Globalization and International Business Essay

Globalization and International Business The Concept of Globalization – putting everything into one village * The process of integration and convergence of economic, financial, cultural and political systems across the world. * Globalization – refers to the integration and interaction between different people and nations. * Globalization is the process of international integration arising from the interchange of world views, products, ideas and other aspects of culture. Globalization – A holistic approach 1. Economic Globalization: the increasing integration of national economic systems through the growth in international trade, investments and capital flow. 2. Financial Globalization: the liberalization of capital movements and deregulations, especially of financial services that led to a sport in cross boarder capital flows. 3. Cultural Globalization: convergence of cultures across the world E.g. Dress codes, ways of living. 4. Political Globalization: the convergence of political systems and processes around the world. Dimensions of Economic Globalization {what has changed} * Globalization of production – the increased mobility of the factors of production especially the movement of capital that has changed countries’ traditional specialization roles. (process is made shorter and cheaper) * Globalization of Markers – technological strides in communication, transport and travel have created new consumer segments. The global markets have become easily accessible. (producing standardized products that are advanced, functional reliable and low priced). * Globalization of competition – it has intensified in such a way that businesses are forced to form mergers or enter into new strategic alliances, competing with new players around the globe. * Globalization of technology – it has advanced rapidly and thus creating shorter cycles for production of goods and services. The running of businesses becomes more effective and efficient. In some cases though, several businesses might have difficulty keeping up with the advancements due to financial constraints. * Globalization of corporations and Industries: – Economic liberalization has led to economic growth in Foreign Direct Investments and relocation of business enterprises as a result, there has been fragmentation in business processes. Where different stages of production are coming out in different countries E.g. Toyota manufactures in Japan and assembles in South Africa. Factors influencing Globalization (Movers) * Economic Liberalization * Technological Breakthrough * Multilateral Institutions * International Economic Integrations * Move towards free marketing systems * Rising research and development costs * Global expansion of business operations * Adverts in logistics management * Emergence of the global customer segment Factors restraining Globalization * Regulatory controls * Emerging trade barriers * Cultural factors * Nationalism * War and civil disturbances * Management myopia – thinking within the box/boarders Quiz: what is meant by internationalization of a firm’s value chain? Reasons for support of Globalization * Maximization of economic efficiencies (learning to use economic resources of a country to the fullest potential) * Enhancing trade * Increase cross-boarder capital movement * Improves efficiency of local firms * Increases consumer welfare Criticism of globalization * Developed Vs Developing countries: unequal players in globalization * Widening gap between the rich and poor * Wipes out domestic industry * Leads to massive layoffs and unemployment * Brings in problems related to balance of payments * Increased volatility of markets * Diminishing power of nation states * Loss of cultural identity * Shift of power to multinationals Response Strategies to Globalization forces for emerging market companies: Defender Extender Dodger Contender 1. Defender Strategy – When pressure to globalize is low, local companies adopt the defense strategy that focuses on leveraging local assets in the market segments where multinationals are weak. 2. Extender strategy – when companies’ posses competitive skills and assets that can be transferred abroad, companies can focus on expanding to markets similar to home base using competencies developed at home. 3. Dodger strategy – when pressure to globalize is high, local companies have no option but to dodge competition by cooperating through a joint venture or becoming a supplier or service provider selling off to multinational enterprises e.g. Skoda Czech car maker sold to Volkswagen. 4. Contender strategy – companies that have high pressure to globalize and competitive advantages that can be leveraged overseas can aggressively compete by focusing on upgrading their capabilities in the niche segment to match multinationals globally ie. TATA India Concepts of International Business 1. International Trade – exports of goods and services to a foreign-based buyer (importer) 2. International Marketing – refers to marketing carried out by firms/companies across the national boarder line. 3. International Investment – cross boarder transfer of resources to carry out business activities. 4. International Management – application of management concepts and techniques in a cross country environment an adaptation to different social-cultural, economic, legal, political and technological environments. 5. International Business – all those business activities which involve cross-border transactions of goods and services and resources between two or more nations. 6. Global business – conduct of business activities in several countries using a highly co-ordinate and single strategy across the world. Types of International Business Transactions * Transactions – exchange of values between buyer and seller typically involving intermediaries and currency as medium of exchange. * Exchange of: production inputs, components partially/nearly finished products, goods/services, ideas/know how. Boarders: their significance * State boundaries – denote sovereignty, citizenship (political authority), legal jurisdiction, security. When there’s no boarder, there’s no state!! * National cultures, National Identity * Economic Unit – eroded due to globalization, economic transactions are mainly domestic. * Boundaries – of mind and habit, boundaries are psychological not just physical. How boarders make a difference: As soon as you have different cultures, different contact forms, different legal structures, different taxation environments, the complexity introduced by that is immense. The reason why businesses that expand overseas fail is: they underestimate the complexity that’s enlarged in an international organization. The Internationalization of Business: * Bringing in new ideas * Moving across the boarders * Companies conduct value adding actitvities on a global scale, primarily to organize, source, manufacture and market. * A Level play field – international activities appealing to all types of firms; large or small. Manufacturing and services sectors E.g. Banking, Transportation, Design, Advertising and retailing. Nature of International Business * Value adding activities * Firms internationalize via experts, foreign direct investment, licensing, and collaborative ventures. * Foreign portfolio investment – less than 10% * Foreign Direct Investment – More than 10% Reasons for International Business Expansion 1. Market seeking motives * Marketing opportunities due to lifestyle cycles * Uniqueness of products or services 2. Economic motives * Economies of scale are achieved * Profitability * Spreading research and development costs 3. Strategic motives * Growth * Risk spread Differences between Domestic and International Business * Economic environment * Social * Infrastructure * Legal * Political * Competition * Technology The Four risks of International Business 1. Cross- cultural risk – occurs when a cultural misunderstanding puts some human value at stake. * Cultural differences * Negotiation patterns * Decision making styles * Ethical practices 2. Commercial risk – refers to a firm’s potential loss or failure from poorly developed or executed business tactics. * Weak partners * Operational problems * Timing of entry * Competitive intensity * Poor execution of strategy 3. Currency risk (financial risk) – the risk of adverse fluctuations in exchange rates * Currency exposure * Asset evaluation * Foreign taxation * Inflation and transfer 4. Country risk (political risk) – refers to the potentially adverse effects on company operations and profitability caused by developments in political, legal and economic environments in a foreign country. Risks: will always be present but can be managed: Managers is such situations should: * Anticipate the risks * Understand the implications thereof * Take pro-active action * Reduce adverse effects Some risks are extremely challenging e.g. the East Asian Economic Crisis in 1998. It generated substantial commercial, currency and country risks. Participants in International Business: 1. Multinationals E.g. Kodak, Nokia, Samsung, Multinational Enterprises own worldwide network of subsidiaries. 2. Other participants * Small and medium sized enterprises; In the USA a small/medium enterprise sized entity is described as that having 500 or fewer employees. * Comprises of 90-95% of all firms in most countries . * Increasingly more SME’s participate in International Business. Why do firms Internationalize? * Seek growth opportunities through market diversification * To earn higher margin profits * Gain new ideas about products, services * Better service to customers that have relocated abroad * Be closer to supply sources * Benefit from global sourcing advantages * Gain flexibility in sourcing products * Gain access to better value factors of production * Develop economies of scale in sourcing, production, marketing and R&D * Confront international competitors more effectively or thwart the growth of competition in the home market. * Invest in a potentially rewarding business venture. What caused the East Asian Economic Crisis Theories of Trade Absolute Advantage: when a country is efficient in producing a commodity than any other country. Countries should therefore specialize in producing a product of which they are efficient in producing and then trade such product for goods produced by other countries. Output per hour of labour – using the same resources | Cloth| Wheat| Country A| 100| 200| Country B| 250| 160| Total| | | Interpretation: clearly The Political Economy of International Trade The political reality of International Trade is that while many nations are nominally committed to free trade, they tend to intervene in international trade to protect the interest of politically important groups. Instruments of trade policy are tariffs, subsidies, import quota, voluntary export restraints, local content requirements, administrative policies and anti-dumping duties. * A tariff is a tax levied on imports that effectively raises the cost of imported products relative to domestic products. * Specific tariffs are levied as a fixed charge for each unit of a good imported. * Ad valorem tariffs are levied as a proportion of the value of the imported good. * A subsidy is a government payment to a domestic producer. Subsidies may take form of a tax break, cash grants, low-interest loan. * Subsidies help domestic firms by lowering production costs * Help them compete against foreign imports * Gain export markets * Government pay for subsidies by taxing individuals(consumers) * Import Quota – is a direct restriction on the quantity of some good that may be imported into a country. * Voluntary export restraints – are quotas on trade imposed by the exporting country, typically at the request of the importing country’s government. * A local content requirement demands that some specific fraction of a good be produced domestically. * The requirement can be in physical or value terms. * Local content requirements benefit domestic producers and jobs, but consumers face higher prices. * Administrative policies are informed bureaucratic rules designed to make it difficult for imports to enter a country. For example Japanese customs inspectors insist on opening a large proportion of express packages to check for pornographic materials. * This process that can delay express packages has made it difficult for FedEx to expand its global shipping services to Japan. * These policies hurt consumers by denying access to possibly superior foreign products. * Dumping is selling goods in foreign markets below their cost of production/fair market value. * Anti-dumping policies are designed to punish foreign firms that engage in dumping. Dumping is viewed as a method by which firms unload excess production in foreign markets sometimes at prices below the cost of production. * The goal is to protect domestic producers from unfair foreign competition. * US firms that believe a foreign firm is dumping can file a complaint with the government. * If the complaint has merit, antidumping duties, also known as countervailing duties may be imposed. Why Governments intervene? Basically there are three reasons: Political, Economic and Cultural 1. Political reasons include: * Protecting jobs and industries from foreign competition, trade controls usually result in higher price for consumers. * National Security – defense related industries often get this kind of protection. * Retaliations are threats used as bargaining tasks to help open foreign markets and force trading partners to play by the rules. It is usually in retaliation to a trading partner’s trade policy. Protect consumers from unsafe products. 2. Economic Reasons: * The infant industry argument(protecting them) * Strategic trade policy – policies that government enact to ensure that firs-mover advantages are reserved for local firms in industries where substantial economies of scale exist. 3. Cultural Motives – unwanted influence causes great distress and can force governments to block imports. Many countries have laws that protect their media programming for cultural reasons – for example in Canada about 35% of music played on TV and radio must be of Canadian origin. Economic Integration The abolition of trade restraints between nations. It is the growing economic interdependence that results when countries within a geographic region form an alliance aimed at reducing barriers to trade and investment. * Three Levels of Economic Integration * Global: trade liberalization by GATT or WTO * Regional: preferential treatment of member countries in the group ie. SACU, SADC, COMESA ,etc. * Bilateral: preferential treatment between two countries * Regional and Bilateral agreements are against the MFN clause (normal trading relations), but allowed under WTO. * Visit www.wto.org for regional trade agreements. Regional Economic Integration * Growing economic interdependence that results when countries within a geographic region form an alliance aimed at reducing barriers of trade and investment. About 40% of the world trade now occurs via economic bloc agreement. Cooperating nations obtain: * Increased product choices, productivity, living standards * Lower prices and * More efficient resource use. Economic Bloc A geographical area that consists of two or more countries that agree to pursue economic integration by reducing tariffs and other restrictions to cross-border flow of products, services, capital and in more advanced stages, labor. Examples: EU, NAFTA, MERCOSUR, APEC, ASEAN and many others. There are five possible levels of economic integration * Customs Union * Common Market * Economic Union * Political Union 1. Free Trade Area – countries agree to reduce tariffs but not eliminate everything The simplest most common arrangement, member countries agree to gradually eliminate formal trade barriers within the bloc, while each member country maintains an independent international trade policy with countries outside the bloc. Eg. NAFTA 2. Customs Union – similar to a free trade area except that the members harmonize their trade policies toward non-member countries, by enacting common tariff and non-tariff barriers on imports from non-member countries. E.g. SACU(Lesotho, Swaziland, Namibia, SA). Members have a revenue pool and it is shared according to how much each has contributed. 3. Common Market (single market)- like a custom union except products, services and factors of production such as capital, labor, and technology can move freely among the member countries. E.g. COMESA – requires much cooperation among the member countries on labor and economic policies. 4. Economic Union – like a common market, but members also aim for common fiscal and monetary policies, standard commercial regulations, social policy, etc. E.g. the EU is moving toward economic union by forming a monetary union with a single currency the EURO. 5. Political Union – perfect unification of all policies by a common organization. Submersion of all separate national institutions e.g. former USSR * Remains ideal, but yet to be achieved. The European Union What is the European Union? * Shared values: liberty, democracy, respect, for human rights and fundamental freedom, and the rule of law. European Coal and Steel Community * In the aftermath of the World War II, the aim was to secure peace among Europe’s victorious nations an bring them together as equals, cooperating within shared institutions. * Based on a plan by French foreign minister Robert Schuman. * Six founding states/countries: Belgium, the Federal Republic of Germany, France, Italy, Luxembourg and the Netherlands – signed a treaty. History of the EU * Treaty of Paris (1951) Formation of ECSC Treaty of Rome (1957) Formation of ECC (European Economic Community) -initially free trade area, becoming a customs union in 1967. * The Stockholm convention in 1960 created EFTA by seven countries to counteract ECC. * Single European Act of 1993 * Creation of single market (common Market) effective on January 1 1993 * Rename EEC by EU (15 members) * Treaty of Maastricht (1992) * Creation of an economic union, EMU * Establishment of European Central Bank on July 1998 * Introduction of a common currency, Euro on 1 January 1999 * Circulation of Euro on 1 January 2002. The EU features: A full-fledged Economic Union 1. Market access: tariffs and most non-tariff barriers have been eliminated. 2. Common market: removed barriers to cross national movement of production factors i.e labor, capital and technology. 3. Trade rules: eliminated customs procedures and regulations, streamlining transportation and logistics within Europe. 4. Standards harmonization: harmonizing technical standards, regulations, and enforcement procedures on products, services and commercial activities. 5. Common fiscal, monetary, taxation and social The European Union Today * 27 members * New members e.g. Poland, Hungary, Czech Republic are low-cost manufacturing sites. * Peugeot, Citroen(france) – factories in Czech Republic. * Hyundai (South Korea) – Kia plant in Slovakia. * Suzuki (Japan) – factory in Hungary. * Most new EU entrants are one-time satellites of the Soviet Union, and have economic growth rates for higher than the 15 Western European counterparts. * Developing economies e.g Romania, Bulgaria, may take decades of foreign aid to catch up. Four Institutions that govern the EU 1. Council of the European Union – the main decision-making body. Makes decisions on economic policy, budgets, and foreign policy and admission of new member countries. 2. European Commission – represents the interest of the EU as a whole. Proposes legislation and is responsible for implementing decisions of the Parliament and the council. 3. European Parliament – up to 732 representatives, hold joint sessions each month. Three main functions are: * Devise EU legislation * Supervise EU Institutions * Make decisions on the EU budget. NAFTA (Canada, Mexico, USA) NAFTA passage (1994) was facilitated by the maquilladora program, in which US firms allocated manufacturing plants just South of the USA border to access low-cost labor without significant tariffs. NAFTA has: * Eliminated tariffs and most non-tariff barriers for products and services. * Established trade rules and uniform customs procedures. * Instituted investment rules and intellectual property rights. * Provided for dispute settlements for investment, unfair pricing, labor issues, and the environment. NAFTA Results: * Trade among the members more than tripled, and now exceeds 1 trillion per year. * In the early 1990’s Mexico’s tariffs averaged 100% and gradually. How the Mexican Economy benefited from NAFTA * Mexico exports to the US grew from 50 billion to over 100 billion per year. * Access Canada and the US helped launch many Mexican firms in industries such as electronics, cars, textiles, medical products, and services. * Yearly US and Canadian investment in Mexico rose from 4 billion in 1993 to nearly 20 billion by 2006. * Mexico’s per capita income rose to about 11 000 in 2007, making it the richest country in Latin America. * Why nations pursue economic integration 1. Expand market size * Greatly increases the scale of the market place for firms inside the economic bloc. Eg. Belgium has a population of just 10 million; the EU has a population of nearly 500 mil. * Consumers can access much bigger selection of products and services. 2. Achieve economies of scale and enhance productivity * Bigger market facilitates economic scale * Internationalization inside the bloc helps firms learn to compete more effectively outside the bloc. * Labor and other inputs allocated more efficiently among the member countries, leading to lower consumer prices. 3. Attract investment from outside the bloc * Compared to investing in stand-alone countries, foreign firms prefer to invest in countries that are part of an economic integration bloc. E.g General Mills, Samsung, TATA invested heavily in the EU. 4. Acquire stronger defensive and political posture * Provide member countries with a stronger defensive posture relative to other nations and world regions, an original motive of the EU. Factors contributing to the success of Regional Integration 1. Economic Stability – the more similar the economies of the member states, the more likely the bloc will succeed. Eg. Wage rates, economic stability e.g. SADC, EU 2. Political Stability – similarity in political systems is key. Countries should share similar aspirations and a willingness to surrender national autonomy e.g EU 3. Similarity of culture and language – Helpful but not absolutely necessary. 4. Geographic proximity – facilitates transportation of products, labor, and other factors. Neighboring countries tent to share a common history, culture and language E.g. NAFTA, EU Consequences of Regional Integration * Trade Creation – as barriers fall, trade is generated inside the bloc. * Trade Diversion – as within the bloc trade becomes more attractive, member countries discontinue some trade with non-member countries. * Aggregate effect – National patterns of trade are altered. More trade occurs inside the bloc. * A concern: a bloc might become an economic fortress leading to more within-bloc trade and less between bloc trade: can harm global free trade. * Loss of National Identity – increased cross-boarder contact makes members more similar to each other E.g. in response Canada has restricted the ability of US movie and TV producers to invest in the Canadian film and broadcasting industries. * Sacrifice of Autonomy – in later stages of regional integration a central authority is  set up to manage the bloc’s affairs. Members must sacrifice some autonomy to the central authority, such as control over their own economy. E.g Britain in the EU. * Transfer of power to advantaged firms – can concentrate economic power in the hands of fewer larger firms, often in the most advantaged member countries. * Failure of small or weak firms – as trade and investment barriers fall, protection is eliminated that previously shielded smaller or weaker firms from foreign competitions. * Corporate restructuring and job loss – Increased competitive pressures and corporate restructuring may lead to worker layoffs or re-assigning employees to distant locations, disrupting worker’s lives and entire communities. * Internationalization by firms inside the bloc – internationalization gets easier after regional integration. * Rationalization of operations – managers develops strategies and value-chain activities suited to the region as whole, not individual countries, by restructuring and consolidation company operations. The goal is to reduce costs and redundancy, increase centralized distribution, instead of decentralization to individual countries. * Mergers and acquisitions – Economic blocs lead to mergers and acquisitions, the tendering of one firm to buy another, or of two or more firms to merge and form acquisitions. Cross – Cultural risk * A situation or event where a cultural mis-communication puts some human value at stake. * Arises when we enter environments characterized by unfamiliar languages and unique value systems, beliefs, attitudes and behaviors. * One of the four major risks in international business. Manifestations of Cross-Cultural risk * Ethnocentric orientation – using our own culture as the standard for judging other cultures. * Polycentric orientation – a mindset in which the manager develops a greater affinity with the country in which he/she does business than the home country. * Geocentric orientation: a global mindset in which the manager is able to understand a business or market without regard to national boundaries. * Managers should strive for a  geocentric orientation. Definitions of Culture: * Incorporates both objective and subjective elements. * Objective aspects of culture include tools, roads, television programming, architecture and other physical artifacts. * Subjective aspects include norms and values, ideas, customs and other meaningful symbols. * Hofstede, a well-known Dutch organizational anthropologist views culture as a collective mental programming of people and the software of the mind; how we think and how we reason. Culture Is: * Not right or wrong – it is relative. There is no cultural absolute, different nationalities simply perceive the world differently. * Not about individual behavior – culture is about groups. It refers to a collective phenomenon of shared values and meaning. * Not inherited – culture is derived from the social environment. We are not born with a shared set of values and attitudes, we learn and acquire as we grow up. Culture is learned: * Socialization – the process of learning the rules and behavioral patterns appropriate to ones given society. Eg. Cultural learning * Acculturation – the process of adjusting and adapting to a culture other than one’s own. Commonly experienced by expatriate workers. * Culture is like an ice-berg-above the surface. Certain characteristics are visible, below the surface is massive base of assumptions, attitudes and values that strongly influence decision making relationships, conflict and other dimensions of business. Cross-cultural proficiency is paramount in Managerial tasks. Examples: * Developing products and services * Communicating and interacting with foreign business partners * Negotiating and structuring international business ventures * Interacting with current and potential customers * Preparing advertising and promotional materials. Cross cultural differences may create challenges: * Teamwork – what should managers do if foreign and domestic nationals don’t get along? * Lifetime employment – workers in Japan often expect to work for the same firm throughout their careers; How should foreign firms handle that? * Pay for performance system – In China and Japan, a person’s age is important in promoting workers. Yet how do such workers perform when merit performance-based measures are used? * Organizational Structure – preferences for centralized, bureaucratic structures may deter information sharing. * Union-management relationships – workers in European firms enjoy a more equal status with managers. * Attitudes towards ambiguity – if you’re uncomfortable working with minimum guidance or taking independent action, you may have difficulty fitting into some cultures. Three approaches to interpreting culture: * Metaphors – refer to a distinctive tradition or institution strongly associated with a society – a guide to deciphering attitudes, values and behaviors. * Stereotypes – are generalizations about a group of people that may or may not be factual, often over looking real, deeper differences. * An Idiom – is an expression whose symbolic meaning is different from its literal meaning. The Nature of Stereotypes * Are often erroneous and lead to unjustified conclusions about others. * Still most people employ stereotypes, either consciously or unconsciously, because they are an easy means to judge situations and people. * There are real differences among groups and societies, we should examine descriptive behaviors rather than evaluate stereotypes. * An example: some Latin Americans procrastinate via the manana syndrome. E.T. Hall’s High and Low context cultures: Low Context * Rely on elaborate verbal explanations putting much emphasis on spoken words. * Tend to be in northern Europe and North America which place central importance on the efficient delivery of messages. * Communication is direct and explicit – don’t beat around the bush. High Context * Establish trust first * Personal relations and goodwill are valued * Agreements emphasize trust * Negotiations slow and ritualistic * Emphasis is on non-verbal messages and use communication as a means to promote smooth harmonious relationships. * Prefer an indirect, polite, face-saving style that emphasizes a mutual sense of care and respect for others, careful not to embarrass or offend others. * It is difficult for Japanese people to say No when expressing disagreement. Much more likely to say it is different – an ambiguous response. * In East Asian cultures, showing impatience, frustration, irritation, or anger disrupts harmony and is considered rude and offensive. * To succeed in Asian cultures, it is critical to notice non verbal signs and body language. Hofstede’s Classification of National culture 1. Individualism Versus Collectivism – refers to whether a person primarily functions as an individual or within a group. 2. Power Distance – describes how a society deals with inequalities in power that exists among people. 3. Uncertainty avoidance – refers to the extent to which people can tolerate risk and uncertainty in their lives. 4. Masculinity Vs Femininity 1.1 Individualistic Society – ties among people are relatively loose,  each person tends to focus on his/her own self interests. E.g Australia, Canada and the UK 1.2 Collectivist Societies – ties among individuals are more important than individualism: business is conducted in the context of groups where everyone’s norms are strongly considered. E.g China, Panama, and South Korea. 2.1 High Power distance societies – have substantial gaps between the powerful and the weak: are relatively indifferent to inequalities and allow them to grow. E.g. Guatemala, Malaysia, the Philippines. 2.2 Low-power distance socities – have minimal gaps between the powerful and weak. E.g. Denmark and Sweden governments instituted tax and social welfare systems that ensure their nationals are relatively equal in terms of income and power. * Social stratification affects power distance. In Japan almost everybody belongs to the middle class, while in India the upper stratum controls decision making and buying power. * In high distance firms, autocratic management styles focus power at the top 3.1 High Uncertainty avoidance societies create institutions that minimize risk and ensure financial security, companies emphasize stable careers and produce many rules to regulate worker actions and minimize ambiguity. 3.2 Low-uncertainty avoidances societies – socialize their members to accept and become accustomed to uncertainty: managers are entrepreneurial and comfortable with risk taking, decisions are made quickly, people accept each day as it comes. 5.1 Masculine cultures – value competitiveness, assertiveness, ambitions and the accumulation of wealth. Both men and women are assertive, focused on career and earning money, and may care little for others. E.g Australia and Japan. The US is a moderately masculine society, as are Hispanic cultures that display a zest for action, daring and competitiveness. In business, the masculinity dimension manifests as self-confidence, pro activeness and leadership. 5.2 Feminine cultures emphasize nurturing roles, interdependence among people, and caring for less fortunate people – for both men and women. e.g. Scandinavian countries welfare systems are highly developed and education is subsidized. Subjective Dimensions of culture Subjective dimensions – values and attitudes, manners and customs, deal versus relationship orientation, perceptions of time, perceptions of space and religion. * Values represent a person’s judgment about what is good or bad, acceptable or unacceptable, important or unimportant and normal or abnormal. * Attitudes and preferences are developed based on values, and are similar to opinions, except that attitudes are often unconsciously held and may not have a rational basis. * Prejudices are rigidly held attitudes, usually unfavorable and aimed at particular groups of people. Examples: values in North America, Northern Europe, and Japan – hard work, punctuality and the acquisition of wealth. Deal Vs Relationship Culture * Deal Oriented cultures- managers focus on the task at hand are impersonal, typically uses contacts and want to just get down to business. Example, Australia, North Europe, and North America. * Relationship Oriented cultures- managers have affiliations with people, rapport and get to know the other party in business interactions, relationships are more important than the deal – trust is highly valued in business, agreements. Example, China, Japan, Latin America etc. It took nine years for Volkswagen to negotiate an automobile factory in China. Manners and Customs * Manners and Customs are ways of behaving and conducting oneself in public and business situations. * Informal cultures – egalitarian in which people are equal and work together cooperatively * Formal cultures – status, hierarchy, power and respect are very important. * Varying Customs: eating habits, mealtimes, work hours and holidays, drinking, appropriate behavior at social gatherings (handshaking, bowing and kissing), gift-giving (complex), roles of women. Religion * A system of common beliefs or attitudes concerning a being or system of thought people consider to be scared, divine, or highest truth as well as the morals codes, values, traditions, and rituals associated with this system. * Influences culture, and therefore business and consumer behavior. * Example: The protestant work ethic emphasizes hard work, individual achievement and sense that people can control their environment – the underpinnings for development of capitalism Language as a key dimension of culture * The mirror or expression of culture, essential for communication; provides insight into culture. * Linguistic proficiency is a great asset in International Business. * Language has verbal and non verbal (unspoken, facial expressions and gestures) * There are nearly 7000 active languages including 2000 in Africa. Technology, the Internet and Culture * Technological advances are a key determinant of culture and cultural change – more leisure time, and computers, multimedia, and communications systems that encourage convergence in global culture. * The â€Å"death of distance refers to the demise of the boundaries that once separated people, due to modern communications, information, and transportation technologies – more homogenized cultures are developed. * The internet also promotes the diffusion of culture, with rapidly growing numbers of internet users. Are cultures converging? The concept of Sovereignty Sovereignty – meaning Self Rule is when a state or government is able to make and enforce laws within its boundaries without interference from foreign nations. It is also connected to the ability of a country to guarantee the best interest of its own citizens. How does Globalization affect sovereignty? Discuss the effect of Globalization on National culture: 1. Stripped us of our culture since people become more attached to western culture and neglect their ways of doing things. Critically evaluate various dimensions of Economic globalization and their impacts on business enterprises: explain how it is affected and give examples. 1. Globalization of Production: increased mobility of the factors of production has changed traditional specialization roles 2. Globalization of Competition: competition with international businesses has intensified and therefore cost reduction is encouraged to improve efficiency. 3. Globalization of markets: markets have become easily accessible, allowing for expansion and growth. Goods are made of a standard level since customers worldwide have the same tastes and preferences. 4. Globalization of Technology: it has advanced rapidly leading to shorter production cycles. It also makes managing a business more effective and efficient. Advancements in technology have also become difficult to maintain due to financial constraints for some businesses. 5. Globalization of Industries: they have the options of putting up shops anywhere in the global village, giving customers a variety of choices in terms of goods and services. Convergence – bringing together two or more things Globalization – putting everything into one village.

Should a Piece of Literature Be Judged on Its Literary Merits Alone, Regardless of Its Historical Context?

Steven Brust once wrote: â€Å"In my opinion, the proper way to judge a novel is this: Does it give one an accurate reflection of the moods and characteristics of a particular group of people in a particular place at a particular time? If so, it has value. Otherwise, it has none. † (Brust, Steven. 2005. Sethra Lavode). Brust, quite clearly has joined this debate regarding literary theories. He claims that if aspects of literary piece, aside from its own merits, are not significant then it has no worth.It is continually and widely argued by critics of literature whether a book should be based on its literary merits alone, or if only certain aspects, such as history, regarding its writing should be relevant. The relationship between history and literary work is often questioned. There are four main models that have been devised to explain this. The first regards a piece literary work as universal and belonging to no time period. The model states that historical context has no si gnificance in literary texts, and that both should remain autonomous from each other.Critics are concerned with literary texts being artefacts in themselves that surpass the possibilities of a particular time, thus the idea of specific historical context is dismissed. R. S. Crane supports this view and in an essay said history is part of â€Å"the general history of culture† whereas literature should be â€Å"imaginative works considered with respect to those qualities which can truly be said to be timeless†¦ quite apart from any knowledge of their origin or historical affiliation† (Crane, Ronald. 1967. History versus Criticism in the study of literature’, in The idea of the Humanities and Other Essays Critical and Historical, Vol. 2. Chicago: University of Chicago Press). In short, this model centres around the basis that a literary work should be judged on its, as Crane said, ‘timeless qualities’ for example the quality of its linguistic feat ures and other aspects that give a work literary merits. The second model regarding history and literature is based on the idea that the historical context of a literary piece helps lead to proper understanding of it.A text is produced within a certain historical context but this should remain separate from the literary context. This model is often favoured by critics that analyse literary texts by considering their historical background and context. This can be regarded to any aspect whether it is: political, cultural or linguistic. A 1934 study by Basil Willey: The Seventeenth Century Background: Studies in the Thought of the Age in Relation to Poetry and Religion shows even by its title a support for this model.It is implied that Willey and similar critics agree that historical context forms a foundation of understanding when studying a literary text. They would argue that literary work in order to be analysed must be understood and to be understood needs to be looked at in respe cts to its historical context. The third model when looking at the relationship between pieces of literature and history is essentially the opposite of the second. It centres on the idea that a literary piece can help us understand the time in which it is set.This is explanation talks about realist texts in particular and how they can provide creative depictions of historical events or periods. It assumes that literary texts are almost subordinate to their historical context and they are reflections of their time. For example Keith Thomas appeals to Shakespeare to justify this point of view: â€Å"In Shakespeare’s plays, the curses pronounced by the characters invariably work†¦ not just for dramatic effect† but that â€Å"it as a moral necessity that the poor and the injured should be believed to have this power of retaliation when all else failed† (Thomas, Keith. 971. Religion and the Decline of Magic: Studies in Popular Beliefs in Sixteenth and Century En gland. London: Wensfield and Nicolson). This model is known as the reflective approach, it regards literary work as an aid to develop our knowledge of history using the historical context of a literary piece. The last model regarding literature and history is probably the most complex, though it is also seen as the most interesting to theorists. It claims that literary texts are connected with other discourses and this makes literature itself a part of history that is continually being written.Critics that agree with this theory, widely known as ‘new historicists’, argue that the question of the relationship between history and literature is wrong; despite their differences the last three models assume that ‘history’ and ‘literature’ are fundamentally separate. They distinguish between the interpretations of literary texts and the transparency of history. Stephen Greenblatt writes in an essay: â€Å"methodological and self-conscious is one of the distinguishing marks of the new historicism in cultural studies as opposed to historicism based upon faith in the transparency of signs and nterpretive procedures† (Greenblatt, Stephen. 1990. ‘Towards a poetic of Culture’, in Learning to Curse: Essays in Early Modern Culture. London: Routledge). Hence, new historicists argue that the making of the literary texts is a cultural practice, and only differ in their specific mode. No absolute distinction can be made between literary and other cultural practices. Theorists such as Hayden White, claim that this model implies that just like literary texts the ‘facts’ of history need to be read (tracing the past is similar to telling a story).In an extract from White’s book, Tropics of Discourse: Essays in Cultural Criticism, He writes: Histories ought never to be read as unambiguous signs†¦ but rather as symbolic structures, extended metaphors, that ‘liken’ the events reported in t hem to some form with which we have already become familiar in our literary culture†¦ By the very constitution of a set of events in such a way as to make a comprehensible story out of them, the historian changes those events with the symbolic significance of a comprehensible plot structure. (White, Hayden. 1991. Tropics of Discourse: Essays in Cultural Criticism.Baltimore: The John Hopkins University Press) Considering this we would come to the conclusion that methods of (critical) analysis should be suitable for both history and literary texts. In short, a new historicist perspective think that in the reading of a literary text the idea of historical context cannot be settled, and that this context is decided by a negotiation between the text and the reader Ultimately, the majority of literary theorists fall on the side that accepts the use and aid historical context when critically analysing a literary text.Only the first model seems to completely disregard historical contex t in literary work for the belief that a piece of literature should be ‘timeless’. The second and third model accept historical context as part of the method of analysing a literary piece. However, still confidently differentiate between literature and history, they are seen as merely aids for each other.The last model is set apart from the rest as it does not polarise the categories and treats them as to intertwine subjects that cannot be considered without each other. In my opinion historical context should be relevant to the reading of literary text, it is inevitable that the two should overlap especially during an in depth analysis of a literary text.

Women of Kievan Rus

The women of Kievan Rus were in a much different setting and social structure than their western counterparts. With the arrival of Christianity in Kievan Rus can new changes to family relations and positions of women in society and the household. The church divided women into two groups, the â€Å"good† and the â€Å"evil† women. The determination of who fell into what group was determined on how they compared to the norms of behavior of saints. With women divided into two groups the church focused more on the conduct of â€Å"evil† women.The church handed down instructions on the conduct of women. The core of these instructions was based on the submissiveness of women to god and their husbands. They urged women to stay silent and be socially dependent. But women’s lives were not totally controlled and they were not treated sub-humanly. As seen in the treaty between Novgorod and Gotland slave women had rights and were defended against harm. The example it gives is the denial to rape or harm slave women. Their social roles were protected and offenders would have to stand trial and pay a heavy fine.Their counterparts, free women were also protected and held interesting privileges. Women were well protected from anything stemming from simple insults to rape. They also had a choice in their marriage partner and if they were forced into a marriage then the parents would have to pay a hefty fine. There were documents unearthed, which showed that Novgorod women lent money and owned land. Women in Novgorod and Kievan Rus were a unique sect of society with both freedoms and restrictions.

Electronic Documentation in Health Sector Research Paper

Electronic Documentation in Health Sector - Research Paper Example In a study to investigate the barriers to adoption of a standard language in the nursing field, data were collected through surveys, which were administered to a random respondent group established by a computerized mechanism of the practitioners who practice within the ambulatory health systems in the US. The descriptive statistics was evaluated through SPSS through which the correlation indices to the factors under analysis were sought and later interpreted. The outcome of the analysis has revealed the perception of the interviewees that nursing care information is often omitted from the records mostly because of three reasons: no easy documentation method, a failure to reimburse the nursing documentation as well as little time to document. The basic tool to overcome the constraint was seen to be the adoption of electronic mechanisms of documentation, which equally relied on availability of technology and its adoption. Therefore, the relevance of the research study by Conrad and th e team to my capstone project is that it affirms the need to embrace technology in documentation of nursing practices for the ease and efficiency of retrieval of the health records (Conrad et al. 2011). Information technology has been seen to be a critical component in the modern day communication between practicing medical staff and the patients. Besides the necessity of the effective communication to bring about satisfaction to patients in the medical procedure, the lack of it results in great failures within the field. In a study to analyze the role of information technology and the assisted communication within the medical field Angst and colleagues adopted the mode of structure and process as well as outcome, to carry out the analysis. The research was informed by the limited literature that existed on the role of information technology when integrated in communication-based transactions within the medical field. It adopted a SPO framework (structure-process-outcome) to test te chnical as well as interpersonal care processes within the medical field. IT was found to serve in both interpersonal as well as technical processes in the medical field. This is because clinical IT affects the technical dimension while the administrative IT impacts the interpersonal patient care dimension. Measures of hospitals performance are often based on the technical competence as well as the patient’s satisfaction. The structure, according to this research, was found to imply not only the physical organizational structures, but also the incorporation of IT into the management practices. The research, therefore, served to affirm the necessity of health practitioners to embrace technological changes for the purpose of efficiencies in processes and practices (Angst et al, 2012). This study, therefore, has concluded that medical health managers should be aware that underutilization as well as the overutilization of IT in the field would be disastrous to the overall outcome of the institutions. Stored medical and clinical data have many uses among which are clinical care as well as purposes of research. Jensen, Jensen and Brunak (2012) sought to study the critical necessity of proper data storage for the clinical data to be used for research studies as well as for better clinical care. Phenotype information as well as patient information within this field stands to have a great significance though it is often little utilized. Information technology has greatly revolutionized the practices of capturing, storing as well as retrieval of information regarding medical and clini

Discussion Essay Example | Topics and Well Written Essays - 250 words - 96

Discussion - Essay Example Further, the author provides 7 strategic ways of ensuring professional leadership by maintaining a balanced EQ. These range from developing healthy escapism to preemptive measures in a bid to avoid indecision as a result of emotional instability. While Mulqueen concurs to psychological factors that catalyze emotional aggression and consequent indecisiveness, he maintains that these triggers can be well countered and resolved. His main remedy is to distract the mind from anger by focusing on situations that detract the escalating tension away (Mulqueen). In this feature, Frank Kalman discusses the benefits of planning ahead despite the uncertainties typical to the future. In his submissions, Kalman explains how one can come up with an educated guess by realistically considering each determinant factor. Whereas even the most informed predictions fail occasionally, having a good plan is far much wiser an initiative than lacking plans at all. As Kalman asserts, even senior leaders fail on their predictions from time to time and therefore do not expect their subordinates to make perfect predictions. All that is required is a well researched plan to ensure an organization maintains its focus on success (Kalman). The CLO Media.com is an essential resource centre for all business persons. Besides orienting its users on matters business and empowering many to make smart decisions, the site also features updated business news from around the world. The site’s subscribers enjoy free learning materials such as magazines, which provide detailed reports and articles including those cited in this essay. Another consumer benefit for CLO Media users is that article writers are usually experts in the fields they contribute

Choose a company to do your research on Paper Example | Topics and Well Written Essays - 1500 words

Choose a company to do your on - Research Paper Example Starbucks considers six guiding principles in accomplishing its mission. These principles include providing an idyllic work atmosphere and equal opportunities to workers. In addition, Starbucks embraces diversity as a way to do business, applying maximum standards to sourcing, roasting, and unsullied delivery of coffee to its consumers. Moreover, Starbucks aims at, â€Å"developing enthusiastically satisfied consumers, contributing positively to the communities and also recognizing that success is necessary for profitability† (Starbucks Global Responsibility Report, 2013). Starbucks has evolved in its commitment and has grown to promote environmentally and socially dependable practices that have resulted to its success. Starbucks considers social and environmental responsibility as an essential part of neighborhoods, as well as, business. Starbucks grant loans to people in need and also lengthens its emphasis on a range of programs that sustain and support cultural diversity. Starbucks is committed to preventing workplace injuries through rules placed to ensure safety of its workers and consumers; for instance, the introduction of digital brewing equipment such as espresso machines at Starbucks has reduced burns in workers (Starbucks Global Responsibility Report, 2013). Employees and customers are one of the most essential resources to Starbucks. All employees at Starbucks are eligible for Starbucks benefits and health care package, on top of a preliminary wage which is over the minimum wage. Moreover, the company endeavors to tender environmentally-s afe products. Starbucks makes noteworthy contributions to the environment, charities, and the homeless and supports AIDS research. Financially, Starbucks has had solid returns and earnings. The Company has managed to maintain healthy operations whilst generating sufficient

Find the thesis analysis Essay Example | Topics and Well Written Essays - 1000 words - 1

Find the thesis analysis - Essay Example Hence, society recognizes man by his power of promise to others and woman’s presence signifies how and in what manner she should be handled. Her actions are mere reflection of her presence and she has been brought up to evaluate them for the sake of man. Thus, she is an artiste and a spectator of her actions. Therefore, her existence is replaced by her presence in case of appreciation only. ‘The surveyor of woman in herself is male: the surveyed female. Thus she turns herself into an object – and most particularly an object of vision: a sight.’ (p. 47). To summarize it, a woman’s actions represent her being and a man’s actions represent his expression. Throughout history, women have been the main theme of art. Artists of different eras, concentrated on women being viewed from various perspectives and diverse surveyors. The subject of nude paintings had its social connotation. Hence, social connotation of any piece of art was and still is; vitally considerable. Traditional nude oil painting period focused its subject towards nude image of a woman hence; these paintings were aimed for the pleasure of gaze. Although, these paintings seem modest in contemporary society, but similarity to them in artistic photographs of present day, cannot be overlooked. The common theme of secular painting era remained the same. ‘the subject (a woman ) is aware of being seen by a spectator’ (p.49). Thus, nude women were painted in a single moment depiction during renaissance. Moment of shame was the manifested theme. The traditional European nude paintings showed how women have been seen and judged. The foremost Adam and Eve, Susannah and the elders, Tintoretto and Susannah, woman looking at her nakedness, are all perfect examples of gaze for pleasure. However, Judgment of Paris introduced a new concept of beauty competency after assessing nude women. Berger has also described that nude art represents social and

TORT LAW- PROBLEM QUESTION Essay Example | Topics and Well Written Essays - 2000 words

TORT LAW- PROBLEM QUESTION - Essay Example This was the original negligent act, so the analysis must stem from this. Below is the analysis of the situation, with a conclusion that outlines the probable outcome. Since this action is one that is based upon negligence, the scenario will be analyzed using the elements of negligence – duty, breach, causation and damages. Duty The first element that must be examined in this action, and any other negligence action, is duty. As far as duty goes, there does not need to be privity between the parties – anybody who might be harmed because of the actions of the person causing the negligence is owed a duty, according to Donoghue v. Stevenson.1 This is particularly true when the harm is foreseeable.2 Therefore, if a person is reasonable, and is driving reasonably, then the harm cannot be said to be foreseeable. This would negate a person's duty. Whereas, previously, in English law, there must be some kind of privity between the tortfeasor and the victim, in that the victim an d the tortfeasor must have had some kind of prior relationship, the landmark case of Donoghue v. Stevenson3 altered this. In Donoghue v. Stevenson, the plaintiff, Donoghue, became ill after drinking ginger beer which had a slug in it. The justice in Donoghue proclaimed that individuals owed a duty to anybody who might be affected by their actions. Another case, Caparo v. Dickman4 states that the duty of care can be explained threefold - that the harm was reasonably foreseeable, that there was a relationship of proximity between the tortfeasor and the victim, and that it would be fair, reasonable and just to impose liability. So, as in the case of Overseas Tankship (UK) Ltd v Morts Dock and Engineering Co Ltd5, the defendants were not held negligent for a fire which broke out on the water, even though they knew that there was oil slipping below the dock onto the water and the defendants could not reasonably foresee that water would ignite. Moreover, proximity is also an issue, becaus e the harm caused must be proximate to the tortfeasor - Palsgraf v. Long Island Railroad Co.,6 is a case where there was not proximate cause between negligence on one end and an unforseeable victim on the other. In that case, the defendant was helping a woman onto a train and this woman had fireworks which exploded. This caused scales to fall on a distant bystander, and the court decided that the distant bystander’s injuries were not proximately caused by the defendant’s actions. On this ground, the client would prevail, because he acted reasonably in his driving, therefore, there was not a duty to Sheila, as the injury was not foreseeable. On the other hand, since he left 10 minutes late,he might have had a duty if there was an issue to where her brain injuries would have occurred with a ten minute delay. Breach Breach is the next element that needs to be looked at. Again, foreseeability is the key to a breach of a duty. The injury that occurs must be foreseeable.7 If the injury that occurred was not foreseeable, then there would not be a breach of duty.8 Again, this would rest upon whether or not the person was acting

Exercise can reduce the risk of various health problems Essay

Exercise can reduce the risk of various health problems - Essay Example According to CDC (2015), prevalence of obesity among adult citizens of USA is more than 34.9%, which represents more than 78.6 million victims. High blood pressure (hypertension) develops due to imbalanced Basal Metabolic Index (BMI) that exerts pressure on the heart and blood vessels. The imbalanced BMI exerts pressures and subsequently narrow the blood vessels that force the heart to generate excessive pressures to pump blood all over the body. CDC reports that the disease affects more than 67 million adults, which translates to over 31% of the American adult population (CDC, 2014). Chronic Kidney Disease compromises the ability of the kidney to perform its functions effectively. Diabetes, heart diseases, high blood pressure and overweight among other lifestyle diseases can cause CKD. Currently, the prevalence of CKD among American adults stands at 13.2% but projected to increase to 16.7% by 2030 (National Kidney Foundation, 2015). The three diseases have similar and related causes, so, physical activities prescribed to treat can also work to treat all. For adult patients suffering the diseases, a nurse can prescribe resistance, flexibility and endurance exercise (Rippe, 2013). Endurance exercise can last to about 60 minutes daily and intensity vary from 5-6 to 7-8 on a scale of 0-10. The exercise involves any activity that does not impose excessive orthopedic stress like walking, aquatic exercise ad stationary cycle exercise. Resistance activity can at a frequency of not less than 2days per week. Intensity measured on a scale of 0-10 can vary from 5-6 and 7-8. For flexibility exercise, a nurse can recommend a frequency of at least 2 days per week at an intensity of 5-6 on a scale of 0-10. The exercise involves any activity relating to stretches of major muscles (Rippe, 2013). A nurse can ensure cooperation of patients to the prescriptions by requesting for support of friends and families of the patients. A nu rse can also agree with patients

The Criminal Justice Policy the Last 20 Years Essay

The Criminal Justice Policy the Last 20 Years - Essay Example In many circumstances, this system has failed to hold offenders accountable, reduce crime, help the victims or even operate with efficiency (Ismaill, 2011, 152-9). The system has many ‘black box’ dealings which contribute too little evidence on the procedures of implementing the policies. Moreover, it has led to problems associated with risks, for instance, increase in crime rates, the victimization on community policing, continuing injustices and the inefficiencies in regards to its operation with information or evidence with less credibility. The criminal justice system has many failure points due to limited training provided for criminal justice officials, practitioners, the various agencies in which it operates and to the researchers (Mears, 2010, 61-9). Evaluation research would help the policymakers in making decisions on whether to design, adopt, reject or improve a given criminal justice policy. Â  The criminal justice system policies are costly. The politicians are lacking appropriate research evaluation strategies and thus could spend billions of dollars in policies that may not be needed by the people or just policies which may not operate as expected (Ismaill, 2011, 152-9). A policy based on research evaluation is a solid start for accountability of the system and reliance on strategies based on evidence (Mears, 2010, 61-9). This also forms a firm foundation for cost-effectiveness in the administration of justice, enables the offenders to be helpful members in the society, enhances the prevalence of justice, and helps in assisting the victims of injustice and the communities impacted on by criminal acts. The public and the policymakers always demand a criminal justice system which is credible, accountable and cost-effective. Â  The number of offenders has significantly risen over the last twenty years (Mears, 2010, 61-9).

Genetically Modified Food is bad Essay Example for Free

Genetically Modified Food is bad Essay The debate on whether genetically modified foods are safe for human consumption is marked with controversy in the political, social, academic, and economic fronts of our community. Proponents of genetically modified foods claim that it is the only viable solution to the food insecurity problem that is eminent in the global community (Roth, 2000). Some scientific research findings have claimed that genetically modified foods have substantial levels of safety for human consumption. Nevertheless, the long term health safety of genetically modified foods has never been confirmed (Atherton, 2002). Despite the numerous claims made by proponents of genetically modified foods, there has been not concrete evidence to qualify such claim, a factor that makes consumption of such foods a risk to the human health. Genetically modified foods have been evidently closely associated with some long term health complications (Atherton, 2002). According to available statistical evidence, the global community is witnessing an increase in the occurrences of terminal diseases such as obesity. This trend has been closely attributed to the ever increasing usage of genetically modified foods in the community (Roth, 2000). Records have shown that thousands of thousands of Americans have fallen victims of obesity. Indeed, this health problem has become an issue of national concern in the American society. According to scientist, the problem has been escalated by the common trends of Americans in using fast foods. This is because, such foods lack fiber components, which are crucial to the human body. Another reason given is that such foods contain high levels of energy, which are usually not necessary to the body. Therefore, genetically modified foods are no doubt a leading cause of the increasing numbers of obese people in the community. Although numerous scientific research finding claim substantial health safety for the consumption of genetically modified foods, no search has been conducted to qualify the potential long term health risk brought by such foods (Karlsson, 2003). It has been established that gene modification can result into totally different type of gene whose impact in the human body can not be predicted. Based on this reasoning it is certain that genetically modified foods cannot be claimed safe unless sufficient research has been conducted. Still on the question of safety is the fact that modified genes are commonly made using denatured toxins, which serve to make the foods more robust to infections (Roth, 2000). According to scientific claims, these toxins are in essence poisonous to the human body cells upon long term accumulation (Roth, 2000). In fact this is what has been identified as potential allergens in genetically modified foods which make some people susceptible to their consumption. In conclusion therefore, genetically modified foods are a potential risk to the sustainable health of the human community. We are no doubt experiencing the impact such have from the ever increasing illnesses such as cases of obesity in the community. Since the question of the long term safety of these foods to the human body are significantly eminent, biotechnology products should be regarded as an issue of concern for the long term social and economic development of the community. Just as is rightly claimed, with the available natural resources and modern technological advancements, the world is capable of supplying its population with sufficient food (Roth, 2000). Therefore, any claim of genetically modified foods being the only solution to the world food security is misleading. It only serves as an indication of ignorance and lack of concern for the sustainable future of the human community. References Atherton, K. (2002). Genetically Modified Crops: Assessing Safety. London: Taylor Francis. Karlsson, M. (2003). Biosafety Principles for GMOs in the Context of Sustain. International Journal of Sustainable Development and World Ecology, 10, 12-43. Roth, G. (2000). Between the Rows: Sideline View of the GMO Debate. Retrieved January 17, 2010, from http://biotech. cas. psu. edu/articles/between_the_rows. htm

Genre Analysis Essay Example for Free

Genre Analysis Essay For this rhetorical analysis I have done research on two electronics engineering documents commonly referred to as project proposals. The first project proposal that was reviewed was for Security Guard Monitoring Systems by Group Engineering Solutions (GES). The second proposal is a business-oriented document for Multi-Robot Manipulation and Maintenance for Fault-Tolerant Systems by Shanghai International Conference Center (SICC). The purpose of this rhetorical analysis is to identify various similarities and differences within the specified texts using Anne Beaufort’s (a linguist in the field of writing) five-knowledge domains: genre, subject matter, rhetoric, writing process, and discourse community. The attention of this rhetorical analysis will be mainly focused on the intended audience, context of the documents, writing structure and format, and each author’s appeal to Anne Beaufort’s rhetorical knowledge domain. The Shanghai proposal was written by an electronics engineer for viewers within several different qualifications and statuses. Apparently this proposal’s targeted audiences are people at the Shanghai Conference Center. The primary audience would consist of employees that are in the workplace genre of mechatronics and automation (MA), such as financers, operators, and managers. The second audience consists of those that may work in smaller sections of the field, such as maintenance workers, auditors, and supervisors. There are also audiences besides the primary and secondary audiences. Other potential audiences might include legislatures, product testers, and other smaller services within the field of engineering. This is evident through the description of the projects maintenance procedures. Someone has to test the machine and meetings must be held to discuss them. Unlike the Shanghai proposal the Group Solutions Engineer (GES) proposal has various audiences that don’t spread out to the same extent that Shanghai’s do. The project proposal by GES does not meet the expectations of business companies instead, their proposal meet expectations for good academics. This claim was easily identified at the beginning of text. They clearly stated that â€Å"Dr. Miguel Figueroa and Dr. Nayda G. Santiago† was receiving the proposal. Additional support to this claim was found through extended research on the two professors. The two professors are both neurologist which seemingly has nothing to do with engineering. This makes it apparent that the professors were teaching at a college or university during the proposal of this project. This also explains why they were the targeted audience (primary audience) for the proposal. The secondary audiences for the GES proposal are other university graduate students. Similar to Shanghai, the GES proposal also has a third audience except, these audiences consist of spectators and scouts. In other words, these viewers are graduate students from another university or managers out for potential employees. Moreover, Shanghai’s proposal contains several rhetorical aspects in is context. Shanghai’s proposal was obviously written in response to a company’s request for improved multi-robot systems. This demand was recognized because of the frequently used term referring to problems, errors, and system malfunctions. More specifically, they used the term â€Å"failure† more consistently than others throughout the paper. For instance, in part â€Å"a† of section five (V Multi- Robot Maintenance policy) the writer of this Shanghai proposal says â€Å"In this period†¦the failure rate of the robot is also increased. † Another aspect contained within the Shanghai proposal is on how they express time as an issue. The term â€Å"failure† also implies that there is a time limit for this project proposal. It is relevant to assume that this project proposal was in the process of being developed during the time that the multi-robot machines were failing to operate accordingly. One can also tell that demand for the proposal was growing by reading the maintenance policy section. They take previous robot failures into considerations and develop loop holes to overcome it. Although the company that the proposal was written for isn’t mentioned in the document, it is easy to see that this proposal was written in response to some company’s policy. Unlike Shanghai’s proposal, the GES proposal does express who the proposal was written in response to. GES proposal was written in response to the request of the University of Puerto Rico (title page). Another contextual aspect in which differs from Shanghai’s proposal is the time constraint that is also posed on their proposal. GES makes it easier to recognize that they are working in a timely manner. They clearly state â€Å"A work breakdown structure has been created in which all members†¦work in two variables: time and personnel† (section 1. 3). This evidence arises from the fact that the group of graduate students working on this proposal are attempting to fulfill the requirements for the project. This evidence is also apparent because of diagrams and charts used to show how much the project proposal has progressed (section 2. 6). In addition to sections 2. 6, section 2. 7 gives explicit detail, also using diagrams and charts, on the â€Å"work breakdown structure. This section displays the tasks assigned to each genre of the project such as, oral presentation, software prototype, web application, and final report. The work is divided evenly amongst the group to ensure that they have successfully completed the requirements relative to the audiences’ values which will, later on, be discussed in further detail. In addition to the contexts (frameworks) of the proposals, there are several similarities in both GES and Shanghai’s writing structures and formats. The first similarity located in the proposals is often used in writing books such as literature, political science, and algebra. Both proposals use a wide range of bold letters, titles, and numbers. They also use titled numbers or subheadings, bullets, and roman numerals. Even though these writing style are incorporated in both project proposals, GES uses titled numbers, subheadings, and bullets (even checks) more frequently than Shanghai’s proposal. Shanghai’s proposal repeatedly uses roman numerals, and subheadings with starting letters (for example; B. Robot Failure). Both seem to be an effective approach to formatting project proposals. Moreover, abbreviations are also used quite frequently throughout the proposals. Like GES, Shanghai makes an effort to use abbreviations to make it less difficult for readers to comprehend. However, their attempt in doing so has obvious flaws that can potentially puzzle the reader and shorten the number of intended audiences. For example, â€Å"Weibull distribution depicts the decreasing-failure-rate (DFR)†¦period of the bathtub curve† (section B: Robot Failure). The proposal tells what each letter in the acronym stands for, but it does not define the abbreviation as a whole whereas, GES proposal doesn’t give an explicit description of each term, but defines it completely. Another method of writing noticed within the proposals is the inclusion of references at the end. These references often consists of others documents that helped produce the current one. It is apparent that references are commonly used in any form of written documents regardless of its field or genre. Adding to the structure and formatting, both proposals present several rhetorical features relative to Anne Beaufort’s rhetorical knowledge domain (ethos, logos, and pathos). The GES proposal puts most of its efforts into establishing its credibility (ethos). In the personal biography section of their proposal they give explicit detail about their background experiences in their field of study such as, software and hardware engineering. The proposal also provides charts and graphs of estimated costs which show that they are the best team to be chosen for the project. It also shows that they are prepared for real life situations. Shanghai’s proposal does not focus the entirety of its text on ethos, because most of its audiences are professionals within their company. There is no evidence to prove their experience in the field however; the credibility that is provided in the document consists of only charts and drawings that show that they will likely have effective productivity. These graphs and charts also help the company see the approach taken to improve the systems. Moreover, both proposals take consideration in establishing logos. The charts and graphs each proposal uses to establish credibility is also used to establish logic. These charts and graphs are used to support their claim that they meet all the required policies for the completion of the project. Pathos is also used widely in Shanghai and GES proposals. As mentioned earlier both proposals are relevant to the audiences common values (end of page 3). These values are expense, time, proficiency, and development. The charts and graphs used to support the ethos and logos in each proposal are also used to support this claim. They provide a description of estimated cost, efficiency and productivity, and give a timely description of the projects progression. The wide-ranging of appeal to these values allows for each proposal to be very persuasive while passing on factual statistics. Most project proposals are done similar to Shanghai’s and Group Engineering Solutions (GES) proposals. These two documents contain several similarities and differences in their rhetorical features. Although both texts may differ in their proposal method, they both have the same goal. They were meant to convince the reader that they were the most fit group or company for the completion of the project proposal. After completing this rhetorical analysis I realize the significance in writing in the specific genre. Each project proposal reflects positively according to the necessity of the request.

Causes of Cardiovascular Disease | Literature Review

Causes of Cardiovascular Disease | Literature Review 2 Abstract 3 Introduction 3.1 Cardiovascular Disease Cardiovascular disease (CVD) is the broad class of diseases that involves the heart or/and blood vessels. CVD includes atherosclerosis, heart valve disease, arrhythmia, heart failure, hypertension, endocarditis, diseases of the aorta, disorders of the peripheral vascular system, and congenital heart disease [1]. However, atherosclerosis accounts for the major part of CVD (up to xx%), and sometimes CVD is misleading used as a synonym for atherosclerosis [REF]. Because atherosclerosis is the underlying disease of several CVD, part of patients, where one diagnosis of CVD became manifest, may present with further co-morbidities, especially other diagnosis of CVD are common. However, the portion of patients with co-morbidities is depending on the baseline disease [2-4]. For example 40-60% of patients with Peripheral Arterial Disease (PAD) also have coronary artery disease (CAD) and cerebral artery disease, but only 10-30% of patients with CAD have also PAD (Figure 1) [2, 4]. Further, the severity of cardiovascular co-morbidities correlates well with each other[5-7]. CVD is today responsible for ca. 30% of all deaths worldwide [8], while heart disease and stroke are the leading causes of mortality and disability in developed countries [9]. Although the mortality rates of CVD has a considerable variation across countries (xx% in xx to xx% in xx) [10], a common trend of increasing rates has been observed worldwide. Before 1900, infectious diseases and malnutrition were the most common causes of death throughout the world, and CVD was responsible for The economic burden and the public health costs are mainly driven by CVD. In terms of combined morbidity and mortality, 148 million Disability-Adjusted Life-Years (DALYs) were lost worldwide (2002), which represents about 10% of all lost DALYs [REF]. In 2008, CVD costs about 192 billion Euros a year alone in the European Union, which results in a per capita cost of 391 Euros [13]. 3.1.1 Atherosclerosis Atherosclerosis is the most frequent and important pattern of Arteriosclerosis, other forms of Arteriosclerosis are Mà ¶nckeberg medial calcific sclerosis and Arteriolosclerosis, which vary in pathophysiological and clinical presentation [14]. As described above (3.1), atherosclerosis is the leading cause of death (up to 30%) in developed countries and represents the major portion of CVD. Atherosclerosis (literal origin from Greek: athero = â€Å"gruel or paste†; sclerosis = â€Å"hardness†) is defined as â€Å"thickening and loss of elasticity of arterial walls† and describes a process, where fatty substances, cholesterol, cellular waste products, calcium and fibrin building up in the inner lining of arteries [14]. These intimal lesions are called â€Å"atheromas†, â€Å"atheromatous† or â€Å"fibrofatty plaques†, which lead into an obstruction of vascular lumens and weakness the underlying media. Even within a given arterial bed, lesions or stenoses due to atherosclerosis tend to occur focally, typically in certain predisposed regions. 3.1.1.1 Pathogenesis of Atherosclerosis Due to overwhelming importance of atherosclerosis, enormous efforts have been spent to discover its cause over the last few decades. Today, the currently accepted concept, so called â€Å"the response to injury hypothesis†, considers atherosclerosis to be a chronic inflammatory response of the arterial wall initiated by injury to the endothelium [15]. Furthermore, lesion initiation and progression are sustained by interaction between lipoproteins, macrophages, T-lymphocytes, and the normal cellular constituents of the arterial wall. This process of developing atherosclerosis, which typically lasts over a period of many years usually many decades, can be divided into several consecutive steps, as illustrated in Figure 2 [REF]. Parallel, a morphological change is observed within the artery wall, where fatty streak represents the initial morphological lesion, even so the pathogenesis has started quite earlier with a chronic endothelial injury [REF]. Figure 2: Illustration of the Pathogenesis and Morphological Development of Atherosclerosis. SMC: Smooth muscle Cell; 6 ÃŽ ¼m thick histology slices of coronary arteries stained with Movats pentachrome. A: pathological intimal thickening with a â€Å"fatty streak†; B: pathological intimal thickening with a macrophage infiltration; C: early fibroatheroma with neoangiogenesis; D: fibroatheroma with thin fibrous cap and a healed rupture; E; late fibroatheroma with a sheet calcification. * demarks necrotic scores. Histology performed by CVPath Laboratory, Maryland, MD. The below described steps of the pathogenesis of atherosclerosis shouldnt been seen as a separated processes. They are interconnected and occur parallel. Further, several mechanism of vicious circles are described [REF]. However, the stratification into the flowing six steps helps to understand the complex pathogenesis and represents the current understanding: (1) Chronic Endothelia Injury As the earliest step in the pathogenesis of atherosclerosis, endothelial activation and chronic injury, also known as endothelial dysfunction, have been described [16]. The following factors contributed in different extent to endothelial dysfunction and are partly known as traditional risk factors for atherosclerosis [17]: advancing age, dyslipidemia, hypertension, increased levels angiotensin, insulin resistance and diabetes, smoking, estrogen deficiency. Several biochemical pathways have been described for those factors increasing the endothelial dysfunction. Other factors like hyperhomocysteinemia, possible infection and especially low or oscillatory shear stress are still discussed whether they significantly contribute to endothelial dysfunction [18-22]. The phenotypic features of endothelial dysfunction are described as the reduced vasodilator and increased vasoconstrictor capacity, an enhanced leukocyte adhesion, an increase of pro-thrombotic and decrease of fibrinolytic activi ty, and an increase in growth-promoting. (2) Accommodation and Oxidation of Lipoproteins In addition and due the endothelial dysfunction lipoproteins, especially low density lipoprotein (LDL), sequestered from plasma in the extracellular space of the arterial intima. Beside the extent of endothelial dysfunction, this process is depending on the concentration of LDL in the blood circulation [23]. Even so several mechanisms have been proposed for transport of LDL into the arterial intima including vesicular ferrying through endothelial cells, passive sieving through endothelial-cell pores, passage between cells, its not finally understand. However, strong evidence exist, that the accommodation of LDL in the arterial intima is not only a passive effect by a â€Å"leaking† vascular endothelium [REF]. Part of the lipoproteins that have entered the arterial wall stay there and are modified subsequently. Especially the modification of the lipoproteins has a trapping function for die selbigen [24]. The most common modification is the oxidation of lipoproteins, giving rise to hydroperoxides, lysophospholipids, oxysterols, and aldehydic breakdown products of fatty acids and phospholipids. But further modification like fusion of lipoproteins, proteolysis, lipolytic degradation and glycation are well known [25]. Such modified lipoproteins or particles of the modification process have inflammatory potential and trigger a local inflammatory response responsible for signaling subsequent steps in the atherogenesis. It includes a further increased endothelial dysfunction, which may cause a vicious circle of LDL accumulation, and activation of various cell types [24, 26, 27]. (3) Migration of Monocytes and Transformation into Macrophages/Foam Cells More important, the inflammatory response induces migration of leukocytes such as monocytes or lymphocytes into the lesion. Leukocytes are attracted by chemoattractant factors including modified lipoprotein particles themselves and chemoattractant cytokines depicted by the smaller spheres, such as the chemokine monocyte chemoattractant protein-1, interleukin 1 (IL-1) or tumor necrosis factor alpha (TNF-ÃŽ ±) produced by vascular wall cells in response to the inflammatory process [REF]. The activated arterial endothelial cells express a number of adhesion molecules and receptors on their surface, which participate in the recruitment of leukocytes from the blood to the nascent lesion [REF]. Macrophages are a key player in atherogenesis [27]. They develop from recruited monocytes, which migrated as described above into the lesion. In the mediator stimulated process of maturation, those macrophages become lipid-laden foam cells by uptake of lipoprotein particles through receptor-mediated endocytosis [REF]. The accumulation of lipid in the macrophages results in the apoptosis and necrosis, which lead first to a boosted expression and secretion of inflammatory cytokines and second to a release of their lipid excess into a necrotic lipid-core [REF]. Macrophages further produce enzymes, such as metalloproteinases, that degrade the extracellular matrix and lead to instability of plaques [REF]. (4) Adhesion of platelets and Release of SMC activating factors The inflammatory process, especially triggered by the necrosis of the foam cells, microscopic breaches in endothelial integrity may occur. Platelets adhere to such sites of limited endothelial denudation owing to exposure of the thrombogenic extracellular matrix of the underlying basement membrane and form microthrombi. Although most of the arterial mural microthrombi resolve without any clinical manifestation, they lead indirectly to lesion progression by pro-fibrotic stimulation [REF]. The platelets, activated by adhesion, release numerous factors that promote a fibrotic response, including platelet-derived growth factor (PDGF), fibroblast growth factor (FGF), insulin-like growth factor 1 (IGF-1), and transforming growth factor alpha (TGF-ÃŽ ±) [28-30]. Thrombin itself generates fibrin that has a pro-fibrotic stimulus [28]. (5) Migration and Proliferation of SMCs The pro-fibrotic response includes first the migration of SMC from the media of the arterial wall, through the internal elastic membrane, and the accumulation within the expanding intima of the arterial wall. Second, stimulate the proliferation of SMC, which is responsible to form the bulk of the advanced lesion. Another part of the advanced lesions is an increased extracellular matrix. TGF-ÃŽ ± and other mediators stimulate the interstitial collagen production by SMC. These mediators may arise not only from neighboring endothelial cells or leukocytes (a paracrine pathway) but also from the same cell that responds to the factor (an autocrine pathway). Together, these alterations in smooth-muscle cells, signaled by these mediators acting at short distances, can accelerate transformation of the early lesion (fatty streak) into a more fibrous SMC and extracellular matrix-rich plaque. (6) Enhanced accumulation of lipids, collagen and proteoglycans The formation of a complex atherosclerotic lesion is characteristic by an extent remodeling process. Further foam cells within the expanding intimal lesion perish, while they phagocytose more and more lipids. The fibrotic cap between the so arisen lipid-rich necrotic core and the vascular lumen may vary in thickness and allows the classification of â€Å"thin cap fibroatheroma†, which correlates with a higher risk for acute luminal thrombosis [REF]. The production of extracellular matrix, as well plaque evolution and complication can be stimulated by diverse growth factors or cytokines like IL-1 or TNF-ÃŽ ±, and can be inhibited by other cytokines (e.g. interferon alpha (IFN-ÃŽ ±)) [REF]. As atherosclerotic plaques advance, they show intimal arterial calcification [REF]. The same proteins, which can be found in bone, are also localize in atherosclerotic lesions, e.g., osteocalcin, osteopontin, and bone morphogenetic proteins [31]. Both, passive and active models are discussed for the development calcification [32]. SMC can, promoted by several cytokines (e.g. transcription core binding factor ÃŽ ±1), acquire osteoblast-like characteristics and secrete bone matrix [33]. These examples illustrate how the pathogenesis of atherosclerosis involves a complex mix of mediators that in the balance determines the characteristics of particular lesions [REF]. 3.1.1.2 The Role of Inflammation The role of inflammation is central, while those inflammatory mechanisms mediate initiation, progression, and the complications of atherosclerotic lesions [26, 34]. Through the inflammatory process, arterial endothelial cells begin to express on their surface selective adhesion molecules that bind various classes of leukocytes, especially monocyte and T lymphocyte which are found in early human and experimental atheroma [REF]. After monocytes adhere to the endothelium, they can first migrate in the intima, largely stimulated by chemokines; and second transform into macrophages and avidly engulf lipoproteins, largely oxidized LDL [REF]. Although the phagocytosis of potentially harmful lipid particles by macrophages and subsequently the transformation into foam cells has an initially protective, this process involves further expression and secretion of inflammatory chemokines like Interleukin (IL)-1, Monocyte Chemotactic Protein (MCP)-1 or Tumor Necrosis Factor (TNF)-ÃŽ ±. Those enhanc e the inflammatory reaction and enable the further migration of leukocytes into the lesion [REF]. Macrophages also produce toxic oxygen species that cause additional oxidation of the LDL in the lesions, and they elaborate growth factors that may contribute to SMC proliferation [REF]. Similary, T lymphocytes (both CD4+ and CD8+) are also recruited to the intima by chemo-attractants. Cross-talk between macrophages and T cells induces a chronic inflammatory state regarding cellular and humoral immune activation characteristics. This state of a chronic inflammation leads also to the next observed steps in the development and progression of atherosclerosis. Thus, it stimulates the migration and proliferation of smooth muscle cells (SMC), as well the proliferation of vascular endothelial cells in the lesion. Through fibrogenic mediators, released from activated leukocytes and intrinsic arterial cells, the replication of SMCs is getting enhanced and contributes to elaboration by these cells of a dense extracellular matrix characteristic of the more advanced atherosclerotic lesion. 3.1.1.3 Vasa Vasorum and Neo-Angiogenesis The vasa vasorum of the aorta is as a plexus in the wall of artery of microvessels, which are functional endarteries [35, 36]. They either originate from major branches, originate from the main lumen of the aorta or drain in concomitant veins [37]. These vessels allow the humoral communication between intravascular lumen, vessel wall and adventitial layer of large arteries including oxygen and nutrients supply [REF]. Several studies demonstrated that hypoxia [38], cytokines (e.g. vascular endothelial growth factor) [39, 40], pro-angiogenic factors (e.g. hypertension or hypercholesterolemia) stimulate the growth of the vasa vasorum [41]. Those increased microvascular network may contribute to inflammation and lesion complications in several ways. First, the vasa vasorum provides an abundant surface area for leukocytes trafficking and may serve as the portal of entry and exit of white blood cells from the established atheroma. Microvessels in the plaques may also furnish foci for intraplaque hemorrhage. Like the neovessels in the diabetic retina, microvessels in the atheroma may be friable and prone to rupture and can produce focal hemorrhage. Such a vascular leak leads to thrombosis in situ and thrombin generation from prothrombin. In addition to its role in blood coagulation, thrombin can modulate many aspects of vascular cell function, as described above. Atherosclerotic plaques often contain fibrin and hemosiderin, an indication that episodes of intraplaque hemorrhage contribute to plaque complications. Multiple and often competing signals regulate these various cellular events. Increasingly, we appreciate links between atherogenic risk factors, inflammation, and the altered behavior of intrinsic vascular wall cells and infiltrating leukocytes that underlie the complex pathogenesis of these lesions. The present data indicate that vasa vasorum neoangiogenesis and atherosclerosis are seemingly inseparably linked, triggered and perpetuated by inflammatory reactions within the vascular wall. 3.1.1.4 Risk Factors for Development of Atherosclerosis Local shear stress In the coronary circulation, for example, the proximal left anterior descending coronary artery exhibits a particular predilection for developing atherosclerotic disease. Likewise, atherosclerosis preferentially affects the proximal portions of the renal arteries and, in the extracranial circulation to the brain, the carotid bifurcation. Indeed, atherosclerotic lesions often form at branching points of arteries, regions of disturbed blood flow. Age, Gender, HTN, HLP, DM, Smoking, Race/Ethnicity, 3.1.1.5 Atherosclerosis of the Aorta In the characteristic distribution of atherosclerotic plaques in humans the abdominal aorta (Fig. 11-8) is usually much more involved than the thoracic aorta, and lesions tend to be much more prominent around the origins (ostia) of major branches. In descending order (after the lower abdominal aorta), the most heavily involved vessels are the coronary arteries, the popliteal arteries, the internal carotid arteries, and the vessels of the circle of Willis. Vessels of the upper extremities are usually spared, as are the mesenteric and renal arteries, except at their ostia. Nevertheless, in an individual case, the severity of atherosclerosis in one artery does not predict the severity in another. In an individual, and indeed within a particular artery, lesions at various stages often coexist. 2009_Dijk_The natural history of aortic atherosclerosis_A systematic histopathological evaluation of the peri-renal region.pdf 3.1.2 Peripheral Arterial Disease Peripheral Arterial Disease (PAD) is caused by atherosclerosis and represents the most common cause of lower extremity ischemic syndromes in developed countries [42]. Symptoms of PAD are variable including pain, ache, hair loss, thickened nails, smooth and shiny skin, reduced skin temperature, cramp, muscle atrophy, or a sense of fatigue in the muscles. Because of the variability of symptoms, the diagnosis of PDA is frequently missed [43]. In addition, the major part of patients with PAD is asymptomatic [REF]. Beside these diagnostic challenges, PAD affects a large and increasing numbers of patients worldwide. Round 30 million people are diseased in worldwide, but of those only 10 million patients are presenting with symptoms [44]. Further, the prevalence is increasing with age [6, 45], while the prevalence is 10% at the age of 60 years [46]. Association to mortality!!! 3.1.2.1 Pathogenesis of Peripheral Artery Disease The leading cause of PAD is atherosclerosis, especially in older patients (>40 years) and at the lower extremities [42]. Other, but rare causes of PAD include embolism, vasculitis, fibromuscular dysplasia, entrapment, and trauma. Atherosclerotic lesions, which are segmental and cause stenosis, are usually localized to large and medium-sized vessels. The pathology of these lesions is based on atherosclerotic plaques development, as described above (xxx). The primary sites of involvement are the abdominal aorta and iliac arteries (30% of symptomatic patients), the femoral and popliteal arteries (80-90%), and the more distal arteries (40-50%) [REF]. Atherosclerotic lesions have been predominantly observed at arterial branch points. These may be explained by altered shear stress [REF]. However, the involvement of the distal and smaller arteries is more common in elderly individuals and patients with diabetes mellitus [REF]. 3.1.2.2 Risk Factors for Peripheral Arterial Disease While atherosclerosis is the major underlying condition of PAD, the risk factors for PAD are essentially the same as those for other form of atherosclerosis (like e.g. CAD), see Table 1 [47-50]. However, the risk factors smoking and diabetes may have even greater effect for PAD as compared for CAD [51]. Risk Factors Increased risk for PAD Hypercholesterolemia 1- to 2-fold (low) Homocysteinemia 1- to 3-fold (moderate) Hypertension 1- to 3-fold (moderate) Smoking (current and past) 2- to 4-fold (high) Diabetes mellitus 2- to 4-fold (high) Table 1: Risk Factors for Peripheral Arterial Disease 3.1.2.3 Clinical Presentation of Peripheral Artery Disease PAD affects more often the lower extremities (xx times more often than upper extremities) [REF]. The most common symptom of PAD is intermittent claudication, which is defined as presence of pain, ache, cramp, numbness, or a sense of fatigue in the muscles. Those symptoms occur during exercise and are relieved by rest, as result of the increased muscle ischemia during exercise caused by obstruction to arterial flow. Patients with PAD in the lower extremities resulting in ischemia may range in presentation from no symptoms to limb-threatening gangrene. Two major classifications based on the clinical presentations are established, the Fontaine and the Rutherford classification. While the more simple Fontaine classification consists of four stages (Table 2) [52], the Rutherford classification has four grades (0-III) and seven categories (0-6). Asymptomatic patients are classified into Rutherford category 0. Any patient with claudicants are stratified into Rutherford grade I and divided into three categories based on the severity of the symptoms. If patients have pain at rest, they belong to Rutherford grade II and category 4. Any patient with tissue loss are classified into Rutherford grade III and categories 5 and 6, based on the significance of the tissue loss [4]. These two clinical classifications can be translated into each other according to Table 2. Fontaine Classification Rutherford Classification Stage Clinical Grade Category Clinical I Asymptomatic 0 0 Asymptomatic IIa Mild claudication I 1 Mild claudication IIb Moderate to severe claudication I 2 Moderate claudication I 3 Severe claudication III Ischemic rest pain II 4 Ischemic rest pain IV Ulceration or gangrene III 5 Minor tissue loss III 6 Major tissue loss Table 2: Classification of Peripheral Arterial Disease based on the Fontaine Classification in Comparison the Rutherford Classification In the Framingham Offspring Study, the prevalence of PAD was determined in 1554 males and 1759 females from 1995 to 1998.55 The mean age was 59 years. PAD, defined as an ankle-brachial (blood pressure) index (ABI) of ABI Severity of PAD The physician also queried the participant about symptoms of intermittent claudication using a standardized questionnaire [53]. 3.2 Local Adipose Tissue Depots 3.2.1 Variability of Adipose Tissue 3.2.1.1 Anatomy and Morphology SACK: Epicardial, mesenteric, and omental fat all share the same origin from the splanchnopleuric mesoderm associated with the gut.11 Pericardial fat (pericardial adipose tissue [PAT]) is defined as epicardial fat in all these possible locations plus paracardial fat.14 Paracardial fat is situated on the external surface of the parietal pericardium within the mediastinum and has alternatively been termed mediastinal fat.15 Paracardial fat originates from the primitive thoracic mesenchyme, which splits to form the parietal (fibrous) pericardium and the outer thoracic wall.16 Epicardial adipose tissue is supplied by branches of the coronary arteries, whereas paracardial fat is supplied from different sources including the pericardiacophrenic artery, a branch of the internal mammary.17 Lipolysis and lipogenesis have not been measured directly in human epicardial fat. Based on approximately 2-fold higher rates of lipolysis and lipogenesis in guineapig epicardial fat than other fat depots, Marchington et al18,19 proposed that EAT serves to capture and store intravascular free fatty acid (FFA) to protect cardiomyocytes from exposure to excessive coronary arterial FFA concentrations during increased energy intake and, at other times, to release FFA as an immediate ATP source for the myocardium during periods of need. Epicardial fat and the myocardium are contiguous. Islands of mature adipocytes are more frequ ent within the subepicardial myocardium of the RV than the LV13 and may act as more readily available, direct sources of FFA for cardiomyocytes. The thickness of the wall of the right atrium is about 2 mm; the left atrium, 3 to 5 mm; the RV, 3 to 5 mm; and the LV, 13 to 15 mm.20 Possibly, FFAs could diffusebidirectionally in interstitial fluid across concentration gradients from epicardial fat into the atrial and RV walls where EAT predominates and vice versa, but this process in the LV wall can be questioned because the diffusion distance is much longer. Peri-vascular adipose tissue is defined as any adipocytes, which are located close to the vascular wall and has the possibility to secret their biomarkers into the vasa vasora of the wall (see 3.2.1.2). 3.2.1.2 Secretion of Biomarkers by Adipose Tissue Adipose tissue is known to have more functions than lipid storing. Adipose tissue secrets biomarkers and serves as an endocrine organ. Beside hormones, it secrets also different inflammatory cytokines and chemokines. The amount of adipose tissue were associated to xxx, xxx, xxx (FRAMINGHAM?!). Especially peri-vascular adipose tissue like epicardial or visceral adipose tissue demonstrated higher expression of inflammatory biomarkers compared to other adipose tissue depots in the body [REF]. Beside the systemic effect of the secreted cytokines and chemokines, also a local effect/paracrine is hypothesied. Biomarkers secreted of peri-vascular adipose tissue reach over the vasa vasora of the major arteries their adventitia, media, and intima. Therefore it might be involved in the inflammatory process of atherosclerotic plaque. Further, a local effect can be thought by direct diffusion. 3.2.2 Association of Adipose Tissue to Cardiovascular Disease 3.2.2.1 Atherosclerosis 3.2.2.2 Peripheral Arterial Disease 3.2.3 In-Vivo Assessmentof Adipose Tissue 3.2.3.1 Traditional Measures * BMI and WC [54] 3.2.3.2 Imaging-based Assessment * dual energy X-ray absorptiometry (DXA) [55] * magnetic resonance imaging (MRI) [56, 57] * ultrasound [58] * multi-detector computed tomography (MDCT) [59, 60] 3.3 Framingham Heart Study 3.3.1 Historical Origin of the Framingham Heart Study Infectious diseases were prior to World War II the major burden for public health. But through a greater microbiological knowledge and improved sanitation, the morbidity and mortality of infectious disease decreased continuously. When penicillin was introduced in 1942, a dramatic reduction was made in the prevalence and incidence of infectious diseases, especially by controlling tuberculosis and pneumococcal pneumonia [REF]. Replacing infectious diseases, public health was challenged by a mounting epidemic of CVD starting in the 1940s. With World War II over the alarming rise of CVD became increasingly evident. In the United States, 30% of all men developed CVD before reaching the age sixty. The prevalence of CVD was twice of cancer by 1950 and had become the leading cause of death [REF]. Even so the available statistic data from around the world was often crude and inaccurate, it clearly demonstrated a worldwide atherosclerotic CVD problem. Furthermore there was no known treatment to prolong life and to reduce mortality. Added to these distresses was the fact that little was known about etiology, pathogenesis and epidemiology of CVD. The big gap between the enormous public health burden of CVD on the one site and the little understanding of this disease on the other site increased drastically the need for action. At this time, some believed a primary preventative approach was more promising than a search for cures [Dawber, Thomas R. (1980), The Framingham Study: The Epidemiology of Atherosclerotic Disease, Cambridge, Mass.: Harvard University Press.], while the secrets of the etiology of CVD and subsequently for treatment were not being uncovered by basic laboratory and clinical research. Some of these prevention-minded individuals occupied positions of influence and were able to translate their beliefs into actions. The key was to develop a preventive approach, where first of all the characteristics of the host and environment, which lead to the early appearance of the disease, had to be determined. In particular, preventable or modifiable predisposing factors had to be identified. If a practical preventive approach was developed, the hope was that doctors and public health officials would adopt it and so have a widespread impact on the reduction of CVD-based morbidity and mortality. Accordingly to the preventive approach, the Framingham Heart Study was designed given the charge to identify these modifiable characteristics of host and environment for CVD. 3.3.2 Initiation of the Framingham Heart Study By the mid 1940s several striking studies were conducted with an examples epidemiological approach in the fields of nutritional imbalance, metabolic disorders, occupational hazards, accidents, cancer and rheumatic fever under principle investigators (PI) Drs. Dawber, Meadors and Moore [REF, Dawber, Meadors and Moore 1951]. In common, an association between the circumstances and the disease could be identified with-out knowledge of the precise etiology. One of those studies was performed by Dr. John Snow in 1936. He demonstrated that cut-ting off the water supply from contaminated wells, despite incomplete knowledge of the pathogenesis of the disease, stopped cholera. He observed on the one hand the source of the water supply and on the other hand the time and place where the disease occurred. He sufficiently pinpointed based on his observations the major environmental factor for cholera. Further investi