Expectancy Violation theory Essay Example | Topics and Well Written Essays - 1000 words

Expectancy Violation theory - Essay Example EVT is used to understand and to evaluate their interactions and the outcomes of those interactions in this scene. EVT asserts that every person has an expectation regarding other people’s behaviors that affect their personal space. Personal space pertains to the invisible and varying spatial levels that people put around their bodies. Their idea of personal space guides their spatial expectations from other people. For instance, Fran has a small personal space, where she talks closely to people, such as one to two feet away from them, regardless of her personal and professional relationship with them. To further understand the scene, the concepts of expectancy, violation valence, and communicator reward valence are applied. Expectancy is what people think will happen (or what they expect to happen) and not what they desire to happen. Context, kind of relationship, and communicator characteristics affect expectancy. Context includes cultural norms and setting. Relationship lev el and status depend on similarity, familiarity, liking, and relative status. Communicator characteristics are comprised of demographics, as well as physical appearance, personality and communication style. During the interview scene, Maxwell expects deference from Fran, since she is applying as a nanny. ... Her cultural beliefs and practices influence her open, honest, and warm attitude and actions toward Maxwell and his children. The context calls for a large distance between Fran and Maxwell during the interview process, but Fran deviates from the social norms when she repeatedly comes close to Maxwell and invades his intimate distance. In addition, the relationship level of the two suggests that as a job applicant of a low-status job, Maxwell expects Fran to be not so familiar in her attitudes toward him. He does not expect to like her immediately, and in fact, he does not think Fran has enough experience and background to be a suitable nanny for his children. Fran acts and feels the opposite once more when compared with Maxwell. She feels at home at the Sheffield’s residence already, as she walks around confidently and speaks closely to Maxwell and his children. She also shows liking toward her employer and treats him like a friend by invading his intimate distance. Finally, for communicator characteristics, Maxwell is detached in dealing with his children and employees. He has a respectable demeanor and he communicates in a formal manner, which is not surprising because he is a Broadway producer. He talks to them rarely within his intimate distance. Furthermore, Maxwell is a handsome bachelor, which makes him appealing to Fran. Fran does not have many similar communicator characteristics to Maxwell because she is friendly, outgoing, and frank. She is attractive and sexy too, which makes her confident in her actions and allows her to easily violate Maxwell’s personal space. Violation valence is the next concept of EVT, which pertains to positive or negative values placed on particular unexpected behaviors. In the interview scene, Maxwell

This a research Paper on Thomas Gray the Poet Example | Topics and Well Written Essays - 1750 words

This a on Thomas Gray the Poet - Research Paper Example His criticisms reiterated on the perception that Gray was fond of communicating using two languages that comprised of a private and public language. The use of private language was somehow challenging. This can be ascertained in his poem that is entitled; the "Elegy Written in a Country Churchyard," which was published way back in year 1751 (Burns & Robert, 1992). On the other hand, William Wordsworth, in his preamble, made decisions to the Lyrical Ballads using the Grays piece of work entitled "Sonnet on the Death of Richard West" that was published in 1775. He used it as an example to depict that Thomas Gray was generally ruled by a fake ideology of poetic articulation that was brought out using a wrong language. In an equal judgment, Matthew Arnold gave a remark on the perspective that the age was erroneous for such a highly serious poetry. Gray also in the same manner and with familiar discernment, asserted that the age was wrong for poetry of such significance. To be noted was that Gray was affected by his ultimate age and thus failed to speak out totally. So, the main precarious biography of Gray’s reputation and reception regarding his poetry are summed up by all these judgments. The attraction of attentive critics has mainly been due to the fact of extra ordinary continuation of ‘Elegy’s significance. It is because this piece of work has been outstanding and seems to be indisputably superior especially when measured against all the other performances. Gray was born in a place known as Cornhill back in the year 1716; and was the 5th child of 12 children of Dorothy and Philip Gray, and more so he was the solitude survivor during infancy. Between the year 1725 and 1734, he attended Eton institution, where he then met Horace Walpole and Richard West, who were very influential. In 1734 he joined Peter house College in Cambridge University. After four

Non-Oil Sector Stocks in Saudi Arabia Research Paper

Non-Oil Sector Stocks in Saudi Arabia - Research Paper Example Saudi Arabia has proven oil reserves of 264.52 billion barrels of oil (OPEC, 2011) and recently surpassed by Venezuela who claimed their oil reserves had risen to 269.5 billion barrels of oil. In terms of oil production, Saudi Arabia has a quota allocation of just over 30% of production among Organisation of the Petroleum Exporting Countries (OPEC) countries. The Saudi Arabian oil production in 2010 was 9.1 million barrels per day which accounted for 13% of world’s total oil production. Oil is the major driver of economic activity in Saudi Arabia. Oil-related activities accounted for 47% of the GDP in 2010 (MoF, 2011), and petroleum products exports amounted to $193 billion and accounted for 84% (by value) of total exports in Saudi Arabia (OPEC, 2011). Therefore, oil prices play a vital role in the Saudi Arabian economy. However, from the perspective of an investor or an enterprise in Saudi Arabian market, it is also important to know whether oil prices have a major role to pl ay in stock prices of non-oil sector companies too. If there is a high positive correlation between oil prices and non-oil sector stocks, an investor can use these stocks to hedge on their investments in oil. The outcome of this study could, therefore, be very useful for foreign investors and enterprises already present or planning to enter the Saudi Arabian market. Clarification of Terms and Concepts Aggregate Demand: The total demand for goods and services in an economy for a specified time period and at specific price levels is called aggregate demand. It is made up of 4 major components – consumption or consumer spending, investment, government spending and net exports. Correlation: A statistical measure that describes how two variables move together with each other. The coefficient of correlation has the value between -1 and 1. A positive value means the two variables move in the same direction simultaneously. The closer the value is to 0, the lesser relative movement th ey have. Disposable Income: The amount of money that the households in an economy have for spending and saving after taxes have been deducted from their total income. It indirectly measures the potential for consumer spending in the economy. Downstream (oil industry): The downstream activities in oil industry refer to refining and distribution of natural gas and products refined from crude oil. Exchange rates: The rate at which two currencies can be exchanged for each other. Essentially, it is the price at which one country’s currency can be exchanged for another country’s currency. Granger-Causality test: A statistical test used to measure whether the change in one variable causes a change in another variable. Granger-Causality tests relationship between two variables. This methodology is employed to test the causality of each variable for the other and establish which variable causes the change in which variable. The key principle used is that the independent variabl e is better able to predict the dependent variable than when taking only the lagged values of the dependent variable to predict it.

Best Buy Case Study Essay Example for Free

Best Buy Case Study Essay Best Buy is a multinational corporation with over 4,000 locations nationwide. Circuit City was Best Buy’s only main competition for some years until it took over and ran Circuit City out of business. Best Buy’s market share increased after that however, other large retailers as well as e-tailers entered into the market. Amazon, Target, Wal-Mart and Apple became Best Buy’s new competition that caused a decrease in market sales in 2010. They all had the same thing in common after the Circuit City collapse and that was to increase electronics. They all had their own strategies to out-beat Best Buy. Although Best Buy acquired some more competition in a 2010 survey consumers still said Best Buy is the first to come to mind when they think about buying electronics. However, even though Best Buy is the first that comes to mind against the other competitors, depending on what the product is they will go to Amazon to buy it instead. Due to their strategy which focuses on three areas; customer-centricity, employment policies and exclusive branding, they are keeping up with the competition. Best Buy’s strategies may help them a majority of the time but they could change their strategies just a little bit. They should try what Wal-Mart does and price match ads with other stores so that way they are still getting the profits and keeping customers. In my opinion, Best Buy could improve their strategy when it comes to prices because they are on the higher end of prices. As a consumer myself, I do look at Best Buy first for my electronics but I usually go somewhere else because the prices are usually cheaper. Other than their prices I actually think their strategies are working out good for them and it shows in their rankings amongst other competitors. Consumer electronics is considered a mature industry because of the new trends. This industry hits record sales during the holiday seasons but still says rather well throughout the year as well. All companies associated with this industry try to keep up so they make their own products. However, due to manufactures cannibalizing their products their product life cycle has decreased. Manufactures started doing this to try to keep their consumers  loyalty. When prices start to fall for technology products this opens a bigger demographic; however by time the prices fall for the products they have come up with better products. In order to recapture the growth of Best Buy they should try to fix the prices to fit a bigger demographic. I think if they at least try to work with the consumers with the prices they would gain more customers. The problem is the fact that consumers go elsewhere when they see the prices and do a price match. Amazon became popular with electronics because people f ound out that they could get electronics of all kinds online. Also Amazon has an advantage over Best Buy because with Amazon there is free shipping on products, well on most products. I think if Best Buy tried to adapt some of Amazon’s strategy they can out beat them in the electronics department. If they could be like Amazon and have a limitless inventory online rather than just have their amount of availability on the showroom. If they did this I think they would see growth in their company. They pride their selves in having the most respected name brands in the consumer electronics industry so if they matched the prices with their pride in their brands I see a definite growth in their company. With Best Buy being a well-known company and is the first that comes to mind when talking about electronics, if they had a bigger choice when it came to the products than they might gain some more growth as well to go along with their already loyal customer base. At Best Buy, they offer a selection of energy-efficient products. These products were designed to help their customers around the world save some more money by using less energy. I think with Best Buy becoming more sustainable they are more able to maintain the interest of the stakeholders. With these products the shareholders play a big role in influencing their overall sustainability strategy. The stakeholders help with modeling Best Buy’s annual sustainability reports. So with them adding this strategy and allowing the stakeholders to get the chance to have a part in the strategy they are gaining their interest. Best Buy actually takes the recommendations from their stakeholders and they try to communicate with them in efforts to keep their interest in their decision to incorporate a sustainability strategy. I think this was a good move on their part because it states they were uncertain about Mr. Dunn’s five year growth strategy. The stakeholders  were worried abo ut Best Buy’s cash position and about if these strategies would work or not. Anytime when stakeholders have the opportunity to have a so in a company is a good thing. In conclusion, I believe Best Buy is a great company but can become a better one if they were to do some modifications with their strategies. With the constantly changing economy they need to adapt their strategies to the changes. I’m not saying they would have to always change their strategies but I think they should always try their best to make their strategies fit the customers as well as help the success of the company. With that being said I believe they will receive even better results for the company as well as the consumers.

Kfc Kentucky Fried Chicken In Nigeria

Kfc Kentucky Fried Chicken In Nigeria KFC Corporation, or KFCÂ ®, also known as Kentucky Fried Chicken, is a chain of fast food restaurants based in Louisville, Kentucky. The peculiar history of KFCÂ ® Kentucky Fried Chicken started between 1952 and 1964 when Colonel Harland Sanders (born on September 9, 1890), a politically appointed Kentucky colonel convinced the owners of 600 restaurants in multiple states to pay him a nickel for every chicken they prepared using his secret recipe seasoning. The seasoning is a blend of 11 herbs and spices and sold with his name on it (kfc 2010). In 1964 The colonel as he was popularly called sold the franchise system to John Y. Brown and his business partner Jack Massey for only $2 million. In 1966 Brown and Massey took their company public and increased efforts towards system development with the help of franchisees and Sanders himself who was a marketing icon by all rights, owing to his entrepreneurial success story and image. The company was listed on the New York Stock Exchange on January 16, 1969. Since KFC Corporation went public and registered tremendous growth over the years, it has been acquired by a couple of other multinational corporations. The latest acquisition of KFCÂ ® was by PepsiCo, Inc. in October of 1986, from RJR Nabisco, Inc. for $840 million (Liddle 2010). In January 1997, PepsiCo, Inc. made KFCÂ ® and a couple of its other small quick service restaurants into an Independent entity known as Tricon Global Restaurants, Inc. And subsequently changed the corporations name to Yum! Brands, Inc. in May of 2002. Yum! Brands, Inc. also owns AW All-American food Restaurant, KFCÂ ® , Pizza Hut, Long John and Taco Bell restaurants making it the worlds principal restaurant corporation in terms of system units and spread, having over 32,500 units spread across over 100 countries. While its primary focus is fried chicken, KFCÂ ® also offers a line of roasted chicken products, side dishes and desserts (kfc 2010) This report will be looking at KFCÂ ® in Nigeria; with the aim of investigating and analyzing their main marketing activities and operations in general. KFCÂ ® looking to develop and extend the volume of their market started operation in Nigeria by opening the first Nigerian KFCÂ ® restaurant in December 2010. According to Keith Warren, Yum!s general manager for Africa, We always knew a 150 million people eating chicken on the bone as their primary protein, had to be a good thing for KFCÂ ®, but we didnt quite know how good a thing it was going to be. They have six stores in Nigeria now and they plan on building 20 more stores in 2011. They also forecast that by 2020 KFCÂ ® will have 300 restaurants doing business in Nigeria (kfc 2010). This report is particularly interesting because KFCÂ ® in Nigeria is a new venture for Yum! Brands, Inc. This means that KFCÂ ® is a well known global brand in a new market environment, therefore, the implementation of its market orientation is still taking shape. In other words, the way that KFCÂ ® has decided to do business in Nigeria is still taking shape. Their market orientation, marketing mix and strategies etc will depend on their perception of the new Nigerian market, so we will be looking at KFCs Marketing strategy. In general terms, especially multinational firms use a different strategy in Nigeria than they do in other markets. We are hoping that KFCÂ ® will follow the same trend. 2. KFCS ORIENTATION A business can be Product Orientated, Marketing Orientated or Sales Orientated; but businesses can develop new products based on either a marketing orientated approach or a product orientated approach (Tutor2u 2010). Organizations orientation refers to its familiarization with and approach to the market. A firm can develop new products either based on what it thinks is the best for the market in order to maximize sales or what the customers think. Sales orientated approach fits the profile of market orientation because it uses such skills as selling, pricing, promotion and distribution except it pays little attention to customer needs, priority being sales maximization (Jobber 2007). Market-orientated approach is popular among most successful businesses as opposed to product orientated approach where firms develop products based on their competencies and capabilities rather than the customers needs (Tutor2u 2010). However, (Tutor2u 2010) cited that some products are argued to create a need or want in the customer/consumer, especially products that have high technology content. E.g. Mobile phones have moved from being a business accessory to being a big consumer brand item, with many additional gadgets, such as pictures, video and Internet access. Innovations create the need rather than the customer being able to second-guess how new technology is going to develop. Most technology driven products that requires high level innovation fall within this range because the products create customer needs and market segmentation takes care of the rest. KFC as an organization is Marketing Orientated because it tends to tailor its products and services to the needs of customers in a particular market. 2.1 KFCS MARKETING ORIENTATION: According to Kaur and Gupta (2010:88) Market orientation is a business culture that ensures a set of behaviours needed for generating, disseminating and responding to both internal and external market information for creating superior customer value through superior organizational skills and competencies which ensures long term profitability by continuously identifying and managing limitation in the system that prevents market-orienting culture in an organization. This is a wholesome definition of what market orientation is all about, in that it takes into consideration the business environment, competences, constraints, activities, strategies, implementation and results/targets of marketing orientation, A market orientation needs to be balanced with creativity and a deep understanding of the firms unique capabilities, competencies and objectives (Houston 1986; Sharp 1991; Hamel and Prahalad 1994). Alternatively, the definition of market orientation acknowledges the understanding and acting upon the dynamics of the markets in which they operate and concentrating on critical relationships (Povey 2000). The market dynamics he is referring to may range from the needs of the customers, to what influences their buying decision. There are positive relationships between market orientation and business performance (Pelman and Wilson 1996; Ruekert (1992). As is the case with KFC, their technique of market specialization (i.e. simply put, giving the customers what they really need and importantly not giving them what they dont need) has made them effective in Nigeria. Market orientation is a popular approach especially for a product/service organization like KFC. The need to gain customer preference over major competitors makes them react to the needs and wants of the customer, in order words, they are customer/consumer focused. KFC in Nigeria takes feedback from customers seriously, and they use feedback from customers/consumers to alter or change their standard products according to the customer specifications. The major characteristics of KFC as a Marketing Orientated business is outlined in Table 1 below according to the compilation of Jobber (2007) Table 1. Business Function Activities Identifying Customer/Consumer needs and wants. Marketing Research Developing Products to meet customer/consumer Research and Development/Production needs and wants Deciding on the value of the product to customers Pricing (Sales and marketing department) Making the products available to customers at the Distribution right time and place Informing customers.consumers of he existence of Promotion the product and persuading them to buy it 2.1.1 CUSTOMER NEEDS: In KFC Nigeria, customer needs are primary. The business decisions that KFC make in Nigeria are mainly based on the needs or otherwise complaints or feedback from the end consumer. The advantage of this approach to KFC is that it gives them an edge (competitive advantage) over their competition in terms of meeting and exceeding customers needs. Because a satisfied customer is a happy customer, a happy customer is a loyal customer and a loyal customer is an additional word of mouth promotion for the company; thereby maintaining and increasing KFCs market share. This approach is also growing in popularity mainly because the average consumer has now become knowledgeable and can have very easy access to information, therefore, rather than just working on making their products and services more appealing to the target consumers, KFC is now paying more attention to the customers wants and needs. This approach enables KFC to not only attract customers, but also to satisfy and more important ly retain them. Groucutt (2005 6-10 and 60) cited that an organization can achieve this by first identifying and selecting their target customers and learn their needs and desires by building relationships that will enable them key in to the customers real needs and develop products or services that can be sold at a profit in conformity with customers desire. He further stated that there must be some form of dialogue between the firm and the customers, where customers state their personal needs and wants, and this may be direct or indirect. Through marketing research a customer may communicate directly with the firm, where the firm seeks feedback on particular market issues. He goes on to say that on the other hand, customers may communicate indirectly with the firm by switching brands, and this is to inform the firm that there is a problem with the product (could be price or quality or both) Groucutt (2005) Groucutt (2005 335) The real needs of customers depends on a hierarchy of motives/motivators ranging from Psychological, Safety, Love and belongingness and self-esteem to self-actualization. KFC uses this approach as well, however, with business profitability as the needed end result. This means that they keep the needs of the customers in focus, while they aim at maximize their profit in general. A good implementation of this approach by KFCÂ ® in Nigeria is evident in the way they tailored their menu for different parts of Nigeria. For instance, their menu in the Northern parts of Nigeria does not contain pork because customers in those parts are predominantly moslems who prohibit the eating of pork, and because the case of belongingness is a huge determinant on what people eat. In the southern parts of Nigeria where you have a high density of educated families who tend to be more safety and health conscious when it comes to what they eat, KFC drafted their menu according to diet specifications, making it appear heathy and diet packed. 2.1.2 MARKETING RESEARCH: Groucutt (2005) defines Marketing research as the process of designing, collecting, analyzing and reporting of information that may be used to solve a specific problem in a firms marketing. The marketing problem he refers to can range from the market for a new product, new market for product (as is the case of KFCÂ ® in Nigeria), to lack of patronage for an existing product. Groucutt (2005) cited that Organizations need to narrow down their targeted segment i.e. who they want to appeal to, before undertaking a proper marketing research. It is only when you know who to appeal to that you devise means to appeal to them. He further said that after understanding their targeted segment, firms must have a clear objective as to what the firm aims to achieve both marketing wise and corporate wise. This is because for KFC to have a competitive advantage, they must be able to successfully tailor customer satisfaction with their objectives and end target. KFC Nigeria use feedback from custome rs as a major marketing research tool. According to Groucutt (2005) When efficiently and effectively used, marketing research can benefit the organization in the short-run and long-run. It can give the organization a complete understanding of the market, which includes understanding their current customers, current competitors, potential customers and the impact of macro environmental forces. Organizations can be proactive or reactive to changing conditions only through understanding these diverse groups, according to Groucutt (2005). Market research is important for KFCÂ ® to understand the behavior of a typical Nigerian customer, by analyzing both current and potential purchasing habits, tastes and influences. Marketing research is both a communication tool and a means of communication for KFC, because they use it to get needed information about current market conditions; on the other hand, customers give them feedback on their products and services. Forsyth (2007) cites market research as the planned problem analysis, model building and fact finding to enable better decision making and control in the marketing of goods and services. This implies that marketing research in addition to being an information tool, also enables the organization to guild their internal activities effectively for better results in the market place. According Forsyth (2007) market research contributes to the management of the marketing mix as well as used to help decide on: the marketing strategy needed to better exploit new opportunities; which market discontinuity to tackle; and the key interest areas for future marketing strategy. In application to KFCs activities in Nigeria, the information they get from market research helps them to better adapt to the Nigerian business environment. For instance, the no camera policy in KFC stores is a way they decided to curtail the excesses of some tough local competitors, because there is no limit to the extent a competitor will go to beat business competition in Nigeria. 2.1.3 RESEARCH AND DEVELOPMENT/PRODUCTION: Effective and efficient use of marketing research creates more information for the organization to potentially undertake research and development of new products; this entails developing products based on customers wants and needs. Ideally, this is should be a continuos process. According to Groucutt (2005). The development of new products and services is usually the key to the beginning of new firms, or the continuation of an existing one. Organizations undertake constant research and development of new products in order to be innovative and stay competitive. Firms engage in New Product Development for various reasons like: To replace a product, to modify a product, to develop products in support of the firms long-term strategic objectives, the adaptation of an existing product, unexpected occurrence leading to unexpected innovation and product and in response to societal, including demographic factors. Societies change and so does their needs, according to Grouccut (2005). The average Nigerian customer is more aware and has easy access to information about different products; therefore his needs and preferences are no longer the same with the last 10 years. KFCÂ ® capitalized on this by rolling out products and services that appeal to Nigerian customers. The important thing is making the products available to the customer when, how and where they want it. For instance, KFCÂ ® incorporated a special type of local chicken seasoning called Suya into their menu in Nigeria because people tend to prefer their chicken made in this way with a lot local pepper spices, different from the rest of the world. KFC also made their chicken a lot spicier because approximately 85% of Nigerians love spicy food and eat spicy food three times in a day. 2.1.4 PRICING: Price is an inherent part of the product/service and must be used as an element of the marketing process (Forsyth 2007) This means that pricing needs to be set carefully because not only does it reflect quality, it ensures that the financial objectives of KFC are met and also creates good image and feeling of value for money by the consumers (Forsyth 2007). Pricing is particularly a sensitive and delicate issue in Nigeria because to most people the price is the first impression about any product. This means that just the mention of the price of a product determines if the average Nigerian customer actually buys a product or not without further inquiry about the quality of the product. Groucutt (2005) thinks that customers may be particularly sensitive to either the set price or increases, even if the increase are marginal. People usually associate this price sensitivity to economic class i.e. lower income groups, but anybody could be price sensitive depending on different factors lik e economic environment or volatility (high growth or low growth). However, price sensitivity in Nigeria can easily be linked to the higher population or high density of lower income people in the population. People work hard and earn relatively less, so it makes sense to want higher value for as low as possible price. Moreover, for most people in Nigeria eating out is a luxury and if that comes with a high price then it is obviously targeted at the higher income groups. This is also a sensitive part of KFCs marketing orientation and it is interesting what they came up with, bearing in mind that they had the objective to penetrate the market and also meet their financial objectives. According to Groucutt (2005) there are different types of pricing tactics that firms use and depending on the objectives/targets and external factors, firms could use some or all of these pricing tactics during the life of a product or service. KFC Nigeria uses Penetration Pricing (Predatory Pricing). Penetration pricing is all about finding a way to access a market by cutting through the existing pricing structures or strategies (Groucutt 2005). Grocutt (2007) also goes on to say that Penetration Pricing can be used to attain entry into an existing market by introducing and maintaining low prices set against the existing average price for that product or service. KFC Nigeria deliberately maintained low prices for most of their products, while at the same time matching the price of competition for some other products. The use of both penetration pricing and Price matching tactics by KFC in Nigeria is very effective, but the use of Penetration Pricing is particularly very important because it was what people mainly responded to and are still responding to. With these pricing tactics, KFC was not just looking at penetrating the market and making sales, but to also create a long lasting impression and customer loyalty in the l ong-run. KFC achieved relatively easy entry in Nigeria mainly because of their pricing tactics because the average Nigerian consumer is very price sensitive and care about quality a lot more than status. 2.1.4 DISTRIBUTION (Brassington Pettitt 2003) Distribution ensures availability and service The availability they are referring to incorporates timeliness as an important factor. It is good enough that customers chose you and not your competition, but it is very important to provide the needed product or service when it is needed on time. Forsyth (2007) cites that distribution is the process that enables products and services to be delivered to customers/consumers in the market. Distribution process typically involves intermediaries but for a fast food franchise like KFC intermediaries are highly unlikely, but for KFC accessibility is vital. Making sure their stores are located strategically to allow easy access by customers when they need to. Therefore, to ensure that customer get timely access to their products whenever they wanted, KFC strategically located their stores in specific parts of Nigeria, depending on the city or area or state. They located stores primarily in areas where customers/consu mers live (suburban and urban locations), close to schools, companies and markets. KFC opened 6 stores in Nigeria in December 2010 in the most populated cities in the country including Lagos city, which is the highest populated city in Nigeria and the 4th highest populated city in the world. KFC also plan to open 20 more stores located strategically in 2011. This also says a lot about KFCs strategy in Nigeria. Currently, KFC does not provide home delivery service which is more convenient for most customers, but they are not the only one in the market who doesnt provide this service. Some of KFCs top local competitors do not provide home delivery service as well because of lack of infrastructure that enables home delivery like good roads etc. 2.1.5 PROMOTION A firm must Promote itself, in other words, it must communicate, clearly and persuasively to let people know what is available and encourage them to buy (Forsyth 2007). There are various promotion tactics like advertising, direct mail, sales promotion e.t.c. Firms decide whether to use some or all of them depending their target audience, the advantages and disadvantages of the promotion tactics, available budget, and level of effectiveness of the promotion tactic (Forsyth 2007). KFC uses advertising effectively in Nigeria as their main promotion tactics. The most effective form of advertising by KFC in Nigeria are electronic and billboard advert by Movie stars and musicians for KFC. KFC takes advantage of the fact that the average Nigerian emulates these stars and follows what they do to some extent. Another promotional tactics that KFC uses in Nigeria and is probably the best at it is Selling. This involves a one-on-one communication with the customer and sometimes forms a final and important, link in the chain of different methods that link a firm to its market, according to Forsyth (2007). KFC is very good at this because they already have standard staff training specifications for all their staff and employees. This is one of KFCs global brand qualities that it brought to the Nigerian market. KFCs competition in Nigeria cannot match this quality at the moment, because they rarely train their staff and even when they do they are not as meticulous as KFC in training their staff and making sure they perfect customer relations. For instance, It is not strange to walk into a fast food store in Nigeria and see a receptionist arguing with a customer, but just few seconds with KFC staff, you will immediately notice that they are different in the way they interact with the customers. They sort of draw you in and make you feel special and appreciated, and for a typical Nigerian customer that respect and appreciation is almost everything. 3. KFCS FOUR Ps OF MARKETING MIX Jobber (2007) suggests that an effective marketing mix matches customer needs, creates competitive advantage, matches corporate resources, and is well balanced. According to Brassington and Pettitt (2003 1105) Marketing Mix is the blend of the 4Ps that creates an homogenous and stable offering to potential customers to satisfies their needs and wants. This means that there must be consistent synergy or balance between these four basic tools of marketing to meet potential customers need and wants. For instance, a good product with bad communication will not work, and so is a bad product with good advertising. This is simply because the elements of the Marketing mix rely on each other and if they lack consistency with each other in what they are saying about the product, then the customers will reject it all because they not stupid. Brassington and Pettitt (2003 25) The 4Ps is a widely recognized concept in marketing and it provides a central organized structure or foundation for marketing activity,which manager can relate to and easily understand, The 4Ps include Product, Price, Place and Promotion. PUT DIAGRAM HERE 3.1 KFCS PRODUCT The product is at the core of marketing exchange. If the product does not deliver the benefits the consumer wanted or if it does not fulfill the expectations created by the other elements of marketing mix, then the whole exercise will be useless. (Brassington and Pettitt 2003 267). A product is a physical good, service, idea, person or place that can offer tangible and intangible qualities that individuals or firms consider necessary, worthwhile or satisfying and are willing to pay for it or exchange any other valuables for it (Brassington and Pettitt 2003 268). This means that for a customer/consumer, the benefit of a product is everything because they buy these products to meet needs, so when a customer/consumer exchanges money, patronage or any other unit of value for a product what he/she is doing is simply paying to get the benefits of that particular product to meet his/her needs. It also means that a product could be anything or place that offers needed benefits and customers/ consumers regard as beneficial. A product (tangible or intangible) is like a personality, and just like a personality there are some characteristics that makes it essentially appealing to the buyer like branding, packaging and labeling, design, style and quality e.t.c. The product and price are the two main parts of the marketing exchange that interests marketers Brassington and Pettitt (2003 268). Alternatively, Groucutt (2005 158) considers products as a collection of features and benefits that provide customer satisfaction. All these different perspectives have two things in common, which is that a product must be beneficial and must provide customer satisfaction. KFC promotes their wide range and varieties of fried, smoked and roasted Suya chickens in Nigeria as nutritious, convenient and even healthy in some parts according to their adverts. According to Doyle (2002) Product decisions comprises of Product variety,product performance, product features, product design, product presentation, product packaging, si zes and brand name. KFCs specialty is fried chicken served in various forms. KFCs primary product is pressure-fried pieces of chicken made with the original recipe. The other chicken offering, extra crispy, is made using a garlic marinade and double dipping the chicken in flour before deep frying in a standard industrial kitchen type machine (Scribd 2011). KFC in Nigeria offers non-durable products and Service products as well. They offer wide range of fried, smoked and roasted chicken in Nigeria, as well as side dishes with fish, port and beef, desserts and ice creams. These are all tangible but non-durable products because the can only be consumed once. KFCs service products in Nigeria represent intangible products such as activities, benefits or satisfaction that customers/consumers derive from their relationship with KFC. KFC menu in Nigeria contains three different segments namely: Family Meals, Individual Meals and Sandwiches. Family Meals comprises of Family Meal, Party Meal and Economy Meal. Ind ividual Meals comprises of Snack Box, Strips Light Meal and Dinner Box. Sandwiches comprises of Suya rap, Suya Burger, Fish rap, beef rap, Chicken fillet supreme, Pork Supreme. They also give customers the chance to make up their own variety box comprising of some or all available products. All the fried Chicken Meals are prepared in the traditional KFC style of frying in oil with the colonels range of spices. All the Meals also have Suya variety, this means that customers/consumers can either chose between the locally prepared Suya or the traditional KFC fried Chicken. KFC also have the same strategy for the beef, fish and pork meals. For the sake of simplicity, this report shall be discussing Fried Chicken. 3.1.1 MARKET SEGMENTATION KFC in Nigeria segments the market demographically by dividing it into groups based on age, gender, family size, income, occupation, religion and ethnicity. KFC segments the market demographically in this way: Age: Between 6 65 Gender: Males and Females Family Size: 2 4, 4 6, 6+ Income: 500Naira and above Family life style: ALL KFCs typical customers/consumers in Nigeria are adults between 18 to 58 who live fast paced lives, and therefore considers convenience when deciding what to eat or drink. This convenience is the totality of what KFC offer in Nigeria. 3.1.1.1 PSYCHOGRAPHIC SEGMENTATION Entails dividing a market into different groups based on social class, lifestyle, religion or personality characteristics (Scribd 2011). KFC in Nigeria divides the market based on psychographic variables like: Upper and Middle class, Life style (not specific) and Personality (ambitious and authoritarian), role expectation of the sexes, reference groups, customs and traditions KFC is concerned about the potential effects of these variables on the sales of its products. This is precedes target market. Psychographic segmentation enable KFC tailor their products or menu content to the specific needs of the target customers in different parts of Nigeria. 3.1.1.2 TARGET MARKET This is the process of evaluating each market segments attractiveness and selecting two or more market segments (Scribd 2011) The two main factors usually considered when selecting a target market segment are the attractiveness of the segment and the fit between the segment and the firms objectives, resources and capabilities. KFC in Nigeria targets upper, middle and a group known as Upper-lower class in Nigeria. KFCs main target are the upper and middle class, but due to the pricing system they initiated, they widened the net to take in this special group known as the upper-lower class, who can afford to take advantage of the KFCs penetration pricing system. KFCs target in Nigeria depends on -Size and growth rate of the segment -Competition in the segment -Brand loyalty of existing customers in the segment -Attainable market share given promotional budget and competitors expenditures -Required market share to break even -Sales potential for the firm in the segment -Resources and structural attractiveness of market segment -Expected profit margins in the segment The market research and analysis discussed before is instrumental in obtaining the above information. (Scribd 2010) 3.1.1.3 MARKET PRESENCE According to Brassington and Pettitt (2006 862) It is a reasonable objective, especially for a small company or a new entrant into an industry/market, to create awareness, both of the firm and of the products offered. According to Jobber (2007) in the communication effects pyramid, 90% Awareness leads to 70% Knowlegde/compreehension, to 40% Liking to 25% Preference, to 20% Trial and 5% Use. This means that to generate more than 5% actual usage which is tantamount to sales of a product, a firm must be more than 90% effective at creating awareness. Even well know brands could have some blind spot relative to a particular market or a new market environment. KFC created awareness in Nigeria through pre-campaigns and promotions, while already gathering potential customers feedback on what they would like to see in KFC eventually. KFC utilized this and tailored their product to popular costumer specifications and needs and this allowed them a relatively easy entry and penetration into the market. The position of KFC products in the minds of target consumers/customers is also important. KFC uses all these attributes to position its products to occupy a clear, distinctive and desirable place relative to competing products in the minds of target consumers/customers. KFC in Nigeria takes feedback from customers and then improve their products. KFC pays more

Management And Treatment And Psychosocial Aspects Of Pneumonia Biology Essay

Management And Treatment And Psychosocial Aspects Of Pneumonia Biology Essay This essay will explore the pathophysiology, management and treatment, and psychosocial aspects of pneumonia in an adult patient. Information has been obtained by the means of history taking, examination, and analysing the patients medical records to form a case study in which the sections mentioned will be considered in relation to the case study. Section A Case History VD is a 68 year old female who was admitted into the acute medical unit (AMU) on 29/1/11 following complaints of generally feeling unwell and chest pain. She had a history of feeling unwell since 25/1/11 coupled with chest pain. This pain was a sharp pain under her right breast which was intermittent and radiated around her chest to her back. The pain was worse on inspiration or when coughing, and was relieved by over-the-counter analgesia. She also felt sweaty, pyrexic (39.7  °C), had rigors and aches over her body, however she was not short of breath. She also had symptoms of a non productive dry cough, poor appetite and vomiting once in AMU (watery and colourless). She previously had no episodes of nausea and vomiting, no palpitations or headaches, no urinary symptoms and normal bowel movements. She has not had any recent contact with anyone who had similar symptoms. In her past medical history she was diagnosed with Sjà ¶grens syndrome and systemic sclerosis last year; both systemic autoimmune diseases. She was on two courses of antibiotics last year for associated pleuritic chest pain. Her family history consisted of her father having ischaemic heart disease (IHD) and her mother dying from lung cancer, although she was a heavy smoker. She currently lives with her husband at home and her occupation is as a shop assistant; this indicates that the infection she has is most likely to be community acquired. She has been a lifelong non-smoker and she does not drink alcohol. She was on no regular medication prior to being admitted, but is now on 1000mg of paracetamol four times a day (QDS) and 500mg of amoxicillin three times a day (TDS). She has no allergies. On examination in a respiratory ward, VD was apyrexial with a blood pressure reading of 95/65, a heart rate of 95 beats per minute and a respiratory rate of 18 breaths per minute. Oxygen saturations (SATS) were 96% in air and she was speaking in full sentences, whilst looking generally comfortable at rest. Her hands seemed dry and scaly on inspection but there were no abnormalities on her face. On palpation of her chest, there was equal chest expansion and no tracheal deviation. There were also no enlargement of cervical or supraclavicular nodes. On percussion, there were dull sounds that could be heard on both right and left lung bases. On ausculatation, coarse crackles could also be heard in the right and left lung bases. There were no abnormal heart sounds heard and her capillary refill time (CRT) was less than 3 seconds. Her abdomen was soft and non tender, and normal bowel sounds were heard. There was normal tone, power and reflexes in all 4 limbs and her Glasgow Coma Scale (GCS ) score was 15/15. Her arterial blood gas values were as follows: pH 7.43, pCO2 5.49, pO2 10.1, HCO3- 26.8, basal excess of 2.8 and glucose of 5.6; these values indicated that she was not in respiratory failure. She was also found to have a raised C reactive protein (CRP) of 210, with a high neutophil count of 10.1. Her chest x-ray film revealed consolidation in her right lung base and no pneumothorax. The impression from the x-ray was that it was right lower lobar pneumonia (Figure 1 is an example of what VDs x-ray would have looked like). 1 No blood cultures were recorded in her notes as it was assumed that due to the neutrophilia the likely source was bacterial. After being initially treated with intravenous (IV) antibiotics in hospital, her symptoms were relieved, no crackles could be heard and her chest was clearing up on 1/2/11. She was then discharged in the afternoon on 2/2/11 given the instructions to continue with her course of oral amoxicillin. Section B Pathophysiology Introduction Pneumonia can be described as an inflammation to the lungs distal airways, particularly the alveoli, usually with a bacterial infection being the origin. 2 3 It clinically presents as an acute illness which can include fever, cough and purulent sputum, although the latter was not present in VD. Pneumonias can be classified by the site of the consolidation (anatomically), or by the aetiology of the disease (see Table 1). 2 3 VD was suspected to have lobar pneumonia after looking at her chest x-ray. The majority of lobar pneumonias are due to Streptococcus pneumonia and can affect a large part, or a whole lobe of the lung. 3 Lobar Pneumonia There are four stages to the pathology of lobar pneumonia, which is a classic example of acute inflammation; these are: congestion, red hepatisation, grey hepatisation and resolution. 3 Congestion is the first stage and lasts for approximately 24 hours. This is represented by protein-rich exudates leaking into the alveolar spaces and also causing venous congestion consequently causing the lung to become oedematous, heavier and redder in colour. 3 The next stage is red hepatisation which has a duration of a few days. Large numbers of polymorphs (neutrophils and basophils) accumulate in the alveolar spaces along with some lymphocytes and macrophages. 3 Many erythrocytes are extravasated from the distended capillaries into the lung tissue, along with the overlying pleura being covered with fibrinous exudates. 3 The lung is now solid and airless, resembling a fresh liver. Figure 1 supports the latter statement by showing a solid consolidation in the right lower lobe. When the lung become s grey and solid, this is grey hepatisation. This also lasts a few days and represents further accumulation of fibrin coupled with the destruction of leukocytes and erythrocytes. 3 The final stage is resolution, whereby the lung reverts to its normal condition. 4 This happens at approximately 8-10 days in cases which are untreated and is when the cells and fibrin in the alveoli undergo fatty degeneration. 3 4 This causes the exudates to be converted into an emulsion, producing a yellow pus-like appearance. 4 The exudates are now in a condition where they can be reabsorbed, whilst preserving the underlying alveolar wall structure. 3 4 The lungs would be softer but remain solid, and this would be confirmed on an x-ray by consolidation of the lungs. Co-morbidities VDs history also mentioned having a background history of Sjà ¶grens syndrome and systemic sclerosis; both systemic autoimmune diseases. Sjà ¶grens syndrome is an inflammatory disease that predominantly affects the exocrine glands with an association to HLA-B8/DR3, which usually causes dryness in the eyes and mouth. 2 5 However it can also cause extra glandular problems such as: Raynauds phenomenon, arthritis and lung inflammation, causing degradation of the lining of the bronchioles and alveoli consequently causing lung infections. 2 5 6 Systemic sclerosis, also known as systemic scleroderma, is a multi-system autoimmune disease in which the cause is unknown. 2 It mainly causes tightness and hardening of the skin (such as VDs hands) but other systems can also be affected, such as the lungs. 2 There is some destruction to the lungs in patients with scleroderma which can lead to right heart failure due to pulmonary hypertension. 7 Other complications that involve the lungs include pulmonary haemorrhage, pneumothorax and pneumonia. 7 Summary VD had come in with an acute infection and was diagnosed with pneumonia. Her right lower lobe was consolidated meaning that she has had it for a few days as protein exudates have leaked into the alveolar spaces and becoming fibrinous, showing up as solid on the chest x-ray, with her CRP (a marker of inflammation) also being raised. VDs medical history last year stated that she had suffered from two previous chest infections that required antibiotics for her to recover. This could possibly be due to the autoimmune diseases aforementioned that she had recently been diagnosed with, causing her to be more predisposed to contracting infections, especially in her respiratory tract. She is currently not on immunosuppressant drugs, but if she were to be for her autoimmune conditions it would then be detrimental to her immune system. This would leave her still being prone to acquiring infections, leaving her in quite a predicament. Section C Treatment and Management VD was on 1000mg of oral paracetamol QDS and 500mg of oral amoxicillin three TDS by the time she was moved to the respiratory ward. The main actions of these drugs were to improve her feverish symptoms and pain whilst also attempting to clear up her infection. Paracetamol Paracetamol (also known as acetaminophen in the USA) is one of the most widely used non-narcotic, analgesic and antipyretic over-the-counter drugs in the world. 8-11 It has properties resembling those of nonsteroidal anti-inflammatory drugs (NSAIDs) such as its analgesic and antipyrexic actions, which can be traced back to the inhibition of the central nervous systems prostaglandin (PG) synthesis. 8 9 It also shares some anti-inflammatory properties, however it does not produce the platelet or gastric side effects that the other NSAIDs do, thus causing argument as to whether it should even be classified as an NSAID at all. 8 It is commonly given orally and is metabolised in the liver, with a half life of approximately 2-4 hours, hence why VD was given it QDS to avoid toxic doses. Mechanism of Action It is considered that the main mechanism of paracetamol is the inhibition of the enzyme cyclooxygenase (COX), COX-2 in particular as studies have shown that it is highly selective towards it. Due to its high selectivity towards COX-2, its inhibition towards pro-clotting thromboxanes is limited. 9 It is said that paracetamol works centrally and is a weak inhibitor of PG synthesis in intact cells, if the concentrations of arachidonic acid available are low enough, through the inhibition of COX-1 and COX-2. 12 This concept was based on research that discovered that PG production in the brain was more sensitive to inhibition from paracetamol by tenfold compared to the spleen. 9 The COX enzymes are responsible for the metabolism of prostaglandin H2 from arachidonic acid. 9 This is an unstable molecule that can form many pro-inflammatory compounds; COX is highly active when oxidised. 9 12 The oxidised form of the COX enzyme is reduced by paracetamol, stopping it from creating pro-inflammat ory compounds. This lowers the amount of PGE2 in the central nervous system, therefore decreasing the set-point of the thermoregulatory centre in the hypothalamus. 9 Exactly how the mechanism of the inhibition of the COX enzymes is still in discussion. Due to the differences of activity between NSAIDs and paracetamol, it is thought that there may be another variant of the COX enzyme that paracetamol interacts with, COX-3 a splice variant of the COX-1 enzyme; however this is just a hypothesis and has yet to be proven. 8 9 12 Side Effects When paracetamol is given at therapeutic doses adverse effects are uncommonly seen, although allergic skin reactions are sometimes observed. 8 Fatal hepatotoxicity can be potentially caused by toxic doses of paracetamol (10-15 grams). 8 Initial symptoms are nausea and vomiting, followed by liver damage after 24-48 hours. 8 13 This happens when the enzymes in the liver, cytochrome P450, catalysing the normal conjugation reactions become saturated, and consequently causes the drug to be metabolised instead by mixed function oxidases. 8 A toxic metabolite, N-acetyl-p-benzoquinoneimine, is formed and inactivated by conjugation with glutathione. 8 13 However when glutathione levels are depleted, the toxic metabolite accumulates and reacts with nucleophilic constituents in the cell, causing necrosis in the liver and kidney tubules. 8 Contraindications Paracetamol is generally well tolerated by the liver when polypharmacy is involved. However, evidence has shown that chronic alcoholics are more susceptible to paracetamol hepatotoxicity, even at therapeutic levels. 13 Chronic alcohol ingestion induces hepatic microsomal enzymes (CYP2E1) by twofold and can increase paracetamol hepatotoxicity, due to increased amounts of the toxic metabolite. 13 Amoxicillin Amoxicillin is a moderate to broad spectrum, ÃŽÂ ²-lactam antibiotic that is commonly used to treat infections that are caused by susceptible bacteria, pneumonia being one of them. 8 14 A derivative of penicillin, this semi synthetic ÃŽÂ ²-lactam antibiotic is created by adding different side chains to the penicillin nucleus, causing it to become broad-spectrum. 8 It is sometimes combined with clavulanic acid in treatment to form co-amoxiclav, which is more effective in treatment nowadays due to the increase in antibiotic resistance; microorganisms are now developing a resistance to penicillins by secreting ÃŽÂ ²-lactamases and the addition of clavulanic acid inhibits this enzyme. 8 Pharmokinetic Aspects The routes of administration are quite vast: when given orally, amoxicillin is absorbed to a different degree compared to other penicillins as it depends on their stability in acid and their adsorption to foodstuffs in the gut. 8 It can also be administered through intramuscular or intravenous injections; however intrathecal administration is generally avoided as it can cause convulsions. 8 Elimination of amoxicillin is rapid and mainly due to the kindneys, with 90% being through tubular secretion. This however may be advantageous as the inhibition to cell wall synthesis is intermittent rather than continuous, and exposure to the drug is reduced. 8 Mechanism of Action Î’-lactam antibiotics inhibit the synthesis of the bacterial cell wall peptidoglycan leading to lysis of the bacterium; this peptidoglycan is crucial for the structural integrity of the cell wall in bacteria, particularly organisms that are Gram-positive. 8 In the synthesis of a peptidoglycan, the final stage is transpeptidation which involves transpeptidases known as penicillin binding proteins (PDPs). Î’-lactam antibiotics attach to these PDPs on bacteria and inhibit the transpeptidases that cross-link the peptide chains attached to the backbone of the peptidoglycan. 8 15 16 The ÃŽÂ ²-lactam antibiotics are closely related to D-alanyl, the terminal amino acid of the peptidoglycan layer. 15 16 The similarity between these two structures allows for the antibiotic and the amino acid to promote their binding to the PDP. 15 The binding of the ÃŽÂ ²-lactam nucleus to the residue of the PDP is irreversible, and it is this irreversible binding of the PDP that disr upts the final transpeptidation of the peptidoglycan layer and consequently inhibits bacterial cell wall synthesis. 8 15 16 The inhibition of transpeptidation due to the ÃŽÂ ²-lactams causes an accumulation of peptidoglycan precursors, which initiates autolytic enzymes to lyse the excess peptidoglycan. 8 Under normal circumstances, the peptidoglycan precursors inhibit the autolytic enzymes; however the ÃŽÂ ²-lactams inactivate this and halt the process. 8 Unwanted Effects Penicillins are mainly free from toxic effects. The main side effects are hypersensitivity reactions caused by by-products of the breakdown of penicillin, which combine with the host protein and become antigenic. 8 Skin rashes and fever are common but much more serious is acute anaphylactic shock which can be fatal in some cases. 8 When administered orally, penicillins, particularly broad-spectrum types such as amoxicillin, can disturb the bacterial flora in the gut; this can be associated with gastrointestinal (GI) disturbances. 8 Summary VD had no complications and responded well to the treatment that she was given. It was suspected that she had community acquired pneumonia and that the treatment would be a broad-spectrum antibiotic to fight the infection. Paracetamol was also prescribed to alleviate her symptoms. As paracetamol and amoxicillin work on different receptors, there were no contraindications to her treatment. She was given medication intravenously, but once she moves onto oral amoxicillin, she must be aware of GI side effects that may occur. Section D Psychosocial Aspects and Public Health Psychosocial Aspects Although initially there may not be many psychosocial aspects to pneumonia, VD could be suffering indirectly from it. A sufferer of Sjà ¶grens syndrome, VD is susceptible to fatigue which can be physically and mentally exhausting. This can lead to depression, emotional stress and general lethargy. As VD is susceptible to getting infections such as pneumonia due to Sjà ¶grens syndrome, it can also further impact on her psychologically whilst dealing with those infections as her quality of life may be significantly reduced. 17 It is important that a patient with Sjà ¶grens syndrome can address these issues to a health professional if they are ever in distress as psychosocial factors may lead to non-compliance in their treatment. Epidemiology There have been many population studies that have been investigating the annual incidence rate of community acquired pneumonia (CAP). In adults, this can vary from, 2.6-13.4 per 1000 inhabitants, with somewhat higher figures in males and at the extreme ages of life. 18 19 Rates of hospitalization range between 22-51%, with annual mortality rates between 0.1-0.7 per 1000 patients. 20 In approximately 50% of patients with CAP, a pathogen of cause was determined. Streptococcus pneumoniae is found in 20-75% of the cases followed by Mycoplasma pneumoniae at 1-18%, Chlamydia pneumoniae at 4-19% and other viruses from 2-15%.20 C. pneumoniae, however, has arisen as a noteworthy pulmonary pathogen in adult pneumonia patients requiring hospitalization. 20 Cost-effectiveness of Patient Care On average there are roughly 4.5 million visits annually to outpatient clinics, emergency departments and physicians offices due to CAP. 21 However, there has been very little in terms of studies gathering national data on the costs of CAP treatment. One study showed that there was, a total cost of $4.8 billion for treating patients aged à ¢Ã¢â‚¬ °Ã‚ ¥65 years and $3.6 billion for treating patients aged Conclusion VD was an elderly woman who was admitted into hospital complaining of acute chest pain and fever for the last few days. After taking a detailed history and examination from her, and with confirmation from a chest X-ray she was diagnosed with right lower lobe community acquired pneumonia. Due to the high neutrophil count in her alveolar spaces, the causative pathogen was most likely to be bacterial and so VD was promptly treated with intravenous amoxicillin, a broad spectrum ÃŽÂ ²-lactam antibiotic that works by inhibiting peptidoglycan synthesis in bacterial cell walls. Paracetamol was also prescribed to alleviate her feverish and chest pain symptoms by inhibiting COX enzymes and PG synthesis in the CNS. Having been diagnosed with chronic autoimmune diseases that can lead to increased susceptibility to chest infections, this can lead to psychological issues such as depression. Recurrent admissions will also be costly to the NHS; if alternative treatments that can allow patients to be treated in an outpatient setting are possible, then there could be significant reductions in cost, particularly for patients over 65.

Obsession in Enduring Love Essay -- English Literature

Explore the ways in which McEwan presents obsession in Enduring Love The theme of obsession is found in many different forms in Enduring Love. McEwan uses language and the presentation of the characters to explore the many different types of obsession. The most obvious obsession in the novel is Jed’s obsession with Joe. As a reader, we find this perhaps the most disturbing because of the intensity with which it is presented. At the opening of the novel, immediately after the accident, Joe walks down the hill to inspect Logan’s body and is closely followed by Jed. McEwan uses language to great effect to convey Jed’s obsession with religion and Jed’s dialogue to show his eagerness to pray. ‘I mean you don’t have to believe in anything at all, just let yourself do it and I promise you, I promise.’ The use of repetition and the word ‘promise’ shows Jed pleading with Joe and expresses his sincere beliefs. There is also a strangeness as Joe decides to tell Parry the harsh truth of his religion ‘There’s no one up there’ ‘Parry’s head was cocked, and the most joyous of smiles was spreading across his face.’ This is a significant moment in the novel as we discover later on that this was the point when Jed’s obsession began and the moment on which the rest of the story is based. McEwan uses religious imagery to convey the embarrassment felt by Joe and passion of Jed’s beliefs. ‘†¦, as I saw it, to deliver me from the radiating power of Jed Parry’s love and pity.’ The use of the verb ‘deliver’ has religious overtones and suggests deliverance in the same Christian sense of Jesus ‘delivered’ mankind. McEwan also uses the phrase ‘radiating power’. This is particularly effective use of imagery as it conveys the idea o... ...as it highlights Joe’s mathematical side. ‘Two bands were entwined in a double helix’†¦Ã¢â‚¬ ¦.to suggest the twenty amino acids on to which the three letter codons were mapped’ McEwan uses the brooch as an object to draw out Joe’s analytical characteristics through the word ‘double helix’ and displays his knowledge of science. The theme of obsession is vital to the novel as a whole and permeates every aspect of the narrative. The obsession is used to invoke a response from the reader, particularly in the case of Jed and Joe as we feel repulsed and disturbed by Jed’s language and feelings. We are also as readers, directly affected by Joe’s love of science. It is evident throughout the novel since often Joe tries to rationalise his problems by making links to science. Finally, it is Jed’s passion for religion that he justifies his obsession and Joe who fuels it. Obsession in Enduring Love Essay -- English Literature Explore the ways in which McEwan presents obsession in Enduring Love The theme of obsession is found in many different forms in Enduring Love. McEwan uses language and the presentation of the characters to explore the many different types of obsession. The most obvious obsession in the novel is Jed’s obsession with Joe. As a reader, we find this perhaps the most disturbing because of the intensity with which it is presented. At the opening of the novel, immediately after the accident, Joe walks down the hill to inspect Logan’s body and is closely followed by Jed. McEwan uses language to great effect to convey Jed’s obsession with religion and Jed’s dialogue to show his eagerness to pray. ‘I mean you don’t have to believe in anything at all, just let yourself do it and I promise you, I promise.’ The use of repetition and the word ‘promise’ shows Jed pleading with Joe and expresses his sincere beliefs. There is also a strangeness as Joe decides to tell Parry the harsh truth of his religion ‘There’s no one up there’ ‘Parry’s head was cocked, and the most joyous of smiles was spreading across his face.’ This is a significant moment in the novel as we discover later on that this was the point when Jed’s obsession began and the moment on which the rest of the story is based. McEwan uses religious imagery to convey the embarrassment felt by Joe and passion of Jed’s beliefs. ‘†¦, as I saw it, to deliver me from the radiating power of Jed Parry’s love and pity.’ The use of the verb ‘deliver’ has religious overtones and suggests deliverance in the same Christian sense of Jesus ‘delivered’ mankind. McEwan also uses the phrase ‘radiating power’. This is particularly effective use of imagery as it conveys the idea o... ...as it highlights Joe’s mathematical side. ‘Two bands were entwined in a double helix’†¦Ã¢â‚¬ ¦.to suggest the twenty amino acids on to which the three letter codons were mapped’ McEwan uses the brooch as an object to draw out Joe’s analytical characteristics through the word ‘double helix’ and displays his knowledge of science. The theme of obsession is vital to the novel as a whole and permeates every aspect of the narrative. The obsession is used to invoke a response from the reader, particularly in the case of Jed and Joe as we feel repulsed and disturbed by Jed’s language and feelings. We are also as readers, directly affected by Joe’s love of science. It is evident throughout the novel since often Joe tries to rationalise his problems by making links to science. Finally, it is Jed’s passion for religion that he justifies his obsession and Joe who fuels it.