Ind.structure of banking Essay Example | Topics and Well Written Essays - 2000 words

Ind.structure of banking - Essay Example Some of the financial determinants that bring about financial development are the level of improvement with the quality, quantity and efficiency of financial services provided at an intermediary level (Boyd, De Nicolo and Smith, 2004). The discussion as to whether or not degree of cluster or concentration of banks at a given location brings about financial development continues to go on in literature. Very often, the expectation has been that the market structure should influence competition, which in turn should influence the way the banks should engage in the support of local businesses with financial intermediary services, and thus leading to financial development. Some of these arguments in literature are analysed below. In a study by Boyd and De Nicolo (2005), they observed that with increases in the concentration of the banking sector, there is an induced internal competition among the banks due to the existence of a perfect competition among the banks. The perfect competition existing means to the banks that there is no barrier to new entrants. This also means that they must guide their strategies along the need to maintaining their customers, while and fighting the threat of new entrants (Fama, 2010). Consequently, Boyd and De Nicolo (2005) noted that with increased banking sector concentration, banks are forced to lower deposit interest rates and rather increase loan interest rates. Once this happens, banks are likely to get more customers opening accounts and thus contributing to the overall internal growth of the banks. On the outside also, borrowers are said to be likelier to be engage in more risky projects as a way of covering up for the high loan interest rates. This way, there is lowerin g in the overall level of asset portfolio risk (Boyd and De Nicolo, 2005). Using the case of Caribbean banks, Alleyne and Waithe (2009) noticed that the increase in loan interest

Statista Report Essay Example for Free

Statista Report Essay The Print Media surveys in Spain EGM ? The EGM is the Print Media survey in Spain †¢ Since 1968 †¢ Multimedia: †¢ Newspapers (currency) †¢ Magazines (currency) †¢ Radio (currency) †¢ Cinema †¢ Tv (Referential for meters) †¢ Internet (Referential for meters) †¢ Outdoors †¢ The EGM is the Cross Media survey in Spain 2 The Print Media surveys in Spain EGM Radio n = 36. 000 EGM 2000 EGM Multimedia n = 43. 000 The Print Media surveys in Spain EGM Radio n = 36. 000 EGM 2007 EGM Newspaper n = 32. 000 EGM Multimedia n = 43. 000 3 The Print Media surveys in Spain EGM With these extensions we have two different data for Radio and Newspapers: ? The official data (multimedia+monomedia) ? The multimedia data from the Cross Media Survey Example: In 2007 the official audience of â€Å"El Pais was 2,234,000 readers, and the result for the Cross Media Survey was 2,127,000 readers, some 5% less. The Print Media surveys in Spain EGM The â€Å"Market† accepted the coexistence of two different data: ? â€Å"the official data†, currency for the media, is used in the monomedia advertising plans for Radio or Newspapers. ? â€Å"the other data† is used in the multimedia advertising plan where Radio stations or Newspapers titles are included. 4 The Print Media surveys in Spain EGM Radio n = 49. 000 EGM 2008 EGM Newspaper n = 45. 000 EGM Multimedia EGM Magazine n = 20. 000 n = 30. 000 EGM TV n = 13. 000 The Print Media surveys in Spain EGM The Market demanded the implementation of a Data Fusion Process with the following conditions: ? Audience data for each title, station, etc, must fully coincide with the data that comes from each official source. ? The procedure must be traceable. ? Lastly, it would be convenient that the procedure not imply a long-time frame to come up with presentable data. 5 The Print Media surveys in Spain Data Fusion: Origin Interviews: MULTIMEDIA 30. 00 DEMO GRAPHICS OTHERS INTERNET CINEMA OUTDOORS + LIFE STYLE EQUIPMENT CONSUMPTION + NEWSPAPERS RADIO MAGAZINES TV MOMOMEDIA NEWSPAPERS + 45. 000 + DEMO GRAPHICS + NEWSPAPERS + + + MOMOMEDIA RADIO + 49. 000 + DEMO GRAPHICS + + + + RADIO + + MOMOMEDIA MAGAZINES + 20. 000 + DEMO GRAPHICS + + + + + MAGAZINES + MOMOMEDIA TV + 13. 000 + DEMO GRAPHICS + + + + + + TV The Print Media surveys i n Spain Data Fusion. Final Objetive Interviews: MULTIMEDIA 30. 000 DEMO GRAPHICS OTHERS INTERNET CINEMA OUTDOORS + LIFE STYLE EQUIPMENT CONSUMPTION + NEWSPAPERS RADIO MAGAZINES TV MOMOMEDIA NEWSPAPERS + 45. 000 DEMO GRAPHICS + NEWSPAPERS + + + MOMOMEDIA RADIO + 49. 000 + DEMO GRAPHICS + + + + RADIO + + MOMOMEDIA MAGAZINES + 20. 000 + DEMO GRAPHICS + + + + + MAGAZINES + MOMOMEDIA TV + 13. 000 + DEMO GRAPHICS + + + + + + TV = TOTAL = DEMO GRAPHICS = OTHERS INTERNET CINEMA OUTDOORS = LIFE STYLE EQUIPMENT CONSUMPTION = NEWSPAPERS = RADIO = MAGAZINES = TV 6 The Print Media surveys in Spain Data Fusion. System We used predefined strata of known size in the population: Province (50) x Town Size (2) x Week Day (2)= 200 strata Province (50) x Town Size (2) x Gender (2)= 200 strata (Depending on the Media being fused) We wanted to make sure that the strata of the 5 studies and the sum of the 5 original files amount to the same as the population within each strata: Example: Province Valencia Town Size + 50. 000 Gender Men Population 902,626 The Print Media surveys in Spain Data Fusion. System The sum file of the 5 initial surveys has missing information that we are going to fulfill in 5 steps, adding with each step the information of one of the media with monomedia extention, and the rest of the information that only exists in the multimedia survey. 7 The Print Media surveys in Spain Data Fusion. System In each strata we used a donor-receiving system, assigned the information to each receiver of the closest donor of the available ones, computed the range on the basis of a wide set of variables: Age Role Social Status Weekday Language Household Size Town Etc. Nationality Children in home Sex The Print Media surveys in Spain Data Fusion. System Distances are rank ordered and the pair of most similar individuals is selected: For each stratus h 1 wr1 2 wr2 Receivers †¦ †¦ j wrj †¦ q wrq Donors 1 2 . . i . . p Weight Weight wd1 wd2 †¦ †¦ wdi †¦ †¦ wdp Distance Matrix 8 The Print Media surveys in Spain Data Fusion. System Donors and their weights: Distance matrix is computed and distances are rank ordered from greatest to lowest. Receivers and their weights: Total Receivers weight: 3,10 0,60 1,40 1,80 1,10 8,00 3,00 1,50 2,00 1,00 0,50 8,00 Total donors weight 8 2 6 1 3 7 5 Distance Matrix The Print Media surveys in Spain Data Fusion. System Donors and their weights: Pair with the lowest distance between them is selected. Receivers and their weights: Total Receivers weight: 3,10 0,60 1,40 1,80 1,10 8,00 3,00 1,50 2,00 1,00 0,50 8,00 Total donors weight 8 2 6 1 3 7 5 Distance Matrix 9 The Print Media surveys in Spain Data Fusion. System Donors and their weights: Receiver is pasted donor information Receivers and their weights: Total Receivers weight: 3,10 0,60 1,40 1,80 1,10 8,00 3,00 1,50 2,00 1,00 0,50 8,00 Total donors weight 8 2 6 1 3 7 5 Distance Matrix Donor weight greater than receiver weight The Print Media surveys in Spain Data Fusion. System Donors and their weights: Receiver is written in to the fused file with its own weight and deleted from the distance table Receivers and their weights: Total Receivers weight: 3,10 0,60 1,40 1,80 1,10 8,00 3,00 1,50 2,00 1,00 0,50 8,00 Total donors weight 8 2 6 1 3 7 5 Distance Matrix Donor weight greater than receiver weight 0 The Print Media surveys in Spain Data Fusion. System Donors and their weights: Donor finishes in the table with a weight equal to the difference in weight bettewn that of the donor and that of the receiver Receivers and their weights: Total Receivers weight: 3,10 0,60 1,40 1,80 1,10 7,40 3,00 1,50 2,00 0,40 0,50 7,40 Total donors weight 8 2 6 1 3 7 5 Distance Matrix Donor weight greater than receiver weight The Print Media surveys in Spain Data Fusion. System Donors and their weights: Pair with the lowest distance between them is selected. Receivers and their weights: Total Receivers weight: 3,10 0,60 1,40 1,80 ,10 7,40 3,00 1,50 2,00 0,40 0,50 7,40 Total donors weight 8 2 6 1 3 7 5 Distance Matrix 11 The Print Media surveys in Spain Data Fusion. System Donors and their weights: Receiver is pasted donor information Receivers and their weights: Total Receivers weight: 3,10 0,60 1,40 1,80 1,10 7,40 3,00 1,50 2,00 0,40 0,50 7,40 Total donors weight 8 2 6 1 3 7 5 Distance Matrix Donor weight less than receiver weight The Print Media surveys in Spain Data Fusion. System Donors and their weights: Receiver is written to the fused file with a weight equal to the donor weight Receivers and their weights: Total Receivers weight: ,10 0,60 1,40 1,80 1,10 7,40 3,00 1,50 2,00 0,40 0,50 7,40 Total donors weight 8 2 6 1 3 7 5 Distance Mat rix Donor weight less than receiver weight 12 The Print Media surveys in Spain Data Fusion. System Donors and their weights: Receiver finishes in the table with a weight equal to the difference in weight Donor is deleted from the distance table Receivers and their weights: Total Receivers weight: 1,10 0,60 1,40 1,80 1,10 5,40 3,00 1,50 2,00 0,40 0,50 5,40 Total donors weight 8 2 6 1 3 7 5 Distance Matrix Donor weight less than receiver weight The Print Media surveys in Spain Conclusions Donor file, Receiver file and Fused file contain exactly the same information in the imputed variables, and this for all the common strata and for all their possible additions. Internal relations among fused variables are kept and are the same for all the files and surveys. For those variables not controlled, distributions should be as similar as possible. Traceability is possible, one can know exactly how many times each record is replicated, and how original interviews are the base for each data. 13 Thank you! WRRS Valencia 2009 14

Personal Reflection On Community Psychiatry And Mental Healthcare Nursing Essay

Personal Reflection On Community Psychiatry And Mental Healthcare Nursing Essay As a part of my clinical SSC, I had to do visits to a variety of mental health care settings: 1 visit to River House at Bethlem Royal Hospital 1 visit to Scutari Clinic at St Thomas Hospital 1 visit Cheyne Ward at Kings College Hospital 4 visits to 190 Kennington Lane Clinic These visits broadened my knowledge about mental health care and the services provided. In each placement, I observed at least one consultation and had an opportunity of talking to a variety of health care professions about mental health care services and patient care. This reflective account discusses my experiences in the mental health care and the things that I observed. A Brief History on Psychiatry Psychiatry can be defined as the study of mental illnesses, their diagnoses, management and prevention (Oxford Medical Dictionary) and when this is carried out in the community, it is called community psychiatry. Here is a brief timeline of transformation from mental asylums to community based care: In 1601 the Poor Law was established which stated that individuals who were unable to care for themselves should be supported (History of Mental Health and Community Care- Key Dates, Mind.org.uk). In 1800s, introduction of the County Asylums 1808 allowed the asylums and psychiatric hospitals to be established, treating mentally ill patients (History of Mental Health and Community Care- Key Dates, Mind.org.uk). The number of bed allocated to patients with mental health problems was at its peak in 1954 (152,000 beds). However, with the introduction of new treatment plans, such new anti psychotic medication, rehabilitation in community, the numbers of people being admitted to psychiatric hospital reduced (ABC of Mental Health, 2nd Edition and History of Mental Health and Community Care- Key Dates, Mind.org.uk). Mental health care centres were the one of the steps taken in terms of the implementation of mental health care policies in 1980s (Sayce et al. 1990). 1990s, mental health care in the community was reformed and implemented a form of community mental health team which is a team of professions including a psychiatric, psychologist, social worker, occupational therapist and care coordinator, manage people with mental illnesses in the community settings (ABC of Mental Health,2nd Edition). Community Mental Health Team and Other Services Mental health problems are normally managed by primary health care, e.g. GPs, and referrals can be made to either community mental health teams or secondary health care if needed (ABC of Mental Health Care, 2nd Edition and Mental Health Policy Implementation Guide: Community Mental Health Teams, 2002). The majority of the patients who use the services provided by community mental health care teams have time limited problems and will be referred back to their general practices once they have made the necessary recovery (Mental Health Policy Implementation Guide: Community Mental Health Teams, 2002). Reflecting back upon a consultation that I observed at Kennington Lane Clinic, a patient was discharged from the clinic after having used the services as there was a significant improvement in her condition. One of the reasons for the referral to community mental health care team is that primary health care may not be able to offer services such as cognitive behavioural therapy or rehabilitation, required for patients with certain mental disorders, for example obsessive compulsive disorder (Mental Health Policy Implementation Guide: Community Mental Health Teams, 2002). Once the referral is done, patient is risk assessed and assigned a care coordinator, who would support, advice and have a regular contact with the patient. At Kennington Lane Clinic, the care coordinator whom I spoke with stated that when one of his patients do not attend a scheduled appointment, then he would go to visit this patient at his/her home so in other words, providing a continuity of care and support. During my time at River House, a medium secure hospital, one of the doctors that I have met articulated the fact that medium secure hospitals fill the gaps that are created by both the psychiatric units of general hospitals and the high secure hospitals. Since the patients admitted to medium secure hospital are not suitable for both: high secure hospitals may not accept these patients because they are not dangerous or insane enough and psychiatric units of general hospital may find these patients dangerous enough to refuse the admission. Therefore, medium secure hospitals are solely developed to accommodate such patients. The same principle can be applied to community mental health teams as they are thought to form a bridge between primary and secondary health care (ABC of Mental Health Care, 2nd Edition). During the transformation to community based psychiatry, it was thought that the prevalence of homicide carried out by psychiatric patients after deinstitutionalisation was going up but in fact these claims were not accurate (Fakhoury and Priebe, 2007). Deinstitutionalisation and allowing patients with psychiatric problems to be managed and cared for in the community settings intended to lessen and curtail social stigma related to patients with mental health problems, to integrate these patients into the community, and importantly to reduce and prevent long term hospital stays (Fakhoury and Priebe, 2007). So, one can conclude the fact that Community health care teams allow patients with mental disorder to stay in the community and have a life that as normal as possible. However, Fakhoury and Priebe, 2007 stated that community psychiatry has not quite achieved its goal in terms of social integration as most of the psychiatric patients in the community are unemployed, live in a sheltered accommodation or even homeless. During my time at Kennington Lane Clinic, I met a patient whom I will be naming as Mr. A due to confidentiality code. This patient looked depressed and was complaining about having nightmares, unpleasant thoughts and phobia of using public transport. He also mentioned having thoughts of self harming and suicide. On further questioning, he revealed that he did think about committing suicide by overdosing himself with his antidepressants but could not do it as he could not find a place to do it: he is unemployed, homeless and lives with his elderly parents and occasionally with his daughters both of whom are married. In terms of what observed and felt at Kennington Lane Clinic, patients whose files that read or met were either using street drugs or having housing problems compared to the patients that I saw at Scutari Clinic in St Thomas Hospital, however this may not be the case in general since I cannot generalise what I observed during my time at both places to the rest of the country. One of the main difficulties experienced by the community mental health team is that the DNA (Did Not Attend) rates are very high in comparison to out-patient clinics at hospitals. I visited Kennington Lane Clinic four times in total but managed to observe only two consultations so I had to read the patient files and talk to their care coordinator instead. At the Scutari Clinic, I noticed that almost all the patients did attend their scheduled appointment with the doctor. I could not help but ask the duty doctors about the rate of DNAs both at the community based clinics and hospital based outpatient clinic levels and the answer that I received did confirm what I observed. I believe that one of good things about community mental health teams is that they facilitate home visits which are not normally offered for the patients attending out-patient clinics. I agree with William R. Breakey, the author of Integrated mental health services: modern community psychiatry, that home visits allow clinicians to see patients in their own surroundings and to allow them plan an appropriate care plan for a particular patient. Of course, there is a variety of services dedicated to patients with mental health problems: an appropriate choice of service would be chosen for the patients best interest. Reflecting back on my time at Kennington Lane Clinic, I came across Mr Bs file from which I read his past medical history and discussed this patient with a social worker who was involved with this particular case. On discussion, I found out that he was originally referred to the clinic by his GP and treated by this clinic quite a long time but unfortunately was relapsing and not compliant with his medication. When something like this is the case, patients can be detained at hospital against their own will under the Mental Act legislation (Rethink, Factsheet, 2010). This particular patient was going to be detained under Section 2 for 28 days. In order to carry this out, the patient had to be seen by 3 professions (2 psychiatrics and 1 social worker) in the presence of police. These three professions are specialise d in mental health care that would assess the patients mental state and make a decision. In addition, during my time at Cheyne ward, I shadowed a senior registrar who was on call in AE. I managed to observe a consultation which lasted about 30 minutes. Mr C was complaining about low mood and was self-harming. Having learnt that his father had a history of long term depression and his relationship with his father is not good, he was suggested to stay in hospital in order to carry out a full mental assessment. End the end of the consultation; he was happy to go ahead with this decision. As can be seen, the main difference between these two cases (Mr B and Mr C) is the way of the admission process: one is being admitted to hospital by force and the other one is giving consent. Mr C is an example of informal patient who is admitted to hospital with his own will and not detained under the Mental Health Act legislation, whereas Mr B is sectioned under the Mental Health Act legislation and cannot have the right refuse treatment. All in all, this revolution of change from hospital based treatment to community based treatment played an important role modernising the mental health services in the UK. Community mental health care provides help and support to those with mental illnesses at the community settings and appropriate patients are referred to this service. From what I observed and read, I can confidently say that community mental health services provide a care that is continuous and offer advice.

Non Hodgkins Lymphoma: Types, Causes and Symptoms

Non Hodgkins Lymphoma: Types, Causes and Symptoms Lymphoma is a type of cancer that affects the lymphatic system. Lymphoma is divided into two types called Hodgkins lymphoma and non-Hodgkins lymphoma. Non-Hodgkins lymphomas (NHL) are a range of diseases emerging from clonal proliferation of lymphocytes which is a type of white blood cells resulting in cancer or tumour formation of lymphatic system.1 An estimated 8,000 new cases of NHL has been diagnosed annually in the United Kingdom at the end of the 20th century.2 NHL is a common hematologic malignancy and ranked eighth as the most common malignancy.2 Male has 1.5 times likelihood than female from being diagnosed with NHL. From the early seventies, cases of NHL have increased by threefold for both male and female throughout many countries beside United Kingdom.2 In 2007, non-Hodgkin lymphoma (NHL) caused 4,533 deaths in United Kingdom. Males and females share almost similar number of deaths but males has higher age standardized mortality rate. However, not all patients die from NHL as infections may be one of the causes. Non-Hodgkin lymphoma has 53% overall 5-year relative survival in an analysis3 conducted over 22 European countries with age adjusted figures 48% in men and 54% in womean. In Scotland, the total number of diagnosed non-Hodgkins lymphoma cases from 1990-1994 were 1,598 for men and 1,708 in women. The percentage of age standardized survival rate for patients diagnosed after one year and five years with 95% confidence interval were 63.5 (61.1-66.1) and 41.0 (38.2-44.0) respectively.3 NHL has no established cause factor and people diagnosed with NHL have no known risk factors. However, NHL can be associated with chronic inflammatory diseases such as rheumatoid arthritis, coeliac disease, and Sjà ¶gren syndrome.4 Study by Lens and Newton-Bishop show association between NHL and cutaneous melanoma.5 Besides that, the risk of developing NHL increases with chronic infection from viruses and bacteria such as Epstein-Barr virus, human T-lymphotropic virus 1(HTLV-1) and human immunodeficiency virus (HIV).2 There was a strong link between Burkitt lymphoma and Epstein-Barr virus6 while adult T-cell lymphoma can be caused by HTLV-1.7 It has been noted that prevalence of NHL was higher in people with HIV infections compared to healthy adults.8 One study conducted by Stolte et al9 showed that there was association between Helicobacter pylori infection and mucosa-associated lymphoid tissue (MALT) lymphomas. It has also been noted that primary effusion lymphomas can be associat ed with human herpes virus while ocular adenexal lymphomas can be associated with Chlamydia psittaci.10 Moreover, evidence has shown association between splenic or large cell lymphomas and hepatitis C infections.11 The risk of developing NHL increases when a person was immunocompromised such as undergoing organ transplant12 or patients with AIDS and autoimmune diseases. Certain chemotherapy drugs and radiotherapy may increase the risk of developing NHL within 10 to 15 years after treatment.4 Solvents, pesticides and other chemical factors have also been associated with causes of NHL.2 Diagnosis In this case, a male patient has been recently diagnosed with NHL but the type of NHL and pathology were unconfirmed. Lymphoma can be divided into two types: indolent and aggressive. Indolent lymphomas such as follicular, marginal zone and lymphoplasmacytic lymphoma13 are commonly accompanied by slow, progressing and painless peripheral lymphadenopathy. There might be history of patients with enlarged lymph nodes before regressing without diagnosis made. These spontaneous regressions of lymph nodes may occur, preventing biopsy diagnostic test from being done and patient was treated for an assumed infection. It is uncommon to see primary extranodal lymphoma or systemic symptoms occurring at early stages but can be encountered as disease progresses. Examples of systemic B-symptoms are fever, weight loss, and night sweats. Indolent lymphoma can undergo histologic transformation or changes to a different, more aggressive usually large-cell lymphoma type. Indolent lymphomas are usually sl ow growing and it may respond to treatment but relapse tend to occur frequently.14 Aggressive lymphomas such as diffuse large B-cell lymphoma are different from indolent with most patients presenting with lymphadenopathy or involvement of extranodal sites. Common extranodal sites affliated are gastrointestinal tract, skin, bone marrow, sinuses, thyroid, or central nervous system. It is usual to see presence of systemic B-symptoms in a third of patients with aggressive lymphomas. Aggressive lymphomas are fast growing and are treatable than indolent lymphomas.14 NHL has been hard to diagnose and recognizing people that has high risk of NHL is difficult. Patient can only be identified correctly after development of lymphadenopathy or other symptoms related to NHL. Even though with the advancement in imaging techniques, histology is mandatory to confirm diagnosis of NHL type before progressing to treatment. It is common to use surgical biopsy either by incisional or excisional with latter being recommended to provide biopsy specimens to be reviewed by hematopathologists. The morphologic appearance obtained with additional information from immunophenotype, genetics and clinical features were then used to classify NHL with definite clinical unit. These were the basis for World Health Organization (WHO) (Table 1) classification of neoplastic diseases arising from hematopoietic and lymphoid tissues. Fine-needle aspiration or large bore-needle biopsies can also be used to diagnose NHL but was discourage for initial diagnosis due to difficulty in co nfirming a specific diagnosis.15 Table 1. World Health Organization (WHO) Classification of non-Hodgkins lymphomas.15 B-cell neoplasms Precursor B-cell neoplasm Precursor B-lymphoblastic leukemia/lymphoma (precursor B-cell acute lymphoblastic leukemia) Mature (peripheral) B-cell neoplasms B-cell chronic lymphocytic leukemia/small lymphocytic lymphoma B-cell prolymphocytic leukemia Lymphoplasmacytic lymphoma Splenic marginal zone lymphoma Hairy cell leukemia Plasma cell myeloma/plasmacytoma Extranodal marginal zone B-cell lymphoma of MALT Nodal marginal zone lymphoma Follicular lymphoma Mantle cell lymphoma Diffuse large B-cell lymphoma Mediastinal large B-cell lymphoma Primary effusion lymphoma Burkitts lymphoma/Burkitt cell leukemia T-Cell and NK-Cell Neoplasms Precursor T-cell neoplasm Precursor T-lymphoblastic lymphoma/leukemia Mature (peripheral) T-cell neoplasms T-cell prolymphocytic leukemia T-cell granular lymphocytic leukemia Aggressive NK-cell leukemia Adult T-cell lymphoma/leukemia (HTLV-1) Extranodal NK/T-cell lymphoma, nasal type Enteropathy-type T-cell lymphoma Hepatosplenic T-cell lymphoma Subcutaneous panniculitis-like T-cell lymphoma Mycosis fungoides and Sà ©zary syndrome Anaplastic large-cell lymphoma, T/null cell, primary cutaneous type Peripheral T-cell lymphoma, unspecified Angioimmunoblastic T-cell lymphoma Anaplastic large-cell lymphoma, T/null cell, primary systemic type MALT, mucosa-associated lymphoid tissue; NK, natural killer. Source: Data from Zelenetz and Horwitz Lymphoma has been categorized into stages following modified Ann Arbor Staging System (Table 2) originally developed for Hodgkin disease. This system as shown in table 2 was based on area of involvement, presence or absence of extranodal involvement and B symptoms such as weight loss more than 10% of body weight, fever, and drenching night sweats.15 Histology and morphology of lymphoma largely determined the treatment outcome and prognosis. Due to different outcomes of patients with lymphoma and limitation of clinical staging, International Prognostic Index (IPI) (Table 3) was developed from 2,031 patients with 5 independent, easily obtained clinical features such as patient age, Ann Arbor stage, serum lactate dehydrogenase level, number of extranodal sites and performance status to predict survival. The IPI (Table 3) served as a guide for clinical management, clinical trial design and interpretation. However, this IPI was designed for aggressive lymphoma. Thus, the Follicular Lymphoma International Prognostic Index (FLIPI) (Table 4) was developed from 4,167 patients for indolent lymphoma with clinical features such as patients age, Ann Arbor stage, haemoglobin level, number of nodal areas and serum lactacte dehydrogenase level. Examples of nodal areas are cervical, para-aortic, inguinocrural, celiac and other ancillary nodal si tes. FLIPI can help determine significantly different mortality risk of patients with indolent lymphomas and improve decision on different aggressive therapy options that may benefit certain patient groups.15 Treatment Non-Hodgkins lymphoma can be treated by a range of treatments available such as radiation therapy / radiotherapy, surgery, stem cell transplant, single-agent or combination chemotherapy, immunotherapy or radioimmunconjugate therapy. Treatments can consist of one or a combination of the options available with different treatments having different duration and doses. In this case scenario, the patient was recently diagnosed with NHL. Due to the lack of information, NHL diagnosed can be assumed to be either indolent lymphoma or aggressive lymphoma. Being 28 year old, patient was eligible for more aggressive treatment compared to patients aged 60 and above.16 Indolent Lymphoma Indolent lymphomas such as follicular lymphoma and MALT lymphoma were not treated at early stages if there were no symptoms present with doctors adopting watch-and-wait approach. In a study conducted by Division of Oncology, Stanford University Medical Center, 43 patients with follicular lymphoma stage I or stage II were observed after deferment of radiation due to a variety of reasons. After a median of 86 months of follow-up, 63% had not been treated and survival was almost the same to the patients that has undergo radiation.17 In this situation, toxic side effects of treatments should be considered against the advantages of undergoing treatments. Patients with low grade, stage I-II NHL lymphoma with localized disease can be treated either with surgery18 or radiation therapy. Radiation therapy as shown in a study conducted by Stanford University can be used to treat limited stage, low grade lymphomas of 177 patients with good remission rate.19 Another study conducted on 103 patient s with stage I and II MALT lymphoma showed 77% disease-free survival rate with radiotherapy.20 Surgery can be done in situations where low grade MALT lymphoma is localized and there is a risk of perforation but if the lymphoma progresses to a more advance stage, then surgery no longer present as first line treatment.21 As lymphoma mainly affects systemic system, surgery is normally used to establish diagnosis. Besides that, stem cell transplant can be used to treat NHL but was limited to younger patients and difficulty in determination of the time to treat patients. A study on autologous stem cell transplant after high dose therapy showed higher response rate compared to immunochemotherapy.22 Chemotherapy options for indolent lymphomas ranged from single-agents such as cyclophosphamide, chlorambucil or doxorubicin to combinations such as cyclophosphamide, vincristine and prednisone (CVP)23 chemotherapy. More aggressive combination of chemotherapy that combines cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) can also be use. In a study conducted in 228 stage III or IV follicular lymphoma patients that were treated randomly either with cyclophosphamide, a less toxic single agent or combination of cyclophosphamide, doxorubicin, vincristine, prednisone and bleomycin (CHOP-B) showed no initial advantage to combination treatment eventhough in an unplanned subgroup analysis showed improved disease control and survival.24 Cyclophosphamide is a nitrogen mustard alkylating agent that acts by causing DNA damage and interfere with cell replication. Besides fatigue, nausea, vomiting, bone marrow suppression and alopecia that were normally associated with anticancer treatment, prolonged use of cyclophosphamide might result in severely affected gametogenesis.25 Chlorambucil has similar mechanism of action to cyclophosphamide with lesser side effects but development of widespread rashes may occur.25 Doxorubicin is a cytotoxic, anthracyclines antibiotic that acts by intercalating DNA. Common side effects are present with additional potential cardiomyopathy and severe tissue necrosis due to extravasation when administering doxorubicin. Vincristine is a vinca alkaloids and act by depolymerising microtubules and thus inhibiting mitosis. It may not have significant myelosuppression along with other common side effects but may cause neurotoxicity and severe tissue necrosis due to extravasation.25 Prednisone is a pr odrug that is converted in liver to prednisolone that has a marked antitumour effect in NHL. However, it may cause immunosuppression, adrenal suppression, mood and behaviour changes, gastro-intestinal effects with mineralocorticoid and glucocorticoid side effects. Bleomycin is a cytotoxic antibiotic that is metabolized to produce superoxide and hydroxyl free radicals which results in DNA damage. However it can cause skin pigmentation and dose related pulmonary fibrosis.26 In addition to chemotherapy, immunotherapy is becoming a standard treatment for indolent lymphoma. Rituximab is a recombinant chimeric monoclonal antibody that targets protein CD20 which is primarily found on the surface of malignant and normal human B cells involved with B-cell proliferation and differentiation. It is said to induce apoptosis of CD20 cells.25,26 Rituximab was generally well tolerated when used compared to other conventional chemotherapy with distinct reduction of haemotological events like severe neutropenia and associated infections.27 Studies28,29,30 conducted on the usage of rituximab for recently diagnosed follicular NHL as single first line therapy showed good response rates around 52% to 73% and a 12-month progression free survival. Rituximab can be combined with chemotherapy such as CHOP as CHOP-R to treat indolent B-cell lymphoma. The trial of CHOP vs CHOP-R31 conducted in 1999 showed 95% overall response rate for CHOP-R with 55% achieving complete remission and 40% in partial remission. Addition of cytokines such as interferon ÃŽÂ ±32, interleukin 233, and interleukin 1234 to rituximab therapy conducted in studies shown that good efficacy profile can be obtained but further studies need to be conducted to confirm. Interferon ÃŽÂ ± has antitumour therapeutic effect but is not side effect free with additional myelosuppression, ocular side effects, cardiovascular problems, hypersensitivity on top of common anticancer side effects. Interferon-ÃŽÂ ± can be incorporated into chemotherapy as a new approach in treating NHL. Incorporation of interferon-ÃŽÂ ± into anthracycline-containing has been demonstrated to increase the remission rate and remission duration. However the data has not been conclusive and further information must be obtained before making it as standard treatment. German Low Grade Lymphoma Study Group has been conducting trial with continuous higher dose interferon maintenance therapy yield 45% relapse-free patie nts.35 Besides rituximab, Food Drug Administration in United States has approved two anti-CD20 radioimmunotherapy agents: iodine I 131 tositumomab36 and yttrium Y 90 ibritumomab tiuxetan37 for treatment of lymphoma. Both agents contain murine antibodies that target CD20 with ÃŽÂ ²-emitting radioisotopes but iodine I 131 tositumomab can also emit gamma radiation. Both still cause side effects although milder with significant one being myelosuppression. University of Michigan conducted a phase II trial where 76 patients were given treatment of iodine I 131 tositumomab as initial treatment for follicular lymphoma and resulted in 75% of complete response and 95% of overall response.38 Yttrium Y 90 ibritumomab tiuxetan has been shown to be effective when used in consolidation therapy after rituximab39 or in relapsed/refractory B-cell NHL.40 Radioimmunotherapy was deemed better than radiotherapy due to prevention of normal tissues from being exposed to radiation and systemic radiation can be a chieved to known and unknown tumour cells. There is another emerging strategy to counter low-grade NHL by administering vaccine to boost patients immune system which leads to tumour rejection by patients body. Trials conducted showed promising results among relapsed patients following chemotherapy with prolonged disease free progression and overall survival. This strategy has not been approved by FDA but personalized vaccine therapy has been received positively in its effectiveness as first line in countering slow progressing NHL. Vaccine therapy was deemed too slow for aggressive NHL but trials were ongoing to determine its efficacy.41 The management of indolent NHL have to depend on considerations such as symptoms, age, comorbidities, extent of disease, prior therapy and others. Most decisions on management of indolent NHL depend on physicians trying to optimize the treatment options to treat this chronic illness.15 Aggressive Lymphoma Aggressive NHL consist mainly of diffuse large B cells demands almost similar treatments to indolent lymphoma. As explained above, radiotherapy is one of the options available. The early treatment for early stage aggressive NHL was radiotherapy alone with relative cure rates of 50% for stage I and decreases to 20% for stage II. Therefore, combination of radiotherapy and a chemotherapy regimen were used to improve the chances of survival for aggressive NHL patients. A study conducted among 400 patients with localized immediate or high grade NHL compared the results of one group receiving 8 cycles of CHOP alone and another receiving 3 cycles of CHOP and radiotherapy. The study showed patients under combined CHOP and radiotherapy has statistically significant overall survival rate than patients receiving CHOP alone. Life-threatening side effects that were encountered by both groups were statistically significant in comparison with fewer patients under combined CHOP and radiotherapy suff ering from adverse effects. Therefore, combination of CHOP and radiotherapy are better for treatment of localized NHL compared to CHOP alone.42 There was another alternative treatment available for patients with aggressive NHL called high-dose therapy with autologous stem cell transplant (HDT ASCT). A number of trials among intermediate and high risk patients have been conducted to determine its efficacy following initial chemotherapy but there were conflicting results resulting in this treatment for not being first-line.43 Combination therapy has been known to be better than single therapy and used to increase the percentage of patients entering complete remission. In 1976 and 1980, CHOP regimen44 as explained above and COMLA regimen45 which includes cyclophosphamide, vincristine, methotrexate with leucovorin rescue, and cytarabine were published respectively. Both regimens have been shown to present a possible cure rate of approximately 30% for patients with aggressive lymphoma achieving long-term remission. In the ensuing years, new second and third generation of aggressive NHL regimens showed 55% to 65% patients being cured. An example of second regimen treatment was m-BACOD consisting of methotrexate, bleomycin, doxorubicin, cyclophosphasmide, vincristine, and dexamethasone.46 Third generation regimens were such as MACOP-B made up of methotrexate, doxorubicin, cyclophosphamide, vincristine, prednisone and bleomycin47 and ProMACE-CytaBOM compromising prednisone, methotrexate, cyclophosphamide, etopo side, cytarabine, bleomycin, vincristine and methotrexate.48 The effectiveness of all these regimens were not known as many of these studies were conducted with relatively small number of patients until 1993, a trial called national high priority intergroup Phase III was held to do a comparison between CHOP, MACOP-B, ProMACE-CytaBOM and m-BACOD regarding effectiveness and side effects.49 The four regimens demonstrate equivalent outcomes but CHOP showed the lowest side effects. Based on this trial, CHOP regimen became the standard treatment for NHL in the United States. Another regimen called ACVBP consisting of doxorubicin, cyclophosphamide, vindesine, bleomycin, and prednisone has been developed by Groupe dEtude des Lymphomes de LAdulte (GELA) in Europe which were compared in poor risk patients against CHOP and results favour ACVBP.50 In another trial, etoposide and CHOP termed CHOEP was shown to increase complete remission rate and survival rate in 18 to 60 year-old patient in a t rial that compared 3 week CHOP-21, 2 week CHOP-14 with CHOEP-21, CHOEP-14. CHOEP was recommended in the conclusion of this trial if the patient is young with good prognostic feature of aggressive lymphoma.51 Etoposide is a synthetic analogue to vinca alkaloids and binds to DNA and topoisomerase II complex in phase G2 to prevent DNA replication and causes strand to break.26 Etoposide is still associated with toxic effects such as alopecia, myelosuppression, nausea and vomiting.25 Immunotherapy also played a part in treatment of aggressive lymphoma with rituximab as a single agent. GELA has shown that the overall response of rituximab as a single agent was 37% with patients suffering from relapsed and refractory diffuse large B-cell lymphoma.52 A randomized controlled trial has been conducted by Mab Thera International Trial (MInT) Group to investigate CHOP-like chemotherapy against CHOP-like chemotherapy with rituximab. The result showed that rituximab combined with cheomotherapy increased overall survival and with no significant increase in side effects.53 Rituximab and CHOP regimen is the most common chemotherapy regimen for diffuse large B-cell NHL. British Columbia Cancer Agency (BCCA) implemented a new policy on 1 March 2001 recommending all patients newly diagnosed with advanced stage diffuse large B-cell lymphoma to be treated with CHOP and rituximab based on evidences from trials conducted by GELA and MInT Group.54 Treatment recommendation. As stated earlier, limited information was available for this case scenario. Patient is only known as 28 year old male recently diagnosed with NHL. An appropriate treatment that could be given as first line is CHOP regimen with addition of rituximab (CHOP-R) based on evidences given above. CHOP-R has significant better results compared to CHOP alone and addition of rituximab does not increase side effects. CHOP-R can also be used for both indolent and aggressive lymphoma with positive outcomes as stated above although symptomless indolent lymphoma may require watch-and wait strategy. However in terms of cost-effectiveness, CHOP-R is more expensive than CHOP alone but CHOP-R is preferred due to its increased efficacy profile and similar side effects. In conclusion, CHOP-R can be given every 14 or 21 days with the course of treatment ranging from 3 to 8 cycles. CHOP-R cycle started with the first day drug administration consisting of rituximab, cyclophosphamide, vincristine and doxorub icin through injection into a vein or through drip and prednisone was taken orally from day 1 to day 5. Conflict: Newton Vs Leibniz Conflict: Newton Vs Leibniz Mathematicians everywhere contributed to the development of Calculus. However, the two most known founders of calculus are Isaac Newton and Gottfried Wilhelm Leibniz. Nowadays, the credit is handed over to both men. Nevertheless, a controversy took place over which of them deserved the recognition. The controversy was both intense and widespread. Isaac Newton: Isaac Newton is known as one of the greatest scientists who have ever lived; in addition, he is recognized as one of the most accomplished mathematicians that England has ever seen. Newton became fascinated in mathematics at an early age. Later in life, he created Calculus. However, he did not publish it until later. This was an enormous mistake. His life: In 1643, Newton was born. Later, in 1655, Newton began the discovery of calculus with the general binomial series which led to him discovering integration, differentiation, and infinite processes. Thirty two years later, 1687, Newton published his work in a book called The Mathematical Principles of Natural Philosophy. At the age of eighty four, in 1727, Newton died. Gottfried Leibniz: Gottfried Leibniz is known as a worldwide scientist. He became a leading international philosopher as well as, a worldwide known comprehensive thinker. He studied forces and weight. He wrote about economics, theology, biology, geology, law, politics, metaphysics, and mathematics. He claims that he invented Calculus independently from Newton, but is it true? His life: In 1646, Leibniz was born in Germany. When Leibniz was 27 years old, in 1673, he moved to England. In 1675, Leibniz began using the integral symbol, which no one ever used before. In 1676, Leibniz developed the Leibniz Calculus. 8 years later, 1684, Leibniz published a superior system of calculus about notation which was easier to use. At the age of 70, 1716, Leibniz died in his home country, Germany. What is Calculus? Calculus is the branch of mathematics that deals with limits, functions, derivatives, integrals, and infinite series. Calculus has two branches: Differential Calculus: Differential calculus is the study of the derivative of a function. It is the study of how a function changes when its input changes. Differentiation is the process of finding the derivative. The derivative at any point equals to the slope of the tangent line of the functions graph. Basically, the derivative of a function determines the best linear approximation. Integral Calculus: Integral Calculus is the study of the properties, definitions, and applications of both, the indefinite integral and the definite integral. Integration is the method of finding the value of an integral. Integral Calculus is related to two linear operations. Indefinite Integral: The anti-derivative, inverse of derivative Definite integral: When you input a function in the definite integral, it outputs a number. This gives you the area between the graph and the x-axis. The Calculus Controversy: The conflict was an argument between Isaac Newton and Gottfried Leibniz over who first invented calculus. Newton claims that he began working on a form of calculus in 1666, but he did not publish. Gottfried Leibniz began to work on his calculus in 1674, and he published his work in a paper in 1684. Newton created his clumsy method of fluxions, in 1655. However, he feared condemnation. Therefore, he did not publish his work until 1704. The fact that he fought with Leibniz before publishing anything raises the question: Was it Newton who invented Calculus? Leibniz developed his calculus in 1673; he used many symbols that we still use today- derivatives as dy/dx and many more. Leibniz published his work in 1684, 20 years before Newton. The last years of Leibnizs life were poisoned by a controversy with Newton over whether he discovered calculus separately, or whether he had invented another form of ideas that were Newtons. Newton influenced the quarrel. In 1673, Leibniz travelled to England. He met some of the leading scientists, like Robert Hookes and showed them his unfinished calculating machine. He did not meet Newton, but he was shown Newtons unpublished work. After Leibniz came back from England his two miraculous yeasr began. After these two years he was considered a creative genius. One of his inventions was calculus. Leibniz needed to contact a broader scientific community, so he became in contact with Christian Huygens, a Danish scientist, and Collins and Henry Oldenburg, secretary of the Royal Society. Leibniz sent his ideas to Collin. In return, Collin sent Leibniz the latest ideas circulating the Royal Society. In Leibnizs defense, however, some documents sent did not reach Leibniz until after he developed his own way. It was clear that he had developed his own ideas on differentiation and integration. Both Newton and Leibniz had partners who helped them develop calculus. Johann Bernoulli, who used Leibniz calculus to maximize function, motivated Leibniz to fight with Newton. Newton was surrounded by people who Leibniz called enfants perdus, the lost children. Newton led the attack, and they continued to carry the battle. Leibniz was accused of plagiarism, a charge that doesnt carry on when you look at the evidence: 1. He published his method years before Newton published anything on Fluxions. 2. He always referred to his discovery as his own invention. 3. The way he developed his ideas of calculus were different than the way Newton developed his ideas. 4. Leibniz came up with ideas of differential and integral calculus before and of Newtons work was published. In June 1676, Newton wrote to Oldenburg, describing the binomial theory. He also stated that all curves can be reduced to infinite series. Moreover, he stated that areas, lengths of curves, and volumes can be obtained through series. Afterwards, Leibniz sent Newton a letter to clarify series. Newton replied by talking about finding the maxima and minima, differentials, and many other topics. However, he did not mention anything about fluxions. Later, Leibniz published his calculus in 1684. When Newton published his work, Newton found out that Leibnizs calculus was very similar to his. Newton also came to know later on that Leibniz has learnt ideas from Collins and Oldenburg; these ideas came from Newton and Gregory. In 1672, Leibniz learnt mathematics and got letters from Collins. What was unusual was that Newton sent Collins similar letters at the same time describing fluxions. Newton then accused Leibniz of copying his work. However, the case leaned towards Leibniz. In defense to the accusation, Leibniz said that when he was shown the works of Newton, but he did not learn anything useful because he did not know much mathematics at the time. Leibniz also said that Collins notes were irrelevant to the subject of calculus. Leibniz died dishonored; on the other hand, Newton was given a state funeral. However, History does authenticate Leibniz. As time goes on, the strength of the controversy decreases. And, Leibniz slowly finds his place as one of the best scientists of all time. All in all, Newton was known to be the first inventor of calculus because there is proof that he developed his theory of fluxions first. He also created differentials, and they were later explained by Leibniz. On the other hand, Leibniz also created calculus independently from Newton. Leibniz described his calculus in a different way than Newton. I personally think that Newton made a mistake by not publishing his work as soon as he created it. This is what led to the controversy. I also think that both men deserve the title of calculus inventors just as equally.

Irrigating Crops With Seawater :: Freshwater Essays

Brown J. Jed, Glenn Edward P., and O’Leary James W. 1998. Irrigating Crops with Seawater. Scientific American. Irrigating Crops with Seawater'; talks about the global problem of finding enough water and land for the world’s population to survive. An estimated 494.2 million acres of cropland is needed just to feed the tropics and subtropics for the next 30 years. However, only close to 200 million acres are available. Therefore, new sources of water and land are needed to grow crops. The writers of this article have been testing the prospect of using seawater in agriculture. This seawater agriculture is when salt-tolerant crops are grown using ocean water for irrigation. Desert areas take up 43% of the surface of the earth and this new agriculture technique can be done in deserts. Hugo Boyko and Elisabeth Boyko first used seawater agriculture after World War II. Many different crops have been tested such as barley and the date palm. The writers of this article however have been testing halophytes, which, is a salt-tolerant plant that can be used for food, forage and oilseed crops. They f irst gathered several hundred halophytes and began testing these plants in the desert of Puerto Peà ±asco. They irrigated the plants daily by flooding the fields with seawater from the Gulf of California. The best halophytes produced roughly the yield of alfalfa using freshwater irrigation. In order to show that these halophytes could replace other crops for use they tested to see if the crops could feed livestock. The halophytes have protein and carbohydrates but they contain too much salt. This limits the amount an animal can eat and dilutes the nutritional value. Therefore, the authors decided to use the halophytes as part of a mixed diet for the livestock. The animals’ meat taste was not affected, but the animals eating the halophyte-mixed diet drank more water and produced 10 percent less meat.   Ã‚  Ã‚  Ã‚  Ã‚  This new agriculture method has many advantages too. First, it is cheaper to pump the seawater than to pump freshwater. In addition, seawater irrigation does not require any special equipment. The same fields have been irrigated for 10 years with no water buildup or salts in the root zone. Finally, installing the seawater irrigation will not disrupt the ecosystems as much because they are installed on barren or almost barren areas. There are also some disadvantages to irrigating crops with seawater. First, a large quantity of high-salt drainage water that will contain unused fertilizer will be discharged back into the sea.

The Medias Impact on the Scopes Monkey Trial :: American America History

The Media's Impact on the Scopes Monkey Trial      Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The 1920’s were a period of transition for America.   The culture of society was quickly adapting to many new ideas and beliefs.   Traditional schools of thought were gradually being replaced with new technology and knowledge.   The changes taking place were the source of much conflict, as many historical events of the twenties can illustrate. One such event is the Scopes â€Å"Monkey† Trial.   From our research we discovered that the trial pitted Modernists against Traditionalists, Fundamentalists against Evolutionists, and the Country against the City.   However, these conflicts would not have been brought to the attention of the American public if the media had not been so engrossed in the event. That idea helped in formulating our research question: Why did the media choose to get so involved in such a localized, small town affair?   Ã‚  Ã‚  Ã‚  Ã‚   In order to answer this question we decided to examine the aforementioned conflicts to try to understand why the media showed such strong interest in the trial.   We found that the media recognized this case as a perfect way to bring these conflicts to the forefront of the American mind.   By doing this, the ideas and beliefs of modernists could be showcased and possibly validated.   This was a way to indirectly force change and progress in America.   To demonstrate this point, the socio-cultural conflicts need to be investigated and related to the Scopes trial.   Ã‚  Ã‚  Ã‚  Ã‚   Before looking at these issues, some background is necessary.   The whole controversy originated when the Butler Law was passed in 1925 prohibiting the teaching of the Evolution theory in state funded schools (Scopes and Presley 52).   When the American Civil Liberties Union discovered the law, they put out a press release requesting the cooperation of a Tennessee teacher in a â€Å"friendly test case† of the law (DeCamp 8). Dayton resident George Rappleyea and some friends came up with the idea to have the case in Dayton and decided to ask John Scopes to be the teacher to test the law.   Ã‚  Ã‚  Ã‚  Ã‚   Scopes was a science teacher at Dayton High School.   However, he only taught Biology for two weeks as a substitute at the end of the school year.   When Rappleyea asked Scopes if he taught the theory of evolution, he said he didn’t really remember.   Nonetheless, Scopes accepted the offer(despite some initial opposition), and the Scopes â€Å"Monkey† Trial saga began.

The New Plant Manager

CASE 1: THE NEW PLANT MANAGER I. TITLE: The New Plant Manager II. POINT OF VIEW: As a Manager III. THE PROBLEM: How can the company even without Toby Butterfield meet its budget and productivity quotas? IV. OBJECTIVES: 1. To understand why organizational behavior is important in an organization. 2. To know the appropriate attitude of a manager in an organization. 3. To analyze organization behavior from the perspective of learning of an organization. V. AREAS OF CONSIDERATION: 1. The Organizational Behavior Organizational behavior speaks about how an individual or a group of people acts within an organization.As a plant manager he must consider how to act professionally. He must know how to act the proper organization behavior even though he is the head of the plant. 2. The Newly Assigned Assistant Plant Manager The Montclair Company is having difficulty meeting its budget & production quotas, the main reason why Toby Butterfield was promoted as the new assistant plant manager of the company. 3. The SWOT Analysis SWOT analysis is a structured planning method used to evaluate the Strengths, Weaknesses, Opportunities, and Threats. Strengths- Butterfield as a new assistant plant supervisor produced a remarkable result in the company’s production quotas in which the productivity quickly exceeded by 7 percent and within five months the plant was within budget. †¢Weaknesses- Butterfield being ambitious and power-oriented wherein he dismissed three supervisors who had failed to meet their production quotas and as a result five other supervisors resigned. †¢Opportunities- Promotion to New York home office because of his outstanding record. †¢Threats- The fall of productivity after Butterfield left the Houston Plant. VI.ALTERNATIVE COURSES: 1. The remaining employees should plan for what is the best thing to do in order to meet its budget and productivity quotas. Advantages: †¢They can come up to new ideas to improve their productivity. †¢They can prove to themselves that even without Butterfield they can still help the company to meet their quotas and budget. †¢They could gain unity. Disadvantages: †¢It is not easily for them to meet their quotas and budget for a few moments because it takes time to plan for new ideas. †¢Planning needs a lot of time in order for it to be implemented to the company. 2.Even without Butterfield, the company would still adopt the organization behavior of him being power-oriented because it helped a lot the company in meeting its budget and productivity quotas. Advantages: †¢It is easy for them to cope up with this kind of organization behavior because Butterfield had already ruled them when he was still in the company. †¢In this way, the company will easily meet their budget and quotas just like few months when Butterfield was still the plant manager of the Houston Plant. †¢Adopting the said organization behavior would help the employees be more competent. Disadvantages: This may be the reason of some employees to resign because they do not like the way of ruling them. †¢This can also be the reason of some supervisor-employee issues. †¢Newly employed employees will have a hard time adjusting with this kind of supervision. 3. Each of the employees must be assigned of their own areas of responsibility to work with in order to help their company meet their budget and production quotas. Advantages: †¢Each of them can focus to the area in were they are assigned only. †¢They could help themselves improve the way they handle responsibilities. †¢They could gain self-confidence in handling responsibilities.Disadvantages: †¢They will not have company unity. †¢This may be the reason of some employee conflicts because the work of the other did not complement to the work of others. †¢This may be result of the delay of work because some may not meet the target time of passing the reports. VII. RECOMMENDATION : Based on the situation given the best alternative the company must use is the alternative no. 2, adopting the organization behavior of Butterfield that is being power-oriented because it is a big helps to the company. Because of this, it is easy for the company to meet their budget and productivity quotas.