have just picked him because he worked nights and could walk around during the day, especially since she'd once said, â€Å"I need someone who works nights and can walk around during the day,† but now that he was a vampire, he could close the door on that insecurity and open another onto a whole new world of insecurities he'd never even considered before. The appropriate age for a vampire is four hundred years old – he should be a world-weary and sophisticated creature, his human anxieties long since overcome or evolved into macabre perversions. The problem with a nineteen-year-old vampire is that he drags all of his adolescent insecur ities into the dark with him. â€Å"I'm really pale,† Tommy said, staring at himself in the bathroom mirror. They'd figured out early on that vampires do, indeed, cast a reflection in a mirror, just like they could tolerate proximity to crucifixes and garlic. (Tommy had run experiments on Jody while she slept, including many involving cheerleader outfits and personal lubricants.) â€Å"And not just winter in Indiana pale. I'm, like, pale like you.† â€Å"Yeah,† said Jody, â€Å"I thought you liked the pale.† â€Å"Sure, it looks good on you, but I look ill.† â€Å"Keep looking,† Jody said. She was leaning against the door frame, dressed in tight black jeans and a half shirt, her hair tied back and streaming down her back like a flaccid red comet tail. She was trying not to appear too amused. â€Å"Something's missing,† Tommy said. â€Å"Something besides color.† â€Å"Uh-huh.† Jody grinned. â€Å"My skin cleared up! I don't have a single zit.† â€Å"Ding, ding, ding,† Jody onomatopeed, signaling that Tommy had hit on the correct answer. â€Å"If I had known my skin would clear up, I'd have asked you to change me a long time ago.† â€Å"I didn't know how to a long time ago,† Jody said. â€Å"That's not all, take off your shoes.† â€Å"I don't understand, I – â€Å" â€Å"Just take off your shoes.; Tommy sat on the edge of the tub and took off his sneakers and socks. â€Å"What?† â€Å"Look at your toes.† â€Å"They're straight. My little toe isn't bent anymore. It's like I've never worn shoes.† â€Å"You're perfect,† Jody said. She remembered finding out this condition of vampirism and being both delighted and horrified because now she felt that she'd always need to lose five pounds – five pounds that were preserved for eternity. Tommy pulled up the leg of his jeans and studied his shin. â€Å"The scar where I hit myself with a hatchet, it's gone.† â€Å"And it always will be,† Jody said. â€Å"You'll always be perfect, just like you are now. My split ends even went away.† â€Å"I'll always be the same?† â€Å"Yes.† â€Å"Just like I am now.† â€Å"As far as I know,† Jody said. â€Å"But I was going to start working out. I was going to be buff. I was going to have abs of steel.† â€Å"No, you weren't.† â€Å"I was. I was going to be an awesome hunk of muscular man-meat.† â€Å"No, you weren't. You wanted to be a writer. You were going to have little stick arms and get winded when you hit the back-space key more than three times consecutively. You're in great shape from working in the grocery store. Wait until you see how you can run.† â€Å"You really think I'm in great shape?† â€Å"Yes, I thought I made that clear.† Tommy flexed his chest in the mirror, which showed not at all through his flannel shirt. He unbuttoned his shirt and tried it again, with little effect, then shrugged. â€Å"What about the writer thing? Will my brain always be like this? I mean, will I get any smarter, or is that stuck in time, too?† â€Å"Well, yeah, but that's because you're a man, not because you're a vampire.† â€Å"You spiteful harpy.† â€Å"I think I've made my point,† Jody said. Jody had put on a red leather jacket, even though she could no longer feel discomfort from the cold fog coming in off the Bay. She liked the way it looked with her black jeans and a low-cut black lace camisole she'd rescued from a Nordstrom Rack Store before some slut got hold of it. â€Å"Come on, Tommy, we need to go find something for you to eat before we run out of night.† â€Å"I know, but I have something I have to do. Give me a minute.† He was in the bathroom again, this time with the door shut. Jody heard the zipper of his jeans go down, then a slightly breathless man-scream. The bathroom door flew open and Tommy, his pants and underwear around his ankles, bunny-hopped in two great leaps across the bedroom. â€Å"Look at this. What's happening to me. Look at this!† He was pointing furiously to his penis. â€Å"It's like I'm some radioactive mutant freak.† Jody went to him and grabbed his hands – held him steady, looked him in the eyes. â€Å"Tommy, calm down. It's just your foreskin.† â€Å"I don't have a foreskin. I'm circumcised.† â€Å"Not anymore,† Jody said. â€Å"Evidently, when you turned, it grew back, just like your toes straightened and your scars all went away.† â€Å"Oh. You don't find it creepy, then?† â€Å"No. It's fine.† â€Å"You want to touch it?† â€Å"Thanks. Maybe later.† â€Å"Oh, sorry, I freaked. Didn't realize. I – uh – I still feel like I have to finish what I was going to do.† â€Å"That's fine,† Jody said. â€Å"You're fine. You go finish up. I'll wait.† â€Å"You're sure you don't want to give it a quick fondle?† â€Å"If I do, can we get out of here?† â€Å"Probably not.† â€Å"Well then, back in the bathroom you go.† She spun him around and gave him a gentle shove. He bunny-hopped his newly recovered foreskin back into the bathroom and closed the door. Jody shuddered at the sound of the door closing. She hadn't thought about whether or not Tommy would retain his incessant horniness after he turned, she had just wanted a companion who could understand what she was, what she felt, what the world looked like through vampire eyes. If it turned out that he was going to be nineteen forever, she might end up having to kill him for real.

Choose 1 Topic Essay Example | Topics and Well Written Essays - 750 words

Choose 1 Topic - Essay Example Here we are going to discuss about the globalization strategies implemented by Toyota in its production line. Company Overview Toyota, a Japanese automobile manufacturer having headquarters at Toyota, Japan was founded in the year 1937. It started its production operations in America in the year 1957. For more than fifty years, the Toyota automobiles have continuously expanded their operations in 170 countries and regions throughout the world. Today, it has its presence in the major markets of North America, Europe and Asia. With the development of their exports the firm has started to localize their production bases, keeping pace with the policy of "producing vehicles where the demand exists". Presently they have 51 production bases in around 26 different regions globally (toyota-global.com). Moreover, there are R&D and design bases in almost nine locations in the foreign market, exhibiting that "from development and design to production, as well as sales and service, Toyota has now achieved consistent globalization and localization." Production System The company has gone through several hurdles while globalizing their production units. One of the most important factors of this process is quality assurance, which emphasizes on the statement, â€Å"no matter where Toyota vehicles are made, they must have the same high level of quality." The company doesn’t follow the policy of putting a "Made in The USA" or "Made in Japan" tag on their products. Instead they prefer to put the label of "Made by TOYOTA† on all its vehicles. This clearly defines the company’s manufacturing philosophy which is the "Toyota Way" and they like to advertise themselves in this manner throughout the world. The firm believes that through educating people they will be able to achieve quality assurance. Therefore they established the Global Production Center (GPC) in 2003 inside the Motomachi Plant in Toyota City. In addition to this, Toyota commenced regional Global P roduction Centers in 2006, in the United Kingdom, Thailand and United States to perform its respective activities in the Asia-Pacific, North American and European regions. The illustration below shows its design and production houses in several regions of the world- The production process of the company is based on two main principles which are continuous improvement and respecting the employees. Toyota's production system is a means of "making things" which is often known as "lean manufacturing system" or a "Just-in-Time (JIT) system.† The production system has been set up on the basis of constant improvements, with the aim of "making the vehicles ordered by customers in the quickest and most efficient way, in order to deliver the vehicles as quickly as possible."   The company’s production process is based on two models- "Jidoka" that refers to mechanization along with some human touch. It implies whenever an issue arises, the apparatus stops instantly that prevents defective production. "Just-in-Time† concept where every process makes the particular part that will be required by the next process and in this way the production flows. Based on these two concepts, Toyota globally produces exactly whatever is in demand within time and in a cost effective manner. Objectives The main objective of Toyota is to offer world class quality and to meet the customer’

Case Study in Systems and Operations Management - Otakowa Essay

Case Study in Systems and Operations Management - Otakowa - Essay Example III. Research and Analysis†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. 1. Research proposal†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ 2. Analysis of Existing Systems and Activities†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. a. Organizational Arrangement scrutiny†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ b. Data Systems Analysis†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. c. Activities analysis†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã ¢â‚¬ ¦. IV. Conclusion and Recommendations†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. V. References†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. I. Executive Summary According to the customer report of Atokowa Advantage Co. Ltd., there is a reported and documented noteworthy drop in corporate productivity over the past consecutive half decade. Along with this is the noteworthy decrement in market share and control from a globally prevailing spot of 35% to insignificant 16% within similar time fame under monitoring. The main aim of this report is to test the systems technology and the operational procedures of Atokowa Company Limited so as to assess its productivity to the general corporate aim of productivity and development. Particularly, it suggests means by which the organization could adopt in order to advance the value of administration and executive management. Additionally, the provision of probability within these marketplaces for its stationary business, the study also gave a novel market position within these markets for sorted out stationary. The markets simply required the basic stationary (Meyler, Fuller, Joyner & Dominey, A. 2008, p. 11). Nevertheless they also demonstrated a wish for more sorted out and expansion within these commodities. It is usually upon a similar wish that Carik enterprises was founded to handle specifically with stationary aimed for the learning institutions. Atokowa Company Limited was established originally two decades ago as Carik enterprises, a subordinate of an Australian corporation known as Dungles Ltd. The organization was originally formed to tap into a developing section off the parent’s organization’s gain dealings. The management of Dungles Ltd. had a mission of developing their business markets within the region and likely into other external markets like the United States, Eastern Europe States similar to Germany and Russia and China were going through a population explosion (Burstein & Holsapple, 2008, p. 369). The organization worked under the identity of Carik enterprises for more than 6 years until it was taken over in 1988 by another American-oriented stationary firm known as Cereomacx enterprises. The organization worked under the new Cereomax title for a year until the second annual overall limited name an Atokowa Company Limited. This is mainly because of the organization’s wish to tap developing and extremely profitable Asian Market (Blanchard, 2007, p. 77). The mission of the organization appears to have hit a thump and as such the company wishes for a convincing fix that will reverse the inclination context back onto the track of productivity and development (Hill, 2011, p. 34). The report scrutinizes the roles of hu man resource in staffing, inventory control, technology adoption and utilization and in novel commodity and novelty. In this regard, the report analysis utilizes

Finance report Essay Example | Topics and Well Written Essays - 4750 words

Finance report - Essay Example We divided its capital into four equal portions of QR 250,000 each to invest in each of the four investment platforms available. As such, we invest QR 250,000 in the Qatar Stocks Exchange, which is the principle stock market of Qatar. It invests another QR 250,000 in Qatar National Banks as bank deposits. It then invests the third portion of their capital, another QR 250,000 in gold and other metals. Some of these gold businesses are international and not available within the country. Furthermore, it invests the last portion of their quarter million in Forex markets, mainly dealing with currencies exchange with the Qatar Riyal. We has an investment philosophy that is of a risk taking capacity, which means that we will easily go for the high risk investments because of the high returns associated with these investments. Furthermore, we is aware that these high-risk investments may either lead to the loss of all the invested capital, or lead to a significant profit way beyond their imagination. We practices on the â€Å"risk-return tradeoff† investment strategy. This investment strategy operates on the principle that the potential of returns raises with an increase I the risk of investment. As such, lower levels of uncertainty, such as loss risk investments, have a high likelihood of bringing in low potential returns on the other hand, high levels of uncertainty, such as in high-risk investments, there is a high likelihood that the investments will yield high potential returns. Consequently, in accordance with the concept of â€Å"risk-return trade off† in business investments, money invested by an investor can render higher profits only if it is subject of a high possibility of losses. This model of business investment strategy requires traders to be always aware of their personal risk tolerance whenever they make choices of their investment portfolios owing to the

The fall of Satan Essay Example | Topics and Well Written Essays - 750 words

The fall of Satan - Essay Example Satan always yearns to be God. He once tried to convince Adam and Eve by telling that if they eat the forbidden fruit, they will be as God. Satan’s desire and purpose is nothing but to be God. We find in the passage that Lucifer wanted to raise his throne above the stars of God. Satan is the author of desire, lust and thirst for position. His mind is clearly revealed in this passage. He wanted to be like the most high. Throughout the bible we find Satan relentlessly attempting to make himself like God. Yet another passage that confirms the mentioning of Satan in Isaiah 14 is Ezekiel 28. Here we find a proud king, king of Tyre who represents Satan. Satan, the father of pride and idolatry is ruling the heart of king of Tyre. We find the lamentation about king of Tyre, Satan. We find that he was in the Garden of Eden, among the fiery stones. He was adorned with precious stones, and was a shining star in heaven. In the same passage we find Satan being thrown out of heaven. His pri de pushed him out of heaven. We find his fall to the earth from heaven. It is the same fall Jesus mentions in Luke 10:18. The description of the fallen star in Isaiah 14, Luke 10 and Ezekiel 28 refer to Satan, the fallen angel. The pride of the fallen star mentioned in Isaiah 14 and Ezekiel 28 accounts to Satan alone. Satan’s status before the God prior to his fall is also explained in Isaiah 14 and Ezekiel 28. In Ezekiel we read that â€Å"Thus says the Lord God: â€Å"You were the signet of perfection, full of wisdom and perfect in beauty. You were in Eden, the garden of God every precious stone was your covering, sardius, topaz, and diamond, beryl, onyx, and jasper, sapphire, emerald, and carbuncle; and crafted in gold were your settings and your engravings. On the day that you were created they were prepared. You were an anointed guardian cherub. I placed you; you were on the holy mountain of God; in the midst of the stones of fire you walked. You were blameless in your ways from the day you were created, till unrighteousness was found in you† (The Holy Bible). Who other than Satan was found in the Garden of Eden? Satan who remained as the guardian angel for Adam and Eve sinned against God and man because of his pride and thirst for glory and power. This unrighteous attitude of Satan is mentioned in the passages. Satan’s unrighteousness was found on the day he developed the desire to place himself above God. Isaiah explain this unrighteousness as â€Å"You said in your heart, ‘I will ascend to heaven; above the stars of God; I will set my throne on high; I will sit on the mount of assembly in the far reaches of the north; I will ascend above the heights of the clouds; I will make myself like the Most High’† (The Holy Bible). The consequence of Satan’s pride is also mentioned in Isaiah 14. We read that â€Å"How you are fallen from heaven, O Day Star, son of Dawn! How you are cut down to the ground, you who laid the nations low!† (The Holy Bible). The explanation of Satan’s position before God, his beauty, his adornment, his perfection and his place (in the Garden of Eden) in Ezekiel resembles to the glory and honor of Satan mentioned in Isaiah 14. Isaiah describes him as morning star, son of the dawn. Ezekiel finds him walking in the stones of fire. The status of Satan before and after the fall coincides in all the three passages. There is no character in the Bible who can be attributed to the characteristics

Impact of Capital Structure on Financial Performance of Real Estate Essay

Impact of Capital Structure on Financial Performance of Real Estate Firms Listed In Chinese Stock Exchange - Essay Example Since the real estate industry is capital intensive, a firm’s capital structure greatly impacts on its financial performance. Capital structures dictate the financial ratios of these companies and subsequently these ratios are used to determine a firm’s performance. In addition, the capital structure of these real estate firms also determines the extent of ownership by different shareholders. The study determined that the profitability and the debt levels of the twenty selected firms have an inverse relationship. It can as well be concluded that the capital structure affects the growth rate of these firms. This means that real estate firms in China that post high profits in their financial statements have financial debts that are lower that the industry’s average. In this regard, managements of real estate firms in China prefer capital structures that attract low costs of debt and will have minimal adverse effect on the firms’ performance in terms of profi tability and capitalization. According to the results of the analysis, high debt means high interest payments and this has a direct effect on the firms’ profitability and subsequently the firms’ Earnings per Share. The major factor that influenced capital structures of the twenty firms under this study is that the real industry shifted to the Chinese capital market for capital sourcing since privatization of state owned corporations. This study used an inductive approach on the twenty selected listed real estate companies in the methodology section. The quantitative methods objectively determine the impact of capital structure on the performance of the 20 selected and listed real estate firms. The reason for was because listed firms are regulated and they represent the best samples that would give reliable results for this study. However, the study would have given better results if a larger sample was used for this study and more time allocated for analysis. These

Johnny Lechner and his 12-year college education at the University of Essay

Johnny Lechner and his 12-year college education at the University of Wisconsin at Whitewater - Essay Example is taking this year instead of the regular 12 to 18 credits, as he has already taken all the existing courses available, and has even unknowingly repeated some of them twice. The decision of almost doubling the fees has come possibly in reaction to Lechners long stay at the institution, and Wisconsinites have dubbed it the Johnny Lechner rule. It is a valid decision, one that will encourage students to treat colleges and universities for what they are, venues for focused learning, for quenching intellectual thirst and gearing an individual towards becoming a useful member of the society. There are those that consider that this decision will be hard on those like Lechner. In Lechners defense, it must be said that he has paid his own fees for the last ten years, by working part time in order to support himself and through student loans, since his parents supported him only for the first two years of his college life. A man can strive to learn more and more for the sake of learning itself, and here is a man that tries to do his bit for society, and volunteers with numerous organizations, including Habitat for Humanity, the UW-Whitewater Prairie Restoration Project and Camp Getaway for inner-city Chicago children with AIDS. He is also a good student, who is regular in class, recently made the dean’s list with a 4.0 grade-point average for a semester and has got good grades throughout, even managing straight As in one semester. So one knows that he is not too weak a student to graduate, and is not graduating out of intention, not incapability. One may also argue that a persons life need not necessarily follow a particular mold, that includes educa tion, employment, marriage and retirement, and eventual death, and as long as he or she is not a burden on society a person may want to learn as much as possible, and study in order to do this. But this is where the contradiction comes in. Lechner has, in fact, been a burden on society these past years, because the

Federal Reserve Policy Essay Example | Topics and Well Written Essays - 2000 words

Federal Reserve Policy - Essay Example The weakness in the real estate markets has spread to become a system wide problem as sub-prime loans turn into toxic assets leaving financial institutions under-collateralized. The US Federal Reserve Board has been criticized for enacting policies that exacerbated the problem, or at least for failing to curtail the spread of the problem by its lack of action. The purpose of this paper is to examine the policies of the Federal Reserve Board during the period of 2006-2009 in light of the current financial crisis. The paper will find that the Federal Reserve Board policies during this period were prudent and appropriate, but failed to exert the political will necessary to address the problems that have arisen in the financial system that were due to factors that are beyond the Board's authority. By many accounts, the current financial crisis began in the housing industry and was fuelled by the twin problems on over-evaluation and high-risk mortgage loans. As the problem grew, financial institutions continued to make high interest, high-risk loans on property that had reached values that were unrealistically high. When the real estate bubble burst, many of these institutions and borrowers were left with assets worth far less than the amount due on the loan. According Bernanke (2008), "housing and housing finance played a central role in precipitating the current crisis. As the crisis has persisted, however, the relationships between housing and other parts of the economy have become more complex.Declining house prices, delinquencies and foreclosures, and strains in mortgage markets are now symptoms as well as causes of our general financial and economic difficulties". Yet, could the Federal Reserve Board (FRB) have taken steps beginning several years ago to address theses ca uses of system wide failure Bernanke (2008) is very clear that the problem was "declining house prices, delinquencies and foreclosures, and strains in mortgage markets". In fact, the FRB was aware of these problems, but failed to enact policies to address these complex issues. Bernanke lists the first cause of the current crisis as the falling prices of housing as the real estate bubble burst. In a free market, asset prices will work to reach equilibrium. A bubble in any industry will eventually deflate in an effort to reach its true valuation. This was seen in the collapse of technology stocks in 1999-2000, and now has hit the real estate market. However, the FRB may have not been able to deal with this problem effectively. In retrospect, Stern (2008) states, "it is challenging at best to identify when asset prices have reached excessive levels, to build support for action once identification has occurred and to implement corrective policy successfully". There is a general philosophy in the FRB that the best strategy for asset inflation is a policy of containment and clean-up, rather than prevention (Stern 2008). In fact, the FRB's policy was "monetary policy easing and last-resort lending", which only deepened and prolonged the crisis (Blanchard 2009, p. 2). Asset revaluation is a political challenge, but is within the FRB's capacity. None of these actions took place, and the FRB continued dropping interest rates. While the falling interest rates were enacted to stimulate a lagging economy, other factors continued to prop up housing prices at unrealistic levels. When mortgage money is cheap, it creates more customers interested in borrowing and the demand for housing remains high. During the

Performing well academically and having a social life Essay

Performing well academically and having a social life - Essay Example â€Å"We can't solve problems by using the same kind of thinking we used when we created them.† Being a 16 years old sophomore I believe I have faced enough competition in the early academic years. Since my childhood, I’ve been a shy, reserved and quiet person. I don’t interact with people much due to my hesitation while talking to new people. I feel uncomfortable when I am surrounded by a group of individuals and I’ve always tried to stay out of group discussions. These natural personality constraints led me to the isolation from my social circle. I have had a few friends and even their knowledge was limited about my problems, likes, dislikes and issues. These personality traits seem normal and unproblematic to many people. However, I personally feel that these were the factors that affected my academic performance the most. I never wished to take a position in the class in order to avoid prominence and attention from others. I did not take part in class discussions as I felt awkward and uncomfortable speaking in front of all students and the teacher. I kept myself from asking question even if I had some confusion in my mind regarding the topic being taught by the teacher. When I was a kid, I used to avoid interactions with other kids. I kept myself isolated in the parks, play grounds and even in the school. I used to keep my feelings secret and ideas personal. All these traits resulted in inner conflicts arising in me. I felt irritated by the thought that people avoid talking to me. I felt aggressive and angry when people talked to each other and did not involve me in their conversations. Somehow these were the reactions of my responses to them when they started a conversation or tried talking to me which I avoided most of the times. My parents noticed these problems and were constantly making efforts to make me friendly, confident and sociable. At first I found the lectures of my parents and elder siblings completely meaningless. I was extremely disheartened by the way people ignored me while talking to each other. This was the most difficult phase of my life. I lost my hopes of getting good grades, having friends and making my way out of the isolation that I created in the past years. However, the constant struggles of my parents motivated me to talk to them about my issues. I started discussing my experiences, daily activities and secrets with them. Their friendliness, affection and loving nature made me confident enough to share everything with them. The main problem then, was to change myself in front of others. I felt comfortable with my parents but when it came to other people I still felt the same hesitation and shyness. I started motivating myself to take part in the conversations. I started writing a diary of my day to day activities in order to blow out the negative feelings. I used to feel relaxed after writing the diary. I made a plan to encourage myself on speaking in crowds. Firstly, I started asking questions during the class lectures when I found anything confusing. I started taking part in the classroom discussions and academic debates which greatly helped me to enhance my social skills. My class fellows started discussing their academic and other issues with me which again was considered as an encouraging gesture by me. The first effect of this step was a positive apparent impact on my

Comparison Between Export Agents and Distributors Essay Example for Free

Comparison Between Export Agents and Distributors Essay Many companies have often found themselves in a dilemma on whether to use export agents or distributors when they decide to venture overseas. This is therefore not a problem constrained to ABLE Limited only. This dilemma often arises from the inability to distinguish between the functions of export agents and distributors. Even with complete knowledge of roles that agents and distributors play in the import and export business, companies still find it challenging to choose the channel to use for distribution of their goods. Perhaps the first step to coming up with a decision on whether to use agents or distributors would be to address the advantages and shortcomings of each. This paper seeks to differentiate agents from distributors which will help in making proper choices when venturing into the export business. Export Agents An agent by definition refers to a person who acts on behalf of a person or company in return for an agents fee. Similarly, an import/export agent acts on behalf of a company to organize import and export deals with customers and suppliers in overseas markets. Import/export agent are at times said to work like brokers only that they serve to bring two parties together for mutual trade benefit. The agents do not engage in physical contact with the goods and their major objectives are to market the principles products, get customers and connect them to the principle who in turn executes the sale directly. To achieve these objectives, an agent usually conducts surveys, negotiates with buyers, undertakes promotional activities and handles any documentation and logistics involved in the sale of goods. It is the duty of an export agent to develop market strategies in targeted countries, introduce potential customers, make contacts and also place orders for the principles goods. When a deal is sealed, the agent receives a commission for sales made in addition to the deposit paid when the agent was hired. The principle also undertakes payment of all the expenses incurred by the agent in marketing and formalizing the deal which involves administration and tax settlements with the foreign government. Before entering into a contract with an agent it is important to establish their affordability, their knowledge of the overseas markets and networks; whether the agents offer their services to a competitor and whether they sell direct to end users or to companies. It is also important o sample sale deals they have made for other companies to establish their ability to benefit the company. The advantage of using an agent is that it saves the company from undertaking the rigorous export procedures. In other words, the company only needs to part with the agent commission and it is assured that their goods enter the overseas market. This is in addition to the fact that the agent knows the market well which is better than starting afresh in an unknown country. The agent undertakes almost all the work so that it is relatively easy for the company. Due to their vast knowledge of the target market, agents prove best when venturing in new overseas markets. As indicated earlier, agents take it upon themselves to advertise the companys product so as to make sales and hence earn a commission. This is likely to make them work harder which is of mutual benefit to the company when its sales increase. Another advantage that the company stands to gain by using agents is that the company may choose to control the agents operations such that it can limit the agent to desired territories. The company can also set the agent free to execute the deals to the best of his knowledge to maximize sales. When using an agent, the company gets to control the prices of its goods in the market since it will deal with customers directly after they are introduced by the agent. There are however disadvantages associated with using agents. Firstly, agents may prove expensive to hire and their commissions may highly reduce the companys potential profits. Secondly, the company bears any market risks and credit risks when dealing with the customers who are introduced. Agents do not purchase from the company directly and neither do they undertake delivery and after sales services. This means that the company may need warehousing facilities as goods await delivery in the overseas market. It must also undertake the provision of after sales services. Export distributors Distributors are companies that buy the firms product for resale in their countries. The distributor acquires possession or title of the good undertakes the risk of resale. This indicates that a distributor acts like a retailer or wholesaler and undertakes the distribution of the goods aiming at obtaining profits from the sales by selling the goods at a higher price the he bought them from the company. The distributor takes responsibility for the shipment of goods to their premises, undertakes the paper work so that the company does not have to bear these costs as opposed to using an agent. The company can appoint distributors available in the market from a list of distributors usually available in international directories. A company can also make use of agents to select distributors to undertake sale of their products. In the appointment of a distributor, the company needs to look out for the warehouse management skills and procedures of the distributor; knowledge of technical characteristics of the companys goods; ability to handle marketing campaigns; credit worthiness and their ability to form a constant market for the firms products. Export distributors are advantageous to the company because they bear all the risks involved in the distribution process in the overseas country. These include tax liability, instances of loss and credit risk. They are convenient in that they provide any necessary after sales services that the goods may require such as installation and delivery. Since distributors aim at making more sales, they are likely to get involved in marketing campaigns which help to expand the firms competitiveness in the market. Warehousing expenses are eliminated because distributors normally have well established inventory warehouses for their merchandise. In many cases, it has proved less expensive to use distributors rather than deal with the customers directly. The distributor handles all the shipment charges and formalities which offers simplicity to the company. Further, the firm does not have to incur agent costs and other costs associated with distribution such as transport costs, logistics and tax liabilities. The absorption of market risks by the distributor is especially advantageous to the company. Since a distributor is likely to offer credit to customers, more customers are attracted to the distributor which increases customer base. The disadvantages of using distributors is that the company is unlikely to exert strict control over their operations. It is upon distributors to act in a manner that is most profitable for them and how they market sell the product cannot be limited. Anti-trust laws in certain countries prohibit companies from dictating prices such that the company may not have control over the prices that the distributor sets. Any mistakes made by the distributor represents the company and this may impact in the companys product demand. Finally, distributors are often known to demand heavy discounts and credit terms since they claim that they are eliminating many trade risks for the company. Conclusion Having identified and scrutinized the applicability of the two methods of selling overseas, it is upon the company to make a decision on which one to take based on the characteristics identified. It is notable that the difference between an agent and a distributor is that the agent is a representative of the company to the customers but does not undertake physical distribution of the goods. The company therefore sells to the customer directly once the agent has convinced him to buy form the company. A distributor on the other hand buys goods from the company which are in turn sold to customers at a profit. There are advantages and disadvantages of using either method of distribution and it is the firms requirements that will determine the choice that ABLE Limited makes. Word Count: 1349 Bibliography Jansson, Hans. Industrial products: a guide to the international marketing economics model. UK: Haworth Press, 1994 Johnson, Thomas. Export/import procedures and documentation. New York: AMACOM Div American Mgmt Assn, 2002

The Infuence Of Technology On Criminal Behavior

The Infuence Of Technology On Criminal Behavior â€Å"That technology influences criminal behaviour in all its aspects can hardly be disputed. If mobile phones and laptop computers are available for seizure by thieves and robbers, technology in the form of anti-theft devices for vehicles and burglar alarms for buildings have also played their part in deterring the felons.† The advancement of technology clearly alters and extends crime and criminal behaviour and has resulted in new offences coming into existence. In turn, criminal detection and legislation has reacted to the effects of technology upon crime, often by adopting new technology and including reference to technology in legislation and judgments. Offences such as fraud have developed through technological advancement resulting in offences becoming much easier to perpetrate: â€Å"The requirement that a person be outside his place of abode when going equipped [to commit fraud] may have worked in 1968, but in the modern world, with computers, fraud may be perpetrat ed by a person sitting at his computer terminal in his home.† Nicholas Yeo highlights how the adapting legislation attempting to tackle the effects of technology upon crime have resulted in Prosecutors having a â€Å"wide palette of overlapping offences, from which to select†. This demonstrates the extent to which the Criminal Justice system is adapting to accommodate technological advances in crime. But what of offences pertaining to the person such as assault and sexual offences? Technology has greatly extended our understanding of what constitutes a sexual offence predominately through the medium of the internet. This form of technology allows sexual offenders to commit offences against children without having to be in the childs presence. It is arguably the internet which most illustrates the extension of the human body which technology may allow. The internet has implications for other crimes against the person, notably the offence of harassment arguably bordering on assault. This essay will assess the implications of the internet illustrated through the offences of sexual grooming and harassment to demonstrate the extent to which technology effects crimes against the person both the offender and the victim. Where crimes develop, clearly crime detection and control must evolve to match this development. Crime control has developed significantly through time, no more than in recent years, due to the advancement of technology. This essay will focus upon the replacement of traditional â€Å"bobbies walking the beat† with CCTV and Electronic witness statement recording. In addition, the methods used to tackle the modern effects of the internet and other technologies upon crime will be considered. Technology has acted to extend criminal activity beyond what was previously physically possible but it has also extended the capabilities of police officers and criminal agencies beyond what was traditionally achievable utilising man power alone. As Richard Card highlights, â€Å"Paedophiles have not been slow to make use of the internet to gain the trust and confidence of children in â€Å"Chat room conversations† for their own purposes.† In light of this, the criminal justice system has legislated, though the Sexual Offences Act 2003 to protect children form internet grooming. S 15(1) provides that an offence is committed should an adult communicate with a child under 16 and intentionally uses this communication to meet with a child to commission an offence. â€Å"Communication† extends to the use of the internet. Under the 2003 Act, for an offence to be committed, the offender must meet with the child and then commit a further sexual offence. However, of course there is the inchoate offence of attempting to â€Å"groom† a child and this sexual offence can be committed purely through the use of the internet. This is an illustrative example of sex offenders using the internet not only as a tool to commit physical crimes but to gain sexual gratification in and of the act itself. However, the Judgment in R v Bollingbroke demonstrates that the Judiciary is aware of the effect of technology upon sexual offences committed and facilitated through the internet and the potential complexities arising in relation to sentencing. Measures have been taken in recent years to combat the use of the internet in child abuse and attempted child abuse cases. In 2007, the then Home Secretary, John Reid announced the Governments intention to curb internet grooming through measures requiring internet paedophiles to register their online identities with the authorities so as to be more easily tracked. These measures received justified criticism in that they would be useless against any paedophile who desired to hide their identity as alternative computers and email accounts could easily be set up. This provides an example of how difficult, if not impossible it is for the authorities to prevent determined internet offenders. By extending the range of offences and the means of offending, modern sexual offenders and child groomers are far ahead of crime control measures. Another cause of this is that victims of internet grooming are not only arguably easy targets but the majority of children use the internet as a social for um and are readily willing to talk with strangers on the internet: â€Å"70% of young people aged between 16 and 24 are using social networking sites; one in 12 children has met someone offline with whom they initially engaged online; and 31% of young people have received unwanted sexual comment online or by text message.† However, as Andrew Joint highlights: â€Å"The growing frequency of the reporting of such incidents [online grooming] highlights the fact that the UKs existing regulation of this area is inadequate to keep up with the variety of ways in which child abusers are using technology to reach their targets.† A further reason why internet grooming is so difficult to control and detect is the ability for groomers to commit offences internationally. However, though the internet makes the potential for grooming very high, research would suggest that in reality the offences committed are quite low. This may suggest that whilst technology extends offenders ability to converse with children, the progression of this to actually physical abuse is still limited. However, the distribution of indecent images of children is greatly increased by the medium of the internet. This issue will not be widely considered in this work as the distribution of images is more removed from the question of using the internet as an extension of the body. Though the images themselves give sexual gratification to the offender, the victim need not have had direct contact with the abuser (the viewer of the images not the maker of the images) through any technological means. This is supported by appeal judgments overturning sentences for public protection in cases involving indecent images of children but actual physical abuse or grooming of children. Though there are obvious difficulties in controlling internet grooming, the National Hi- Tech Crime Unit has been set up in the UK to work with local units in tackling this issue directly. Clearly specified technology units are required to deal with technology based offences. It has been suggested that as the Government is failing to control and keep up with the technological sophistication of internet offenders, it is beginning to rely on Internet Service Providers to assist them. However, this measure also appears to have little impact on the number of sexual offences committed through the internet. The 2005 Cabinet paper, â€Å"Connecting the UK: the digital strategy† established a multi-agency national internet safety centre attached to the Serious Organised Crime Agency. Some thinkers believed this to be a turning point in the control of internet crime and internet crimes against children in particular. However, in reality this measure was merely an extension of the metho ds already in place and acted to incorporate SOCA into more areas of law rather than progress the tackling of online grooming. Another offence which has been greatly facilitated by the internet is harassment. Like offences relating to the distribution of indecent images of children, this offence is not as physical as other internet offences. However, legislation used to tackle this offence illustrates how the Criminal Justice system is reacting to offenders use of the internet as an extension of more traditional means. The Malicious Communications Act 1988 was amended in 2001 to include electronic communications and s1 of the Harassment Act 1997 applies directly to the internet. The consideration of internet sexual offences has illustrated that whilst criminals are adopting technological methods to extend the range of crimes they can commit, crime control has attempted to adapt to counter this. Whilst we have seen that in the case of internet grooming, technology benefits the criminal more than it benefits the authorities, there are many examples of crime control being greatly developed and enhanced by technology. In the past, crime control was very much in the hands of the police officers themselves. However, the advancement of Closed Circuit Television and other technological breakthroughs have resulted in modern policing relaying ever less on man power and ever more on technology. The UK has more than 4 million CCTV cameras acting throughout the country as the eyes of the constabulary. This has both positive and negative implications and effects. From a positive viewpoint, there is a suggestion that CCTV reduces street crime. However, there is no proof of this and the Home Office has conceded that in fact street lighting is more of a deterrent to criminals than CCTV. There are of course negative implications for the wide spread use of CCTV including the much discussed infringement upon civil liberties. The findings of a research paper by The Centre for Criminological Research in Sheffield suggest that the use of CCTV â€Å"represents a shift from formal and legally regulated measures of cr ime control towards private and unaccountable justice†. This may be an extreme view of the use of CCTV but it certainly highlights the potential breaches of Article 8 of the Human Rights Act 1998. There is clearly some contention between what is a public area to be monitored by the police and the extent of ones right to move about the country as a private citizen. Peck v. Brentwood City Council (2003) ECHR suggests that the widespread use of CCTV in the prevention and detection of crime may be acceptable but any other use, such as the release of footage to the media is breaching the subject of the footages right to a private life. A further example of the Police Authorities use of technology to overcome the limitations of the human body is the use of Electronic witness statement recording technology. It has been argued by many prosecution authorities and prosecutors that the taking of witness statements should always be recorded so as to avoid the much relied upon technique of the defence to question the original statement maker and the accuracy of the statement: â€Å"The accuracy of the written statement as a record of what the witness actually said or intended to say is liable to be impugned by a number of factors, such as misapprehension, presupposition and inattention, mainly on the part of the statementtaker. Moreover, the written word is clearly an inadequate instrument for conveying adequately the nuances of meaning through intonation and inflection. The delay involved in statements composed post facto from notes will clearly increase the risk of inaccuracy.† The implication of the electronic ta king of statements may be more successful prosecutions but in light of very few police authorities using these methods, there is a suggestion that the negative implications outweigh the positive. Electronic means are generally used in relation to vulnerable witnesses and in very serious cases such as murder but clearly in practice, the police resort to the traditional methods of handwriting statements. Funding is evidently an issue but there can be little doubt that should the authorities use widespread electronic methods for recording witness statements, the defence will no longer be able to rely on human error in cross examination and perhaps more convictions could be achieved. In conclusion, there can be no argument that technology has allowed criminal behaviour to expand both in quantity and nature. Internet grooming is the best example of technology extending an offence which was previously limited to the physical but which has been adapted and enhanced by technology. Further, it is apparent that whilst crime detection and prevention authorities seek to limit and uncover internet grooming, technology is making it easier to offend and much more difficult for the detecting of such crimes. Technology has not only extended the body of the abuser in that it has allowed offenders to access victims more readily but it has also extended the physical being of the victim by exposing children to new forms of abuse. Whilst technology has increased sexual offending and sexual offences it has been utilised by the police in detecting and preventing crime. Arguably the need for police officers to physically look for crime through patrolling public places has been usurped by the widespread use of CCTV. Whilst many view this as an infringement upon civil liberties, it cannot be argued that CCTV has not had some positive role to play as evidence. Though it could be argue the police are not using technology to the extent of the more criminally minded, there can be little doubt that technology has radically altered to nature of crime and criminal justice.

Management Respiratory Distress Syndrome Infants Health And Social Care Essay

Management Respiratory Distress Syndrome Infants Health And Social Care Essay Respiratory distress syndrome (RDS) is one of the most common consequences of prematurity and a leading cause of neonatal mortality and morbidity as a result of immature lungs. RDS particularly affects neonates born before 32 weeks of gestational age but is also recognised in babies with delayed lung maturation of different aetiology i.e. maternal diabetes. Since its initial recognition there have been vast advances in understating the pathology and management of this complex syndrome. However, in order to understand the pathology behind RDS it is imperative to obtain a good foundation of normal lung maturation and physiological changes that occur in the respiratory system during the transition from fetal to neonatal life. Physiological Development and Function of the lungs During intrauterine growth, fetal lung development begins as early as 3 weeks and progresses until 2-3 years. Conventionally it is divided into 5 stages; embryonic, pseudoglandular, canalicular, saccular and finally alveolar1 (Table 1). During the embryonic stage, the lungs develop from the fetal ectoderm to form the trachea, the main bronchi, the five lobes of the lung and the major blood vessels that connect the fetal lungs to the heart; the pulmonary arteries. This is followed by the pseudo glandular stage which results in the formation of the terminal bronchioles and associated primitive alveoli. These then further divide in the Canalicular stage to form the primary alveoli and subsequently the alveolar capillary barrier. This stage also comprises the differentiation of Type 1 and 2 pneumocytes which will later go on to produce surfactant. Thus babies born after 24 weeks, have a chance of survival as the platform for basic gas exchange has begun to develop. During the saccular st age there is further differentiation of type 1 and type 2 pneumocytes and the walls of the airways, in particular the alveoli, thin to enlarge the surface area present for gaseous exchange. This is followed by the alveolar stage which occurs through the transition form fetal to neonatal life up until 2-3 years. The hallmark of this stage is alveolar formation and multiplication to augment the surface area available for gas exchange to meet the increasing respiratory demands as the infant grows. Stage Time period Structural Development Embryonic 0-7 weeks Trachea, main bronchi and five lobes of the lungs develop from the fetal ectoderm. Pulmonary arteries form and connect to heart. Pseudoglandular 7-17 weeks Formation of terminal bronchioles and alveoli Canalicular 17-27 weeks Formation of alveoli-capillary barrier and differentiation of type I and II pneumocytes Saccular 28-36 weeks Walls of airway thin for efficacious gas exchange Alveolar 36 weeks -2 years Alveolar multiplication Table 1: Stages of Lung Development Once the pulmonary epithelium develops, it begins to secret fluid into fetal lungs, the volume and rate of which is imperative for normal lung growth. Another important factor essential for normal lung development and function is the production of surfactant. At about 24 weeks of gestation the enzymes and lamellar bodies required for surfactant production and storage begin to appear 3. Thus a normal fetus age is not ready to be delivered at this stage due to surfactant deficiency. As type II pneumocytes mature between 32-36 weeks, surfactant production increases and it is stored in the lamellar bodies of these cells. Surfactant is a complex mixture of phospholipids, neutral lipids and proteins 1, 4 that has a fundamental role in maintaining the alveolar-capillary interface and reducing surface tension. It is secreted as a thin film at the liquid-air barriers to facilitate alveolar expansion and prevent end-expiratory collapse of small alveoli, especially at low alveolar volumes. A key event in the development of the lungs is the establishment of spontaneous breathing post-delivery. Prior to delivery the fetal lungs decrease lung fluid production and as the lungs mature there is simultaneous maturation of the lung lymphatic system. During labour the mechanical compression of the fetal chest forces about 1/3 of this lung fluid thus preparing the fetus for spontaneous ventilation. This will require several stimuli; including hypoxia, hypercrabia and acidosis as a results of labour5 and hypothermia and tactile stimulation. Furthermore the stress of labour stimulates chemo-receptors in the fetal aorta and carotids to trigger the respiratory centre in the medulla to commence breathing. As the fetus emerges from the birthing canal, the fetal chest re-expands creating negative airway pressure which subsequently draws air into the lungs. This again forces the lung fluid out of the alveoli and allows for adequate lung expansion. As the newborn cries there is further e xpansion and lung aeration generating positive intrathoracic pressure which maintains alveolar patency and forces any remaining fluid into the lymphatic circulation. As the neonate adapts to extra-uterine life, the normal muscles of respiration work to maintain breathing (Figure 1). In order to inhale, the diaphragm and external intercostals muscles contract to increase the size of the thorax. This generates negative air pressure in the pleura and lowers the air pressure in the lungs so that the gradient between atmospheric air and alveolar air causes air to enter into the lung of the neonate. As the neonate inhales, the elastic recoil force of the lung increases. Once inspiration ceases, the elastic recoil force of the lung causes expiration. The diaphragm and external intercostals muscles relax, the thorax returns to its pre-inspiratory volume resulting in an increase in intra-thoracic pressure. This pressure is now greater than atmospheric pressure and air moves out of the lungs producing exhalation. Figure 1: The Mechanics of breathing6 For most neonates, this transition from fetal to extra-uterine life is uneventful and completed during the first 24 hours of life. The neonate is able to establish good lung function, maintain cardiac output and thermoregulate. However, for a certain population of neonates, usually those that are born early and thus called preterm, this transition is less smooth and it is these babies that will require the support and care of the whole paediatric department. Respiratory Distress Syndrome Respiratory distress syndrome (RDS) is the most prevalent disorder of prematurity and despite a better understanding of its aetiology and pathology, RDS still accounts for significant neonatal mortality and morbidity. The incidence RDS is inversely proportional to gestational age2 such that it decreases with advancing gestational age, from about 60-80% in babies born at 26-28 weeks, to about 15-30% in babies born at 32-36 weeks 1. Risk factors for developing RDS are summarised in Table 2 and include maternal illness, complications during pregnancy and labour and neonatal complications Table 2: Risk Factors for RDS1 Respiratory distress presents early in post-natal life particularly during the phase of transition from fetal to extra-uterine life. These babies will present with signs of grunting, cyanosis, nasal flaring, intercostal and subcostal recession, increased respiratory effort, and less commonly apnoeic episodes and circulatory failure. The severity of symptoms experienced are related to the pathology of disease and it is important to identify babies at greatest risk and commence management early in order to prevent respiratory complications such as chronic lung disease (previously called bronchopulmonary dysplasia), pulmonary hypertension and in adverse cases respiratory failure and even death. Identifying normal transition and respiratory distress is largely based on evaluating the risk factors for RDS, assessing the severity of symptoms and close neonatal observation if in doubt. Babies that are born close to term or those via caesarean section may display a difficult albeit a normal transition. These babies present with transient tachypnoea of the newborn in the first few hours with respiratory rates of about 100 breaths per minute and increased oxygen requirements. Symptoms are short lived, self limiting in most cases and usually relived by oxygen. Neonates who suffer from RDS will present with worsening symptoms of longer duration, respiratory rates of 120 and increased respiratory effort with a longer requirement for oxygen. Recovery if plausible usually begins after 72 hours and is associated with decreased oxygen requirements and better functional residual capacity. Pathophysiology of Respiratory Distress Syndrome Since its initial recognition, more than 30-40 years ago, much has been elucidated about the pathophysiology of this complex syndrome. In the premature neonate, the structurally immature and surfactant deficient lung is unable to maintain the basic lung mechanics required for adequate ventilation. As aforementioned lung mechanics rely on surfactant production, alveolar multiplication and maturity for effective gas exchange, chest wall elasticity and a functionally developed diaphragm. It is therefore evident that premature neonate who lack surfactant and have structurally immature lungs will develop RDS, atelectasis and abnormal lung function. In these neonates the essential first breaths are followed by a secondary pathological cascade characterised by tissue damage, protein leakage into the alveolar space and inflammation, which may resolve or progress to BDP or chronic lung disease of prematurity (CLD)7. In neonates with RDS, end-expiration results in the collapse of alveoli due to surfactant deficiency and a subsequent reduction in the functional residual capacity (FRC). The FRC is the volume available for gaseous exchange i.e the volume of gas left in the lungs after exhalation. It is determined by an intricate balance between the collapsing and expanding forces of the chest wall and lungs7. An ideal FRC enables the best possible lung mechanics, efficient ventilation and gaseous exchange. As the FRC is reduced at end-expiration due to alveolar collapse due to high surface tension, the pressure that will be required to re-inflate the already immature lungs is increased. This in turn increases the respiratory effort needed for adequate gas exchange which presents clinically as increased respiratory rate and subcostal/intercostal recession. Moreover reaching an optimal FRC may be further impeded by both surfactant deficiency and by the preterm infants impaired ability to clear fetal lung fluid. Radiographically a chest x-ray will show the characteristic ground-glass appearance with diminished lung volumes and the cardinal features of respiratory stress, tachypnoea, nasal flaring, intercostals recession, subcostal recession, increased breathing effort and grunting will begin to manifest early on. Despite this effort to breathe, alveolar ventilation remains poor. As these areas are receiving an adequate blood supply this produces a ventilation/perfusion mismatch resulting in right to left intrapulmonary shunting1. The lungs are unable to maintain good gas exchange and blood oxygen saturation and the level of carbon dioxide begins to increase resulting in respiratory acidosis, hypoxaemia and hypercarbia. The neonate further struggles to breath and attempts to generate higher negative pleural pressures to ventilate the lungs. The ensuing acidosis further diminishes surfactant production and neonates deteriorate rapidly as blood oxygen saturations plummet. The natural progression of the disease if left untreated will lead to pulmonary oedema, right-sided heart-failure and ultimately the most devastating outcome, neonatal death. Therefore the management of these neonates requires an aggressive multi-disciplinary team approach based on the pathology of these aforementioned homeostatic mechanisms. Alongside this the basic principles of neonatology; thermoregulation, nutritional support, efficacious cardiovascular support and infection control, are all fundamental in achieving the best therapeutic goal. Ultimately the aim is to provide adequate ventilatory support, allow the lungs to heal, impede further pulmonary injury, correct hypoxaemia and acidosis and above all to keep the neonate alive. Management of RDS As aforementioned the aim of treatment is to promote lung healing and reduce further pulmonary insults. We have already established that with increasing gestational age, particularly post-32 weeks, the infant will require less aid to help it cope with the transition from fetal to neonatal life. However, before 32-weeks there is an increased propensity to develop RDS and as the neonate is unable to cope, some form of respiratory support is required. Over the past 40 years there have been numerous management therapies including ventilatory support, surfactant therapy, nitric oxide therapy and supportive therapeutics strategies amongst others. The mainstay of treatment today remains supportive and involves the use of antenatal steroids, surfactant replacement therapy, continuous positive airway pressure and mechanical ventilation, which all aim to address the pulmonary insufficiency that manifest in these individuals Antenatal Glucocorticoids Glucocorticoid receptors are expressed in the fetal lung at early gestation and as the fetus grows stimulate surfactant production post-32 weeks. Alongside receptor expression there is an increase in fetal cortisol levels at late gestation9, which coincides with lung maturation, type II pneumocyte differentiation, surfactant synthesis as well as alveolar thinning. If birth occurs before this increase in serum cortisol, the pulmonary system has not matured adequately and therefore there is an increased propensity to develop RDS. Thus a single dose of glucocorticoids such as dexamethasone or betamethasone in the antenatal period promotes lung maturation. One of the first published reviews that showed the efficacy of antenatal steroids in preterm labour was produced by Crowley in 19958. Crowley showed that steroids given in preterm labour were effective in preventing RDS and improving neonatal mortality rates. Since then several randomised controlled clinical trials have evaluated the efficacy of steroids in reducing RDS. A recent Cochrane review of 21 trials assessed the effects of antenatal corticosteroids, given to women expected to go into preterm labour, on fetal/neonatal mortality and morbidity8. The authors concluded that a single dose of antenatal steroids promoted fetal lung maturation thereby reducing the risk of RDS and the need for assisted respiratory management. The mechanisms by which glucocorticoids are thought to exert their efficacy are described below. Firstly, glucocorticoids stimulate phospholipid production. Phospholipids are a major component of endogenous surfactant and as a result augment surfactant synthesis in the biochemically immature and surfactant deficient lung 9, although the exact mechanisms by which this occurs remains to be elucidated. Secondly glucocorticoids enhance lung maturation and development. As aforementioned, in order to produce surfactant, fetal lungs must produce type II pneumocytes which will then generate lamellar bodies in which surfactant is stored. Glucocorticoids enhance this process, promoting pulmonary epithelial cell maturity and differentiation into type II pneumocytes9. Furthermore glucocorticoids cause a decrease in pulmonary interstitial tissue thereby decreasing alveolar wall thickness. A thin alveolar wall thickness facilitates efficacious gaseous exchange and will therefore assist ventilation and oxygenation of the neonate once born thus decreasing the chances of developing RDS. Another known benefit of antenatal glucocorticoids is found in reducing oxidative stress on the immature lung and prevention of pulmonary oedema9. This accumulative evidence suggests that glucocorticoids are essential for normal pulmonary development and giving a single dose to mothers at risk of preterm birth may substantially decrease the chances of the infant developing RDS. Surfactant Therapy As discussed before, endogenous surfactant has a fundamental role in maintaining the alveolar-capillary interface in order to prevent end-expiratory alveolar collapse. This is achieved by thin spread of surfactant around the alveoli which ultimately acts to reduce surface tension. The most important component of surfactant which achieves this fundamental function is a phospholipid called dipalmitoylated phopshatidylcholine (DPPC)11. DPPC also stabilises the alveoli at end expiration, further preventing alveolar collapse. Alongside DPPC the synergistic actions of surfactant proteins (SP) SP-B and SP-C also lower surface tension11. Thus a deficiency in surfactant will cause alveolar collapse, decrease pulmonary compliance, increased pulmonary vascular resistance and produce ventilation-perfusion mismatch. Hence the aim of exogenous surfactant therapy is to reverse this pathological cascade and ultimately prevent alveolar collapse thereby limiting pulmonary damage and improving ventilat ion. Since the first clinical trial assessing the use of surfactant in managing neonatal RDS by Fujiwara in the 1980s10, our understanding of the composition, structure and function of surfactant has progressed vastly. In this uncontrolled trial the chest x-rays of 10 babies diagnosed with RDS, both clinically and radiologically, showed significant improvement after exogenous modified bovine surfactant was administered with a decreased requirement for ventilation. Since then several randomised controlled trials12 have shown that surfactant therapy, alongside antenatal steroids and ventilation continues to improve neonatal morbidity and mortality. Both natural (derived from an animal source) and synthetic (manufactured chemically) surfactants are available to use in managing RDS. Meta-analysis of trials comparing the two types of surfactant have shown that natural surfactants show a more rapid response in improved lung compliance and oxygenation12 thereby reducing neonatal mortality. Furthermore natural surfactants are less sensitive to inhibition by accumulative products of lung injury such as serum proteins. Surfactants need direct delivery to lungs and usually require intubation with short periods of assisted ventilation. Traditionally two therapeutic approaches have been established in managing RDs with surfactant. The first adopts the use of surfactant prophylactically, with surfactant given immediately after birth to enable the neonate to cope with extra-uterine life. The obvious benefit of this approach is that surfactant is administered to the baby before severe RDS develops resulting in long-term pulmonary sequelae for the neonate. However this technique is invasive, as surfactant administration requires endotracheal intubation, it is expensive and furthermore it may result in the unnecessary treatment of neonates. Moreover poor intubation with failed attempts and prolonged apnoeic episodes may further damage the lungs resulting in CLD. Despite this, there is a strong body of evidence for prophylactic use of surfactant and current guidelines state that all preterm babies born befo re 27 weeks of gestation, who have not been given antenatal steroids should be intubated and given surfactant at birth7. The second therapeutic approach evaluates the role of surfactant in rescue treatment used in neonates with an established diagnosis of RDS requiring ventilation and oxygen. The advantages of rescue treatment include that it is reserved for neonates in whom RDS is confirmed and it may decrease the morbidity associated with unnecessary intubation. The obvious disadvantage is that delay in surfactant delivery may allow for irreversible lung injury to develop with decreased efficacy of surfactant administration12. Several studies have aimed to clarify the issue between prophylactic and rescue surfactant treatment. A randomised trial by Rojas et al. showed the benefits of surfactant delivery within 1h of birth in neonates born between 27-31 weeks14 with an established diagnosis of RDS who were treated with continuous positive airway pressure soon after birth. 279 infants were randomly assigned either to the treatment group (intubation, very early surfactant, extubation, and nasal continuous positive airway pressure) or the control group (nasal continuous airway pressure alone). The results of this study demonstrated that infants in the treatment group i.e. those treated with surfactant, showed a decreased need for mechanical ventilation with a decrease in the incidence of CLD and pneumothoraces. Neonatal mortality rates were similar between both groups. A meta-analysis by Soll and Morley compared the effects of prophylactic surfactant to surfactant treatment of established respiratory distress syndrome (i.e. rescue treatment) in preterm infants33. The authors analysed eight studies comparing the use of prophylactic and rescue surfactant treatment and concluded that the majority of the evidence demonstrated a decrease in the incidence of RDS when surfactant was given prophylactically. Moreover the meta-analysis showed that infants treated with prophylactic surfactant had a better clinical outcome with a reported decrease in the risk of pneumothorax, pulmonary interstitial emphysema, CLD and mortality33. As a result of such studies most neonatal units continue to practice delivery of surfactant prophylactically in preterm babies at high risk of RDS. However, some literature still debates whether there are any real advantages of prophylactic surfactant over rescue treatment. What is evident is that surfactant therapy should play a fundamental role in the management of RDS. Future trials will need to further assess the indications for surfactant therapy in treating neonatal RDS and perhaps in the management of other pulmonary insufficiency disorders that affect the neonate. Although much remains to be elucidated about the complex pulmonary surfactant system, since its introduction 25 years ago, surfactant therapy has been at the forefront of reducing RDS and its role in decreasing neonatal mortality and morbidity cannot be disputed. Mechanical ventilation Mechanical ventilations is one of the cornerstones of neonatal intensive care units and regardless of the modality used, the primary function is to maintain adequate oxygenation and ventilation. The goals of mechanical ventilation are: to establish efficacious gaseous exchange to limit pulmonary insult and CLD to reduce the respiratory effort and work of breathing of the patient To achieve these basic goals several techniques, devices and therapeutic options are available to the neonatologist that can be either invasive or non-invasive. Continuous Positive Airway Pressure The use of CPAP; continuous positive airway pressure, in the treatment of RDS was first described in the 1970s and has since been identified as a important management strategy. CPAP applies positive end expiratory pressure (PEEP) to the alveoli throughout inspiration and expiration so that the alveoli remain inflated thereby preventing collapse. The pressure required to re-inflate the lungs is reduced as partially inflated alveoli are easily to inflate than completely collapsed ones. Animal studies with premature lambs have shown the benefits of nasal CPAP over mechanical ventilation. CPAP acts to lower the markers for CLD for example granulocytes, and markers of white cell activation, increases the amount of surfactant available, improves oxygenation and lastly corrects ventilation/perfusion mismatching2, 15. Moreover CPAP produces a more regulated pattern of breathing in neonates by stabilising the chest wall and reducing thoracic distortion16. Like surfactant therapy there are two ways in which CPAP can be administered. The first method, InSUrE: intubation, surfactant and extubation, adopts a brief intubation to administer surfactant and extubation to CPAP approach and the second is the Columbia method in which babies are started on CPAP in the delivery room and are only mechanically ventilated, and intubated if the need for surfactant is established. Several studies have shown the benefit of the first approach. A study by Verder et al. randomised 68 neonates with moderate to severe RDS; 35 infants were randomised to surfactant therapy following a short period of intubation and then extubation to CPAP and 33 neonates were randomised to nasal CPAP alone. The results of this study showed that infants in the earlier group had a reduced need for ventilation; 21% in comparison to 63% in the second group16,17. Another similar trial by Haberman et al. assessed the use of surfactant with early extuabtion to CPAP and subsequently the results showed a decreased need and duration for mechanical ventilation12. Furthermore a recent Cochrane review of six studies using the InSuRE method showed that neonates with RDS treated with early surfactant therapy followed by nasal CPAP, were less likely to need mechanical ventilation and develop air leaks in comparison to neonates that were treated with the Columbia approach (i.e. early CPAP therapy foll owed by surfactant if needed)17, 18. A more recent review by the same authors further confirmed the findings of the initial review and the relative risk for developing CLD was 0.51 (95% CI 0.26-0.99) with early surfactant treatment and nasal CPAP when comparing the two methods18. The Columbia method requires the stabilisation of neonates with CPAP in the delivery room with intubation and surfactant therapy used as necessitated. This approach was adopted when retrospectives studies done by Avery et al. and later Van Marter et al. evaluated the clinical outcomes in multiple neonatal units across the US2. In both cases a lower incidence of CLD was observed in the Columbia University Hospital which adopted CPAP as a primary treatment strategy as opposed to intubation and mechanical ventilation like other units. Leading on from this Ammari et al.. evaluated the Columbia method recently. The outcomes of 261 neonates with birth weight So far the evidence base for the Columbia method has been derived from retrospective cohort studies with a lacking in RCTS and therefore a lack of stronger evidence. One RCT that had aimed to evaluate the Columbia method was the recent COIN trial by Morley. This study evaluated whether the incidence of death or BPD would be reduced by CPAP rather than intubation and ventilation shortly after birth13. 610 neonates born between 25-28 weeks were randomised to CPAP or intubation and ventilation at 5minutes after birth and surfactant was administered at the neonatologists discretion. The results of the study demonstrated that at 28 days of gestation, infants in the CPAP group had a decreased need for supplemental oxygen and fewer deaths2,13. However worrying results from this study were that approximately 46% of babies in the CPAP group went onto require intubation and had a higher rate of pneumothoraces13. There are few randomised control trials assessing the benefit of CPAP alone in managing RDS and the results of the Columbia Hospital study have been irreproducible in other centres. The mainstream use of CPAP for managing RDS remains to start CPAP in the delivery room, after intubation for surfactant treatment. There is not enough evidence to show that CPAP alone can prevent RDS and associated complications in comparison with invasive ventilation. The evidence does suggest that there is a decrease in complications with surfactant therapy and CPAP but the relationship with CLD is less transparent. At present there are two RCTs ongoing that may provide further insight into the role of CPAP in RDS when complete. The first trial is the SUPPORT study, which is randomising infants between 24-27 weeks to CPAP beginning in the delivery room with stringent criteria for subsequent intubation, or intubation with surfactant treatment within 1 h of birth with continuing mechanical ventilation2. The second is the trial by the Vermont-Oxford Network in which infants born at 26-29 weeks gestation will be randomised after 6 days into one of three groups; (1) intubation, early prophylactic surfactant, and subsequent stabilisation on mechanical ventilation; (2) intubation, early prophylactic surfactant, and rapid extubation to CPAP; and lastly (3) early stabilisation with nasal CPAP, with selective intubation and surfactant administration according to clinical guidelines2. The immediate management of the RDS neonate with CPAP remains controversial and maybe the results of these ongoing RCTS wil l provide invaluable answers to the many uncertainties surrounding this device. Nasal intermittent positive pressure ventilation Another relatively recent development in non-invasive ventilation that has evolved from NICU ventilator machines and CPAP devices is the use of NIPPV for managing RDS. Sometimes called BiPAP (for bi-level positive airway pressure), this form of non-invasive ventilation is able to provide two levels of airway pressure, without the need for intubation. BiPAP maintains positive pressure throughout respiration but with a slightly higher pressure during inspiration. By doing so BiPAP/NIPPV is able to assist neonatal breathing by: reducing the work of breathing improving tidal volume increasing blood oxygen saturation and increasing removal of CO2 thereby limiting hypoxaemia and respiratory acidosis. As the neonate inhales, the NIPPV device generates a positive pressure thereby assisting the neonates spontaneous breath and providing ventilatory support. This is at a slightly higher positive pressure. As the neonate begins to exhale, the pressure drops, but a positive airway pressure remains in the lungs to prevent alveolar collapse and thus increase gaseous exchange. NIPPV may be a potential beneficial treatment for the management of babies with RDS and has been used in NICUs since the 1980s. Recently multiple studies have aimed to evaluate the efficacy of NIPPV in stabilising neonates. A randomised controlled prospective study by Kulgeman et al.. found that NIPPV was more successful than NCPAP in the initial treatment of RDs in preterm infants19. Kulgeman and his colleagues randomised infants A further study by Sai and colleagues also established the advantages of NIPPV over CPAP in managing RDs and reducing the need for mechanical ventilation and intubation in preterm infants. In their study 76 neonates between 28-34 weeks gestation with RDs at 6h of birth were randomised either to early NIPPV (37 neonates) or early CPAP (39 neonates) after surfactant use20. Firstly they documented that the failure rate with NIPPV was less in comparison to the CPAP group (p