Royal Greenland Essay Example for Free

Royal Greenland Essay Royal Greenland is the largest producer of cold water prawns and the market leader of ever expending seafood products. The company belongs to Greenland and catches their primary raw materials and the clear ice cold water from there. The company has its modern part of hunting and fishing culture, which is always existed there and the catches are made with deep respect in Greenland nature and people. Royal Greenland’s clear aim is activities to contribute to the wellbeing Greenland community. Royal Greenland is not just a brand – it’s a promise. No matter what the challenges are, the company depends of committed staff. Royal Greenland has focus on quality and refuses to compromise. In this way Royal Greenland has been a reliable supplier and a trust world partner since 1774. Today is the company still in lead and extended itself as the most innovated and competitive player on the market. Whether if its own brand, as a supplier of private labels or via directed sells to the industry. For more than 230 years has Royal Greenland been associated with the first class seafood. The company’s future plans in investing are to have focus on improving their techniques and products to match the need of their modern consumer. Royal Greenland cooperates with private and public research institutions in order to continue developing their processing, distribution techniques and production. 2. Royal Greenland brand value Applying the Maslow hierarchy of needs, one may argue that Royal Greenland customers seek for self-esteem, recognition and status; they believe that being seen with the Royal Greenland products brand will fulfill these needs. Therefore, the value added to its customers is more intrinsic, being that is a physiological need the act of eating. Royal Greenland Royal Greenland However we may say that Royal Greenland stands in between level 1 and 2 of the Maslow Pyramid and maybe some may argue also between level 3, so that it can be also associated to a kind of luxury level of food and restaurants. Anyway is mainly a physiological need, the customers go for best in the balance of quality facing price. 3. The 4 P’s Products Seafood such as shellfish, natural fish, smoked and marinated fish, prawns. In their webpage they have a catalogue with 162 of different kind variation of the seafood that they offer. As a full-range supplier of seafood products Royal Greenland’s product assortment reflects the company’s ability to meet the need of our consumers and Royal Greenland’s ability to renew ourselves. In Royal Greenland marketing it is in matter; at their products have high quality standards. Royal Greenland is proud to present a broad range of high quality seafood products from their own fisheries and from selected suppliers around the world. They offer the â€Å"highest quality standards† in the world – their global quality team makes sure of that. If there are any complains about the products or about the services, the company takes them serious and they take professional action towards and try to avoid that happening again. Price For centuries, Royal Greenland has been associated with high quality seafood at affordable prices. The company’s product range makes it possible to prepare healthy and tasty meals for any occasion. Royal Greenland, have a price that most customers can afford. Royal Greenland gives the customers the products what they pay for. Place – They owns Production facilities in Canada, Denmark, Germany, Greenland and Poland. The customers can be sure that Royal Greenlands products get delivered o time and in a perfect condition. When dealing with perishable food products and especially frozen goods, it is extremely important to keep temperature constant during transportation and storage. In order to retain the high, natural quality of their products they are checked all the way from production, through storage to the customer by their Quality Control Team. In Denmark the company is distributing in different Danish supermarkets such as Irma and Fotex Promotion They use as promotion mainly their homepage. There the customers can find information about the company, the quality of their products, the way they prepare their products. Even though that the company don’t use any special way to promote themselves, Royal Greenland is the largest producer of cold water prawns and the market leader of ever expending seafood products. 4. Strategic Analysis For in depth analysis, to start with we need to identify the elements which affect the strategic decision; strategic position and strategic choice. The strategic position, where it argues the environmental and stakeholder’s effect on the issue, we identified two elements; economic downturn and new consumer needs. We used the Ansoff matrix to show how Royal Greenland stands concerning Markets and Products as it is shown below. Upon investigation of the company’s reports, one comprehends that both the sales growth rate and profit margin are declining. The company in its mature phase reveals that is the time to look for new segments or new markets. The time seems right for diversification by new product in new markets. 5. IMS (International Market Selection) Analyses The IMS analysis will help us to identify the right market to export. It is based on low psychic distance, low cultural distance and low geographic distance. Our assignment is about Far East countries and Polynesian Islands. We don’t have to argue why it is that, because it’s given. - In their official webpage there is a summary of companies owned or partially owned by the parent company Royal Greenland A/S. There we can see that Royal Greenland is a limited company and 100% of the stock is owned by the Greenlandic Selfrule Government is in Japan. That means that they already have knowledge with the Far East culture, and are ready to export to more Far East countries a brow. Royal Greenland is the biggest seafood company in Denmark. Royal Greenland is a large and complex organization with subsidiaries in a number of countries around the world. Royal Greenland A/S had an annual turnover in 2010/2011 of 4,7 billion DKK and more than 1,800 employees around the world. It has advantage of food  fresh  and  production technology. Royal Greenland has expanded to  many countries and regions on sale. The global economic is downturn, we should keep currently market share and develop the new market. Royal Greenland owns several production facilities located in the immediate vicinity of fisheries and their â€Å"key markets† Greenland, Canada, Denmark, Poland, Germany. We will go along 4 steps. We will describe more detail the general and specific criteria that is mention above. Step 1: In step one, we have the micro level. – Here we make decision which market the product is going to enter. This is about external factors such as PESTEL (politics economic, social, technology, environment and legal). In the first step we analysis IMS (International market selection). We chose New Zealand, China and Philippines. We will mainly look at those three countries political and economic factors. After those first reflections, we can figure out where we want to start. We will reduce from three, to two countries. Then we will make a Pest Analysis and compare them. Criteria – size and economy. Step 2: In step two, we have MECO. We will do our product analysis and market analysis. We will find information about the competitors, and compare our products to the competitors. We will do a competitive analysis. Step 3: Internal analysis. All the internal tickets: are proactive or reactive. Step 4: In step four we actually do segmentation in regards to customers. Demographics – lifestyle, age, gender, buyer behavior, income. New Zealand PESTEL Analysis Political and Environmental Factors: Elizabeth 11 queen of New Zealand has no real political influence and her position is essentially symbolic. Political power is held by the democratically elected Parliament of New Zealand under leadership of Prime Minister, who is the head of government. New Zeland has ranked fifth in the world for political stability in the IMD world competitiveness yearbook 2009. In New Zealand electronics are held every three years so the government has to at time make some compromises with economic growth in order to pursue its political motives. While it may have been acceptable in the past for businesses to pursue profits single minden with a little or no consideration for the wider social and environmental impact of their activities, this is not the case anymore today. The consumer movement and the environmental lobby are now firmly established as vigilant and powerful watchdogs, and have successfully brought changes in business practice and in how businesses must operate. In New Zealand the government announced significant changes to business taxation and the business environment to help develop a more innovative and dynamic economy better able to compete in the global marketplace. Economic Analysis: The Economy of New Zealand is a market economy which is greatly dependent on international trade, mainly with Australia, the European Union, the United States, China and Japan. It has only small manufacturing ad high-tech sectors, being strongly focused on tourism and primary industries like agriculture (though both sectors are highly profitable). Economic tree – market reforms of the last decades have removed many barriers to foreign investment, and the World Bank in 2005 praised New Zealand as being the most business – friendly country in the world, before Singapore. Social Factors: The first release of data from the 2010 New Zealand General Social Survey showed that: New Zealanders have relatively high levels of overall life satisfaction. In the survey, 87 percent of the population reported they were ‘satisfied’ or ‘very satisfied’ with their lives overall. However, satisfaction with life varied across different groups within the population, in particular when looking at people’s labour force status, stage in life, household income, and the type of family they live in. Technological Factors: As a Western country, New Zealand has a proactive, creative and skilled labor. They have the worlds leading educational institutions; a highly educated population with graduate level is increasing. English is the main language of New Zealand. New Zealanders also have excellent quality of soft skills, professional ethics and the spirit of daring to do famous. Technology includes: * processes/systems (operational) * machinery * intellectual property * IT systems. The technology or business skills must be introduced into New Zealand as a result of the investment they must not already be in New Zealand. PEST analysis for China Political Analysis: China is communist country but it is transforming into democratic form of government. The Chinese government has, in the past, strongly controlled such things as prices, markets, products, foreign assets, and personal assets. However, during the past decade, the Chinese government has chosen to open their markets to world investors and to create laws and regulations more in line with the World Trade Center guidelines. This change in philosophy has encouraged foreign investment in China. However, regardless of the recent move towards an open market, the Chinese socialist political environment should remain a key risk factor in any potential expansion. There is only one party in china which is communist party of china. As there is only one party ruling the country so there is stability in the country which is very necessary for business activities. The stability in the country attracts foreign investments in the country. The government also provides different incentives and securities to the new businesses. For example government can declare certain area tax free and thus attracting new investors in the country. The laws are a bit complex for the new investors. But if the new investment Is approved then it will be a successful business. Economic Analysis: Chinas economy is huge and expanding rapidly. In the last 30 years, the rate of Chinese economic growth has been almost miraculous, averaging 8 percent growth in Gross Domestic Product (GDP) per annum. The economy has grown more than 10 times during that period, with Chinese GDP reaching 3. 42 trillion US dollars in 2007. China already has the biggest economy after the United States and most analysts predict China will become the largest economy in the world this century. China is a very good market for the investors to invest and earn profits. Both the industry and agriculture sector provides opportunities to the investors to invest. Inflation rate (consumer prices): The inflation rate in china is 5%. The inflation is very much low and it is in single figure. The prices of commodities are low in china. And this figure is also a controlled one. Central bank discount rate: 2. 79% (December 2009) This is a very good sign for the investors as the financing would be easy and funds can be generated if needed. As the rate is very lower so the expected inflation rate is also low which means that more employment. Social Factors: Chinas spectacular economic growth-averaging 8% or more annually over the past two decades-has produced an impressive increase in the standard of living for hundreds of millions of Chinese citizens. At the same time, this economic development has had severe ramifications for the natural environment. There has been a dramatic increase in the demand for natural resources of all kinds, including water, land and energy. The population growth of china is high and government is taking steps to control this growth of the population. The population growth rate of the country is 0. 94%. The 72. 1% of the population is 15-64 years which is the main target population for the businesses. Technological Factors: The history of science and technology in China is both long and rich with many contributions to science and technology. THE end of cheap China is at hand. Blue-collar labour costs in Guangdong and other coastal hubs have been rising at double-digit rates for a decade. Workers in the hinter land, too, are demanding—and receiving—huge pay increases. China is no longer a place where manufacturers can go to find ultra-cheap hands. Contrary to conventional wisdom, it will not mean that companies close their Chinese factories and stampede to somewhere poorer. China is still a terrific place to make things. Labour may be cheaper elsewhere, but it is only one cost among several. Unlike its lower-paying rivals, China has reasonable infrastructure, sophisticated supply chains and the advantage of scale. When demand surges for a particular product, the biggest firms in China can add thousands of extra workers to a production line in a matter of hours. Environmental Factors: Chinas development and environment practices have made the country one of the worlds leading contributors to regional and global environmental problems, including acid rain, ozone depletion, global climate change, and biodiversity loss. Environmental degradation and pollution in China also pose challenges well beyond those to the natural environment. The ramifications for the social and economic welfare of the Chinese people are substantial. Public health problems, mass migration, forced resettlement, and social unrest are all the consequence of a failure to integrate environmental considerations into development efforts effectively. Sacrificing environmental needs, such as trees, for economic gain. PESTE analysis Philippines Political analysis The Philippines’ diverse population, which speaks more than 80 languages and dialects, is spread over 7,000 islands in the Western Pacific Ocean. The country returned to democracy in 1986 after two decades of autocratic rule. President Benigno Aquino III took office in 2010 with a mandate to address pervasive government corruption. Economic analysis Despite the challenging global economic environment, the Philippine economy has been on a steady path of economic expansion. The government has pursued a series of legislative reforms to enhance the entrepreneurial environment and develop a stronger private sector to generate broader-based job growth. Overall progress has been gradual, but regulatory efficiency has been notably enhanced. The economy has expanded at an average annual rate of close to 5 percent over the past five years. The economy of the Philippines is hampered by huge foreign debt, a low savings rate, inefficient tax collection, inadequate infrastructure , especially outside major cities, and poor agricultural performance. The Philippine economy is vulnerable to oil-price increases, interest-rate shifts by the U. S. Federal Reserve, and the performance of international stock exchanges. Social Factors: Social factors that have a negative impact on the economy include a high crime rate, especially kidnappings and rape, pockets of Communist rebels in rural areas, threats from Muslim separatist movements, high rates of poverty and unemployment, and the governments inability to begin its land-distribution program. Environmental factors also damage economic development, including frequent typhoons and drought. Worker productivity is adversely affected by illnesses brought on by air and water pollution. In metropolitan Manila alone, the effect of pollution on health and labor productivity has been estimated to be equal to a loss of about 1 percent of gross national product annually. Technological Factors: In todays fast paced world, the need to operate globally and without boundaries has increased the abilities and expectations for technology. Information technology, being the theme on everyones mind throughout the last decades is still reaching new levels. The new and tremendous dvancements in telecommunication technology in the new millennium were the milestone for the outsourcing of service activities that were about to penetrate the Philippines. The country has a lot of highly skilled IT people and the IT infrastructure and supports are very advanced. Therefore, the technology allows products and services to be made significantly cheaper than in domestic markets, and yet maintain at lea st the same quality. The employees are working at wages approximately 400% smaller than in Europe but the final results they deliver are hard to distinguish from the European ones. The cheap costs also give the possibility to be more flexible and take risks because there is not much to lose. It is easy foreigners who did not really have beliefs or big plans for their businesses but they thought it would be fun to run a company without seriously endangering your budget. Environment Factors: The Philippines is prone to natural disasters, particularly typhoons, floods, landslides, volcanic eruptions, earthquakes, and tsunamis, lying as it does astride the typhoon belt, in the active volcanic region known as the â€Å"Pacific Ring of Fire,† and in the geologically unstable region between the Pacific and Eurasian tectonic plates. The Philippines also suffers major human-caused environmental degradation aggravated by a high annual population growth rate, including loss of agricultural lands, deforestation, soil erosion, air and water pollution, improper disposal of solid and toxic wastes, loss of coral reefs, mismanagement and abuse of coastal resources, and overfishing. According to Greenpeace SouthEast Asia, the Philippines major historical river, the Pasig River is now biologically dead due to negligence and industrialization. Currently, the Philippines Department of Environment and Natural Resources has been busy tracking down illegal loggers and been spearheading projects to preserve the quality of many remaining rivers that are not yet polluted. Conclusion: By using the PESTEL framework we analyzed the many different factors in a firms macro environment. In some cases particular issues may fit in several categories. The PESTEL Factors in China appears in several categories, we simply make a decision of where we think it best belongs. We think that to export in China will have the greatest impact. We have made a SWOT analysis, which proves that China would be the best market to export in. 6. SWOT Analyses SWOT analysis is a strategic planning method used to evaluate the Strengths, Weaknesses/Limitations, Opportunities, and Threats involved in a project or in a business venture. It involves specifying the objective of the business venture or project and identifying the internal and external factors that are favorable and unfavorable to achieve that objective. So concerning our previous explanations and answers to themes in analyses, we came up with the following SWOT analyses: 7. Business Law Contract for the International Sales of Goods (CISG): CISG stands for contract of sale of goods, the convention applies when the buyer and seller have their place of business in different states and when the parties are from contracting states . As Royal Greenland Company is going to sell its product to China from Denmark. At the same time, China is approved to apply CISG, but Denmark is not agreed with the CISG Law. So there are two conditions: ?Royal Greenland company (seller)—the buyer in China: If the two parties did not agree about which law is to apply, then the rule of seller? s country shall apply. So in this situation, the rule of the Denmark should apply, as the Danish law mentions that the CISG takes precedence in international sales. So if the Royal Greenland Company is seller and the buyer is in China, then the CISG should be applied. ?Royal Greenland company (buyer)—the suppliers in China: It is also about the sales of goods, the rule of seller? s country shall apply, and as the China is not approved the CISG. So the law from the China shall be applied if the Royal Greenland is buyer and the supplier is from China. Performance is the fulfillment of a promise in the contract. Many issues can arise in a sales contract after the contract is made and before a partys performance is required. Sometimes performance may be made impracticable. If the goods are completely destroyed before the risk of loss has passed to the oversea buyer, and the goods have not been destroyed through the fault of either party, Royal Greenland may be excused from performing. Risk of loss is responsibility for any damage or destruction of goods; the parties may decide in the contract when the risk of loss of the goods passes from Royal Greenland to the buyer. If the goods are only partially destroyed or have deteriorated, the buyer may demand to inspect the goods and either void the contract or accept the goods with a reduction in the contract price. Royal Greenland may avoid performing only if the destroyed goods were specifically identified when the sale was made. There are two situations in which a party must make a substituted performance in case the agreed method of performance becomes impracticable. First, when the goods cannot be transported by the agreed-upon method of transportation, Royal Greenland must use available transportation that is a commercially reasonable substitute. Second, if an agreed-upon method of payment fails, the buyer must use a commercially reasonable substitute method of payment if one is available. If a party fails to substitute transportation or payment, she could be liable to the other party for losses resulting from the failure. In some cases the purpose of a sale may be frustrated by circunstances beyond the control of both buyer and seller. At times it may appear to a party that the other party will be unable to perform by the expected date. For example, assume that a party agrees to sell goods on credit. If the buyer becomes financially insolvent before the goods are delivered, the seller may demand cash before delivering the goods. If the goods are in transit, the seller may instruct the carrier to withhold delivery of the goods. A party is considered insolvent if she cannot pay debts as they come due, has ceased to pay debts, or has liabilities that exceed assets. If a party has reasonable grounds to feel insecure about the other partys ability to perform, the insecure party may demand assurances before performing. Alternatively, if the other party gives the assurance, the concerned party must follow through on his obligations. Precisely what constitutes an effective assurance is a question of fact that depends on the nature of the goods, the size of the contract, the length of time until performance, and similar considerations. In any case a concerned party may not make commercially unreasonable demands on a party prior to performance and then withhold performance if the other party does not meet the demands. Delivery We think that there are two-clause suit for the Royal Greenland Company, one is F-clause, and the other is C-clause. ?F-clauses FOB (free on board). In this situation, the Royal Greenland must load the products on board the designed by the buyer in the China. The goods are delivered when they have been handed over to the first carrier designed by the buyer. The advantage of this rule is the transportation fees and the risk is shared by the Royal Greenland and the buyer in the China. FAS (free alongside Ship). In this situation, the Royal Greenland must deliver the goods to the specified spot; the goods and risk are delivered when they are placed alongside the ship. The advantage of this is that the seller don? t need to take the goods to the board. ?C-clauses CIF (cost insurance and freight). In the situation, the seller shall pay for marine insurance and costs all the way to the place of destination, the risk passed when goods are on board the ship in the dispatch port. For example, we deliver the products (named of) to China and we pay all the insurance and transportation fee until the products arrive to the place of destination, The advantage of this rule is although the Royal Greenland pay all the transportation fees and insurance fees but they have the lowest risk, if they got any damages during the transport the insurance company will pay all the losses. Seller? obligations (CISG) and Buyer? s obligations (CISG) ?The seller must: 1, Deliver the goods 2, Handover documents 3, Transfer rights of ownership of goods to the buyer The seller must deliver the right goods quantity and quantity at right place and at the time agreed in contract. And hand over the document that is necessary. Transfer rights of ownership of goods to the buyer, such as risk. There are many conditions: some risk is passed to buyer when the goods are hand over to the first independent carrier. Some risk passes to buyer when buyer at the time of receipt of the goods at the seller? s place of business. When the risk passes to buyer, it is depend on the which kind of transportation way that the seller and buyer choose. ?The buyer shall to take delivery of goods and pay the payment that has been agreed at the agreed time and place. Buyer? s remedies in the event of the seller? s breach of contract (CISG) There are also some remedies in the event of each parties breach the contract. First of all, we list several breaches from the seller, and remedies for the breach. When the sell breach a contract in case: 1. Delay 2. Defect 3. Defective title. The buyer can choose to: 1. Affirm 2. Cancel 3. And claim damages if a loss has been incurred. The buyer can also demand corrective performance, at the same time the seller has a right to correct also after the goods have been delivered. Seller? s remedies in the event of the buyer? s breach of contract (CISG) When the buyer breach a contract in case: 1. Not paying for the goods 2. Not taking delivery of the goods. In such cases happen, the seller has the rights to: 1. Affirm 2. Cancel 3. Claim damages. Conclusion It is benefit for the Royal Greenland Company to put then in a good position if they are similar with the CISG and doing the international sale with China. 8. Economics As attachment in appendix there is the study on investment table as well as the net-cash flow diagram. Anyway below is our conclusion: 9. Conclusion Royal Greenland A/S (Royal Greenland) is a Denmark based company operating in the provision of seafood products. It is one of the worlds biggest producers of coldwater shrimps and a market leader in a wide range of seafood products. The company, along with its subsidiaries is engaged in fishing, processing, production, marketing and distribution of seafood products. The core products of the company include prawn and shellfish products, fillet products, ready to eat products and smoked products. The company operates through a number of production sites across Greenland, Denmark, Germany and Poland, and sales offices in Europe, the US and Japan. Royal Greenland is headquartered at Nuuk in Denmark. Export to restaurants. In our assignment we decided after making an PESTEL analysis in 3 different countries from Far East, to export in China. Beside that we chose to export in the restaurant market. The reason why we chose to export in restaurants is, that restaurant is the largest segment of the profit foodservice sector in China, accounting for 94% of the sectors total value. The pubs, nightclubs and bars segment accounts for a further 1. 2% of the sector Market analysis. The Chinese profit foodservice sector displayed double digit growth over the 2007 to 2011 period. The sector is forecast to post healthy growth during the period up to 2016. In comparison, the Japanese sector will decline with a compound annual rate of change (CARC) of -0. 8%, and the Indian sector will increase with a CAGR of 17. 4%, over the same period, to reach respective values of $102. 8 billion and $58. 1 billion in 2011. Sector consumption volumes are forecast to increase with a CAGR of 3. % between 2007-2011, to reach a total of 115. 6 billion visits in 2011. The sectors volume is expected to rise to 133. 1 billion visits by the end of 2016, representing a CAGR of 2. 9% for the 2011-2016 period. The restaurants segment is expected to be the sectors most lucrative in 2011, with total revenue of $135. 5 billion, equivalent to 94% of the sectors overall value. The pubs, nightclubs and bars segment will contribute revenue of $1. 7 billion in 2011, equating to 1. 2% of the sectors aggregate value. Market value forecast In 2016, the Chinese profit foodservice sector is forecast to have a value of $236,162. 1 million, an increase of 63. 8% since 2011. Buyer power in the profit foodservice sector in China Buyers in the global profit foodservice sector are individual consumers, which are large in number but hold very little financial muscle independently. High transaction volumes mean that the impact of any one customer on revenues is usually small. The exception here can be in the case of premium-price, non-chain restaurants, whose business model relies on low-volume, high-margin sales. This lack of financial muscle minimizes the power of buyers, although they benefit from the lack of costs incurred by switching from one profit foodservice player to another. Profit foodservice is not strictly essential to consumers: they can backwards integrate by cooking their own food. Profit foodservice players have invested heavily in brand-building, especially in the low- and medium- price segments. The Uppsala model has described the internationalization of a firm as a process of experiential learning and incremental commitments which leads to an evolutionary development in a foreign market. Royal Greenland Export Royal Greenland A/S sales subsidiaries have been established on the most important markets i. e. in Denmark, France, Germany, Italy, Japan, Sweden, the UK and the USA. The southern part of Asia is yet another potential sales subsidiary location. However, no matter where a subsidiary is placed, company policy dictates that it be managed by local staff to ensure the greatest insight into each countrys market, and dietary and cultural traditions a policy which has proven very rewarding. The Export Division sells about 65,000 t of high-quality products from a constantly expanding product range to 40 main markets all over the world. The divisions product development department ensures that customer demands concerning products and lines are made in consultation with Royal Greenland. Delivery reliability is equally ensured and realised through close collaboration with the Divisions colleagues in Greenland. Royal Greenland Development Royal Greenland Development was established in 1995 to offer its know-how and expertise to Third World fishery development projects. The divisions role is to participate in research fishing aimed at establishing what resources are at hand and to assist with product development and production. Further assistance in the form of raw materials and sales facilities may also be offered by the Division, which works in collaboration with internationally recognized aid organizations. Contracts have already been drawn up in India and Vietnam and business prospects are promising in China, Southeast Asia, Africa and South America. 11. Reference List Global Marketing – A Decision-Oriented Approach Fifth Edition, Svend Hollensen Business and Danish Law Book ttp://www. royalgreenland. com http://www. royalgreenland. com http://www. slideshare. net http://www. stats. govt. nz http://www. linz. govt. nz http://www. economywatch. com http://www. economist. com http://www. cfr. org http://www. heritage. org http://www. nationsencyclopedia. com http://en. wikipedia. org http://www. articlesbase. com [ 1 ]. The countries that are in Far East are: China, Hong Kong, Macau, Japan, Mongolia, North and South Korea, Brunei, Cambodia, Indonesia, Laos, Malaysia, Myanmar, Papua New Guinea, Philippines, Singapore, Thailand, Vietnam, Russia. Geographically, the Polynesian Triangle is drawn by connecting the points of Hawaii, New Zealand and Easter Island. The other main island groups located within the Polynesian Triangle are Samoa, Tonga, the Cook Islands, Tuvalu, Tokelau, Niue, Wallis and Futuna and French Polynesia. [ 2 ]. - (http://www. royalgreenland. com/uk/Our-company/Organisation/Ownership-and-Asso ciated-Companies. aspx ) [ 3 ]. http://www. royalgreenland. com/uk/Our-company/Facts-Figures. aspx [ 4 ]. http://www. royalgreenland. om/uk/Fishery-and-processing/Production-facilities. aspx [ 5 ]. http://www. slideshare. net/Nokhov/new-zealand-presentation-847054 [ 6 ]. http://www. slideshare. net/Nokhov/new-zealand-presentation-847054 [ 7 ]. http://www. stats. govt. nz/browse_for_stats/people_and_communities/Families/nz-general-social-survey-info-releases. aspx [ 8 ]. http://www. linz. govt. nz/overseas-investment/applications/technical-resources/benefit-nz-factors/new-technology [ 9 ]. http://www. economywatch. com/ world_economy/china/? page=full [ 10 ]. http://www. economist. om/node/21549938 [ 11 ]. http://www. cfr. org/china/chinas-environmental-challenge-political-social-economic-implications/p5573 [ 12 ]. http://www. heritage. org/index/country/philippines [ 13 ]. http://www. heritage. org/index/country/philippines [ 14 ]. http://www. nationsencyclopedia. com/economies/Asia-and-the-Pacific/Philippines-OVERVIEW-OF-ECONOMY. html#ixzz2AIfp1mkg [ 15 ]. http://www. articlesbase. com/outsourcing-articles/technological-factors-in-the-philippines-4035972. html [ 16 ]. http://en. wikipedia. org/wiki/Environment_of_the_Philippines

Effectiveness of Second Generation Tyrosine Kinase Inhibitor

Effectiveness of Second Generation Tyrosine Kinase Inhibitor Susmi Suresh Effectiveness of Second Generation Tyrosine Kinase Inhibitors in the Treatment of Chronic Phase Chronic Myeloid Leukaemia: a systematic review Abstract Background: Chronic Myelogenous Leukemia (CML), a cancer of the myeloid lineage, affects around 15 per 100,000 people per year in the UK. Tyrosine Kinase Inhibitor (TKI) oral therapy is used to target the causative BCR-Abl protein. Second-generation TKIs namely dasatinib and nilotinib are understood to be more potent than the first-generation prototype imatinib. However, cost-effectiveness is hindering the widespread use of second-generation TKIs. The patency of these drugs will expire in the immediate future and so, the prices of these are expected to fall. A clear understanding of the efficacy of the potent second-generation TKIs will aid decision-making bodies such as NICE UK to form guidelines on front-line drugs. This review aims to collect and examine evidence from current literature on the effectiveness of second-generation TKIs in the treatment of chronic phase CML. Method: A systematic search of major databases was carried out and the results were screened using specific inclusion and exclusion criteria. Five major randomised controlled trials were identified. Data extraction and risk of bias assessment were carried out using standardised forms developed specifically for RCTs by the Cochrane Collaboration. Quality assessment of the trials was performed using the CASP tool. Results: The five chosen RCTs were the DASISION trial, the S0325 trial and the SPIRIT 2 which compared dasatinib with imatinib, and the ENESTnd trial and the ENESTchina trial which compared nilotinib with imatinib. A participant pool of 2692 patients had a mean age of 61 years and similar features. A total of n=789 and n=697 patients were randomly assigned to dasatinib and nilotinib arms. Second-generation TKIs were associated with greater response rates in patients than imatinib; for example, dasatinib was associated with an odds ratio (OR) of 0.0803 (95%CI 0.0434 to 0.1489 Pin the S0325 trial, and nilotinib OR= 0.1772 (95%CI 0.1217 to 0.2581 Pin the ENESTnd trial. Conclusion: Current evidence points to a greater efficacy of second-generation TKIs, namely dasatinib and nilotinib, than imatinib. Adverse events (AEs) were reported for all three drugs. Due to the lack of a direct comparison between second-generation TKIs, the effectiveness of dasatinib over nilotinib could not be inferred. In order to aid bodies such as NICE to choose the most apt and safe TKI for use as a first-line treatment choice, it is suggested that future studies aim for a direct comparison. Toxicity data should also be generated to supplement this process. Introduction       Chronic Myelogenous Leukaemia (CML), a cancer of the myeloid lineage, accounts for 8% of adult leukaemias in the UK (1). This acquired genetic disorder causes the pluripotent myeloid stem cells in the bone marrow to undergo unregulated growth (2). A proliferative advantage thus results in patients having abnormally increased levels of serum leukocytes. The WHO ICD-10 classifies this disease as a malignant neoplasm with Philadelphia positive, t(9:22) (q34:q11) translocation and crisis of blast cells. With an annual incidence of 14.8 per 100,000 per year (3), leukaemia, along with its subtypes, is the twelfth most common cancer in the UK. The disease has a male predominance and its incidence increases with age (4). Although no causative environmental leukomogens have been identified, several studies have observed higher incidence in patients exposed to very high doses of ionising radiation (5). CML is often triphasic, with an initial chronic phase (CML-CP) followed by the advanced phases of accelerated (intermediate) phase and a final blast crisis- all with deteriorating laboratory profiles and clinical signs. Tyrosine kinase inhibitor (TKI) oral therapy has been used to extend the clinical course (particularly that of CML-CP). CML today is one of the fewest cancers which can be treated to attain 79% survival rates (6). Since the introduction of TKIs, there has been a significant reduction in mortality rates in the UK- from 1.5 per 100,000 in 2000, to 0.6 in 2010 (7); TKI-attributed mortality reduction is however debatable (8). Currently, imatinib is used as first-line treatment and is available to patients in the UK. Approved by the FDA in 2001, imatinib has been shown to be very effective in the treatment of CML. Prognosis is excellent with an increase in 5-year survival rates by 32% since its introduction (9). Hailed as the magic bullet against cancer (10), there have been several setbacks since introduction. Firstly, patients soon developed resistance. This was counteracted with the development of second-generation TKIs: nilotinib and dasatinib for imatinib-resistant (or intolerant) patients (2). Secondly, TKIs are deemed as one of the most expensive cancer drugs. For instance, in countries such as India where the generic forms are used, the cost difference for a month course, when compared to that in the UK, is an astonishing  £4200 and  £620 for imatinib and dasatinib, respectively (11). As a result, the availability of TKIs is strictly regulated by NICE. Whereas NICE recommends nilotinib as a first line drug if the manufacturer makes Nilotinib available with the discount agreed as part of the patient access scheme (PAS), dasatinib is neither a part of PAS nor is it recommended in CML-treatment (12). NICE explicitly comments on the low cost-effectiveness as the major reason for this despite it acknowledging these drugs to be more effective (13). It is to be reminded that NICE uses clinical as well as economic data to form its guidelines. Prices are expected to fall when the patency of TKIs expires in the future. For example, the patency for imatinib will expire in December 2016 in the UK. This may lead to possible alterations in the NICE recommendations and the use of second-generation drugs for first-line treatments may be favoured. Knowledge on the effectiveness of second-generation TKIs will help us shape the choice of appropriate TKIs in the future, when the pharmaceutical industry will be flooded with their generic versions. As such, this review aims to examine current evidence on the effectiveness of second-generation TKIs in the treatment of CML-CP patients. The molecular basics of CML CML is an acquired neoplasm resulting from the formation of an aberrant gene. In the myeloid stem cells of patients, the breakpoint cluster region (BCR) on chromosome 22 and the Abelson murine leukaemia (c-Abl) on chromosome 9 undergo a (9;22) translocation (Figure 1) . This results in the formation of the aberrant BCR-Abl fusion gene which is seen in 95% of patients (who are so referred to as Ph+ve). The BCR-Abl gene is translated into the leukemogenic protein p210BCR-Abl, an aberrant tyrosine kinase (TK) enzyme that is capable of constitutive activity. TKIs inhibit these aberrant TKs. c-Abl, the non-aberrant version of the gene, has a kinase domain which houses the ATP-binding pocket, an SH2 upregulating domain and an SH3 inhibitory domain. The kinase is strictly auto-inhibited and shuttles between the nucleus and the cytoplasm. However, the BCR-Abl TK is localised in the cytoplasm and this is implicated in its constitutive TK activity (Figure 2). In the cytoplasm, it undergoes auto-dimerisation which activates the enzyme by triggering structural alteration. c-Abl works by phosphorylating the Grb2 substrate protein. This activates the SoS effector molecule which facilitates the conversion of Ras-GDP to Ras-GTP. This further activates Raf due to which MEK1/2 is phosphorylated. As a result, ERK, a critical regulator of Cyclin D is also activated. ERK induces the synthesis of Cyclin D, which along with cdk4, determines whether the cell cycle is allowed past the G1 Restriction point. Once past this checkpoint, cell cycle cannot be reversed and so, the resultant daughter cells are produced. Cyclin D phosphorylates retinoblastoma (Rb), which in its inactive state is unphosphorylated and attached to E2F (a transcription factor), and releases E2F. This allows the cell to enter into the S phase (14) to begin DNA replication. Expression of the BCR-Abl gene upregulates proliferation by constitutively activating the Ras signalling pathway (Figure 3); cyclin D is continuously produced. BCR-Abl expression also facilitates anti-apoptosis and disrupts adhesion (Figure 4). A disrupted adhesion to stromal cells and the extracellular matrix reduces the regulatory effect transmitted via focal adhesions (15). Also, clonal expansion is aided by the evasion of apoptosis. Thus, uncontrolled Ras signalling, upregulated anti-apoptosis and disrupted adhesion are understood to lead to the ultimate manifestation of CML   (16). TKIs inhibit these aberrant tyrosine kinases. Imatinib is a competitive antagonist of the tyrosine kinase domain of BCR-Abl (16). Tyrosine kinases exist in active or inactive states, depending on whether the activation loop located on the C-terminal domain is open or closed (Figure 5).In the inactive state, the activation loop is closed and folds towards the ATP-binding pocket (17). Imatinib and nilotinib bind to the inactive conformation (Figure 6) whereas dasatinib binds to both conformations. Several studies have shown second-generation TKIs to be more effective in treating chronic phase CML (18-20). One such study showed that dasatinib was 325-fold more effective than imatinib at inhibiting BCR-Abl in vitro; this is attributed to its ability to bind to multiple conformations (21). Methods (Appendix A) Results Five randomised controlled trials were identified (Table 9). These included three trials- DASISION, Second Phase S0325 and SPIRIT 2- that compared dasatinib with imatinib and two trials- ENESTnd and ENESTchina- that compared nilotinib with imatinib. All of these together show better outcomes for CML-CP patients treated with second-generation TKIs. The primary end point of all these trials, except DASISION and SPIRIT 2, was MMR rates at 12 months. The DASISION trial looked at CCyR at 12 months. The primary endpoint of SPIRIT 2, the largest dasatinib trial, is event-free survival at 5 years. This will only be measured in March 2018 but nevertheless, secondary outcomes such as CCyR rates at 12 months have been published. All other studies also measured CCyR at 12 months as the secondary outcome. The Dasatinib versus Imatinib Study in Treatment-Naive CML Patients (DASISION) (22) The study aimed to find whether patients given dasatinib had a higher CCyR by 12 months of treatment. CCyR and MMR at 12 months were compared for both drugs and it was concluded that dasatinib may improve long-term outcomes in CML-CP patients due to its shorter response time than imatinib (Table 9; Appendix B: CCyR and MMR measurement methods and scale). Considered as a landmark study, these results proved to be pivotal in accepting dasatinib as a standard second-generation TKI. A 5-year follow-up was conducted to understand whether dasatinib can be continued to be considered as a standard therapy for CML-CP patients. The results (Table 10) supported the original finding (23). The Second Phase S0325 Intergroup (South Western Oncology Group, East Cooperative Oncology Group, Cancer and Leukemia Group B and NCI Canada Clinical Trial Group) Trial (24) The study aimed to compare the response rates for dasatinib- and imatinib-treated patients. Following standard clinical measurement of CCyR rates (Appendix B), dasatinib was found to produce more early short-term cytogenetic and molecular response rates (Table 9). However, the study also noted Grade3-4 toxicities in 58% patients in the dasatinib arm, compared to only 35% in the imatinib arm. Toxicity data were not reported in DASISION or SPIRIT2. ST1571 Prospective International Randomised Trial (SPIRIT 2) (25) CCyR response rates for dasatinib- and imatinib-treated patients were compared. The study observed an increased response rate for dasatinib compared to imatinib (Table 9). With these results, the study concluded that dasatinib was favoured in CML-CP treatment. Evaluating Nilotinib Efficacy and Safety in Clinical Trials- Newly Diagnosed Patients (ENESTnd) (26) A multicentre three-arm trial, this aimed to assess the efficacy and safety of nilotinib compared with imatinib. Two groups of patients given different doses of nilotinib were compared to those treated with the standard imatinib dose. CCyR was found to be higher in both nilotinib arms, compared to the imatinib arm (Table 9). The study thus concluded that nilotinib at either doses produced a clinical response better than imatinib. A 5-year follow up (Table 11) aimed to evaluate the long-term outcomes in patients taking nilotinib; MMR and 5-year overall survival (OS) rates of these patients were examined (27). Patients treated with the higher dose of nilotinib were found to have more AEs. Despite this, due to the short-time with which MMR and CCyR were achieved, the study concluded to recommend nilotinib at 300mg twice daily over imatinib. Current evidence provided by DASISION trial and the works of Quintas-Cardama A et al., 2009 and Hochhaus et al., 2009 were referred by the researchers. These directly link shorter response time with increased long-term benefits and reduced risk of progression (28, 29). Evaluating Nilotinib Efficacy and Safety in Clinical Trials- China (ENESTchina) (30) The trial, conducted in Chinese patients, aimed to observe MMR rates at 12 months in nilotinib and imatinib treated patients. Also, conclusions on whether genetic and ethnic factors affect response to treatment were drawn using the results. Whilst MMR showed a similar pattern as seen in the original ENESTnd trial, CCyR at 12 months for the nilotinib arm was lower than the imatinib arm by 3.6%. Since CCyR at 6 months showed an increased rate for nilotinib (66.4% vs 57.1% for imatinib), the study noted this inconsistency to be favouring nilotinib. Previous studies were cited to have observed early CCyR indicative of better response (31, 32). Thus, it was concluded that nilotinib was more effective.   Study Intervention Dosage n Males (%) Median age Lost to follow up (%) CCyR at 12 months MMR at 12 months DASISION Dasatinib 100mg daily 259 56 46 15 83% (95%CI 78-88; P-value 0.01) MMR3x 46% (95%CI 40-52 P-value Imatinib 400mg daily 260 63 49 19 72% (95%CI 66-77; P-value 0.01) 28% (95%CI 23-34; P-value S0325 Dasatinib 100mg daily 123 60 47 na* 84% (95%CI 74-92; P-value 0.040) MMR3 59% (95%CI 48-68; P-value 0.059) Imatinib 400mg daily 123 63 50 na 59 % (95%CI 56-80; P-value 0.040) 44% (95%CI 34-55; P-value) SPIRIT 2 Dasatinib 100mg daily 407 61.4 53 0 53.4% (P-value MMR3 58.4% Imatinib 400mg daily 407 59.2 53 0 41.6% (P-value 43.1% ENESTnd Nilotinib 300mg twice daily 282 56 47 16 80% (P-value MMR3 44% (P-value Nilotinib 400mg twice daily 281 62 47 18 78% (P-value 43% (P-value Imatinib 400mg daily 283 56 46 21 41.6% (P-value 22% (P-value ENESTchina Nilotinib 300mg twice daily 134 67.9 41 na 77.6 (66.4 at 6 months) 52.2% (95%CI 43.4-60.9; P-value Imatinib 400mg daily 133 60.9 39 na 80.5 (57.1 at 6 months) 27.8% (95%CI 20.4-36.3; P-value Table 9 Study Characteristics; (*na= not available; x See Appendix B: Parameters for measuring effectiveness of TKI) Study Intervention Dosage MMR MMR4.5x 5-year OS (HR 1.01; 95%CI 0.58-1.73) Adverse Events* : Drug-related Pleural Effusion DASISION 5-year Follow-up Dasatinib 100mg daily 76 (P-value= 0.0022) 42(P-value= 0.0022) 91% 28% Imatinib 400mg daily 64 (P-value= 0.0251) 33(P-value= 0.0251) 90% 0.8% Table 10 DASISION 5-year Follow-up Study (*No new adverse events were reported; x See Appendix B: Parameters for measuring TKI effectiveness) Study Intervention Dosage MMR4.5 OS Overall Adverse Events ENESTnd 5-year Follow-up Nilotinib 300mg twice daily 54% 93.7% (95%CI 90.8-90.6) 32.9% Pleural Effusion: 1.8% Nilotinib 400mg twice daily 52% 96.2% (95%CI 93.9-98.5) 41.4% Pleural Effusion: 0.7% Imatinib 400mg daily 31% 91.7% (95%CI 88.3-95.0) 32.7% Pleural Effusion: 1.1% Table 11 ENESTnd 5-year Follow-up Study Discussion The pooled data from 2692 patients show that the second-generation TKIs were more effective than the first-generation TKI imatinib. The results from the three RCTs which compare dasatinib with imatinib give an average absolute risk reduction (ARR) of 26.0%; for nilotinib, average ARR is 24.6% (Table 12). Together, second-generation TKIs produce a very promising complete cytogenic response in 253 per 1000 patients per year. As a comparison, a Cochrane systematic review conducted by Aguilar MI et al., 2005 to understand the efficacy of oral anticoagulants in preventing ischemic heart attacks, collected data from five RCTs with a pool of 2313 patients. This showed that warfarin gives an ARR of 4.05% and so the use of warfarin as a common anticoagulant was continued to be supported (33). Hence, a very high combined ARR of 25.3% shown in this review emphasises the potency of second-generation TKIs in treating CML-CP. With continuous treatment using these TKIs, remission can be attained. à ‚      RCT Intervention Odds Ratio Absolute Risk Reduction (ARR %) ARR per 1000 population (per year) DASISION Dasatinib 0.5242 (95%CI 0.3437 to 0.7997 P=0.0027) 0.11089 (11.1%) 110.9 S0325 Dasatinib 0.0803 (95%CI 0.0434 to 0.1489 P 0.55409 (55.45%) 554.1 SPIRIT 2 Dasatinib 0.6217 (95%CI 0.4713 to 0.8203 P= 0.0008) 0.11825 (11.8%) 118.3 ENESTchina Nilotinib 1.1871 (95%CI 0.6578 to 2.1426 P=0.5691) -0.04282 (-4.28%) -42.82 ENESTnd Nilotinib (300mg) 0.1772 (95%CI 0.1217 to 0.2581 P 0.40358 (40.4%) 403.6 Nilotinib (400mg) 0.2025 (95%CI 0.141 to 0.2925 P 0.37672 (37.7%) 376.7 Table 12 Data processed by the review author Dasatinib Trials The DASISION trial was industry-sponsored and as such, the results are to be approached with caution due to a possible risk of bias. However, the largest dasatinib trial, SPIRIT 2 also shows a very similar ARR of 11.8%. Moreover, the European LeukemiaNet Panel used the results from the DASISION and other similar studies to set the 2013 guidelines in the management of CML-CP (34). Hence, the results are widely acknowledged by the scientific community. However, due importance must be given to toxicity data generated from these studies whilst interpreting the results. Whilst DASISION stated that adverse events (AEs) for both arms were similar, toxicity data were not explicitly reported in DASISION and SPIRIT 2 studies. The S0325 trial addressed this issue (See Results). The team suggested that the choice of TKI should only be made based on a patients individualised risk of progression, pre-existing comorbidity and compliance (24). With reference to this, the 5-year follow-up of DASISION emphasised that there were no new events reported outside of the initial 12 month period (23). Nonetheless, both teams reiterated the quick response of dasatinib in treating CML-CP as an indication of its greater efficacy. However, this increased effectiveness becomes equalised in the long-term, with both dasatinib and imatinib producing similar overall survival rates five years post-treatment (23). Nilotinib Trials Compared to dasatinib, the risk of AEs was only slightly increased in nilotinib patients. Unlike the other RCTs, ENESTnd trial observed imatinib-treated patients to have a high risk of AEs. Nausea and diarrhoea were reported in a very high percentage of patients- 41.1% and 46.1% respectively. The molecular mechanisms of AEs are not currently understood and no studies have been trialled in patients to quantify and assess TKI-related AEs. Hence, a clinically-relevant conclusion was not drawn from these results. Limitations One main factor limiting this review is the absence of direct comparative studies between dasatinib and nilotinib. The S0325 trials observed that the standard dose of dasatinib produced more AEs than imatinib and the ENESTnd trial showed that the higher dose of nilotinib produced more AEs than imatinib. However, these observations alone cannot be used to highlight nilotinib over dasatinib. Another limitation is the possibility of selection bias. Currently, numerous on-going clinical trials worldwide aim to compare the various TKIs. However, much data is yet unpublished. These could not be included in this review due to the lack of an appropriate critical appraisal tool, other than the CASP tool used in this review, with more rigorous criteria. Despite these, conclusions drawn from a large pooled study population of 2692 patients remain reliable. Nonetheless, inconsistencies on both efficacy and AEs data were present when comparing the five trials. The ENESTchina trial observed a better result with imatinib at twelve months than nilotinib (OR= 1.1871; 95%CI 0.6578 to 2.1426 P=0.5691). Additionally, the ENESTnd trial reported imatinib to be associated with higher AEs than dasatinib. However, the pooled data show a greater efficacy of dasatinib and nilotinib than imatinib. Dasatinib is also associated with more AEs than standard dose nilotinib and imatinib. The comparability of ENESTchina to other trials could be questioned. Patients from all ethnicities was a definite inclusion criterion and hence this study could not be excluded. The primary aim was to evaluate the efficacy and safety of nilotinibà ¢Ã¢â€š ¬Ã‚ ¦vs imatinibà ¢Ã¢â€š ¬Ã‚ ¦ (in) patients with newly diagnosed P

Brave New World Utopia Or Dystopia Philosophy Essay

Brave New World Utopia Or Dystopia Philosophy Essay Brave New World is both, utopia and dystopia. The author Aldous Huxley intended to depict an imagined new world after Ford, an industrial era, where all people would be happy and extremely satisfied or as content as the ideal society would let them be. Yet, to determine utopia and dystopia in Brave New World, we have to look at the new world from our own time and from the time before Ford, seen through the eyes of John the Savage, our predecessor. The world we observe herein reflects a futuristic world, a world that is to come, and a happy world we can imagine with an amount of disbelief. People of our world, the world which is happier than the savages world, still not as happy as the Fords world, will have to consider all the facts that make the new world look happy and brave. The notion of a brave world will inevitably lead to the question of what makes the new world brave. Freedom to do only what pleases us or freedom to identify only with our single-minded community, whose happin ess is controlled, makes us submissive to the rules, intrinsic and learnt rules, for we wish to enjoy our lives despite all odds. The ideas are as brave as the community that fosters them keeps them alive and effective. BNW has the power to control and please its citizens, because they indulge to their hedonistic consumer orientated feelings, blessed by their God Ford. Therefore it is necessary to confront the values and ideas people share at the time before Ford and after Ford. Is the BNW a good or a bad world? How utopian is it and how dystopian is it? Is this world, which Huxley satirically depicted, is it a real utopia or its bad version, an unimaginably and disgustingly surreal dystopia? BNW as utopia This novel is presenting many brave ideas placed in future. The community depicted in the novel, being futuristic, appears as a utopian society. There are a couple of elements that present its utopian side. They are: a highly reproductive, healthy, wealthy and stabile community. These are provided by the government who ensures planning and controlling everything that is in peoples interest. Government takes good care of their citizens. Citizens live and work closely together, they are agreeable on everything and there is no conflict. Reasons control emotions in a society whose member should all feel happy with what they are and what they have. Being a utopian novel, BNW tells a story about being ultimately happy in a world that does not incite emotions or causes pain. Genetically improved people live an undisturbed happy and healthy life in a society that provides for their constant well being. They are very intelligent Alphas and Betas, and less intelligent Gammas, Deltas and Epsilons, but all of them are happy with what they are and how they live. A stable caste system solved by standard Gammas, unvarying Deltas, uniform Epsilons. Millions of identical twins. The principle of mass production at last applied to biology (Huxley, 2002:8). Love in this community is deprived of feelings or its disturbing emotional conditions, or to say love does not exist. It cannot hurt, as it usually hurts. There is no pain or regret. Sex is considered as recreation and there is no immorality in orgies. It is simply a pleasure that people should do often and with all the other beautiful members of the community. All members of the community have whatever they need: drinks, food, sex, soma (drugs). A reproductive goal is painless delivery of new people to the world, controlled properly for the sake of the health, prosperity and stability of the society. Women do not have to deliver babies. They do not have to go through the pain. Everybody loves everybody. It is phenomenal to have so much love anywhere people go. Ford justifies promiscuity with biological animal reasons. People intercourse with everyone and ladies are so fittingly pneumatic, just like Ford vehicles are. Babies are raised in bottles that are to be predestined in detail (Huxley, 2002: 9) through the Bokanovsky process as it is one of the major instruments of social stability!( Huxley, 2002: 7). There, in the bottles, they are prepared for what they are going to be when they come out and grow up in the society where everyone knows their place, they know about things they are predestined for and diseases they will be cured against. People are not afraid of death, because it is a natural course of things. All the aforementioned conveniences provide members of the happy BNW community with their unique identity of a happy nation. They are free members of their community in the way that they are free to extremely enjoy life in the line with the rules of their happy community. They have been taught that understanding of the world since the bottle time, and afterwards through hypnopaedic incantation for the sake of stability, lulled by their thoughtful proverbs like Leninas favorite a gramme is better than a damn. The director of the Central London Hatchery and Conditioning Centre educates that two hundred repetitions of the same or a similar lesson would be wedded indissolubly. What man has joined, nature is powerless to put asunder (Huxley, 2002:17). As for art, people do not make it. Their life is so colorful, stable and happy that no inner state of mind should be expressed more effectively than consuming goods and reaching satisfaction, which pleases human bodily and spiritual needs. Talking about science, there is nothing that should be invented as the society living in wealth, and everyone have their lives at ease. The community is well advanced and further advancements could only misbalance the casts needs, and it is unnecessary because everyone has his own predestined role in the stable society that is already prosperous. How utopian indeed! Huxley observed in foreword of his novel written in 1946 with the time he set in the novel six hundred years in the future, although it seems to him that we are hardly one hundred years far from the horror (KoljeviĆ¡, 2002:137). His opinion leads us to the notion of dystopia, as the author concludes it to be a horrifying reality in which people shall live in one day in the alienated world enriched with technologies. BNW as dystopia By converting into dystopia, the happy society becomes a place ruled under totalitarian conditions in our own eyes. Initially, John the Savage grasps the new word because he thinks it is a world with brave ideas, but later on he recognizes the world to be sinful. Being different entails ones expatriation from the happy society. One has the freedom to choose between thinking differently and being a follower. Huxley questions the world that solved all of its problems where children are made in labsà ¢Ã¢â€š ¬Ã‚ ¦grown up in the spirit of three main social paroles: community, identity, stability. These paroles are imprinted in their minds when they were sleeping and once they became adults they would keep repeating them as supreme wisdoms and morality(KovaÄ eviĆ¡, 1984:268). Attempts to distort the unquestioned identity of the community will lead to social isolation. Freedom to think differently dies with dystopia. Island is the perfect place for the different member of the community. Some members are not reliable members of the society, their appearance, skills and performance are not as they are meant to be, some of the members want to conduct scientific researches, and science is found as a disturbing element for the community. Such people who are like Bernard and Helmholtz need to accept the regime or to be expatriated if disobeyed. To cure the disagreement sickness that leads into instability, people better take soma. People are meant to obey as they were learnt to, as their creators predestined them. Creators decant babies as socialized human beings, as Alphas or Epsilons, as future sewage workers or future à ¢Ã¢â€š ¬Ã‚ ¦future World controllers (Huxley, 2002:109). BNW is really a disgusting society, which gives one all hedonistic pleasure he/she can think of, against Bible and morality. No feelings exist there, people are not free to make their own choice, their physical existence is abuse of their blood and flesh without any pain for pains a delusion (Huxley, 2002:108). Women are decent Alpha Leninas, highly respected whores; all people enjoy promiscuity. Svetozar KoljeviĆ¡ cites June Deery that women in the society are seen and regard themselves as meat and, as in our society, meat which must be lean, not fat (KoljeviĆ¡, 2002:136). As sexually immorality caused decay of Rome, so it could have the same implications on BNW. The brave new world is just a technically advanced world, a new world that was foreseen by Ford, the master of mass production. Ford is the God, the master of a technologically perfected world of commodities and consumers, the one who looks down at his consumers, who blindly follow their consumer instincts and beliefs. Identity of the consumers comes with their religion in Ford and massive consumption and comforting with their sins. The followers have no freedom to feel, think over or react to all the immoralities. Unlike utopia, dystopia in BNW is threatening to everything that is normal. In such a stable community, people have to give up on the things they have always known and felt normal. The unsettling feeling about universal happiness appears when people think about giving up on normal values like home, family, freedom and other traditional value. It is not a real happiness. Happiness comes from vices: orgies (Bernard says that Orgy-porgyà ¢Ã¢â€š ¬Ã‚ ¦is just a Solidarity Service hymn (Huxley, 2002:122), promiscuity (à ¢Ã¢â€š ¬Ã‚ ¦but every one belongs to every one else (Huxley, 2002:18), drugs that makes us love everyone more deeply and if anything should go wrong, theres soma (Huxley, 2002:155). The curse of unquestioned stability is an element that suppresses the element of freedom. It suppresses the emotions about being special or different. People should fear emotions, because they are the sign of weakness and an inappropriate reaction. Life is not valued, as every life can be repl aced by thousands of other lives. Unnaturally, people should take death with ease. Dying is nice as they are taught so. They learn to take dying as a matter of natural course à ¢Ã¢â€š ¬Ã‚ ¦.like any other physiological process (Huxley, 2002:109). Even when they die, their body is burnt and the ash is used for pragmatic needs. As for art, it is considered as an expression of feelings or attitudes that must be controlled. One should not express them, as they threaten stability of a totalitarian society. Those should not influence other people, and this resembles Middle Ages state of art, not a futuristic era. Science is a threat to stability, as it brings changes and inventions. Mond lectures the Savage in that à ¢Ã¢â€š ¬Ã‚ ¦every discovery in pure science is potentially subversive; even science must sometimes be treated as a possible enemy. Yes, even science. (Huxley, 2002:154). This really sounds dystopian, because the futuristic times anticipate novelties. Science shapes history with its inventions. Summary The paroles of community, identity and stability are axis of the new society Huxley presented through the mirror of utopia and dystopia. Those are two sides of the same coin: the question of how the world will look like with all the technology advancements, enlarged mass production and an increasing hedonistic consumers society. It tackles with peoples perception of the well engineered future and their attitude about how they want the world to be. In modern terms, in touches the notion of influence of social and commercial propaganda merged with the power of large-scale technology and industry creators of the present world order.

Decline of Christiany in Europe Essay -- Religion

Introduction The decline of Christianity in Europe did not happen spontaneously. It was a process which took place over many years. Further, it would be impossible to identify any one trigger for the decline. Numerous factors have combined to erode Christianity in Europe. Changing political parties, with varying tolerance towards Christianity, have been a major factor in the decline. In addition, new ideas about the ability and goodness of man to create a good society, without the need for God, served to undermine Christianity. Finally, the failure of the church to respond firmly to the crises of the modern world significantly accelerated its decline. While many of these factors have roots going back as far as the seventeenth century, many came to a head in the twentieth century. Political Parties In the nineteen hundreds, many European countries were being swept by changing political tides. This era saw the rise of socialism for many European countries. Some of these new governments discriminated against Christianity. Education and even some professions were closed to Christians. Some countries were harsher in their anti-Christian policies, and others merely neglected the church.1 The church was in a dangerous position; it was expected to comment on the political situation of Europe, but in grave danger if it did so.2 Furthermore, Christianity was generally seen as contrary to the ideology of these governments. At worse, Christianity was seen as a threat to Marxist ideals. At best, it was seen as silly superstition, an unnecessary crutch.3 While some Marxists respected Christianity and perhaps even learned from it, many felt that religion was primarily a tool of oppression which should be banished in the name of so... ...and Biography, July 18, 2003. http://www.christianitytoday.com/ch/news/2003/jul18.html?start=2 (accessed February 1, 2012). Hindson, Ed, and Ergun Craner, eds. The Popular Encyclopedia of Apologetics. Eugene, OR.: Harvest House Publishers, 2008. Kannampilly, Vijaykumar. "Marxism and Christianity." Social Scientist 3, no. 3 (October, 1974): 57-63. http://www.jstor.org/stable/3516372 (accessed February 1, 2012). Pauck, Wilhelm. "National Socialism and Christianity: Can They Be Reconciled?" The Journal of Religion 20, no. 1 (January, 1940): 15-32. http://www.jstor.org/stable/1198646 (accessed February 1, 2012). Tolson, Jay. "European, Not Christian." U.S. News and World Report 138, no. 20 (May 30, 2005): 52-53. http://search.ebscohost.com.ezproxy.liberty.edu:2048/login.aspx?direct=true&db=mth&AN=17115426&site=ehost-live&scope=site (accessed February 1, 2012).

Humorous Best Man Speech -- Wedding Toasts Roasts Speeches

Humorous Best Man Speech The hotel management have asked me to ask you not to stand on the tables or chairs during the standing ovation at the end of my speech. Now, I asked around for an idea of how long my speech should last, and the general response was about as long as it takes the groom to make love. So with that in mind, thank you, you have been a wonderful audience. (Sit and then get back up) I think an introduction is worthwhile. For those of you who do not yet know me my name is Whatwouldvouliketodrink. I hope as many of you will come and say hello at the bar later, but I do insist you use my full name. At this point I would like to thank the groom for his kind words. I would also like to add my own appreciation. I think you'll all agree the bridesmaids both look lovely today in their dresses and I know the bride wants me to thank them for the help they have provided, not only today but in the weeks and months leading up to the wedding. I would like to propose a toast. Ladies and gentlemen, the bridesmaids. I'm sure a number of the guys here today have been a best man at a wedding before, but I wonder how many of you have ever received written guidelines from the bride to be. I would like to read you an e-mail that the bride sent me prior to the wedding. (Produce e-mail) Wouldyoulikeanotherdrink (Remember that is my name) I was very pleased when you were asked to be best man at our wedding. I have known you for some time now and I cannot think of anybody more charismatic, intelligent, better looking or downright sexy than you to fulfill this crucial role on our big day. As we get close to the wedding day, most tasks have been... ...tion?" Big & Bouncy magazine.) Obviously my toasts are going to focus on the most important people here today. The people we all feel a great love for and without whom today wouldn't be possible. At some stage in the evening I’m sure we will all be sharing with them our thoughts from this special day and giving them our love and best wishes so I would like to propose a toast to: the bar staff. Now the real version. I would like to thank the groom for asking me to be his best man. It has been a pleasure helping them prepare for today. For all the banter that has passed between us it should be fairy obvious that we are the best of mates. I am going to finish now by asking you to join me in wishing them many years of happiness. Ladies and gentlemen, the bride and groom. That's the end of my speech. I am sure you will be as glad as me that there is no more.

Group Paper Analysis: the Effects of Culture in Patient-Provider Interaction

Group Paper Analysis: Group #3 The Effects of Culture in Patient-Provider Interaction and Means for Dealing With It Shawn Burke, Shin-Hyung Lee, Siamak Mahdavi, Thuan Nguyen, Brittany Oswald, Teasha Walters As a culturally diverse country discrepancies in health care have been documented and continue to serve as a threat to satisfactory patient care. Data has shown that minority groups suffer more greatly from cardiovascular disease, diabetes, and cancer, amid other ailments. In 1998, the Health Resource and Services Administration Health Disparities Collaboratives was designed to provide proper care and treatment for citizens that are uninsured and/or medically vulnerable, such as certain racial groups. This organization is aimed at lessening racial and ethnic disparities presented in health care and improving the quality of care for this population (Grossman et al. (2008). Although this progressive system aids in eliminating health care disparities, there is still an evident effect of culture on patient-provider interactions. With an increasing change in the demographics of our country, it is imperative to improve patient-provider interactions among various races and ensure proper treatment for all. In order to counteract these disparities and promote appropriate care for all races, health care systems formed the subject of cultural competence. According to Betancourt et al (2003), in a culturally competent health care system, the significance of culture and implementation of services to properly meet culturally necessity needs are integrated within and focuses on the health beliefs for different cultures and specific treatment for different patient populations. In order to function properly as a culturally competent health care system, specific requirements are mandated. The health care system needs a diverse staff reflective of the community surrounding the institution, translators to communicate with patients, specific training for health care providers, and valuable signs and information available in different languages (Betancourt et al. 2003, Anderson et al. 2003). Implementation of a culturally competent health care system increases the potential for improving patient care and efficacy and helps to eliminate health care disparities among culturally diverse ndividuals. It is very important to understand cultural values in order to improve patient-provider interactions. Many foreigners face difficulties when they are faced with seeking medical attention mainly due to only having limited vocabulary skills as well as not being familiar with medical terms commonly used in the United States. These main cultural differences lead to many peop le having great difficulty when trying to communicate their symptoms to a medical professional. It is comprehensible that health care providers have a hard time giving a diagnosis if a patient cannot correctly describe their symptoms. However, this can be improved by respecting cultural values such as courtesy, empathy, and harmony. According to the study â€Å"Patient satisfaction in Japan† written by Elluch, the author states that health care providers should emphasize cultural values such as courtesy, empathy and harmony to improve foreign patient satisfaction when delivering medical services. This is because satisfied customers are an important asset for the healthcare provider as satisfied customers tend to reuse the service and recommend it to their families and friends. In order to reduce the threats which are the discrepancies in health care, respecting and considering cultural values and differences will be useful to improve patient-provider interactions among various races. Moreover,by emphasizing those cultural values it will help to maintain long-term relationships between patient and providers. There are numerous documentations describing the consciousness of physicians towards health beliefs and values of their patients. As previously mentioned, barriers in communication between physicians and their patients due to differences in cultural stance can lead to interruptions in care and undesirable patient outcomes. Research by Street and Haidet (2010) states â€Å"current evidence indicates that physicians often have a poor understanding of their patients’ perspectives with respect to patients’ preferences for involvement in decision-making, desire for information†¦beliefs about treatment effectiveness and prognosis†¦and emotional states† (Street & Haidet, 2010). It is imperative for physicians to understand patients’ cultural perspective because treatment care plans are based off the communication that doctors have with their patients. Street and Haidet conducted a cross-sectional observational study that used the CONNECT instrument to asses the â€Å"6 domains of an individual’s perceptions about a particular health condition†¦Ã¢â‚¬ (Street & Haidet, 2010) within a â€Å"convenience sample of 207 patients and 29 primary care physicians from 10 outpatient clinics† (Street & Haidet, 2010). The key results indicates â€Å"Physicians' perceptions of their patients' health beliefs differed significantly (P

Psychological View

Psychological View Many Americans, until this day, have been diagnosed with psychotic disorders. According to the Schizophrenia Health Center, psychotic disorders are a group of serious illnesses that affect the mind. These illnesses affect a person’s responsibility to think clearly, make good judgments, respond emotionally, communicate effectively, understand reality, and behave appropriately. When symptoms are severe, people with psychotic disorders have difficulty staying in touch with reality and often are unable to meet the ordinary demands of daily life. In Edgar Allan Poe’s poem â€Å"The Raven†, we can see that the speaker of this famous piece of American literature is a man grieving over the death of his beloved, Lenore. The speaker tries to go on with his life, but he always feels grief for the person he lost. No matter what he does, the feeling comes back, and he cannot ignore it – just like we couldn’t ignore a bird in our room who was always staring at us. Based on my reading on â€Å"The Raven† by Edgar Allan Poe, the speaker was hallucinating images, suffering depression, and struggling through delirium tremens. After reading Poe’s poem, we can clearly see all of the speaker’s psychological conditions. Throughout the poem â€Å"The Raven†, the speaker suffered hallucinations. The loss of his beloved Lenore hit him hard, especially psychologically. â€Å"That I scarce was sure I heard you – here I opened wide the door; – Darkness there and nothing more† (page 468 lines 23-24). Through this quote, the speaker shows auditory hallucinations. He’s sure he heard a knock on the door, but when he opened it, there was nothing but darkness. According to my understanding of the poem, the speaker also suffered visual hallucinations, unless we assume that the speaker really did see a raven. However, it does work well as a symbol for mental disorder, especially as a raven is known for its color, and depression is often referred to as the black dog. People who have hallucinations may hear sounds or voices or see things that are not really there, just like the speaker from â€Å"The Raven† thought he saw a raven. The speaker’s loss of his beloved Lenore brought great depression upon him. â€Å"Eagerly I wished the morrow; – vainly I had sought to borrow from my books surcease of sorrow – sorrow for the lost Lenore – for the rare and radiant maiden whom the angels name Lenore† (page 467 lines 9-11). The speaker is grieving for his ‘lost Lenore’ and it is almost as if the raven has been sent as a messenger from the underworld to torment the speaker even more. According to the Depression Health Center. eeling depressed can be a normal reaction to loss, life’s struggles, or an injured self-esteem. Left untreated, depression can lead to problems at home, work, school, drug abuse, and even tragedy. Depression is a mental illness that affects most of the world’s population, but if treated correctly it could be cured. The loss of the speaker’s beloved Lenore made him fall into depression, and sadly he couldn’t get himself any help. Based on my understanding of the â€Å"The Raven†, the speaker is struggling through delirium tremens. According to an article from Medline Plus, delirium tremens is a severe form of alcohol withdrawal that involves sudden and severe mental or nervous system change. The speaker of â€Å"The Raven† had too much going at one time of his life, so most likely he turned to alcohol as a nepenthe. Nepenthe was an ancient Greek concept of a medicine for sorrow, it would be what today is classified as an anti-depressant or a â€Å"drug of forgetfulness†. Scholars have thought of it as a substitute for Opium or Wormwood. We can tell he had some drinks because he was feeling weary. â€Å"Once upon a midnight dreary, while I pondered weak and weary†¦Ah, distinctly I remember it was in bleak December† (page 467 lines 1 and 6). The speaker mentions that it is night time and that he’s in his chair feeling weak and weary. This could be possibly due to extreme alcohol consumption especially since the poem mentions that it is December, a time to be ‘merry’ with our loved ones, or perhaps just alone and drunk if we have lost our loved one just like the speaker in â€Å"The Raven† did. According to an article all about delirium tremens, the main symptoms of delirium tremens are confusion, disorientation, agitation, and fever. The speaker seemed confused and disorientated because he was still grieving the loss of his beloved Lenore. â€Å"The Raven† by Edgar Allan Poe is one of the most famous poems in American literature. Among other achievements, the poem is a detailed examination of hallucinations, depression, and delirium tremens. Poe’s protagonist moves through several specific stages of grief until he sinks into hopelessness at the poem’s conclusion. He does not come to accept his loss; he only suffers and attempts to deal with it. The raven symbolizes grief. The speaker tries to move on with his life, but something keeps pulling him back, and he can’t ignore it – just like the raven that sat in the room, staring. Throughout â€Å"The Raven† we saw many psychological conditions the speaker had to deal with. It’s very sad knowing how loosing someone we love can affect our life to a point where we just feel hopeless.