The Effect of Smartphones on Work-Life Balance

13 has also created employment as developers seek to capitalist on the market available for development of APS and other content for semaphore devices. As Postman (1995) discusses In a 1995 Interview that all new technology is like a†Faustian bargain in that it gives us something important but we also legitimating important in the process†. This would appear to be true of Thessalonians. The benefits of the semaphore have been discussed throughout this paper as have the negatives.They provide users with the ability to stay onto of work outside of the office and employers In theory benefit from Uncharacteristically, often at little expense to themselves as users are choosing toothbrush the phones themselves. The principle losses would be in terms of loss personal time and the erosion of boundaries between work and personal time_l feel that it is really a personal choice that all owners of this technology need tomato in relation to usage patterns of the devices for work rela ted activities. Some users are happy to be connected all the time and see no issue with it.However, others cite that it results in increased stress, while others articulateness who have been using the devices longer state that they have consciousnesses boundaries in relation to their semaphore use. Much of the academic literature in this area has focused on managerial levelness of smartness. I feel that studies should possibly be conducted Into teahouse patterns of non-executive level personnel also in order to help stratospherically HER

Research Utilization Project †Fecal Transplantation Essay

Clostridium difficile (C-difficile) is a common bacterium that is a frequent cause of infection in the colon and effects numerous patients. Clostridium difficile increases the hospital costs associated with inpatient care, including identification of the organism as well as treatment. The most common cause of C-difficile infection is the elimination of normal intestinal flora caused by antibiotic use. Standard treatment of C-difficile infection includes the use of oral (Flagyl) and intravenous (Vancomycin) antibiotic therapy. The use of fecal transplantation to treat C-difficile infection is increasing in popularity. Research regarding fecal transplantation dates back to 1958; however, the efficacy of fecal transplant for the treatment of C-difficile are rapidly emerging with noted benefits for patients. The mere thought of presenting fecal transplantation for the treatment of a C-difficile infection is often dismissed because of limited available evidence and the concerns about using someone else’s stool to treat the infection. The necessity to educate patients with C-difficile is an additional challenge. Potential donors and recipients need to be assured of minimal risks associated with the screening and transplantation process. The ability to educate society on the results of evidence-based practice regarding the treatment of C-difficile with fecal transplantation should minimize concerns and enhance patient outcomes. The creation of a patient education programs is increasingly beneficial when multiple health care professionals and interdisciplinary teams are involved. Thus, a project objective in implementing an educational patient program for fecal transplantation is the creation of an informative brochure for potential use in the Endoscopy Department at Sharp Memorial Hospital by December 2014. The treatment regimen for initial and chronic C-difficile with fecal transplantation is inexpensive and noted as extremely effective. The articles reviewed consistently reveal efficacy rates greater than 85%. Fecal transplantation for the treatment of C-difficile continues to illicit multiple verbal and non-verbal responses and is not considered a standard of care for patients, families, communities, and hospital staff. The implementation of an informative educational brochure will minimize fears, hesitations, and reluctance for the treatment of C-difficile with fecal transplantation. The central theme of transplanting feces from a selected healthy donor to the recipient with C-difficile is often met with resistance. The fecal transplantation brochure will encompass aspects of fecal transplantation with the expectation of educating patients, families, and communities. Additionally, the brochure would enhance awareness of hospital staff providing an opportunity to educate units or departments. The application of Kurt Lewin’s change model for the implementation of an educational brochure for fecal transplantation will be employed. The current treatment modalities for C-difficile and the methods of transmission are increasingly becoming expensive for health care organizations. The financial goals of the organization are to decrease the rates of C-difficile and possibly entertain the concept of fecal transplantation. A dichotomous survey will be used to measure awareness and use of fecal transplantation for the treatment of C-difficile. The interdisciplinary team employed to create the brochure would prove beneficial in developing standardized procedures in performing fecal transplantations. The Southern California Society of Gastroenterology Nurses and Associates is an excellent venue for potentially validating and communicating the results. The two possible grant funding sources for the fecal transplantation brochure is the American Gastroenterological Association (AGA) and the American Society of Gastroenterology Nurses and Associates (SGNA). The creation and implementation of an educational brochure for patients considered for fecal transplantation would enhance community education and minimize fears in treating C-difficile with fecal transplantation. Keywords: fecal transplantation, clostridium difficile, fecal micobiota transplantation Problem Identification The traditional treatments for patients diagnosed with infections of the colon are antibiotics. However, many antibiotics kill the normal healthy bacteria of the colon. This results in an overwhelming increase in the risk for developing a C-difficile infection. Medicine. Net (2012) stated, â€Å"Patients taking antibiotics are at risk of becoming infected with C. difficile as antibiotics can disrupt the normal bacteria of the bowel, allowing C. ifficile to become established in the colon† (para. 1). The potential for implementing the use of fecal transplantations for the treatment of C-difficile among the general population is questionable. The mere thought of presenting fecal transplantation for the treatment of a C-difficile infection is often dismissed because of limited available evidence and the concerns about using someone else’s stool to treat the infect ion. Rohlke and Stollman (2012) stated, â€Å"Cure rates of > 90% are being consistently reported from multiple enters. Transplantation [fecal] can be provided through a variety of methodologies, either to the lower proximal, lower distal, or upper gastrointestinal tract† (p. 403). An additional consideration is the perception of fecal transplantation within the community. The necessity to educate patients with C-difficile is an additional challenge. Potential donors and recipients need to be assured of minimal risks associated with the screening and transplantation process. Current research supports and discusses a comprehensive approach to identification and screening for potential fecal donors, donor preparation, and transplantation procedures. The procedure for donor selection and screening is comprehensive to prevent the transmission of infection. According to Hamilton, Weingarden, Sadowsky, and Khoruts (2012), â€Å"The [donor] history includes assessment of infectious risk, including identification of known risk factors for HIV and Hepatitis, current communicable diseases, and recent travel to areas of the world with a higher prevalence of diarrheal illnesses† (p. 3). In educating patients, families, and the community at large, the rigor associated with the screening process must be emphasized to reduce fear. The project objective in implementing an educational patient program for fecal transplantation is the creation of an informative brochure for potential use in the Endoscopy Department at Sharp Memorial Hospital by December 2014. The brochure will be created using a collaborative approach by employing endoscopic nursing champions. The goal is for the brochure to be patient specific and encompass appropriate information to decrease fears and answer questions associated with fecal transplantation. Additionally, the development of a patient posttest associated with the brochure will be created to evaluate the effectiveness of content delivery and adjusted accordingly to meet patient needs and desired outcomes. The proposed solution will minimize the ambiguity and fears associated with fecal transplantation for the treatment of C-difficile. Solution Description The proposed solution for teaching potential recipients and donors about fecal transplantation for the treatment of C-difficile is to diminish infection rates. By creating and implementing a comprehensive nursing educational approach patients and donors can be well informed on this innovative treatment modality. â€Å"In many areas of clinical decision making, research has demonstrated that â€Å"tried and true† practices taught in basic nursing education are not always best† (Polit & Beck, 2012, p. 25). The ability to educate society on the results of evidence-based practice regarding the treatment of C-difficile with fecal transplantation should minimize concerns and enhance patient outcomes. The creation of a patient education program is increasingly beneficial when multiple health care professionals and interdisciplinary teams are involved. The importance of evidence-based practice is to ensure the evidence about fecal transplants has been collected, evaluated, and implemented to establish the best practice and approach. The main premise for patient safety is to ensure donors have been thoroughly screened to minimize the potential for the transmission of other diseases with feces. According to Rohlke and Stollman (2012) on donor selection, â€Å"There have not yet been any adverse events reported that can be conclusively or directly attributed to [fecal microbiota transplantation] FMT, and proper donor screening is essential to avoid transmitting communicable diseases from donor to recipient† (p. 406). Individuals with recurrent C-difficile infections are moderately self-educated regarding treatment modalities and are receptive to the idea of fecal transplantation. The emphasis on educating patients, families, and communities regarding fecal transplantation as the initial treatment regimen is the focus. Hospital and individual associated costs in administering antibiotic therapy for the treatment of C-difficile could be drastically reduced by using fecal transplantation as the initial therapy. Brandt (2012) stated in reply, â€Å"Do patients typically accept fecal transplantation as a treatment option? Yes †¦patients typically respond with interest, and they are generally positive about trying it and they do not typically react with disgust† (para. ). The current research base associated with fecal transplantation demonstrates high cure rates while minimizing the reoccurrence of C-difficile. Rohlke and Stollman (2012) stated, â€Å"Cure rates of > 90% are being consistently reported from multiple centers† (p. 403). The review of current literature demonstrates that patient education for fecal transplantation is performed by a gastroenterologist and not the gastrointestinal (GI) nurse. Patient education provided to patients from physicians typically entails a one-way communication style. In this scenario, the gastroenterologist sends the information to the patient, and there is little discussion with the receiver. Thus, patients commonly seek out more information from the registered nurse. The ability to educate patients regarding fecal transplantation using the proposed brochure would facilitate a commonality and minimize fears. The feasibility of implementing the brochure into endoscopic departments would be perplexing and centered on nursing knowledge of fecal transplantation. Brodine and Kellogg (2013) stated, â€Å"All patients infected or colonized with C. ifficile must be educated about this bacterium, proper disease management, and transmission prevention. The nurse should use patient-centered communication—free of jargon and appropriate to the patient’s health-literacy level† (para. 13). The health care organization must employ educational programs specific to the needs of the patients and desired outcomes. â€Å"The Joint Commission recommends using the â€Å"teach-back† and â€Å"show-back† methods to educate patients; that is, ask the patient to â€Å"teach back† the information provided or demonstrate understanding by â€Å"showing† a skill†¦Ã¢â‚¬  (Brodline & Kellogg, 2013, para. 3). The organizational culture at Sharp Memorial Hospital for nursing is centered on the American Nurses Credentialing Center (ANCC) Magnet Recognition Program ®. The nursing strategic plan is developed by nursing leaders with input from nursing staff based on the hospital strategic plan. Additionally, nurse leaders emphasize that innovation is a core value and part of the nursing process. Nurse leaders encourage innovation through training, resources, and role modeling (Beyond Excellence, 2013). The roposed solution of implementing patient education for fecal transplantation is supported by Sharp Memorial Hospital because it involves introducing new knowledge regarding innovative, evidence-based treatment modalities. Research Report Clostridium difficile infection remains a constant struggle for hospitals. The standard treatment regimen of antibiotics commonly results in relapses. Research on fecal transplantation is continuing to emerge as a promising alternative approach in treating chronic C-difficile infections. Numerous studies demonstrate positive outcomes with the administration of fecal transplant in the treatment of C-difficile (Rohlke & Stollman, 2012). Fecal transplantation has shown through research studies to be a useful treatment for C-difficile infection via the restoration of intestinal normal flora (Brandt, 2012). The most common sign reported by patients diagnosed with C-difficile is chronic diarrhea. Johnson (2012) stated, â€Å"The administration of antibiotics can alter the balance of normal colonic flora to permit the overgrowth of pathogenic C. ifficile strains that produce toxins which cause diarrhea and associated symptoms† (para. 5). In an article published in the Alimentary Pharmacology and Therapeutics, the authors reported 17 of 22 fecal transplantations for the treatment of C-difficile were effective (Landy, Al-Hassi, MLaughlin, Walker, Nicholls, Clark, & Hart, 2011). The substantiated results of the review article highlighted major differences in patients, donors, screening, methods of administration, and the definition of treatment responses (Landy et al. , 2011). The multiple factors highlighted in this review of treating C-difficile with fecal transplantation review across the spectrum using a standard approach is essential to supporting increased use of this treatment modality. Landy et al. (2011) stated, â€Å"Standardized controlled studies are necessary to ascertain the most effective treatment regimen as well as the most acceptable method of treatment† (p. 414). Grehen, Borody, Leis, Campbell, Mitchell, and Wettstein (2010) published a study, â€Å"to demonstrate the benefits of fecal biotherapy and the role of new therapeutic strategies for the treatment of gastrointestinal conditions† (p. 51). The study included 10 patients treated with fecal transplantation and monitored the progress of bacterial population of the colon pre and post transplantation for a 24 week period. Grehen et al. (2010) found the following: At intervals of 4, 8, and 24 weeks after the procedure, the bacterial populations in the patients’ fecal samples consisted predominantly of bacteria derived from the health donor samples. Comparisons of similarity at 4, 8, and 24 week samples to the donor-infused sample were made and each recipient’s baseline sample was statistically significant with Friedmen test. p. 551) Rohlke and Stollman (2012) noted that C-difficile rates continue to rise with greater intensity and severity. The treatment of C-difficile with fecal transplantation is an emerging and accepted intervention in patients with recurrent C-difficile. Rohlke and Stollman (2012) stated, â€Å"Cure rates of >90% are being consistently reported from multiple centers. Transplantation can be provided through a variety of methodologies, either to the lower proximal, lower distal, or upper gastrointestinal tract† (p. 403). The review by Rohlke and Stollman (2012) analyzed reports validating the factors of â€Å"donor selection, appropriate patient criteria, and the preparations and mechanisms of fecal microbiota transplant delivery available to clinicians and patients† (p. 403). The internal validity of the research articles reviewed demonstrates moderate samples were randomly selected. The current literature validated the need for more randomized controlled studies to determine established guidelines for the implementation of fecal transplantation. Additionally, the treatment regimen for initial and chronic C-difficile with fecal transplantation is inexpensive and noted as extremely effective. The independent variable of the effectiveness of fecal transplantation for the treatment of C-difficile remained a consistent theme. The articles reviewed consistently reveal efficacy rates greater than 85%. The external validity of the study articles revealed fecal transplantation processes are varied in the process of which patients are treated, the donor selection criteria, donor screening protocols, and the methods of delivery. The outcomes of the results reported are moderately consistent; however, the ability to generalize a standardized treatment pathway is ambiguous and larger multi-organizational and multi-disciplinary studies are essential. Rex (2012) found the following: Several studies of fecal transplantation have demonstrated high cure rates. The latest and largest to date is a retrospective case series involving 70 patients in Finland (mean age, 73; 86% outpatients). Overall, 94% of these patients had symptom resolution during the first 12 weeks after transplantation, including 32 of the 36 infected with the O27 strain of C. ifficile and all 34 of those infected with other strains. No immediate complications occurred. (para. 1) Fecal transplantation in the treatment for C-difficile has proven to be highly successful in a limited number of studies. In determining if fecal transplantation should be the standard of treatment for C-difficile infection, larger controlled studies are required. Additionally, a standard process related to donor screening, implantation techniques, transplant follow-up, and regularly documenting patient outcomes are essential in establishing standardized fecal transplantation protocols.

Baroque Music

Opera was the new musical form of the Baroque period and it was very expressive of the baroque cultural values. By then end of the operatic form was stylized into a recipe, including improbable plots, small motivations for the characters, and magical transformations, which were signs of opera's baroque nature. Oppress united drama, dance, elaborate stage mechanisms, and scenery with music. Johann Sebastian Bach was one artist whose greatest legacy was religious music.His works re distinguished by their inventiveness and complete mastery of major and minor tonality. George Frederic Handel was renowned for his Italian-style operas. He had a brilliant way in which music allows the singers to show their virtuosity. Yes, Opera was the new musical form of the Baroque period; it originated from Italy in the late sixteenth century by a group of Florentine musicians and poets who had ties with the aristocrats. However, let us not forget that if it was not for the four trends that gave he musi c of this time period its distinctive qualities.One in which was the creation of the major and minor tonality which was prefigured by Joaquin des Perez. That was the rise of modern music. The second was the mixing of the genres, which was well known in the literature and the arts made its way into baroque music. In addition, the third thing was the expressiveness in the music in the late 1 sass; it became more magnified and was used in emotions in the text of the music that may not have been eared. And lastly was the age of virtuosos, master musicians, especially singers, who would perform with great technical skill and vivid personal style, and of a growing variety of musical instruments. † That brings us back to Opera; this musical form brings all the mentioned trends together, became the ultimate symbol of the age. Claudio Monteverdi was the first great composer of opera; he composed Refer (1607) about a legendary ancient Greek poet-musician named Orpheus. It incorporated r am, dance elaborate stage mechanisms and painted scenery with music (410).Monteverdi was known for expanding the dramatic appeal by taking each of the five acts and ending them with a powerful chorus. He took the use of aural symbols and music phrases to intensify events. Jean-Baptists Lully was the founder of French opera but he was actually Italian. He would later become a French citizen and serve as Louse's court composer. French opera under Lully's direction would become more dignified and full of choruses and would add ballet and French text. Baroque Music The name Baroque, which is a French word from the Portuguese’s barroco, originally used in architectural design in Europe specifically in Italy having a deformed style as an irregularly shaped pearl. In music, it is known for its inconsistencies that the twentieth century historians later used the term baroque as an identification of the Early Classical Period in music.Instrumental music using piano or clavier (a German word for keyboard), violin, harpsichord and other string instruments ruled the Baroque Era of Western European Art Music between the years 1600 to 1750. Characteristics and Forms Although Temperley argues that â€Å"Baroque music was written largely for monarchs, aristocrats, and authoritarian church leaders† (par 9), the soulful melody and dramatically arrangement of any musical piece created during this era captured the hearts of the religious and nonreligious groups.Furthermore, as Kisser said â€Å"the middle class formed too in this era† (par 1). Generally, baroque music has the counterpoint and contrast as the main ingredients. Its characteristic is designed to be emotional in nature having a more rigid formal design with modern tones and experimental rhythm using the combination of a firm and repeatedly strong bass line with florid treble as composers aimed to communicate with contemporary music in accordance to their affectionate behavior. Musical forms are not stiff to instrumental music alone.Along with suite, fugue, partita, canzona, sinfonia, fantasia, ricercar, toccata, chaccone, sonata, concerto and concerto grasso, which the orchestra is composed mainly of different musical instruments to create a smooth polyphony sound, the use of vocal music with the form of cantata, monody, anthem, passion, masque, chorale prelude, oratorio and opera started to emerge and soon became in-demand. The incorporation of ballet dancing and theatrical arts is also introduced, and the public appreciated it as such. The Era of Baroq ue Music 1600-1630 (Early Baroque)The death of Renaissance period segued into the Early Baroque Music in the year 1600. It started when the Florentine Camerata decided to reinvent the conventional polyphonic sound from complex arrangements to basic accompaniment and simple melodies. As a result, counterpoint musical compositions began rising. The initiative to use chords instead of notes created tonality, and harmony is then expressed. As Baroque genre is starting to emerge, Protestantism also appears elsewhere in Italy. Experimentation in arts and music becomes powerful in reviving Catholicism.Instrumentation and lively orchestral music was one of its products. However, when public grew tired listening over purely musical instruments, another innovation come out. The use of music and text is demonstrated in Orfeo, the first ever opera composed by Claudio Monteverdi with the use of singer actors and music combined. 1630-1680 (Middle or Classic Baroque) Due to the patronage in Baroqu e genre, availability of orchestral instruments increased. Playwright artists gave vast contributions and became popular as well as opera and other theatrical drama, dances such as ballet, and vocal music genre.Most of their themes were excerpted from the rhetorical approach of Greek and Roman in arts and music. Formal teaching of art lessons specifically music started in Middle Baroque to give focus more on music and harmony. Counterpoint compositions turned out to be more systematic and well-arranged. However, the attractiveness of theatrical genre did not give concerto and concerto grasso a hindrance to be accepted. Instead, music in this era is more appreciated by the public. Some of the endless masterpieces created during the Classic Baroque survived until today like George Friedrich Handel’s Hallelujah and Johann Pachelbel’s Canon in D.1680-1750 (Late Baroque) The declination of Baroque period began in the year 1680 and ended in the year 1750. Germany in this tim e adopted Italy’s artful tradition that they developed later on putting German touch. Music here was high-priced due to the demand of royal courts and members of the aristocracy. European art-music started to be respected by other neighboring continents like the United States of America. Knowledge and scientific discoveries as well as art and music were given utmost attention where composers and musicians are treated patrons even by the secular and religious members.Before the Baroque period moved to classical era, another significant innovation in music has been made available, and two composition styles were observed. These are called â€Å"the homophonic dominated by vertical considerations and the polyphonic dominated by imitation and contrapuntal considerations†. (Wikipedia par 69) Composers and Musicians of Baroque Era Further studies of Thornburgh and Logan said, â€Å"Baroque musicians were not concerned with expressing their own feelings and emotions, rather they sought to describe with objectivity, feelings and emotions which were distinct from what they actually felt†.(par 21) Here are some of the most admired, influential and well-appreciated composers, playwright artists, and musicians during this era. Italy: Monteverdi, Frescobaldi, Corelli, Vivaldi, Domenico and Scarlatti France: Corneille, Racine, Moliere, Couperin, Lully, Charpenter, and Rameau Germany: Praetorius, Scheidt, Schutz, Telemann, Pachelbel, Handel and Bach England: Purcell, Donne and Milton R E F E R E N C E S Baroque Music. Wikipedia, the free Encyclopedia. 11 Nov. 2007 < http://en. wikipedia. or g/wiki/Baroque_music>Bukofzer, Manfred. Music of the Bartoque Era. New York: Norton Company Inc. , 1947 Kisser, Brandon. A Brief History of Music: The Baroque Era Part I. Sept. 2007. Newsvine. Com. 12 Nov. 2007 Temperley, Nicholas. Baroque Artists of Champaign-Urbana: Baroque Music. 11 Nov. 2007 < http://www. baroqueartists. org/guide. asp> Thornburgh, Elaine and Log an, Jack, Ph. D. Baroque Music Part One. 12 Nov. 2007 Baroque Music According to Craig Wright, â€Å"â€Å"baroque† is the term used to describe the art, architecture, dance and music of the period 1600 to 1750 (Wright, 97). † The sound has been described as â€Å"rough, bold [and] instrumental† (Ibid). Originally, the term â€Å"baroque† was pejorative (Ibid). One of the main traits of baroque art and architecture, that extends itself to the music of the period, is massiveness. Everything in baroque society was larger than life. Grandiose was also a term that was used to define the music of the period.With this grandiosity was also an attention to detail that showed itself in â€Å"vigorous, pulsating rhythms with strong, regular beats and many smaller subdivisions (Ibid). † During the baroque period, there was much development and innovation in the field of music. During this time, three musical forms developed and reached their zenith, the Baroque Opera, Concerto Grosso, and the Cantata. These three forms were be st represented by Claudio Monteverdi, Antonio Vivaldi, and Johann Sebastian Bach. The first form that came to innovation was the Baroque Opera. This was best exemplified by the operas of Claudio Monteverdi.One of his operas was The Coronation of Poppea. In it, you hear the swelling melodies and subtle undertones that define baroque music. Though it is one of Monteverdi’s last compositions, many critics view it as one of his best, sowing the seeds for all future Italian opera. Tim Smith of the Baltimore Sun notes that â€Å"[t]his is a pinnacle of early baroque style (Smith, 2009). † Craig Wright states that Monteverdi and other composers of early opera used a particular style to convey heightened passions. It was a â€Å"new, more expressive and flexible style of solo singing for the stage called stile rappresentativo (Wright, 107).† This form allowed the singer to move from one mood to another without alerting the viewer to the subtle changes in mood. This was a key component of baroque music, as one of the key aims of baroque is to create emotion in the listener and to give a sense of grandness to the vocal production. Eventually, â€Å"stile rappresentativo would soon be transformed into two different and contrasting types of vocal writing, recitative and aria (Ibid). † The second form of baroque music that emerged during this time period was concerto grosso.According to the Encyclopedia Britannica, concerto grosso was â€Å"characterized by a contrast between a small group of soloists and the full orchestra (Britannica, 2009). It flourished eventually as secular music for the royal court (Ibid). Britannica says that the typical â€Å"instrumentation†¦was that of the trio sonata (Ibid). † It consisted of two violins, a bass string instrument and a harmonizing instrument like a harpsichord. â€Å"Wind instruments were also common (Ibid). † The number of movements for the concerto varied depending on the compose r. Some had three movements, others had four.The fast movements â€Å"often used a ritornello structure, in which a recurrent section, or ritornello, alternates with episodes, or contrasting sections played by soloists (Ibid). † The composer best known for this form was Antonio Vivaldi. Vivaldi’s greatest concertos are the series known as the Four Seasons. More than 150 recordings have been made of the Four Seasons alone. In his works, you can hear the melodies and subtleties that make up baroque music. The final form of music that was developed during this time was the cantata. The cantata was a form first used by the Italians, and was later adopted by Johann Sebastian Bach.Though Bach never called them cantatas, they were considered such due to their structure. According to the Encyclopedia Britannica, Bach rejected calling his works cantatas because that connoted secular music, and if there was something that Bach was not, it was secular. When one listens to Bachâ⠂¬â„¢s music, one can hear the massiveness of the sound that is obviously designed for a church and for a multi-voiced orchestra. Under Bach, â€Å"the music of the Baroque reaches its greatest glory (Wright, 127). † He was a great virtuoso on the organ, studying his craft by listening to others and even traveling hundreds of miles just to hear a performance.He was a composer of church music, and later became a court conductor. One of Bach’s greatest known cantatas is a seven-movement work known as Awake, a Voice is Calling. It is a more formalized structure, with movements one, four, and seven being choruses, movements two and five being recitatives and movements three and six aria duets. This piece is a chorale piece, which is a spiritual melody or religious folk song (Ibid). The Baroque period, while a young period in musical history is full of new and innovative developments.The opera, the concerto grasso, and the cantata are all innovative developments in music th at show us how our rich musical history developed and changed over the hundreds of years that we have been maintaining our musical heritage. We need to embrace and encourage our musical growth and musical challenges so we may continue to grow as a culture and as a society. Works Cited â€Å"Cantata. † Encyclopedia Britannica. 2009. Encyclopedia Britannica. Web. 18 Apr 2009. . â€Å"Concerto Grosso. † Encyclopedia Britannica. 2009. Encyclopedia Britannica. Web. 18 Apr 2009.. Smith, Tim. â€Å"Opera Vivente tackles timeless ‘Coronation of Poppea'. † Baltimore Sun 09 Mar 2009 Web. 18 Apr 2009. . Wright, Craig. Listening to Music. Second Edition. St. Paul: West Publishing, 1996. Print. Josquin Desprez was a giant of Renaissance music. According to Craig Wright, he was the greatest composer of the Renaissance or any age. He was born on the border between modern France and Belgium and died in the same region.He was attracted to Italy for the same reason many oth er composers were attracted to the region—professional and monetary gain (Wright, 86). He worked consistently as a singer at the cathedral of Milan, the chapel of a cardinal in Rome, the Sistine Chapel of the pope, and in the chapel of the Duke of Ferrara. According to Wright, he â€Å"possessed a temperamental, egotistical spirit typical of many artists of the Renaissance: He composed only when he, not his patron wished; he demanded a salary twice that of composers only slightly less gifted; and he would break into a rage when singers tried to tamper with the notes he had written (86).† One patron threatened to throw him in prison if he did not stop composing for outside clients, yet he was recognized for his genius. He was praised by contemporary humanists of the time, and he was a favorite of Martin Luther, who said in essence, that Josquin mastered the notes; the notes did not master him (Ibid). â€Å"Josquin wrote more than twenty settings of the Ordinary of the Mass and a large number of French chansons (Ibid). † According to Wright, he especially excelled in a form called the motet.A motet is a composition written for a choir, setting a Latin text on a sacred subject. It was intended to be sung in a church or chapel or at home in a private devotion. Most were sung a capella, which literally means â€Å"in the chapel (Ibid). † This means that they were performed by voice alone, without any instrumentals. Instruments other than the organ were not allowed in churches during the Renaissance (Ibid). This clean, a capella sound accounted for the â€Å"often serene quality of the sound of Renaissance sacred music (Ibid).† Wright states that the Renaissance is often called â€Å"the golden age of a capella singing (Ibid). † It is in this setting that Josquin wrote Mille Regretz, a beautiful a capella piece that brings male and female voices together in harmony. The male and female voices play off each other, pulling the listener into the music and the gentle harmonies that are displayed. Josquin’s talent is evident, as the music has clean lines and tones, and the notes are precise and well-toned to blend together flawlessly.The first voices you hear are the male and female voices in harmony, and then it seems as if the female voice takes over, but there is a subtle bass to the tones, then the men dominate the piece while the women play a supporting role. Next the men and women are in harmony together, blending and rising their voices in a slightly mournful tune reminiscent of the Ave Maria. This piece speaks very well to the time period in which it was written.Mille Regretz means â€Å"A Thousand Regrets† in Italian, and it would seem as though this religious piece plays to the penance one would have to pay for their sins. There is a great emphasis placed on the polyphonic nature of the tones, and the multitonalism that results from the blending of the voices; all characteristic of R enaissance religious music. This piece probably represents Josquin at his height, as a power player in the courts and chapels of Italy. Listening to this piece, there is no reason to doubt his standing as one of the premier composers of his day, and this piece attests to it.This has the a capella quality that was desirous in Renaissance music, and there are few voices involved, which means that it was most likely meant for a small chapel and not for a grand cathedral. Josquin accomplished his goal of creating peaceful, religious music that soothes the soul and easily defined the time period in which it was popular. Then there is the quality of imitation involved. Josquin used this technique often. Imitation is a process â€Å"whereby one or more voices duplicate in turn the notes of a melody (Ibid).† You can clearly hear the imitation by the male and female voices as they move through the piece. In Josquin’s imitative writing, all the voices have a chance to equally pr esent the melodic material and all are of equal importance (Ibid). You can also clearly hear the â€Å"point-counterpoint† pattern in the singing that is common when the voices are working together to compliment each other. The sound produced would, on paper, appear to be discordant, but is far from such, as the â€Å"point-counterpoint† creates a harmony that belies what is placed on the paper.The voices work smoothly together to create a cohesive whole, so the piece comes together as a masterwork. Josquin’s work was a sublime effort despite his temperamental soul. Though he may have been tormented by having to achieve perfection, his works show he did just that. We can look at his music and clearly see the liturgical future that music took. He was a pioneer in sacred music, and his contributions must continue to be appreciated for how it speaks to us and our musical future. Works Cited Wright, Craig. Listening to Music. Second Edition. St. Paul: West Publishin g, 1996. Print.

Philosophy of human nature Essay Example | Topics and Well Written Essays - 1750 words

Philosophy of human nature - Essay Example Humans are the only beings who realize their mortality and are able to make a death the most sensational topic for discussions. Inevitability of own death is accepted by people not as an abstract verity but something that is able to bring the biggest emotional shock and touch the deepest feelings of personal inner world. To find the answers on the questions of life sense and existence of life after death, mythology, religion, philosophy and even art present numerous arguments to support both sides of the coin. The theme of life and death is everlasting and essential for the spiritual culture of humanity in all its manifestations. This permanent philosophical matter is widely covered in print and broadcasting media. Reflecting about possibility and existence of eternal life is intriguing, first of all, because we do not know the exact explanation with the lack of doubts in its veracity. Everything that is unconceivable and unknown causes interest and stimulates imagination. The proble m of death and everything that concerns it has been mentioned since ancient times by Plato. Humanity may have a great hope for the existence of life after death; however, there is no any certainty or scientific proof for conjecture. The only thing left is to make assumptions, which are able to form person’s belief and positive attitude or distrust and rejection. The discussion of death may cause various reactions including even groundless prejudices and undisguised fear. However, among respectable scientists, there are a lot of optimists who present persuasive arguments to believe that after death human’s soul does not disappear. One of such literary works that stimulates thinking process and force people to review own opinions is the article of Andrew Dell’Olio, who claims that near-death experience (NDE) is a valid ground to believe in eternal life. Due to the stories of people who have experienced near-death, it has been concluded that when a person dies, the brain still remains its activity and consciousness; otherwise it is hard to explain how people who return to life remember everything that has happened in addition to the new visions that they have seen during the death of the body. According to the statistics, the number of clinical deaths increases because of the technological development and innovations implemented to the medical services, which help to revive a person after death. Therefore, today there are more and more people who have had NDE and based on their memories and feelings some significant conclusions can be made. Despite ambiguity of philosophers’ attitude, Dell’Olio tries to find out whether there is a rational basis to believe that NDEs prove the eternal life. It is evident that studies on the matter of near-death should take into account such factors as mind and body illnesses of the patient and the nature of personal identity. In spite of the fact that life after death is genuinely philosophical i ssue, it is fair to admit that there is a tendency of philosophers to ignore this question mostly because of its over popularity and urgency. Materialists consider that NDE does not represent any interest for philosophy simply because it is only hallucinations, which are caused by the decrease of brain’s activity. Basing his argument on the religious aspects, Dell’

Promotion Research Paper Example | Topics and Well Written Essays - 1000 words - 2

Promotion - Research Paper Example Promotion is inclusive in marketing and is believed to play the part of a marketing investment that is excessively essential in businesses (Gordob, 2010). Over the years, phone manufacturers have had to deal with wireless carriers so that they can have adequate access to their networks. This is the reason most phone companies have their prices dictated by the same carriers mentioned above. High pricing caused people to find other services that can be used in place of the phones. As the struggle went on, different manufacturers have used the technological ideas currently flooding the markets and have come up with the models that have been used to end the struggle. According to latest statistics, world mobile users have greatly increased such that they have surpassed internet users. It has been stipulated that more than forty five million people use smartphones. The fact that almost everyone owns a phone can be attributed to the high quality advertising strategies in the present world (Newton, 2009). This increase in the numbers of the mobile users can only offer promoters hope that the market will soon become phenomenal. In the act of promoting mobile phones, it is essential to understand that most people typically are attached to them. For this reason, the more features a mobile phone offers the better and the more its promotion will result to the company’s prospected success. Most companies seem to have conducted enough research on characterized customer satisfaction, customer research, and products use, but seem to have forgotten to question directly from the customer of their expectations. The promoters need to realize that their aim is to satisfy the needs of their customers as they make extremely large amounts of money. In my opinion, the customers’ demands have not yet been reached despite having new models of phones in the market (Saulimen, 2011). This is because most people

Economic Considerations, and not Justice, should be the Basis of Tort Essay

Economic Considerations, and not Justice, should be the Basis of Tort Law - Essay Example A tort is a common law that deals with resultant interactions between people. It is a civil wrong that mainly ensure the behaviors of an individual does not affect the well-being of another individual. A tort may not encompass an illegal activity, but it concentrates on the harm or loss an individual gets because of another individual action. It, therefore, helps people maintain their previous positions and status they enjoyed before the occurrence of the tort act. In a tort law, the tortfeasor is liable to reinstate the breach of an individual natural position through compensation mainly by monetary terms1. Various debates have prevailed on the intentions of tort law whether to restore justice or ensures people gain previous economic conditions. This is because tort suits make victims transfer problems to other people gaining previous positions while at the same time enduring justice. In as much as torts act as a form of justice, it basis should be economic considerations as justice remain relative through diverse societies. As opposed to common law, this guarantees punishment for the offender upon approval of offense; torts focus on judgment of liability. Concurrently, liability gets paid through economic means that cover compensatory damages to relieve the plaintiff. It is also significant to note that tort does not make judgments based on claims as opposed to criminal laws, which allow claims with support of evidence2. This, therefore, proves torts to be focusing on economic rejuvenation rather than ensuring justice for the offended parties. In an art, shell the argument attempt to reveal the intention of tarts laws, whether to ensure economic fairness of justice. Notably the economic discourse is coming into the forefront of tort law. As a result, many scholars have done proficient research on the arena to establish and gather evidence of the same. From the past, torts remain confused with the aspect of justice while, in real terms, they help restore econo mic lose suffered by the offended victims. They, therefore, are consequential economic loss experiences because of negligence causing a physical injury3. Coincidentally, confusion regarding tort based on justice rather than economic loss also arises due to strict liability accorded to torts. It, however, is essential to note that a difference regarding the economic nature of torts arises due to the strict liability characterized by tort laws. Consequently, torts are not diffusible by excuse or ordinary prudence a factor that approves torts to be focusing on economic justification. Therefore, in as much as torts act as a form of justice the main reason existing behind the action of torts remains economic reactivation4. Various theories can explain the reason why torts consider economic perspectives rather that justice. Deterrence theory, for instance, works on the basis that, for every action, there is equal and opposite reaction. Judging by the principles, deterrence theory ensures people who commit varied offenses remain responsible for their action through limiting future similar actions. From the perspective of this theory, torts subject people to reimbursement of the offended not to ensure justice, but ensure economic stability of the affected5. Consider a person affected by the actions a surrounding industry, which pollutes the immediate environments spreading diseases. The industry is responsible for spreading of diseases, therefore, is responsible for

Managing Environmental Issues Essay Example | Topics and Well Written Essays - 1000 words

Managing Environmental Issues - Essay Example Fryxell and vryza (2007) assert that the simulation focuses on three major environmental philosophies on human responsibility towards the environment. Examples of simulation put in place in order to manage environmental issues include the anthropocentric view, biocentric view and ethical extensionism. The model explored by Fryxell and vryza (2007) explores on how human being inter and intra relates to the natural world and therefore assesses how human activities impacts on the natural environment. Therefore, this discussion contributes to the critical study of the mankind responsibility in protecting and managing the nature and his role in the environment. Environmental justice refers to the fair treatment that explores the meaningful involvement of people especially the minority and low-income populations into the development, implementation and enforcement of the environmental laws, regulation and policies as asserted by Fryxell and vryza (2007). Consequently ensuring coverage of adverse and desperate health impacts that are a burden to the environment and affect also affect the people. Environmental justice is achieved when everyone within the environment can enjoy the same degree of protection from the environment and from health hazards activities of the population. Environmental simulation aims at accessing the decision making process by the stakeholders to have a healthy environment in which all the people can live, learn or work comfortably without any disturbances (Fryxell & vryza, 2007). This is achieved by facilitating open dialogues among many stakeholders involved in managing the environment. In doing this, fair treatment is achieved in involving all kinds of people from different part of the world regardless of their race, color, originality or income with an aim of achieving a healthy environment for the benefit of all. There are many stakeholders involved in the management of environmental

Project Resources Essay Example | Topics and Well Written Essays - 750 words

Project Resources - Essay Example delegation of tasks, and their scheduling to facilitate sequential and feasible delivery. Here the term, "Work Breakdown Structure" (Gerard) becomes applicable, which refers to the approach of setting tasks up in order of precedence and including every detail of the tasks in its realizability. For this purpose, a sequence diagram or a pert chart will come in handy. Consequently, it is paramount to make consultations with the actual job doers and the marketers in order to ascertain the practicability of the structure, its time-table and its possibly guesstimated cost- implications, and to modify the draft-structure, if necessary, according to their recommendations subjected to the manager's critical consideration. The next phase, implementation phase, involves executing the developed concept. Here milestones are set and important stages of accomplishments defined, which become "sub- goals." ( James, 1975) . At this stage, the task of the manager ends at the point of sensible and proactive allocation of tasks to the team members. The remaining work involves the actual job- doers. At this stage, though the manager is not totally out of communication, inter-team communication is the main sort of communication. However, since the fulfillment of the project rests entirely on the success of this very essential phase, constant and multiplex must be the communication among the project team towards: 1. A sustained focus - so that every team member keeps to the goal and does not divert; 2. Topicality of suggestion - so that unenvisaged circumstances and conditions are answered, every member necessarily liaising with others and with the project manager to keep the project team posted.... Always keeping eyes on completion according schedule, the manager is concerned that the work should be closed out as planed; when he sees a possibility of failure, he constantly urges, presses, admonishes the workers to greater effort, and works to answer emergencies by making urgent telephone calls, writing letters, making personal visits and errands, etc. The workers, in turn, if cooperative, not only diligently mind their own businesses, but alert their managers on any emerging material or personal emergencies. "Customers feel let down by tardy delivery, staff are demotivated by constant pressure for impossible goals, corners get cut which harm your reputation, and each project has to overcome the same problems as the last" ( Ibid) All these vagaries call for daily communication among the project team- from and to the manager and the workers- call for moral encouragement, recommendations and suggestions.

Core nursing competencies Essay Example | Topics and Well Written Essays - 750 words

Core nursing competencies - Essay Example They are, providing patient focused care. The nurse should have the patient as the center of their attention in providing fully fledged care and attention. A patient is the main reason for the existence of the nursing occupation anyway. Therefore it is the role of the nurse to provide ultimate care to the patient without diverging interest. The second competency involves being able to work in interdisciplinary groups. This competency requires respect among workers which is one of the provisions in the ANA code of ethics. Interdisciplinary workers come from different departments in the health care system who work together to provide health care services. All the professionals in healthcare work together to attend to the patient’s needs and meet effective patient care results. The third competency is using evidence based practice. This requires knowledge of processes and procedures in handling patients well enough. Methods of handling patients should be established so as to iden tify the methods that suit patients most. The third competency involves utilizing quality improvement. Multiple strategies get used in order to maximize the use of resources in serving patients. This should aim at making quality improvement effective. The best research strategies get utilized, clinical expertise are not disregarded and patient values to make patient care decisions. The fifth competency is use of informatics. This involves error reduction, good management of information as well as knowledge, decision making and communication. Nursing from a health care perspective looks at the many challenges that nurse’s face in their work. Most nurses can relate to stories of victimization at their workplaces (Bureau of Labor Statistics, 2012). Form the interviews of nurses on their experiences as nurses, it is right to conclude that it is an occupation that contains a lot of challenges to face. Some of the challenges in the nursing profession include the media’s nega tive image, challenges in nursing recruitment as well as retention, workplace culture and education. There have claims that nursing education theory differs from the practical work. Nursing is also disconnected from other spheres of influence in other areas of study. There is poor communication with other disciplines as stated. This creates a gap between nursing and other disciplines that could contribute to the efficiency of nursing. These other disciplines offer unique perspectives that could offer interprofessionalism. Health care safety remains a key matter in the profession. Safe practice with all people the nurses come in contact with improves communication with them. It also involves the nurse’s ability to think critically and apply the knowledge they have gained (American Holistic Nursing Association, 2012). They put their skills best in use and use their general wisdom in providing their service. Victimization, powerlessness and the inability to achieve things in the nursing profession has been a hurdle needed to be overcome. This has resulted in the undermining of the nursing profession. Many get external information that nursing is a hard and challenging job that would not be as satisfying. Nurses in the profession already get leveled at a lower status than other professions. It would not be because health care is undermined but how people perceive nurses. As This results to fewer people having the interest to become nurses. Nurses in colleges do not get enough preparation on

Seminary in Brooklyn Should be Encouraged Essay Example for Free

Seminary in Brooklyn Should be Encouraged Essay In the beginning of twelfth many girls have the conflict of deciding whether they should attend a year in Israel for an experience in Jewish studies, or to stay home and have the same kind Jewish Studies of experience in New York without being in Israel and attend college. In this beginning time period of twelfth grade the chatter of whose going to seminary and whose not are the constant conversations. This causes way too much stress and tension on girls regarding which seminary in Israel they should apply to. Not applying to seminary It makes the twelfth grade year an unstressed year. Twelfth grade should be a stress free zone since it’s the last year spending time with your friends. Seminary is valuable, but Israel is not necessary. Seminary in Israel should not be presented and pushed as the only alternative. Schools tend to forget the spectacular seminaries we have here, in Brooklyn NY. of November, schools start to bring seminary into talk. Signs for open houses, seminary meetings, option nights are posted everywhere. Option night is an assigned night for all twelfth graders along with their parents to attend. What goes on this night is that one representative from each seminary speak. They speak about the seminary they attended send describe their own personal experience with that seminary. They give the audience a feel of the seminary. Students and parents go home with a lot of confusion. Which seminary is my daughters’ type? Which one will she do well in? so many difficult questions arise. This turns into stress. In my opinion if they speak about Brooklyn seminaries and not hide it in the sand, it would change plenty of parent’s minds, and make the decision an easier one. Seminary advisors send out notes to set up a meeting with each individual student along with their parents. The goal of this meeting is to help make the right decision for the gir l and what is best for her. The seminary advisor takes out a list of all seminaries, and goes through each one individually. She tries cutting down the seminaries that are not the right fit for the student. This minimizes their selection and makes it easier for the girl and the family to choose what is best for each individual girl. The seminary adviser that is assigned to each girl does help many girls, but I think they are mainly focusing on the Israel part and barely mentioning staying home. Peer pressure at this point is above indescribable. Girls that don’t really want to go and would be okay in Brooklyn are feeling that pressure, â€Å"my friends are going therefore I should go.† I went through this myself. I didn’t want to feel like that loner that’s giving away the opportunity, and going to stay home alone. Seminary in Brooklyn is definitely not being discussed as much as it should be. It should be equally advertised as Israel is. I feel this system should be changed. Schools should cut down on the pushing girls to go to Israel. and start focusing on the superb seminaries we have here in the United States. I’ve interviewed friends of mine whom experienced the Israel seminary program along with those who have stayed in Brooklyn seminaries. Debra was in Darchei Bina for a year. She had a grand year. The one word she used to describe her experience was â€Å"indescribable† she had no words to describe her experience. I asked her what she gained from that year and why she would encourage Israel seminary. She answered me back one word â€Å"friendship, that’s the highlight of my year†. I told her to explain and elaborate on what she meant by that. She said the friendships she made within those ten months of her life she will always cherish forever. She became closer to girls in 10 months, than she as with her friends back home that she was with for years. I asked how such a thing is possible. She replied briefly â€Å"seminary is a time period where a girl is mature and knows what and who she is in life, and what she wants to perceived as in the future. She knows what type of friends are good for her and which girls will help her and be the person she wants to be in the future, you find those few friends who will stay with you forever. Debra is already four ye ars out of seminary. Her closest friends she made that year live in London and Chicago. They speak every night and visit each other on occasion. She brought up a good point because in higschool you move from friend to friend because nobody is stable yet. I personally say that you can find those same friends in Brooklyn seminaries. It will definitely take longer to bond but at the end of the day you will find that. It will take longer since you’re not together 24-7. You’re together for a couple of hours a day. Debra brought up a fantastic point; some girls need that quick friendship process that brings everlasting friendships. Not everyone needs that and not everyone gains such friendships in Israel, it’s not guaranteed. Another friend of mine, Michal who attended seminar told me about her experience. Michal focus and reason to go was to gain independence. â€Å" I used to be that girl that needed mommy for everything, whether it was driving me places, going shopping, or even making my bed.† After a year of completing the seminary stage in her life she said she is no longer that same old Michal anym ore. She’s more independent than anyone else can be. â€Å"Without that one year of Israel I wouldn’t be who I am today, I would be a mommys girl that nobody appreciates†. For her it was the best move of her life. Girls who need that sense and feel of living on your own and become independent, Israel may be a success. Some girls do need that. Doing laundry on your, cleaning, folding, taking care of shabbos meals, basically doing everything without mommy. On the other hand she shares the negative part of her experience. She is used to a cozy comfortable life. Her clean room, her clean spotless house. She had a very hard time adjusting to this big switch. She said everything in seminary is flying, its ugly. She believes a girl should know what she is coming to before she registers for seminary. â€Å"Its not something a person should jump into, if you’re that type of clean person, think twice before coming.† This was difficult for her but she kept telling herself I’m here for the right reason, to gain independence, therefore I will live with this. â€Å"If a girl doesn’t have the right reasons to come, I believe she should stay in Brooklyn seminary.† I enjoyed interviewing Michal. What she said really touched me. It did bring a valid point that girls should be aware of. Mrs. Edery, a parent of a twelfth grader explains as follows. â€Å"It’s so unfair and unnecessary to us the parents to spend so much money on seminary in Israel, it’s a burden these schools are putting on us it seems like they don’t realize what’s going on in this economy.† She said plenty of parents cannot afford it financially but feel the pressure to take every penny and even loans to send their daughters. She does not understand what’s wrong the seminaries here that they are not being enforced. I’m on the same boat as Mrs. Edery. If seminary in Israel is so important and they feel everyone is obligated to go, they should cut down tuition fee. There are scholarship programs that some families are qualified for. Even with that help it’s difficult. Chevy, who was recently a kallah, tried giving over her point of view regarding isreal. She brought up an excellent point that many people only realize once they get back from Israel. Free time in Israel can lead to bad and downfall of a person. When you’re free and bored you look for bad, that’s nature of a person. This defeats the whole purpose of â€Å"growing† in Israel. Most parents are naive and tend to throw this right over their head while they’re figuring out the seminary for their daughter. â€Å"If parents knew what goes on there at certain hours, certain places, they wouldn’t even think twice to send their daughters there† I was actually in Israel a couple of weeks ago and I was astonished by what goes on. Bis Yaakov girls hanging around because there are no night classes certain nights. These seminaries are trying to do well but they are missing an important point. Every parent wants only good for their child, in my7 opinion they should go check out the scene there before sending their child. In Brooklyn a girl has parents watching her and controlling her. This saves her from falling most of the time. A person has to be extremely strong and know their limits if they’re planning on spending the year in the holy land. Mrs. Fink, a seminary advisor in Prospect Park agrees with this free time issue. She says people sometimes get this wrong. They think they’re entering a place with kedusha and its going to stop them from doing bad. That’s not true, because if a person wants to do bad he will find his way. So you really have to know yourself ad beware of this. Boys are sent off to Israel and they hang out on the streets that are a danger for girls. She also explains how Israel is amazing because you focus on limudei kodesh and spiritually a whole day. This is a watering the seed of a person to grow. But in Brooklyn it’s just a couple hours of the day and the rest is secular studies. It’s a big expense; some families financially can’t afford it so the child has to understand accept this matter. â€Å" some families need that extra 20,000 dollars for the Childs wedding, instead of spending it on seminary† after seminary the girl iyh is ready to get married and the chatuna is a big expense, so seminary expense should be cut down. Another reason Mrs. Fink thinks a girl should stay home, Shabbat placing. Although seminaries make sure you have a place for Shabbat, it’s not always that homey atmosphere a child needs. Girls are sent to random families they don’t know, how can parents let such? It’s hard for some girl not to be in their own home, in the atmosphere they are used to for Shabbat. One of my cousins, Leora, went to BYA maalot here in Brooklyn, NY. â€Å"Main reason why people go to seminary is to grow, and they think that can only happen in Israel, but here I am proving them wrong† She grew tremendously, great hashgafa and great teachers. She met a lot of new girls and built real true friendships with them. â€Å"All my friends went to 9sreal, I felt left out at first but after gaining so much I realized how lucky I am to attend seminary near home†. She said it was really convenient instead of sleeping in a dirty dorm room she was able to sleep in her own house and bed and even go to seminary!!!! Some girls think they won’t grow by staying in Brooklyn. It’s because our schools aren’t discussing and bringing girls in whom had great and meaningful experiences here. â€Å"I wish I was able to repeat seminary in Brooklyn again† Leora is already 2 years out of seminary and still values every moment of her attendance to BYA m aalot. Marlene, a friend of mine whom also stayed in Brooklyn agrees with my cousin Leora. She attended Machon in Boro Park. â€Å"The teachers were role models, their hashgafa was amazing, I wanted to grow and gain some more torah knowledge before entering the next stage in my life, and yet I did.† Marlene fell into peer pressure and did apply to seminary in Israel. Her sister veevee, who went to Israel a couple years before convinced her not to go. Veevee went for the wrong reasons, peer pressure. She saw what it was like and returned home after a couple of months and attended seminary in Boro Park mid November. She didn’t feel the obligation to be in Israel when she was able to be home and gain the same thing. Therefore she told Marlene the truth that it’s a fashion statement to go to Israel. â€Å"You want to grow, you can even grow in Brooklyn, and it doesn’t say in the torah that growing only works in Israel†. I strongly agree with this, it’s something important that should be taken into concern. A downside about Israel seminary from my point of view is brain wash. I see it with my own eyes, m=when my friends come back from seminary in Israel they are totally different. The ones that become frumer are brainwashed for six months then they’re back to themselves how they were before leaving to seminary. I see this with all my friends that went to seminary and grew for the better. It stops the girls from dating right away, they have to wait till that â€Å"brainwash† is washed away, or else this can be dangerous. As opposed to the ones that stayed in Brooklyn, I’ve never came across such incidents. Some girls do need Israel. Some girls need the experience for the right reason. It’s a big decision that needs a lot of thought out in to it. Parents and schools should put Brooklyn seminaries on their list too and set aside time to look into it. No question there are many people whom go to Israel to study but thank god we are blessed to have fine seminaries here in Brooklyn, NY that a girl can grow spiritually and gain similar benefits. In my opinion this whole Israel â€Å"business† is a trend and everyone feels the need t o stay in fashion and be in style. The fact that schools aren’t focusing on Brooklyn seminaries it makes this concept a tougher decision then it really should be.

Literature Review on Pricing Strategies and Theories

Literature Review on Pricing Strategies and Theories Abstract: This purpose of this research is to study how the organization decides the price for the products. As price is considered has a very high sensitive factor of an organisation. In this study we are going to see the role of Pricing, different methods of pricing and effects of pricing on organisation and consumer behaviour. The pricing is explained with literature review followed by critical evaluation and ends with solution with valid recommendation. Introduction: Customers and determination of price is necessary for every organization. As this both customers and price have a high relation to the demand for products. Even there is a small increase in price levels it will highly affect the demand for the product and the organization profit. The price determines what products/services could be produced and in what quantities. Secondly it determines how to produce and finally whom to produce. There organization should be cautious while altering the price for the goods and services by changing the quantity, quality and by providing premiums or discounts, acceptable form. When there is raise in demand for service will led to increase in prices, which in terms led to concern of public or governmental activity. There are different ways in which the price of the products is determined. These are the foremost strategies that business use like Competition based pricing, Cost-plus pricing, Creaming or skimming, limit pricing, Loss leader, Market-oriented pricing, Penetration pricing, Price discrimination, Premium pricing, Predatory pricing, Contribution margin-based pricing, Psychological pricing, Dynamic pricing, Price leadership, Target pricing, Absorption pricing and Marginal-cost pricing. As their name it explains the method of pricing. Methods: Pricing was considered has a process towards achievement and to face the competitors of business. So that organisation thinks effects of pricing should be the targeted on returns. What method of pricing to be adopted. Whether adopted pricing would attract the customer and maximize the profit of business. Determination of price requires the organisation fully focused on the markets. These strategies should be considered while determining the price for the product. Aims Objectives: The aim of this research is to investigate; whether CRM supports the Marketing Strategies of an Organization. To conduct the literature review on Pricing Strategies To evaluate the methods of pricing theories To analyse the effects of pricing on returns. Literature Review: Customers are important for every organization. Numerous researches had been conducted for determining the method of pricing, which is explained in Literature review, has normally segregated in two divisions. First division will explain about a pervasive context about the, pricing and methods of pricing. The second part of this assessment deals with the previous related studies. Price is a highly sensitive factor of an organization. The standard economic analysis of pricing is based on the customers desire for the product its usually depends up on the income of the customer and other factors like ethnic origin. There are some consumers may pay high prices, while others willing to pay only lower prices. Instead of charging same price to all, the organization decided to charge different price for different customers as it will increase the business profit. This method of pricing is known as price differentiation. In earlier days sellers of perishable goods would sell the old products at low price instead of dumping or taking back home. If the price of competitor product was reduced it is necessary to reduce the price of the product, as it could create loss of customer and market. The pricing based on the competitors is competitive based pricing. The simplest method of pricing is cost-plus pricing. It just calculates cost of producing the product and adds on a percentage of profit to that price. Sacrificing high sales for gaining higher profit. Low volumes at high price. This is suitable for products that have short life cycles. It skims the profit from the market. It is known as market skimming. A monopolist set limit price to discourage others entry in to the market. Limit pricing is illegal in many countries. Loss Leader pricing strategy was illegal under EU and US. They sell the product below the cost, so the loss appears as public interest. It is similar to predatory pricing. Some business set their prices based on the analysis and compiled from the target ed market. This is known as Market-Oriented pricing. The organization set different price for the same product In the different segments to the market. This method is called Price discrimination Psychological pricing strategy the price is designed on the positive psychological impact on customers. For example, price of the product at  £3.95 or  £3.99, rather than  £4. Price leadership is an observation that usually one company would be the dominant competitor among several other companies. They will follow that soon. Target pricing strategy is calculated to produce a particular rate of return on investment for a specific volume of production. It is often used by public utilities and companies with high capital investment. These methods of pricing all the cost incurred are recovered. This is a form of cost-plus pricing. The practice of setting the price of a product to equal the extra cost of producing and an extra unit of output is marginal-cost pricing. The impact of price e lasticity should be considered while deciding the price. The degree of price elasticity focuses on the proportionate changes. The percent of change in price would be something less than the fall in sales is inelastic price. In case of price elastic the percent of change in quantity demanded greater than change in price. Slow inflation rates from other countries economies have led to the need for new approaches of pricing strategies. Five factors to be considered on determining the price are Demand, cost, competitive factors, corporate profit and market objectives and regulatory constraints. Previous Related Study:- Combivir and Trizivir case study â€Å"Some of the more dominant groups with observe to pricing in the HIV market are patient advocacy groups. Distinct patients on other condition, save probably cancer, HIV/AIDS patients are predominantly mobilized and oral when it arrives to treatment. This had guided to the growth of a widespread expanded admittance programs for products in development, and then patient assistance programs for new, costly products. Companies are well aware of the benefits of maintaining a positive relationship with the patient base. Combivir was launched essentially the same price as the some of the components. This not only replicates GSKs desire to make new treatments accessible to patients at a reasonable price, but also that mixture therapy was flattering more widespread and that physicians did not need a discounted price to justify recommendation. However, clearly single-agent therapy is still commonly used, as lamivudine unit sales (not including combinations) continue to be greater than Combivir unit sales. Only around the end of 2002 do lamivudine unit sales begin to decrease. Trizivir was also priced similarly at the some of its components prices, indicating the companys aspiration to keep it available to treatment for immature patients. GSK held Combivirs price the same in most markets when Trizivir was launched. The intension was not to have Trizivir cannibalize Combivir patients. Combivir still had a low price relative to Trizivir which would continue to make it attractive to many physicians. Sales of Trizivir quickly slowed as a result of clinical results showing that the three drugs used in the fixed-dose combination were not as effective as other three product combinations. Combivir has not had similar clinical setbacks and has continued to enjoy strong, but flat, sales.†( Combivir and Trizivir case studies) In this case study Combivirz has adopted the market oriented pricing method and penetration pricing hence it can be able to survive in the market after the tough competition with Trirzivir. Determination of price is considered as important to survive in the market and to gain consumer interest. Borden Company vs. Federal Trade Commission In 1958 the FTC issued a complaint against Borden Company for selling the same products to different customers at a different price and ceased price discrimination on goods. Tom Nagle, Reed Holden, Kent Monroe, Eric Mitchell had trail the price leadership and companies following these ideas but when it is tested with the scientific methods invented like hypothesis does not fetch the expected results. Michael V.Marn, Eric V. Roegner and Craig C.Zawada has analyzed about price wars in the book The Price Advantage explains how to react for the change in price of competitors. They said that make the customers focused on the benefits, do not over spend on advertising, gaining the market share rapidly from one or two competitors. Rapid changes in the market almost set the price war. Do not react until you understand the reason for price cut of competitor. If you dont understand the well delay your response until you understands the facts. Do not react with lower price as it affects the organization. They suggest when there is need in change of price it is necessary to analyze the consequences as it could affect the market and over all organization. â€Å"Thomas Nagle and Reed Holden outline 9 laws or factors that affect buyers price compassion with respect to a given purchase in the book The Strategy and Tactics of Pricing. o Reference Price Effect Buyers price sensitivity for a given product rises the elevated products price relative to apparent alternatives. Perceived alternatives can vary by buyer segment, by occasion, and other factors. o Difficult Comparison Effect Customers are less sensitive to the price of a known / more reliable product so they would have complexity of comparing it to possible alternatives. o Switching Costs Effect The higher product-specific on investment a buyer must make to switch suppliers, the less price responsive that buyer is when decide between substitutes. o Price-Quality Effect customers are less sensitive to price they think higher prices seems higher quality. Products for which this result is particularly relevant. o Expenditure Effect Buyers are more prices sensitive as soon as the expense accounts for a large percentage of buyers obtainable income or budget. o End-Benefit Effect The effect refers to the relationship a given purchase has to a larger overall benefit, and is separated into two parts: Derived demand: The more responsive buyers are to the price of the end benefit, the more responsive they could be to the prices of those products that contribute to that benefit. Price proportion cost: The price amount of cost refers to the percent of the total cost of the end benefit accounted for by a given element that helps to produce the end benefit (e.g., think CPU and PCs). The lesser the given components portion of the total cost of the end benefit, the less sensitive buyers will be to the components price. o Shared-cost Effect The smaller the portion of the purchase price buyers must pay for themselves, the less price sensitive they will be. o Fairness Effect Buyers are more sensitive to the price of a product when the price is outside the range they perceive as â€Å"fair† or â€Å"reasonable† given the purchase context. o The Framing Effect Buyers are more price sensitive when they perceive the price as a loss rather than a forgone gain, and they have greater price sensitivity when the price is paid separately rather than as part of a bundle. Critical Evaluation: The research conducted on the supermarkets the Cost effects all the other coefficients are important and reliable with well-mannered approximate reproduction, representative to contributing extra services produce extra costs bear by the supermarket chains. The approximate limitation for the long-run charge components designate that 0.15% and 0.21% (respectively) of the extra long-run cost for effective food and non-food services is owed to milk sales, while the amount of the additional cost of operating a store that is 1,000 square feet /larger owed to milk sales is 0.13%. Also, although the additional long-run cost module does not collision the short-run marginal cost, at the model averages, for each gallon of milk sold the long-run marginal cost of services is approximate equal to $0.0216 for the in-store services model and $0.0158 for the store-size model. Overall, the results confirm Ellicksons (2006) finding that retailers provide Quality with an augment in fixed costs, followin g Shaked and Suttons (1987) endogenous cost model.( Journal of Revenue and Pricing Management) The estimated marginal collision of retail services on milk prices (at the sample averages). Affects milk prices positively, in constancy with preceding answer (Cotterill 1999; Bonanno and Lopez 2004). spotlight on the in-store services model results first, food services show a marginal price-increasing effect roughly one-third that of non-food services. While the consequence of non-food services on milk prices is mainly due to marginal cost changes, the effect of food services is mainly due to market power. It should be noted that there are considerable economies of scope produce by increases in food services.( Journal of Revenue and Pricing Management) A limitation of the analysis offered in this article includes dependence on strong supposition based on the nature of supermarket competition. Prospect research might expand the analysis by comforting the short-run monopoly postulation to unscramble the communications between strategic pricing and service provision. Another noticeable limitation is the use of burly functional forms used for the demand and cost functions. The use of more elastic functional forms, although hard to apply with the available data. ( Journal of Revenue and Pricing Management) First, the study was limited to one service setting and one customer segment. Additionally study transversely other services that apply revenue management and other customer segments is needed to institute the simplify aptitude of our conclusion. Secondly, the data used in the revise were obtained from an existing survey database. Research using review instruments specially intended for a field study should also be carry out to determine the robustness of the results. Finally, the study did not, nor was it planned to; detain all of the qualifications of revisit meaning. In particular, there may be extra factors power the relationship between price and customers return intentions. An attractive research area to believe is role of customer discernment of value in the price-return intentions relationship. The effect of affective commitment on the price-return intentions relationship also merits examination. (Journal of Revenue and Pricing Management Vol. 7, 4 357-369) the steps needed to appropriately implement the strategies: breaking down pricing decisions by region or by customer segment; constructing result on rigid data filter during complex software; basing optimal prices on inventory positions, offering manufacture capacity, demand predictions and aggressive market conditions; and creating â€Å"sense and respond† mechanisms that allow them to test often and react fast. Conclusion: The pricing strategy is considered as the success factors for the organization. Now we know the consequences of pricing decision are likely to have on customers purchasing behaviours—and on financial performance, regionally or globally, short term and long term. They could plan more assertively for the potential on more calculated risks and creation of fewer guesses. Finally, effective pricing is the most excellent way to make the major difference in earnings while conserving unit sales and market share. It is, in effect, the last major step on the path to high performance. References: †¢ The price is right . . . isnt it? Greg Cudahy and George L. Coleman †¢ Competition effects of supermarket services Alessandro Bonnanno and Rigoberto A.Lopez †¢ The effect of price on return intentions:Do satisfaction and reward programme membership matter? Breffni M. Noonen and Daniel J. Mount 2008 Palgrave Macmillan, 1476-6930 Vol. 7, 4 357-369 Journal of Revenue and Pricing Management †¢ The price advantage By Michael V. Marn, Eric V. Roegner, Craig C. Zawada †¢ Pricing on purpose: creating and capturing value By Ronald J. Baker

Pharmacogenetics And Pharmacogenomics In Pharmacy Practice Biology Essay

Pharmacogenetics And Pharmacogenomics In Pharmacy Practice Biology Essay The study of the interaction between genetics and therapeutic drugs is variously called pharmacogenetics or pharmacogenomics. The differences between the two are the initial approach of the science: Pharmacogenetics starts with an unexpected drug response result and looks for a genetic cause. Pharmacogenomics, on the other hand, begins with looking for genetic differences within a population that explain certain observed responses to a drug or susceptibility to a health problem (The Australasian Genetics Resource Book, 2007). Pharmacogenetics refers to the study of inter-individual specific genetic variation (Zika et al. 2006). The term pharmacogenetics is occasionally used in a limiting sense to describe how different gene variants affect drug-response but it can also be defined more broadly as the study of the effect of heredity on human drug-response (Newton et al. 2007). Factors that influence how an individual responds to medication include their external and internal environments and overall health, as well as their genetic make-up. The goal of pharmacogenetics is to understand the role that an individuals genetic make-up plays in how well a medicine works, as well as what side effects are likely to occur in the individuals body. Understanding this can help tailor drugs in the future best suited for a particular individual (personalised medicine) or group (The Australian Genetics Resource Book, 2007). The small differences in the genes between different population groups, or some families within a population group, that have built up over the generations can mean that they react differently to medicines. However, some diseases, notably cancers, develop in cells which have an altered genetic constitution, so that the genetic make-up of the diseased tissue is no longer the same as that of the person in which it is present. Specific genes present in the diseased tissue may play a critical role in determining the optimum treatment. To establish this, it will therefore be necessary to identify the genetic make-up of the cancer itself: testing the patient before a cancer has developed is of no use, because the genetic changes are only present in the cancer cells and not in the normal host tissues (Nuffield Council on Bioethics, 2003). Some potential benefits of pharmacogenetics include the following: More powerful medicines: Drugs may be developed targeting specific health problems that will maximise therapeutic effects but decrease damage to nearby healthy cells Safer drugs the first time: Doctors could have an idea which drug to use based on a genetic profile versus trial and error, decreasing the likelihood of adverse reactions More accurate methods of determining dosages: Instead of dosages being based on body weight and age, it would be based on an individuals genetics. This would decrease the likelihood of an overdose. Better vaccines: Vaccines made of genetic material could activate the immune system to have all the benefits of existing vaccines but with reduced risks of infections (The Australasian Genetics Resource Book, 2007). Implications of pharmacogenetics in practice are vast and encompass broad areas such as: Drug response the effects of angiotensin converting enzyme inhibitors have been found to be greater in people of European or UK ancestry than African-Americans. Pre-treatment genetic screening of patients will eventually enable this knowledge to be applied in clinical practice. Moreover, variation in the genes that code for receptors (drug targets) may mean that some people may produce receptors that do not interact well with the drug. For example, some people have a lack of response to the drug salbutamol, used in the treatment of asthma, due to genetic variation in the gene that codes a receptor on the surface of smooth muscle cells lining airways of the lungs. Drug targets Genes may also determine how many of the receptors are produced on or within cells and genetic variation may mean that some people produce more of these sites than others. The action of the widely used antipsychotic drug haloperidol (Haldol) depends on its ability to bind to the dopamine (D2) receptor site. In one study, 63% of patients whose genetic make-up caused a large number of these receptor sites to be produced had a response to treatment with haloperidol. About 29% of patients with a smaller number of dopamine (D2) receptor sites responded well to the drug. Drug metabolism Pain relief medications such as codeine require an enzyme produced in the liver called CYP2D6 for the drug to be used by the body, break it down and remove it. Variations in the information contained in the CYP2D6 gene determine how much of this enzyme is produced in the liver (The Australasian Genetics Resource Book, 2007). The implication of variations in genotype on the metabolism of the immunosuppressant azathioprine is also an example. Polymorphisms in the gene encoding for the enzyme thiopurine S-methyl transferase (TPMT) lead to changes in the activity of the enzyme and rate of metabolism of azathioprine. Changes in the activity of the enzyme present clinically as an increased risk of neutropenia or a decreased chance of responding to azathioprine, at normal dose ranges. A genetic test for the polymorphism can identify individuals who are more likely to develop neutropenia. Thus, the aim of a pharmacogenetic test here is to minimise an adverse effect, although in other cases, a pharmacogenetic test may be able to predict an effective responseto a medicine by correlating an individuals genotype with the observed pharmacological actions of medicines (phenotype) (Clemerson et al. 2006). Drug development Excluding from clinical trials those people whose genetic makeup would make the drug being tested harmful or ineffective for them will increase the chance that a drug will show itself useful to a particular population group. This would increase the chance that the same drug will make it into the marketplace. Undertaking pre-genetic screening of those patients taking part in a clinical trial should also make the clinical trials smaller, faster, and therefore less expensive. For example, as seen in clinical trials for developing drugs for Alzheimer disease and other forms of dementia (The Australasian Genetics Resource Book, 2007). The application of pharmacogenetics has two main aspects: improvements in the safety and efficacy of medicines. In improving safety, pharmacogenetics works in the following ways: Pharmacogenetic tests reveal genetic variations already known to be associated with adverse reactions, allowing physicians to avoid exposing patients to medicines that would put them at risk. The majority of adverse reactions are caused because of an exaggerated effect of a medicine in the body. Less often, an adverse reaction may be an idiosyncratic response to the medicine. Adverse reactions to medicines have significant costs, in both human and monetary terms. However, it is difficult to ascertain the impact of genetic variation in response to medicines because data concerning adverse reactions often include problems caused by errors in prescription, and because information about other causes such as interaction between different medicines may be non-existent. Results from pharmacogenetic tests may also inform physicians in selecting the medicine most likely to benefit a particular patient. Many medicines are effective in only a proportion of patients treated. Sometimes, for a medicine to be effective, different doses are required for different patients. In the absence of a pharmacogenetic test for efficacy, the most appropriate medicine or dose is conventionally found by trial and error, although in some cases, tests of renal function may be used to predict the appropriate dose. It has been suggested that a trial and error approach to prescription may reduce compliance for medicines that do work, since patients acquire a general aversion to taking medicines because of the unpleasant side-effects which they might experience. This therefore helps in improving efficacy of medicines (Nuffield Council on Bioethics, 2003). A potential barrier to the development of pharmacogenetic tests concerns the application of intellectual property rights. Pharmacogenetic tests may be developed in a number of ways. The pharmaceutical company which is developing the medicine may also develop the pharmacogenetic test. Alternatively, a third party, such as another company or researchers from the public sector may develop the test independently. Furthermore, while the effect of pharmacogenetics may be to reduce some of the costs of developing new medicines, it would be imprudent to infer from this that the cost of purchasing medicines will necessarily fall (Nuffield Council on Bioethics, 2003). Pharmacogenomics Pharmacogenomics is the study of genetic variations that influence individual response to drugs.   Knowing whether a patient carries any of these genetic variations can help prescribers individualise drug therapy, decrease the chance for adverse drug events, and increase the effectiveness of drugs (AMA, 2013).   Pharmacogenomics holds the promise that drugs might be tailor-made for individuals and adapted to each persons own genetic makeup. Environment, diet, age, lifestyle, and state of health all can influence a persons response to medicines, but understanding an individuals genetic makeup is thought to be the key to creating personalised drugs with greater efficacy and safety. Pharmacogenomics combines traditional pharmaceutical sciences such as biochemistry with annotated knowledge of genes, proteins, and single nucleotide polymorphisms (Human Genome Project Information, 2011). The field of pharmacogenomics is still in its infancy. Its use is currently quite limited, but new approaches are under study in clinical trials. In the future, pharmacogenomics will allow the development of tailored drugs to treat a wide range of health problems, including cardiovascular disease, Alzheimer disease, cancer, HIV/AIDS, and asthma (Genetics Home Reference, 2013). The cytochrome P450 (CYP) family of liver enzymes is responsible for breaking down more than 30 different classes of drugs. DNA variations in genes that code for these enzymes can influence their ability to metabolise some drugs. Less active or inactive forms of CYP enzymes that are unable to break down and properly eliminate drugs from the body can cause drug overdose in patients. Clinical trials researchers use genetic tests for variations in cytochrome P450 genes to screen and monitor patients. In addition, many pharmaceutical companies screen their chemical compounds to see how well they are broken down by variant forms of CYP enzymes. Another enzyme called TPMT (thiopurine methyltransferase) plays an important role in the chemotherapy treatment of common childhood leukemia by breaking down a class of therapeutic compounds called thiopurines. A small percentage of Caucasians have genetic variants that prevent them from producing an active form of this protein. As a result, thiopurines elevate to toxic levels in the patient because the inactive form of TMPT is unable to break down the drug. Today, doctors can use a genetic test to screen patients for this deficiency, and the TMPT activity is monitored to determine appropriate thiopurine dosage levels (Human Genome Project Information, 2011). Similarly to pharmacogenetics, pharmacogenomics  has the potential to  provide tailored drug therapy based on genetically determined variation in effectiveness and side effects (AMA, 2013). This will mean: More powerful medicines   Pharmaceutical companies will be able to produce therapies more targeted to specific diseases, maximising therapeutic effects while decreasing damage to nearby healthy cells. Better, safer drugs the first time   Recovery time will go down and safety will go up as the likelihood of adverse reactions goes down or is eliminated altogether. Improvements in drug discovery, design, and development are obvious applications for pharmacogenomics. A deeper understanding of the genetic factors which cause variance in drug metabolism can aid in the design of drugs with improved potency, reduced toxicity, and fewer side effects. For example, pharmacogenomics can identify potential drug targets (targets are typically enzymes or other proteins), and determine which targets are least prone to genetic variance. By selecting drug targets which are not prone to genetic variance, drug designers can create drugs which are more likely to have standard, expected, and safe reactions in people who take it. More accurate methods of determining appropriate drug dosages   Current methods of basing dosages on weight and age will be replaced with dosages based on a persons genetics how well the body processes the medicine and the time it takes to metabolise it. Pharmacogenomics can also be useful in clinical trials for drugs which have passed through the approval process sufficiently that human trials are possible. Using this approach, a technique called genostratification can be used in selecting participants for clinical trials. This means that clinicians use genetic typing to select participants who are genetically more likely to react positively to the treatment which is under study. This can potentially allow for an improved level of treatment success, and means that proof of concept can be achieved sooner. This technique can also allow for a reduction in the required sample size for the trial, or shortened trial duration. Ultimately, a drug which may help save or improve lives can be used in the general public more quickly than otherwise would be possible. Economic issues from molecule to marketplace Pharmacogenomics eventually can lead to an overall decrease in the cost of health care because of decreases in: the number of adverse drug reactions, the number of failed drug trials, the time it takes to get a drug approved, the length of time patients are on medication, the number of medications patients must take to find an effective therapy, and the effects of a disease on the body (through early detection). Applying pharmacogenomics to patient treatment can help devise individualised treatment regimes, to ensure that patients receive the drugs which are most appropriate for their genetic makeup. In particular, this approach has significant potential in treating cancer, because there is a great degree of variance in the way people react to chemotherapy drugs. Tumors themselves are highly variable in genetic terms, and this partially accounts for the variance in drug responses. Using an approach which individualizes treatment regimes, to accommodate for this variance could improve cancer treatments significantly. Pharmacogenomics is useful in general for patient treatment because it has the potential to identify on an individual basis the drugs which might cause adverse reactions. A person who might experience such a reaction can then be prescribed an alternative drug (Lloyd, 2008). However, there are several potential barriers to pharmacogenomics which have to be overcome before the above discussed benefits of pharmacogenomics can be realised (Human Genome Project Information, 2011). These include the following: Complexity of finding gene variations that affect drug response   Single nucleotide polymorphisms (SNPs) are DNA sequence variations that occur when a single nucleotide (A,T,C,or G) in the genome sequence is altered. SNPs occur every 100 to 300 bases along the 3-billion-base human genome, therefore millions of SNPs must be identified and analyzed to determine their involvement (if any) in drug response. Further complicating the process is our limited knowledge of which genes are involved with each drug response. Since many genes are likely to influence responses, obtaining the big picture on the impact of gene variations is highly time-consuming and complicated. Limited drug alternatives   Only one or two approved drugs may be available for treatment of a particular condition. If patients have gene variations that prevent them using these drugs, they may be left without any alternatives for treatment. Disincentives for drug companies to make multiple pharmacogenomic products   Most pharmaceutical companies have been successful with their one size fits all approach to drug development. Since it costs hundreds of millions of dollars to bring a drug to market, will these companies be willing to develop alternative drugs that serve only a small portion of the population? Educating healthcare providers   Introducing multiple pharmacogenomic products to treat the same condition for different population subsets undoubtedly will complicate the process of prescribing and dispensing drugs. Physicians must execute an extra diagnostic step to determine which drug is best suited to each patient. To interpret the diagnostic accurately and recommend the best course of treatment for each patient, all prescribing physicians, regardless of specialty, will need a better understanding of genetics. Conclusion Despite the various potential barriers to both pharmacogenetics and pharmacogenomics, these fields are rapidly evolving with the promise that someday a simple and rapid DNA test will determine potential risks of adverse effects with a certain drug, and thus turning to another drug which would be more suitable for the patient.