Lung Cancer The Number Of Diagnostics And Deaths Of Cancer

Lung cancer leads with both the number of diagnostics and deaths of cancer. Although it is typically caused by smoking, Lauren developed lung cancer because of the harmful chemicals and radiation that she was exposed to on a daily basis. She began to experience a cough that would not go away, chest pain, wheezing, shortness of breath, and even coughing up bloody phlegm. Some patients are lucky. Cancer is caught in the first or second stage, but because the symptoms are not common or regular until a later stage, it sometimes goes undetected until it is too late. Lauren was diagnosed with stage 3 because she was unable to detect any problems early on. In Jane E. Brody’s article, â€Å"Screening, and Enabling, Smokers† she interviewed Dr. Russell P. Harris, who stated, â€Å"’At best,’ he said, ‘screening might reduce lung cancer deaths by 8,000 a year. But in the year 2000 alone, smoking cessation reduced lung cancer deaths by 70,000’† (B rody 1). Cancer is not a death sentence, and one can often prevent it from developing in extremely simple ways. If it is not prevented, cancer patients go through a number of symptoms that drastically affect their life, and their loved ones’ lives. The first symptom begins with drowsiness and loss of energy. Cancer takes a toll on the body. Fatigue is extreme tiredness and drowsiness, and is caused by activities that require an abundant amount of energy to participate in and to heal from. In this case, chemotherapy is an extremely tiring treatment,Show MoreRelatedCancer : The Leading Cancer Killer1159 Words   |  5 PagesEveryone in the world today has been impacted by cancer in some way. Lung cancer is the leading cancer killer in both men and women in the United States. In 1987, it surpassed breast cancer to become the leading cause of cancer deaths in women. Lung cancer causes more deaths than the next three most common cancers combined (colon, breast and pancreatic). 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Liquid biopsies have been recent blood based tests that analyze circulating tumor DNA (ctDNA) or circulating tumor cells (CTCs) in lieu of the standard tissueRead MoreSmokers in Great Britain and the United States1533 Words   |  7 Pagesattitudes towards the habit. Some countries have strong negative altitude against smoking while others do not. In both America and United Kingdom, smokers are seen as social pariahs while in Hong Kong, the altitude towards smokers is not strict (Diagnostic and statistical manual of mental disorders, 2013). However, the only one similar attitude between all the three countries is that they all disapprove smoking. This paper will explore the statement Smokers in Great Britain and the United StatesRead MorePatients With Pancreatic And The Prognosis Of Lung Cancer Patients1368 Words   |  6 Pagespancreatic (1), hepatocellular (2), or breast (3) cancers, comorbidity caused by diabetes mellitus (DM) contributes to diminished long-term survival. 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Managing Stress On A Working Nurse At A Local Hospital

1. Assume you are in charge of socializing the newly hired nurses at a local hospital. What steps would you take to ensure that they understand the hospital s organizational culture? How would you help them understand how to manage stress on a daily basis so as to prevent burnout later in their careers? Explain. As the person in charge of ensuring new hires embraced and became a part of the local hospital’s culture I would implement the three stages of socialization, the Anticipatory, Accommodation and Role management studied this week as a checklist with the following steps. I. Anticipatory a. Ensure the newly hired nurses have all the information needed to describe what it will be like to work at the hospital. b. Make†¦show more content†¦After all an organization is only as good as the people it keeps. f. Also follow up with the new nurses’ manager and mentor to ensure they have a successful integration within the hospital and understand the crucial role they have. III. Role Management g. Ensure the employee is aware of the benefits provided by the company related to time management and work/life balance h. Educate and provide the newly hired nurses with information related to work place conflict resolution. I would help the employee understand how to deal with on the job stress and prevent burnout by making them aware of all the benefits the hospital provide to ensure good balance between work and home life. I would also make the aware that we are a big family and we have employee assistance program for them and the families where they can contact and obtain support as needed. I would encourage them to spend time with their family and love ones and how beneficial it is when it comes to stress. Finally I would suggest to them have an hobby and stay engage in the hospitals wellness program and maintain a healthy lifestyle. 2. Hospital environments are more stressful in nature than the work environments found in many other organizations. What are some of the unique challenges that hospitals face when attempting to create a supportive organizational culture that helps

Fundraising Presentation Free Essays

string(79) " activities which your organization wants to carry out over the next year\? l\." Fundraising Presentation, Gyumri April 15 –April 16, 2013 I. The Basics of Fundraising a. What is fundraising? i. We will write a custom essay sample on Fundraising Presentation or any similar topic only for you Order Now Raising money for a cause or project ii. Includes building a prospect pool, asking for money or in-kind donations, meeting donor expectations, clearly defining needs and resources, thanking the donors (stewardship), events, public relations, and monitoring and evaluation iii. Most important aspect: relationships, which can take time to develop b. Why is funding diversity important? iv. Chair example: If a chair only has one leg, it is unstable and will fall over. The more legs a chair has, the more stable it becomes. Same for an organization, if an organization has a sole funder, their success is determinant upon the stability of that relationship and continued funding. The more funders an organization has, the more stable they are. If one funder pulls their support, the organization does not collapse. c. Think about your organization for which you are fundraising (hand out index cards for everyone to write their answers) v. What is their mission? vi. What is their vision? vii. Why do they exist? viii. What would happen if this organization didn’t exist? x. Why are you here? x. Can everyone from your organization, your community, your beneficiaries, your donors, etc clearly define the mission of the organization and is it basically the same? xi. Is the financial support you have received in the past and are looking to secure in the future in line with your mission? xii. Look at yourselves as a public benefit organization d. Presentatio n of the Organization xiii. Are you all working towards the same mission? xiv. â€Å"Elevator Pitch† 1. Clear and concise description of your organization, its work, and its value 2. Thirty seconds to two minutes (one of the most important interactions with your donor) 3. All staff, volunteers, and those associated with your organization should have a pitch 4. Give Peace Corps example 5. Homework for second day xv. Needs of the NGO 6. Needs include money, resources, materials, trainings, etc. 7. Can you tell me today what your specific needs are and how much those needs would cost? (Financial/ Resources Needs Assessment) xvi. Public Relations 8. Website, Newsletters, Email Updates, Facebook page 9. All of your social media and newsletters should be consistent with each other, updated at the same time with comparable information 10. We’ll go into more details about Public relations shortly e. Donor Expectations xvii. If you were to give money to an organization, what would you want in return? 11. Elevator Pitch 12. Clearly defined mission and vision 13. Reasons why they should invest in your NGO/project 14. Projects, ideas, and plans for which you need financial support 15. Overview of successful projects you have done in the past 16. Reports 17. Good reputation in the community and with beneficiaries 18. Communication, Honesty, Transparency 19. Commitment and cohesiveness of the staff 20. What exactly you are going to do with their money f. Donor Relations and Stewardship xviii. Updates to donor xix. How are you thanking them? xx. How are you recognizing their donation? xxi. Will they give again? xxii. Will go into more details about this shortly II. Identifying and Working with Donors g. Donor Prospect Pool xxiii. Who might want to give to this organization? brainstorm a list) 21. Parishioners of the church 22. World Vision, Caritas, other NGO’s in the community with resources to give 23. Family and friends 24. Local community members (why is what you’re doing important to them? , Who will feel moved by the work you are doing? ) 25. Diaspora 26. Corporations – VivaCell, Orange Foundation, Coca Cola 27. Realities of fundraising in Armenia a. Grants- majority are international b. Corporate Giv ing/ Corporate Social Responsibility- new concept here in Armenia c. Government funding- In 2011, the state provided NGO’s with $8 million, mostly to sports federations and state-funded or state-operated organizations on a noncompetitive basis d. Individual donations e. Community Support f. Diaspora g. Funding Diversity h. Projects being donor driven not mission driven i. Overhead costs xxiv. Who do you know? xxv. Relationships are the key to building your prospect pool xxvi. Invite potential prospects to visit your organization, build the relationship before you ask them for something h. What makes a person or organization donate? xvii. If you meet with an organization, how do you expect them to present themselves to you? 28. Clear, concise, honest overview 29. Well thought out, able to easily identify the mission, vision, and beneficiaries to be served 30. Overview of successful projects, current projects, and future plans 31. Overview of specific needs of the NGO xxviii. Do you believe in the mission and vision? 32. A donor has to believe in the mission or vision, or you have to help them believe, give them reasons to care. xxix. How do they have to use your money and what do you want in return from them? 33. Communication, honesty, transparent used exactly as they say it will be used for effective projects xxx. What will make you give again? 34. communication, success, beneficiary satisfaction, reporting, relationship with the organization, recognition of the organization, name in the community/associated with the project xxxi. What kind of relationship do you expect from the NGO? 35. strong leadership, honesty, communication, want to feel proud of the work they are doing and the reputation they have in the community, understanding of strategic goals, I want to see the organization has taken the time to define themselves III. Fundraising Plan i. Should be written on an annual basis j. Who is going to write the plan? xxxii. Should have a lead who collaborates with your Director, key stakeholders, and the board k. Start with your fundraising goal (how much money do you need? ) xxxiii. This fundraising goal amount should be based on the needs of the organization xxxiv. How much money needs to be raised/ resources secured in order to carry out the activities which your organization wants to carry out over the next year? l. You read "Fundraising Presentation" in category "Papers" The mission/ message (Why do you need the money? xxxv. What do you plan to do with the money you raise? xxxvi. Line by line- what are you using your budget for? m. The Tactics (How are you going to raise this money? ) xxxvii. Figure out how you are going to raise different amounts of money over the course of the next year and where that money is going to go. xxxviii. Identify different tactics 36. Individual Giving 37. Major Donor Gro ups- talking with larger corporations 38. Events 39. Online giving 40. Participatory Fundraising 41. Grants 42. Corporate Giving Programs n. The Timeline xxix. Create the timeline to include dates for all events and fundraising goals throughout the year IV. Donor Relations and Stewardship (managing the gift, thanking and keeping the donor engaged) o. The comprehensive effort of any nonprofit that seeks philanthropic support to ensure that donors experience high-quality interactions with the organization that foster long-term engagement and investment. This effort is commonly thought to have four elements. xl. Gift acceptance and management 43. Your organizations policies and procedures for gifts. 44. Discussion about how the gift is going to be used, making sure the donors requests and the organizations needs are in line. 45. Procedures to track how the gift is being used. 46. Structures for Giving Opportunities (Example: donor recognition pieces/plaques, named spaces, or giving societies) xli. Acknowledgement 47. Thanking the donor j. Personalized letters, E-mails, phone calls, visits- should happen within the first week in which the gift is received xlii. Donor Recognition 48. How do your donors wanted to be recognized for their giving? 49. Mention in the newsletter, announcement at events, naming a space, donor plaques, press release, 50. This is the public forum for thanking a donor for their gift but need to ask for donor permission to do so. 51. For Participatory Fundraising- announcing and rewarding the top fundraisers publicly 52. Honor Rolls- announcement of donors to the organization printed publicly and thanking the donors through this forum. 53. Donor Walls/Donor Plaques- having a space in the center where donor names are listed for the public and your beneficiaries to see 54. Donor Recognition Events, awards, mementos, and volunteer opportunities-these not only are fun for the donors, but also help to strengthen your relationship with your donors and also show them that they are important to you. Can be big events with all of your donors or intimate lunches with the Director and/or some of your beneficiaries. xliii. Reporting (also referred to as stewardship) 55. Telling the donor the impact they are making on the mission of your organization or the specific projects they have given to. Why their giving has made a difference. 56. Two different ways of reporting: qualitative (storytelling confirming the usage of funds) and quantitative (shows the carrying out of spending funds properly) V. Public Relations (or PR) p. Everything your organization does to get public/press coverage of what your work q. Why is it important? xliv. Gets the word out and communicates your message xlv. Builds your audience xlvi. Builds your credibility and reputation within your community, with your beneficiaries, and your donors, thus helping to foster stronger relationships xlvii. Shows the results and successes of your work xlviii. Good time to use your elevator pitch r. Examples of PR xlix. Printed materials 57. Newsletters 58. Press Releases (work with your local media) 59. Brochures 60. Announcements about projects including donor/supporters names 61. Can be a two way street with your supporters (donors and volunteers) l. Television 62. Use for advertising about programs/projects or upcoming events 63. Can also be used for purposes of interviewing about your organization li. Online 64. Website 65. Facebook 66. Email blasts 67. Online newsletters/news stories lii. Special Events 68. Lectures or talks with experts, beneficiaries or having one of your donors to come in and speak 69. Volunteer Day s. Why is PR important for fundraising? liii. Can increase the money and resources coming in liv. New prospects find you 70. People learn about your work 71. If really good coverage- prospects come to you to learn more, volunteer, and possibly even invest in your work lv. Raising General Awareness 72. Remember to refer to yourself as a public benefit organization 73. Raising awareness in your immediate community about the work which is being done around them and the need to help accomplish those goals 74. Helps people remember your name and your mission lvi. â€Å"Social Proof† 75. Again building on your credibility- coverage shows that what you are doing is important and a leader in your community 76. Can also bring your public relations materials during donor meetings to further engage donors. VI. Let’s create a campaign! t. Make a plan lvii. What are we raising money for? lviii. Why are we raising money for this? lix. How much money do we need? lx. When do we need the money? 77. How are we going to raise the money? lxi. Who is going to be on the committee? lxii. What kind of advertising are we going to do for the campaign? lxiii. What kind of materials/resources do we need for the campaign? lxiv. How are we going to engage and thank our donors? u. What are we raising money for? lxv. Pick one project/event you would like to do with your organization 78. Birthday parties for kids with disabilities 79. Gifts/events for the chronically ill v. How much money do we need? lxvi. Create an overall budget which not only includes money but also resources lxvii. Can also create a useful tool to provide for your donors 80. Show them what their money will do: If you donate XX, we can include 5 more adults in our trainings for example. w. When do we need the money? 81. Create a timeline of not only the deadline, but all things which need to be done between now and the deadline as well as who is going to do those things x. How are we going to raise the money? lxviii. Participatory Fundraising (Get the crowd involved in your campaign, have to be very careful with planning to make sure the investment you make in these events is worth the return) 82. Athons- Walk-a-thons, Dance-a-thons, Read-a-thons k. a type of community or school fundraiser in which participants raise money by collecting donations or pledges for walking a predetermined distance or course, dancing for a predetermined amount of time, or read a certain amount of books within a predetermined time frame. 83. Spare Change boxes in the church 84. Raffles l. Sell raffle tickets for a particular item or a 50/50 raffle 85. Auctions m. People bid on certain items which have been donated for the cause. 86. Game competitions or carnival (Lemon ball) Each guest pays 1,000 dram for a lemon and closest lemon the bottle wins it. 87. Futbol tournament n. Have each team pay a certain amount to be a part of the tournament which will be donated to the organization. lxix. Individual Donors 88. Create a list of people/companies/organizations which may be interested in giving to this campaign lxx. Online Giving 89. Firstgiving. com y. Who is going to be involved in the committee? lxxi. Who needs to be included in all of the decisions made? Who is going to be in charge of which part of the campaign? . What kind of advertising are we going to do for the campaign? lxxii. Objective and Goals of the campaign lxxiii. Choose a campaign title 90. Race for the Cure (Run Breast Cancer out of Town) 91. Relay for Life (American Cancer Society) lxxiv. Create an â€Å"About the campaign† lxxv. How are we engaging the press? lxxvi. How are we updating our own online/print presence? {. What materials/ reso urces are we going to need? lxxvii. For example: how many people/volunteers are needed and for what amount of time lxxviii. Do you need prizes/awards xxix. Do you need space to put on the event lxxx. Need to think about things that may happen (for example, if it rains during the futbol tournament, what other arrangements need to be made? ) |. How are we going to engage and thank our donors? lxxxi. If participatory fundraising: need prizes/ awards for top fundraisers, guidelines, and thank yous lxxxii. Thank you letters, personalized, emails, phone calls, meetings lxxxiii. Online giving- should have thank you letters sent and update after the project is successful Fundraising P How to cite Fundraising Presentation, Papers

Wound Healing free essay sample

Stages of Healing How Do Wounds Heal? Research work on acute wounds in an animal model shows that wounds heal in four phases. It is believed that chronic wounds must also go through the same basic phases. Some authors combine the first two phases. The phases of wound healing are: * Hemostasis * Inflammation * Proliferation or Granulation * Remodeling or Maturation Hemostasis: Once the source of damage to a house has been removed and before work can start, utility workers must come in and cap damaged gas or water lines. So too in wound healing damaged blood vessels must be sealed. In wound healing the platelet is the cell which acts as the utility worker sealing off the damaged blood vessels. The blood vessels themselves constrict in response to injury but this spasm ultimately relaxes. The platelets secrete vasoconstrictive substances to aid in this process but their prime role is to form a stable clot sealing the damaged vessel. We will write a custom essay sample on Wound Healing or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page Under the influence of ADP (adenosine diphosphate) leaking from damaged tissues the platelets aggregate and adhere to the exposed collagen. They also secrete factors which interact with and stimulate the intrinsic clotting cascade through the production of thrombin, which in turn initiates the formation of fibrin from fibrinogen. The fibrin mesh strengthens the platelet aggregate into a stable hemostatic plug. Finally platelets also secrete cytokines such as platelet-derived growth factor (PDGF), which is recognized as one of the first factors secreted in initiating subsequent steps. Hemostasis occurs within minutes of the initial injury unless there are underlying clotting disorders. Inflammation Phase: Clinically inflammation, the second stage of wound healing presents as erythema, swelling and warmth often associated with pain, the classic â€Å"rubor et tumor cum calore et dolore†. This stage usually lasts up to 4 days post injury. In the wound healing analogy the first job to be done once the utilities are capped is to clean up the debris. This is a job for non-skilled laborers. These non-skilled laborers in a wound are the neutrophils or PMN’s (polymorphonucleocytes). The inflammatory response causes the blood vessels to become leaky releasing plasma and PMN’s into the surrounding tissue. The neutrophils phagocytize debris and microorganisms and provide the first line of defense against infection. They are aided by local mast cells. As fibrin is broken down as part of this clean-up the degradation products attract the next cell involved. The task of rebuilding a house is complex and requires someone to direct this activity or a contractor. The cell which acts as â€Å"contractor† in wound healing is the macrophage. Macrophages are able to phagocytize bacteria and provide a second line of defense. They also secrete a variety of chemotactic and growth factors such as fibroblast growth factor (FGF), epidermal growth factor (EGF), transforming growth factor beta (TGF-__ and interleukin-1 (IL-1) which appears to direct the next stage. Proliferative Phase ( Proliferation, Granulation and Contraction): The granulation stage starts approximately four days after wounding and usually lasts until day 21 in acute wounds depending on the size of the wound. It is characterized clinically by the presence of pebbled red tissue in the wound base and involves replacement of dermal tissues and sometimes subdermal tissues in deeper wounds as well as contraction of the wound. In the wound healing analogy once the site has been cleared of debris, under the direction of the contractor, the framers move in to build the framework of the new house. Sub-contractors can now install new plumbing and wiring on the framework and siders and roofers can finish the exterior of the house. The â€Å"framer† cells are the fibroblasts which secrete the collagen framework on which further dermal regeneration occurs. Specialized fibroblasts are responsible for wound contraction. The â€Å"plumber† cells are the pericytes which regenerate the outer layers of capillaries and the endothelial cells which produce the lining. This process is called angiogenesis. The â€Å"roofer† and â€Å"sider† cells are the keratinocytes which are responsible for epithelialization. In the final stage of epithelializtion, contracture occurs as the keratinocytes differentiate to form the protective outer layer r stratum corneum. Remodeling or Maturation Phase: Once the basic structure of the house is completed interior finishing may begin. So too in wound repair the healing process involves remodeling the dermal tissues to produce greater tensile strength. The principle cell involved in this process is the fibroblast. Remodeling can take up to 2 years after wounding and explains why apparently healed wounds can break down so dramatically and quickly if attention is not paid to the initial causative factors.

Lean Manufacturing processes

Impact of Lipitor Patent Expiry on Pfizer. Essay Example

Impact of Lipitor Patent Expiry on Pfizer. Essay Example Impact of Lipitor Patent Expiry on Pfizer. Paper Impact of Lipitor Patent Expiry on Pfizer. Paper IMPACT OF LIPITOR PATENT EXPIRY ON PFIZER. TABLE OF CONTENTSPAGE NO Executive Summary3 CHAPTER 1: INTRODUCTION 1. 1 Introduction4 1. 2 What is Lipitor5 1. 3Expiry of Lipitor patent5-6 CHAPTER 2: CHALLENGERS 2. 1 Challengers6 2. 2 Pfizer’s strategies7 CHAPTER 3:FINANCIAL IMPACT ON PFIZER AS LIPITOR GOES GENERIC 8-9 Recommendations10 Conclusion11 Executive summary: This report is about the impact of patent termination of Lipitor on Pfizer pharmaceutical company. Lipitor has been in the market since 1997 and is the mother of all drugs. wsj_live, 2011) As of November 30th 2011 Pfizer lost the patent of Lipitor opening path to generic competitors for America’s most popular medication and now all generic producing companies will be able get hold of the patent and produce their own stock legally. Pfizer was the first to earn 11$ billion in a year selling Lipitor and 130 $ billion over the patent’s life Lipitor is responsible for the one sixth sales of Pfizer. Due to the patent expiration of the drug Lipitor now other generic producing companies will be able to produce the drug and sell it at much lower rate than Lipitor which is a branded drug. Lipitor is a blockbuster drug of Pfizer which is responsible for making a huge profit and has kept the company at the no1 position. Until now Pfizer was the sole producer and enjoyed the monopoly of the drug. As Lipitor goes generic the rates of the drug are falling down massively so as to keep the current users of the drug to continue it. Pfizer is putting up a fight with all generic producing companies and as it is the best marketing pharmaceutical company in the world it is using strategies to keep the sales up and to make the consumers eep using Lipitor even after the expiration. It is good news for the consumers but not so much for the pharmaceutical industry. Lipitor is a blockbuster drug which going generic is a very big deal in the world of pharmaceuticals; it has been responsible for making a 27% of total sales revenue for all biopharmaceuticals. Pfizer is the best marketing pharmaceutical company in the world which is why it will squeeze out all of the value of the brand by using all strategies which are applicable in this case. It has a lot of challengers who have been waiting to get an opportunity to start producing the generic version of Lipitor like Ranbaxy and Watson pharmaceutical who have the approval to produce the generic Lipitor for 180 days after the patent expiry. While Pfizer thanking on the fact that the price difference between the branded and generic will not be much for the first six months. (sanburn, 2011) Pfizer is hoping for all the current users of Lipitor to remain loyal to the brand and at the same time is negotiating and made deals with sellers to have them sell Lipitor in the market at the generic prices. wsj_live, 2011) The impact on Pfizer financially is at large in the start but due to its solid financial risk and excellent business risk profile it will be able to withstand the loss in the coming time. The investors are warned at expecting lower numbers and with plans to stabilize them in a short period of time. It is a very complex situation but due to Pfizer’s creative pr ocess to deal with the situation it will help to bring the numbers up. With the patent expiry of Lipitor it is challenging to present the investors with the numbers Pfizer has hit before but it’s not impossible. philippidis, 2011) INTRODUCTION: PFIZER is the world’s largest pharmaceutical company. It was created in the year 1849 by Charles Pfizer and company, a chemical business; over the last century it has associated itself with developing trends to become a research-based pharmaceutical company. The penicillin used during the World War 2 was produced was Pfizer. The company is situated in New York with its research department in Groton, Connecticut, united states. It owns the best cholesterol lowering drug Lipitor and has other 14 blockbuster drugs. In the first year it generated revenues of 67. 8$ billion and net income of 8. 26$ billion. (philippidis, 2011)Pfizer is the largest player in the pharmaceutical market having the best power in marketing and forming associations. It also posts the highest dividends in the industry. Pfizer faces challenges common to all pharmaceutical companies such as patent expiration and FDA regulation. It is dedicated to applying science and global resources to progress health and well-being at every stage of life. Subsidiary members are Agouron pharmaceuticals, G. D Searle company, Greenstone, Park- Davis, Wyeth, Pharmacia, Upjohn, Warner lambert. (control, 2011) Pfizer‘s ceo Ian Reid announced that company would dissociate substantial portions of the company with the aim to focus on pharmaceuticals. Its business is divided into two divisions which are biopharmaceutical with 86% of revenues which consists of primary care, speciality care, established products, emerging markets and oncology. The diversified makes 14% of revenues which consists of consumer healthcare, animal health, nutrition among others. Some major products of biopharmaceutical (86%of total revenue) are; (sanburn, 2011) Lipitor- statin that decreases LDL levels, best-selling and and the most important for Pfizer as it contributes significantly to the growth of the company. However, the patent expired opening it to competition with the generic drugs. Enbrel- for arthritis, plaque psoriasis ankylosing spondiltis. this with the purchase of Wyeth was the largest drug acquired with Pfizer. Lyrica- used for the treatment of epilepsy9most successful pharmaceutical launches of Pfizer. Also used for treating central nerve pain and anxiety disorder. Prevnar- for invasive pneumonia. Celebrex- used for arthritis joint pain. Viagra-Important drug for Pfizer lost its patent in 2010. It’s used for erectile dysfunction. Norvasc- most prescribed branded medicine for lowering blood pressure. Pfizer has an enormous RD budget spending 9. 48$ billion in 2010 for research and development purposes. LIPITOR (GENERIC NAME IS ATORVASTATIN CALCIUM) Lipitor is the mother of all drugs. It is a statin that is used to lower cholesterol levels. Pfizer best-selling drug and the world’s largest selling drug. It is sold in 10, 20, 40 or 80mg. Lipitor came in the market in 1997 and collected in 100$ billion even in a crowded market containing many other cholesterol lowering statins many of them have already gone generic. Pfizer’s sales from Lipitor have made 11$billion in a year which is about one-sixth of Pfizer’s total sales. 8. 7 million American’s use Lipitor to lower their cholesterol levels. Lipitor contributes significantly for the growth of Pfizer; it is one of its blockbuster drugs. It has been the most profitable prescription drug in the history with millions of users. It is a big change for the consumers and for the world of pharmaceutical companies. EXPIRY OF LIPITOR’S PATENT: Lipitor has been in the market since 1997 being the only drug available in the market for lowering cholesterol levels but Pfizer lost patent rights of Lipitor on nov30th 2011 making pathway for the generic competitors for America’s most popular medication. Pfizer made an 11$ billion in 2010 worldwide selling Lipitor and a 130$billion over the patents life. Lipitor is one of the blockbuster drugs of Pfizer. After patent expiry of Lipitor other generic producers will be able to produce it and sell it at a much cheaper rate making it lose it exclusivity. The most profitable drug in the history loses its exclusivity after being in the market for 14 yrs. Pfizer took a hit of 4% or 1. 5 $billion due to patent expiration of Lipitor. (time, 2011) Before patent expiration it cost 5$ a pill for the consumers but after patent termination it has come down to 4$ per month, it is likely to reduce much further in the next coming 6 months in which there would be a price war. People will now be able to buy Lipitor for 80% off its original cost. Lipitor global sales were 10$ billion last year and they are to go as low as 3. 2$ billion in the year 2012. cnbc news, 2011) Pfizer has already lost exclusivity of Lipitor in Brazil, Mexico, Canada, and Spain last year but is still making revenues from the developing countries. Pfizer is forced to sell their branded drug Lipitor at generic prices as the patent ends. Now any pharmaceutical company can get hold of the patent and manufacture their own stock legally. Pfizer enjoyed the monopoly of the drug for all these yrs. and was the sole producer of the drug Lipitor until November 2011. Pfizer has been able to maintain its global no1 ranking for years because of Lipitor sales. THE CHALLENGERS: There are many generic drug making companies around the world. Ranbaxy India’s largest generic drug maker had to settle proceedings with Pfizer back in 2008 who has won the rights to sell the drug exclusively for the next six months after the patent expiration. Ranbaxy got the approval from the food and drug administration (FDA) to make the generic version of the drug Lipitor which will be manufactured in New Brunswick at the ohm laboratories and will be sharing its profit with Teva pharmaceuticals for the first six months. After six months another authorised generic version of Lipitor will be sold by Watson pharmaceuticals that have an exclusive agreement with Pfizer, according to which Pfizer will manufacture and sell generic Lipitor to Watson for the next five years. But those generics won’t be significantly cheaper than Lipitor if at all. (narayan, 2011) After the Ranbaxy settlement several other legal issues were resolved with generic drug making companies which were looking in for some action which included Mylan, Teva pharmaceuticals and one of the most recent was Dr. Reddy’s laboratories. philippidis, 2011) Teva pharmaceutical company clashed with Pfizer for quite some time but then on October 7 both decided that Teva would not sell generic Lipitor in the UK market till the expiration of the drug in the country which is still may 2012. More generics mean more competition and fewer sales . PFIZER STRATEGIES: Lipitor has made millions in profit for Pfizer therefore Pfizer using an ex tensive plan to keep its 10 million patients using Lipitor to stay on it. Pfizer is fighting against all generic producing companies to keep the Lipitor sales as high as possible. Pfizer strategy to prevail the loss of patent rights of its bestselling drug Lipitor has resulted in making deals to sustain a part of 11 billion annual sales from Lipitor and to hold on to the exclusivity of the drug in the market. Deals like, ? Drug-benefit agencies providing discounts to the patients for prolonged use of the drug even after the patent termination. ?Making it available over the counter to stand the attack expected from generics. ?Negotiations made with insurance providers blocking pharmacies from making generic version of Lipitor available to the patients. (wsj_live, 2011) ? Providing patients with discount cards so they can purchase the drug for 4$ a month (25$ lower from the average co-pay for a brand name drug) (sanburn, 2011) ? Paying pharmacies to mail patients with a 4$ copay card and to continue it. (wsj_live, 2011) ? Deals made with catalyst health insurance Inc. and Coventry health care Inc. to not let the generic version of Lipitor gets into the hands of customers until next summer. ?And Pfizer made deals with other health care companies will keep Lipitor at a low price for the next 6 months. ?Pfizer negotiated terms with Medco health solutions Inc. to supply Lipitor through its direct mail services. Pfizer’s lipitor. com website is another online channel set up to sell Lipitor. ?Pfizer’s program called â€Å"Lipitor for you† according to which the drug is delivered to your house, focusing on the consumers. Pfizer being the best marketing pharmaceutical company in the world will do everything to squeeze out every possible v alue from the brand. From each 90 day supply of Lipitor Pfizer will make a profit of 100$ from the usual 225$ which it made before the market opened to generics. If the manufacturing companies were to scale back their marketing campaign profits for Pfizer could stay up. Due to the new changes in the statin market it could be a win-win situation for all as consumers have the option to stay on the original Lipitor which is available at cut off prices and also the benefit to the consumers from low cost generics. Pfizer is using a very creative process to deal with this complex situation. (sanburn, 2011) FINANCIAL IMPACT ON PFIZER AS LIPITOR GOES GENERIC: After 14 years world’s most profitable prescription drug goes generic with many people using it for all these years (newshour, as patent of lipitor expires is era of blockbuster drugs over, 2011). Pfizer has made 130$ billion over Lipitor’s patent life. A Lipitor pill cost about 5$ a pill while costing only a dime to make it has come down to costing 4$ a month, it has come down and will initially fall lower then that. As generic are as good as branded drugs that is why people would choose to buy the low cost generic version of the drug. Lipitor roughly is responsible for one sixth of Pfizer’s total sales. (sanburn, 2011) Pfizer’s sales in 2010 were 67. 8$billion while after the expiration of Lipitor the sales forecast in 2012 will be as low as 63 to 63. $ billion. (dupont, 2011)Lipitor’s sales were 10$ billion in 2010 and in 2012 they are forecasted to be down to 3. 8$ billion. Lipitor which costs 120$ a month will fall down 30% in December 10 to 20% more than the usual drop of price when a patent expires of a drug. Pfizer will not be able to compensate the drop of price in short term but Pfizer maintaining the solid minimal financial risk and excel lent business risk profile will be able to withstand the revenue loss in the next 2 years. Lipitor’s sales have been downsizing since the last few years, in 2006 it accounted for 27% of total biopharmaceuticals revenues by making sales of 12. 9$ billion in that year, while coming down to 11. 4$billion in 2009 , yet at 10. 7$billion in sales worldwide while US alone responsible for 5. 3$billion in sales. Lipitor has been the best prescription drug sold all around the world and Pfizer’s best blockbuster drug for years. The drug alone accounted for 18% revenues of biopharmaceutical worldwide. (philippidis, 2011) Pfizer’s EPS investors losing 3% or gaining 1%over last year’s 2. 3$. EPS is expected to fall somewhere between 2. 16 to 2. 26$. Pfizer lowers the RD spending this year to 8 to 8. 5$ billion from 9. 4$ billion in year 2010. Before the companies merger between Wyeth and Pfizer of 65$ billion, RD spending were 11$ billion in the year 2009. pfizer has warned the investors to expect lower number in the year 2012 with the revenue ranging between 62. 2$ to 64. 7$billion which is 5% at the lower end and 3% at the higher end. RD to fall again after every guidance. Pfizer expects the EPS to bounce back 2. 25 to 2. 35 which is up 4% at both ends. Without a blockbuster drug like Lipitor it is challenging to present investors with numbers that Pfizer has hit before. Lipitor has been the blockbuster drug of Pfizer for years making it a very successful company and is responsible for the growth of the company keeping it at the no1 position for years. (philippidis, 2011) RECOMMENDATIONS: As the situation is complex and Pfizer should use a very creative way to deal with the situation so as to maintain the sales of Lipitor in the market and to have all the current consumers to continue with the drug even at a low rate as the generics. The drug is clinically approved and the most reliable which is used for low cholesterol. The same formulation drug which will be available at a low rate after the expiry of the patent, therefore the company should make deals with generic producers of Lipitor where they will agree to sell the drug which will be manufactured by Pfizer for a certain period of time, likely for the first 6 months pricing it to the same value as the other generic versions of Lipitor. And to use marketing strategies which would help in making the consumers use the best medicine which has been used for the past 14 years and is known all around the world as the best and most profitable prescription drug. The generic Lipitor will be manufactured by Pfizer and will be sold all around the world through different generic making pharmaceutical companies where Pfizer will also supply the drug to the companies at a lower rate. The supply cost of the drug to the companies will be lower than the other companies. Pfizer can use the drugs which are still in the pipeline and make another blockbuster drug which will not be able to take place of Lipitor but would help in increasing the revenues of the company and make up for the loss of profit from the lowering of the prices of Lipitor. at present having no other blockbuster drug to fill that hole is creating problems and Pfizer trying to hang on to all the revenues that can come from Lipitor, therefore it’s important to pay attention to making another blockbuster available in the market as soon as possible to compensate the loses. Pfizer can make deals with other pharmaceutical companies also to sell their drug without the brand label and in turn share the revenues with them. it costs less than a dime to make a pill and now saving on the costs of advertising and marketing the branded drug will also be saved, which would help in making more deals to sell the drug in the market. Making agreements with all the generic producers which are vast in number all around the world and to get them to give a percentage or royalty on the sale of that then Pfizer will be benefitting from all those companies. CONCLUSION: After a patent of a drug expires it is assumed that the drug will vanish after that from the market but Pfizer has fought and will continue to fight for Lipitor and will stay with it, as it has been proved by the company by using all types of strategies and making deals and programs to keep the sales up and protecting it from vanishing. All efforts have been made by Pfizer to stave off initial competition by offering Lipitor at the same price as the generic equivalents that are to flood the market. Due to the limited competition in the start as only two companies have got the approval to produce the generic Lipitor, it will be easy for Pfizer to keep the market for Lipitor users and to be able to still maintain sales of the drug in the market. The company has also cut the co-pays of all the eligible patients to as low as 4$ a prescription which is for branded Lipitor and also it will cover up to 50% for a co-payment of every prescription through December 2012. It is too early to know if the approach used by Pfizer will benefit or not after 6 months and if Pfizer will continue to fight with all other generic makers after that period as that would result in lowering the prices even further more which would not be profitable for Pfizer. (linda a. johanson, 2011) In conclusion of this report it can be said that the impact of the patent expiration of Lipitor has proven to be a very complex matter and the company has taken ever possible step towards reducing this impact and will continue to do so in the future. Pfizer the best marketing pharmaceutical company in the world and it will be able to fight with other generic making companies at least for the first 6 months due to the limited competition. (wsj_live, 2011) Pfizer is not ready to let their gig money maker go down without a fight and will continue to do so even after generics hit the market. Lipitor is not going to just exit stage left, as it is the expiration of US biggest drug in history. REFERENCES: Bibliography pfizers big problem: lipitor patent expiration. (2011, november 15th). Retrieved december 11, 2011, from pharmacytimes. com: pharmacytimes. com/blogs/redheaded-pharmacist/1111/Pfizers-Big-Problem-Lipitor-Patent-Expiration agustino fontevecchia. (2011, august 2nd). pfizer suffer loss of exclusivity, braces itself lipitor expiration. Retrieved december 10th, 2011, from forbes. com: forbes. com/sites/afontevecchia/2011/08/02/pfizer-suffers-loss-of-exclusivity-braces-itself-for-lipitor-expiration/ brian o. relly, p. (2011, november 30th). three things more important to pfizer than losing lipitor.

Concepts and modes of expression in human imagination, values, and Essay

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The Use Of Skype Education Essay

The Use Of Skype Education Essay The rapid growth and interest of college students in Computer Mediated Communication and social media has impacted the second language learning and teaching process. This study is a reflection of a pedagogical experience that attempts to analyze the use of Skype as a Synchronous Communication tool in regards to the attitudes of students in learning a foreign language when interacting with native speakers and engage in conversation. The participants are Spanish foreign language students at Fordham University in New York City and English foreign language speakers at a Jesuit University in Bogotà ¡, Colombia. Students were paired up and were required to set up online conversation meetings. The results of this pilot project suggest that students felt more interested to engage in conversation with native speakers and exchange personal and academic information as wells as other aspects of their culture using the target language rather than completing language laboratory activities or writing compositions. Key words: Computer mediated communication, Skype, socio-cultural competence, synchronous communication El continuo interà ©s y la rà ¡pida evolucià ³n de la comunicacià ³n a travà ©s de la tecnologà ­a y las redes sociales en estudiantes universitarios han transformado el proceso de enseà ±anza y aprendizaje de los idiomas extranjeros. Este estudio es una reflexià ³n de una experiencia pedagà ³gica que busca analizar el uso de Skype como una herramienta de comunicacià ³n sincrà ³nica en cuanto a las actitudes de los estudiantes en el proceso de aprendizaje de un idioma extranjero con la interaccià ³n de estudiantes que son hablantes nativos para participar activamente en conversaciones. Los participantes de este proyecto son estudiantes de espaà ±ol como idioma extranjero en Fordham University en la Ciudad de Nueva York y estudiantes de inglà ©s como idioma extranjero en una universidad jesuita en la ciudad de Bogotà ¡, Colombia. Los estudiantes fueron emparejados con el propà ³sito de organizar sesiones en là ­nea y hablar usando el idioma que està ¡n aprendiendo. Los resultados de este proyecto piloto indican que los estudiantes se sintieron muchos mà ¡s interesados en conversar con hablantes nativos para intercambiar informacià ³n personal, acadà ©mica y cultural haciendo uso del idioma que està ¡n aprendiendo en lugar de hacer ejercicios y escribir composiciones en el laboratorio de idiomas. Palabras clave: comunicacià ³n a travà ©s de la tecnologà ­a, Comunicacià ³n Sincrà ³nica, Competencias Socio Culturales, Skype Introduction As a young college language instructor, I find myself always trying to provide my students with opportunities in which they can see a real purpose of using L2 (foreign language) outside the conventional classroom where interaction is often reduced to their peers and instructor. The idea of this project was to encourage my students to speak via Skype with other college Spanish native speakers with like-minded interests -lifestyle, culture, education, and food -through the use of Computer Mediated Communication (CMC). The idea of this project started in one of my graduate courses at Fordham University when I had to survey a sample of Jesuit undergraduate students and their likelihood to interact with their surrounding community. Fordham Universitys main campus is located in the Bronx. The New York Botanical Garden and the Bronx Zoo surround the campus. However, Fordhams main campus is located in a community where there is a large low income Hispanic and African American population wher eas the demographics at Fordham is mostly a white upper middle class student body. The survey aimed to understand how much interaction existed between these two communities Fordham students and the surrounding community. Based on the results of the survey, most of the students prefer to spend their free time either on campus or in Manhattan. I also realized that specifically my Spanish students would not take advantage of the Hispanic population to practice their Spanish skills as they felt English would be an easier way to communicate. Consequently, I thought that as a language instructor, I would need to provide my students with a setting in which they feel comfortable and make use of the target language specifically with native speakers who have similar interests or experience similar learning conditions. This article summarizes a pedagogical experience with the purpose of sharing with other language colleagues how I started and structured the project and it also reflects upon its outcomes. Literature Review Computer Mediated Communication (CMC) CMC is defined as the process of creating, exchanging, and perceiving information via networked telecommunications systems facilitating the encoding, transmitting, and decoding of messages (Romiszowski Mason, n.d.). CMC was the result of linking different computers and having people interact by sharing messages and data. CMC spread rapidly and it allowed people from geographically dispersed locations to communicate replacing traveling and Face-to-Face (FtF) meetings with more efficient ways to instantly communicate. Different studies have shown that FtF gatherings give speakers with higher positions or power in any organization a larger portion of speech time while CMC meetings offer an equal share of the meeting participation (Walther, 1996.) Other studies, on the contrary, suggests that CMC does not contribute to active participation because it is assumed that in many CMC discussions a few members dominate the floor and the rest of the members become lurkers or passive recipient s. Both offline and online discussions have passive recipients; this implies that CMC does not discourage active participation and learning (Romiszowski Mason, n.d.). Allowing students to interact with others considering their mutual interests and giving them the freedom to make their own choices when learning a foreign language is essential to motivate them. Bastidas (2002) proposes integrative and instrumental motivation affecting foreign language learners. On one hand, integrative motivation suggests the interest of learners in the community and culture that involves the second language. Instrumental motivation, on the other hand, refers to the specific goals of the students. Bastidas also shows the communicative need to use any foreign language as an aspect affecting learners motivation. He explains that many language students feel demotivated to learn a foreign language because they think the L2 is neither important nor useful for them. Additionally, more than a real life experience, I wanted this project to be an exposure to the target language with native speakers. Fordham University is located in a highly populated Hispanic community in th e Bronx. Unfortunately, many Fordham students do not take advantage of this opportunity to practice Spanish with native speakers. Noam Chomskys innatist theory (Lightbown Spada, 1993) suggests that after that critical period of humans to learn a second language, input exposure is essential to gain L2 proficiency. For this reason, a project including input exposure with native speakers would stimulate students interest in engaging in conversations using the target language. Synchronous and Asynchronous Communication The continuous growth of Internet-based communication and college students interest in social media and networking seems to have a greater impact in the way they interact with others nowadays. These types of communication can be Synchronous or Asynchronous. Synchronous Communication or real-time communication refers to face-to-face discussions among people, whereas Asynchronous Communication (delayed communication) suggests a significant time delay between receiving and sending messages (Romiszowski Mason, n.d.). Hence, the inclusion of a computer-based activity and synchronous communication in my instruction was necessary in order to encourage and engage my students in the L2 learning process. I believe that real time communication would allow learners to provide instant feedback to each other, to emotionally bond, and to be spontaneous. According to Celce-Murcia (2001), the use of media in language classes only brings the outside world to the classroom and makes the learning proce ss more exciting and meaningful. Nevertheless, the only purpose of this project was not the improvement of L2 speaking proficiency but it also aimed to raise awareness in students about other cultures. In other words, I wanted to promote and instill values of inclusion, tolerance, and diversity as a principle of life in this globalized world. Teaching culture in a language class results in better communicators of L2. Culture is understood as body language, gestures, concepts of time, traditions, and expressions of friendliness. Consequently, linguistic proficiency is not enough for a second language learner social cultural competence is fundamental for a more proficient and effective L2 speaker. Hymes (1996)  [1]  also stresses the importance of socio cultural competence by saying that an individual who is not aware of the appropriateness norms accepted in a determined community is likely to be placed in a position of inequality. Similar Projects Other instructors and universities have implemented and explored a similar project, like the one I proposed at Fordham University, with positive results. Dickens (2009) shared an experience of two classes (one from the US and the other from Italy) in which students were initially paired up and required to interact with their partners discussing about different aspects of their life and classes topics using Twitter. After a couple of months the instructors decided that it would be appropriate to have them interact on video chat using Skype. Dickens report about the experience is positive. Students were able to communicate in the target language and to simultaneously multitask (surf on Facebook, share videos on YouTube, Google information, etc.) Alas, most of the session was held in the students native language. In a different experiment, Carney (2008) started a project in which an English class interacted with a Japanese class through the use of blogs, wikis, Skype text, voice, and vi deo chat and the exchange of homemade DVDs movies. Skype sessions in general were set up so that four English class students talk with one Japanese student. Each English class student had to prepare different questions to ask their Japanese partner. Some of the Japanese students were not able to speak due to the lack of web cams and computers. In general, this was a great experience for these students. The author recognizes the importance of CMC and its impact in foreign language classes. Project Objectives There were three major objectives identified at the beginning of this pilot project which will serve as an assessment of the achieved goals: Provide students with a space in which they can practice their listening and speaking skills in the L2 with native speakers by means of interactive and contextualized conversations online. Encourage students to learn from their partners culture, country, and traditions. Give the students the opportunity to interact in real life situations using the target language. Participating Institutions The two participating institutions are private higher education universities under the Cura Personalis (care of the other) philosophy and Jesuit Tradition. Fordham University is the Jesuit University in New York City. Fordhams Department of Languages and Literatures requires undergraduate students to take up to five levels of a foreign language aiming to develop the linguistic proficiency and cultural competence of Fordham students. The Colombian University in Bogota is a Jesuit University offering its community with quality Catholic education. The Department of Languages offers an undergraduate program qualifying its students to become language teachers. Participants A total of 50 students participated in this project. The participants are students from Fordham University (25 students) and from a Jesuit University in Bogota, Colombia (25 students.) Fordham University students are English native speakers learning Spanish in high beginner level courses. Students in Colombia are Spanish native speakers in intermediate English courses. It is important to clarify that Fordham students are studying Spanish (or any foreign language offered at the Department) as a mandatory language course during five (5) academic semesters. Some of them might want to minor in this language. The students at the Colombian university are future language teachers who are majoring in English. Fordham students age in average is 19 years old; whereas their online partners age in Colombia raged between 20 to 45 years old. The technological skills of the students were not considered when implementing this project. Pedagogical Proposal This pedagogical experience attempts to determine if there is any relationship between the implementation of Internet-based Synchronous Communication and the interest of foreign language students and native speakers to engage in conversation and learn about their culture. In order to start this project, a written proposal was submitted to the Chair of the Fordhams Department of Languages and Literatures and the Spanish Language Coordinator. In this document, objectives, description, proposed activities, projected timeline, proposed partners, and their responsibilities of the whole project were specified. The Chair at Fordham University had two important concerns about this initiative: 1. safety of students and 2. feasibility of the project. With the support of the Faculty Technology Center at Fordham University, I was able to persuade the Chair that there were no risks associated with the use of Skype for educational purposes and that its viability was directly related to the collaboration of the other university and the participation of the students. I should note that at Fordham University, foreign language students are required to attend the language laboratory two hours every week. For that reason, I decided to merge this project within the labora tory activities grade. As part of the curriculum at the Department of Modern Languages, language students are required to go to the language laboratory one hour a week. During this time (students are free to decide when to go to the laboratory from Monday to Saturday in a specific schedule) students listen to the audio section of their workbook as well as they complete different grammar exercises on line as part of their course evaluation. Roger Goodson (2005) states that some faculty members and administrators are normally resistant to include technology in their instruction because of time constraints, their demanding academic workload, lack of training, and insufficient research proving the effectiveness of E-learning. It is common to see some institutions still reluctant to explore technological changes in instruction, as it was the example of San Jose State University (SJSU.) The Associate Vice-President of San Jose State University proposed to ban Skype at the University imply ing that Skype might infect the institutions computers with viruses and that Skype might distract students and professors in the classrooms. One faculty member expressed his concern and called the institution luddite about this issue and explained the reasons why Skype should not be banned: 1. Skype allows communicating at no cost with other colleagues around the world, 2. There are many international students who might use Skype to communicate with other students, and 3. Foreign Language instructors have started to use Skype to have their students communicate with other students who are native speakers of the language they are learning Shaw (2006.) When the Chair of the Department at Fordham approved this pilot project, I immediately contacted different universities in Colombia. However, I thought that it would be a good idea to work with another university under the same Jesuit philosophy. Fortunately, a Jesuit University in Bogota, Colombia responded with great interest and eagerness in starting the project as soon as possible. The Chair of the Department of Modern Languages in Colombia designated his English Speaking Advanced class to take part in this linguistic experiment. The groups were not chosen based on any specific criteria. My two Spanish courses would participate in this project. At the Jesuit University in Colombia, the Chair chose that specific class because he was the professor in charge and had asked his students about their interest in partaking in this initiative, which had a positive reaction by the students. I clarified that this was intended to be a pilot project, which if it were to result with positive outcomes could be institutionalized by Fordhams Department, or at least it would encourage other instructors interested in creating a similar online community with their students. Community Development in general refers to the notion of people living close by to each other, face-to-face interactions, companionship, and support at different levels (Wellman, 1999.) However, in online communities the lack of physical location, verbal, and nonverbal cues implies impersonal relationships not able to build a community. However, other studies suggest that online communities can be built if participants have similar interests regardless their physical location they might find as an obstacle to communicate Face-to-Face (Romiszowski Mason, n.d.). Once the project was presented and approved by the two universities, it was necessary to establish a clear set of stages and assigned responsibilities to each instructor in order to launch this initiative. Table 1 describes the different stages that were considered. Task Observations Person in charge Outlining responsibilities A list of responsibilities was outlined and shared to students, professors, and administrators. Instructor at Fordham University. Pairing up students It was easier for the instructor in Colombia to pair the students as he had more students in his class than I did in with my two classes. Instructor at the Colombian University. Choosing topics for each session Both instructors agreed that each session should focus on content, culture, and grammatical structures, which would reinforce the topics, learned in classroom. Both instructors. Setting up a chronogram Considering that the end of the semester was coming soon for both universities, it was important to use the time wisely. Both instructors. Table 1. Stages of the Project The first step was to inform all the participants (instructors, students, and administrators) about their responsibilities regarding this project as shown in Table 2. Instructors Pair up students based on their proficiency level Monitor that students are attending their Skype meeting Make sure that students are respectful with their peers time Remind students to be punctual Decide the topics the students will be discussing Communicate with the other instructors if there are doubts or suggestions Provide a space for the students with the necessary technology to access to Skype Students Be punctual Speak only the language they are required to speak during the session. Prepare enough questions to carry out the conversation. Submit a screen shot of their Skype conversation in order to confirm that they actually had a conversation with their assigned partner and the required time for each session Administrators Establish the partnership between the two universities Attend the on line meeting in December to analyze the effectiveness of the project Table 2. Participants Responsibilities Participants received an email with their respective responsibilities. Consequently, a list of Fordham students was sent to my colleague in Colombia. He was in charge of pairing up his students with mine. His class was considerably bigger (in terms of number of students) compared to my two classes together at Fordham. There were not any specific criteria when pairing up the students it was just a simple matching exercise from two rosters. Then, each student received an email with a list in which they would find their matches for the fours sessions. The list included names and emails. The final stage of the project required each instructor to choose the topics. It was the responsibility of each professor to decide the topics students would be discussing in every session. Each session was expected to last approximately 15 to 20 minutes and it was expected to be conducted by students as follows: use of the target language previously determined (English or Spanish), personal introductio ns (as every session they were paired up with different partners), discussion of a previously determined topic. The topics varying from academic structure, personal interests, gastronomy, etc. were carefully selected so that students have a wide exposure to new vocabulary, expressions, and especially culture. The sessions were organized as shown in Table 3. Session Language Topic In charge One Spanish Exchange personal information (names, hobbies, favorite food, sports they practice) Also get to know about each other. Understand how easy or difficult is to learn English or Spanish. Fordham Two English Compare academic structures from their schools and the differences of educational system. University in Colombia Three Spanish Compare lifestyle, culture, gastronomy, and currencies. Fordham Four English Understand how languages are taught in the US from elementary school through the university. University in Colombia Table 3. Organization of the Sessions Students were required to prepare questions and organize their ideas in order to have a meaningful conversation during the following week. Furthermore, each Fordham student was required to snap a screenshot of their Skype conversation records as a proof that they did Skype with their assigned partners. All the conversations were set up by each student at different times and days (within a week period) this with the purpose of giving students the opportunity to organize their busy time and also to give students a sense of belonging to the project. One important aspect to mention is that the administrators did not ever set up a meeting to discuss the outcomes or implications of the project due to the lack of time. When the project was over the university in Colombia was already in winter break. Findings In this section, the advantages and weaknesses during the completion of the project will be described. In addition, I will mention the opinions and thoughts of 18 participant students who were surveyed after the project was finished. Starting the project was somehow challenging due to the lack of time and the resistance of the administrators to approve the project. Additionally, the communication between the two universities was slow. As it was previously mentioned, each student was randomly paired up with another one from the other university. In order to set up their online meetings they emailed each other. Students reported that their partner did not respond their emails in a timely fashion or kept postponing the meeting, and some others never got an answer from their partner. One student said: I thought it was very interesting and cool to learn about the life of a complete stranger! Sometimes communication was difficult but it was a good experience. This frustrated a big part of the students because it did not allow them to ever experience a conversation My student never answered my emails so we were not able to talk via Skype. A student added. Sometimes there were problems related to technological issues an d Internet connection, which prevented students to have voice conversations. Nonetheless, students opted to chat instead. A great part of participants described their Skyping experienced as interesting and fun. In their own words they said: I found it extremely useful and fun. It was very interesting to speak with my partner and I believe that she and I will probably continue speaking even though the assignment has finished. I would definitely do it again and hope I have the chance to in the future. Another student added: I did enjoy interacting with a student from another country. I found it relatively easy to understand her but harder to express my own ideas. No matter the skill level or level of success, I think it is always helpful though to get practice speaking with someone who knows the language so well. Each session was supposed to last between 15 to 20 minutes. However, most of the sessions ended up exceeding this time limit because they truly enjoyed conversing with their peers. Other students thought it was rude to conclude a conversation in only 15 minutes and they allowed more time to this activity even if they were only text chatting. Only one student requested to be given a different Skype partner. One of them was more than 20 years older than the other participant creating an uncomfortable environment in the younger student. Based on the student at Fordham, her Skype partner made her feel uncomfortable as in their first email that they had exchanged, the student in Colombia had expressed that he had physical issues that prevented him of speaking. He was asking to have someone else participate in the sessions. The student at Fordham thought it was not a good idea and as a Fordham professor I am not allowed to ask her to do something when she has expressed that it makes her feel uncomfortable. Therefore a new Skype partner was assigned to her. Throughout the development of the project some students, who were able to set up their online meetings, expressed during class that they were bonding while many others felt discouraged because they never had the opportunity to speak. It is important to note that this pilot project has led to a possible partnership between Fordham University and AUSJAL (Asociacià ³n de Universidades Confiadas a la Compaà ±Ãƒ ­a de Jesà ºs en Amà ©rica Latina), which is an Association of Jesuit Universities in Latin America. A representative from AUSJAL has contacted me with the purpose to start a possible project in which these types of online environments would benefit students from various Jesuit universities in South America and the United States. Opinions of the Participants A number of 18 participants in this project completed an online survey on Survey Monkey (www.surveymonkey.com) about three different aspects regarding the development of the project as shown in Table 4 and Table 5. The third aspect was an open-ended question in order to understand the opinions of the students and their likelihood to participate again in a future similar project. Surveymonkey.com provides users with free web-based surveys. I chose this website because the website helps you to create any type of survey with predetermined formats. Additionally, Surveymonkey.com does not require a software installation, everything is self-explanatory and most importantly the basic features are free. Based on the answers from Table 4, it can be inferred that after different Skype sessions, students mostly learned about their partners culture regarding personal information, similar interests, and education. The results suggest that students in general were not able to exchange as much information as expected about their regions food, their schools academic structure, and quality of life in their countries. 1. Which of the following aspects do you think Skype sessions helped you learn about your partners culture? Completely disagree Somehow disagree Agree Somehow agree Completely agree Food 27,3% 27,3% 9,1% 27,3% 9,1% Education 0,0% 8,3% 33,3% 25,0% 33,3% Academic Structure 16,7% 8,3% 33,3% 33,3% 8,3% Personal Information 8,3% 0,0% 25,0% 8,3% 58,3% Similar Interests 0,0% 0,0% 41,7% 33,3% 25,0% Quality of Life 8,3% 25,0% 41,7% 16,7% 8,3% Table 4. Cultural Appreciation According to Table 5, students seemed to have a greater difficulty trying to set up a Skype session with their partners than expressing their ideas and carrying out spontaneous conversations. Additionally, participants also believed that understanding their partners ideas was challenging. 2. Considering that your Skype partners were college students with similar interests but they were people you did not know, to what degree was it easy or difficult to interact with them using the language you are learning? Very easy Easy Difficult Very Difficult Understand your partners ideas 25,0% 16,7% 50,0% 8,3% Set up a Skype session 16,7% 8,3% 33,3% 41,7% Carry out a spontaneous conversation 25,0% 25,0% 16,7% 33,3% Express your ideas 8,3% 33,3% 25,0% 33,3% Table 5. Degree of Difficulty in Communication Finally, based on the surveyed student responses, it can be inferred that most of the participants thought that the Skype Project with a foreign country did allow them to learn something new about another culture. Many students were surprised that, different from the US, the majority of Colombian college students live with their parents when they attend college. Also, students at Javeriana University do not use their institutional email account as frequently as many American college students do. In general, participants felt that the project was much more fun than going to the language laboratory and writing compositions. Although, they expressed that communication was somehow difficult due to technological inconveniences (e.g. Internet connection, time flexibility, lack of web cam), participants acknowledged the importance of getting to know people from other countries who are native speakers. Most of the participants agreed that setting up meetings was by far the most tedious part of the project because of their busy schedule, their lack of interest of some participants, and the fact that they were talking to, in literal words, a complete stranger. In addition, the idea to participate in a similar project seems to be a viable one for many of them because they think these types of experiences forced them out of their comfort zone. Unfortunately, some other students were not able to provide any feedback because they were never able to speak with their Skype partner because they never got a response to set up a meeting. Conclusions and Implications The idea of this pilot project between Fordham University and the Jesuit University in Colombia was to understand if Internet-based Synchronous Communication would motivate

Bermuda Triangle :: Devils Triangle Paranormal

Bermuda Triangle, region of the western Atlantic Ocean that has become associated in the popular imagination with mysterious maritime disasters. Also known as the Devil's Triangle, the triangle-shaped area covers about 1,140,000 sq km (about 440,000 sq mi) between the island of Bermuda, the coast of southern Florida, and Puerto Rico. The sinister reputation of the Bermuda Triangle may be traceable to reports made in the late 15th century by navigator Christopher Columbus concerning the Sargasso Sea, in which floating masses of gulfweed were regarded as uncanny and perilous by early sailors, others date the notoriety of the area to the mid-19th century, when a number of reports were made of unexplained disappearances and mysteriously abandoned ships. The earliest recorded disappearance of a United States vessel in the area occurred in March 1918, when the USS Cyclops vanished. The incident that consolidated the reputation of the Bermuda Triangle was the disappearance in December 1945 of Flight 19, a training squadron of five U.S. Navy torpedo bombers. The squadron left Fort Lauderdale, Florida, with 14 crewmen and disappeared after radioing a series of distress messages, a seaplane sent in search of the squadron also disappeared. Aircraft that have disappeared in the area since this incident include a DC-3 carrying 27 passengers in 1948 and a C-124 Globemaster with 53 passengers in 1951. Among the ships that have disappeared was the tanker ship Marine Sulphur Queen, which vanished with 39 men aboard in 1963. Books, articles, and television broadcasts investigating the Bermuda Triangle emphasize that, in the case of most of the disappearances, the weather was favorable, the disappearances occurred in daylight after a sudden break in radio contact, and the vessels vanished without a trace. However, skeptics point out that many supposed mysteries result from careless or biased consideration of data. For example, some losses attributed to the Bermuda Triangle actually occurred outside the area of the triangle in inclement weather conditions or in darkness, and some can be traced to known mechanical problems or inadequate equipment. In the case of Flight 19, for example, the squadron commander was relatively inexperienced, a compass was faulty, the squadron failed to follow instructions, and the aircraft were operating under conditions of deteriorating weather and visibility and with a low fuel supply. Bermuda Triangle :: Devil's Triangle Paranormal Bermuda Triangle, region of the western Atlantic Ocean that has become associated in the popular imagination with mysterious maritime disasters. Also known as the Devil's Triangle, the triangle-shaped area covers about 1,140,000 sq km (about 440,000 sq mi) between the island of Bermuda, the coast of southern Florida, and Puerto Rico. The sinister reputation of the Bermuda Triangle may be traceable to reports made in the late 15th century by navigator Christopher Columbus concerning the Sargasso Sea, in which floating masses of gulfweed were regarded as uncanny and perilous by early sailors, others date the notoriety of the area to the mid-19th century, when a number of reports were made of unexplained disappearances and mysteriously abandoned ships. The earliest recorded disappearance of a United States vessel in the area occurred in March 1918, when the USS Cyclops vanished. The incident that consolidated the reputation of the Bermuda Triangle was the disappearance in December 1945 of Flight 19, a training squadron of five U.S. Navy torpedo bombers. The squadron left Fort Lauderdale, Florida, with 14 crewmen and disappeared after radioing a series of distress messages, a seaplane sent in search of the squadron also disappeared. Aircraft that have disappeared in the area since this incident include a DC-3 carrying 27 passengers in 1948 and a C-124 Globemaster with 53 passengers in 1951. Among the ships that have disappeared was the tanker ship Marine Sulphur Queen, which vanished with 39 men aboard in 1963. Books, articles, and television broadcasts investigating the Bermuda Triangle emphasize that, in the case of most of the disappearances, the weather was favorable, the disappearances occurred in daylight after a sudden break in radio contact, and the vessels vanished without a trace. However, skeptics point out that many supposed mysteries result from careless or biased consideration of data. For example, some losses attributed to the Bermuda Triangle actually occurred outside the area of the triangle in inclement weather conditions or in darkness, and some can be traced to known mechanical problems or inadequate equipment. In the case of Flight 19, for example, the squadron commander was relatively inexperienced, a compass was faulty, the squadron failed to follow instructions, and the aircraft were operating under conditions of deteriorating weather and visibility and with a low fuel supply.

Community Health Nursing Plan

Elevating Prostate Cancer Awareness in Orange County among African American Men University of Central Florida Community Diagnosis Health seeking behavior: prostate cancer screening among African-American men ages 40 and older related to the fact that African American men are 50% more likely to develop prostate cancer than any other racial or ethnic group (Maurer & Smith, 2005, p. 43) and risk factors: family history of prostate cancer, a diet high in fat, and non-participation in screenings as evidenced by a total prostate cancer mortality rate of 84 deaths per 100,000 population in 2009-2011and an incidence of 606 per 100,000 population in 2009-2011 in Orange County, Florida; and Healthy People 2020 C-7 reduce the prostate cancer death rate: Baseline: 23. 5 prostate cancer deaths per 100,000 males and Target: 21. deaths per 100,000 population; and Healthy People 2020 C-19 (Developmental) Increase the proportion of men who have discussed with their health care provider whether or not to have a prostate-specific antigen (PSA) test to screen for prostate cancer. (Florida Charts, 2010; U. S. Department of Health and Human Services, 2011). Review of Literature PICO: In African-American men, are focus groups using audio-visual methods of prostate cancer risks and early detection better than videography in increasing knowledge about the importance of early prostate screening, diagnosis, and treatment?According to the American Cancer Society (2012), African American men who are diagnosed with prostate cancer are more likely to die than any other race or ethnicity. Prostate cancer ranks fifth in overall cause of death among African American men aged 45 and over. From 2009-2011, 42. 5 per 100,000 African American men died from prostate cancer in Florida. Studies show that this disproportion is due to African American men not being screened in the early stages of the disease and delaying treatment in the later stages of disease progression (Carter, Tippett, Anderson, Tam eru, 2010).It is estimated that over 230,000 men will be diagnosed with and over twenty nine thousand men will die of prostate cancer in the year 2013 (American Cancer Society, 2012). Prostate cancer is the second leading cause of cancer death among men, with the exception of lung cancer. Among African American men, disparity in incidence has been attributed to lack of access to healthcare screening, decreased awareness of cancer symptoms, and various environmental and biological factors (Rivers, Underwood, Jones, 2009). Among 4,782 groups of men, only 37. percent report use of available cancer screenings and only 14 percent reported a high level knowledge among prostate cancer. African American men experience a higher mortality rate than white men, and this may be attributed to the fact that they present with more advanced stages of the disease and thus worsens the outcome of survival rates. This paper attempts to identify the cause and incidence of prostate cancer among African Am erican men in Orange County, FL and facilitate an increase in prostate cancer awareness early in the disease. Why is this diagnosis a health problem for this target group?Prostate cancer is responsive to early detection, and more than 75% of prostate cancer cases are diagnosed when the disease is locally confined and curable. â€Å"The U. S. Preventive Services Task Force (USPSTF) found that although early detection and treatment might prevent some prostate cancers from spreading, screening is also likely to detect other cancers that would have grown slowly and not caused health problems† (McBride, 2009). Although routine screening for prostate cancer is a contentious issue, prostate cancer screening offers the only possibility of early detection for individuals at high risk.African American men have the highest prostate cancer incidence and mortality rates worldwide, but have lower screening rates compared with Caucasian men. Risk factors such as age and genetic factors play host to disease progression and warrants an even closer look to the availability of healthcare screening for prostate cancer. Studies show that having a brother or father increases the risk of prostate cancer by two fold, with the risk even higher for a biological brother with history of the disease (America Cancer Society, 2012).Prostate cancer risks rises rapidly after age 50, with almost 2 out of 3 prostate cancers found in men over the age of 65. African Americans have also shown the detection of prostate cancer at an earlier age, younger than 45, a factor that is associated with more aggressive disease and poorer treatment outcomes (Baker, 2008). Healthcare screening access, lack of knowledge, and cultural attitudes regarding cancer seems to be factors associated with the discrepancy in prostate cancer incidence among racial groups.In one study, fear of prostate cancer was the main culprit of African American individuals delaying their prostate screening (Baker, 2008). What ar e the current nursing interventions for this problem? What interventions have been successful and what interventions have NOT been successful? A study conducted by Arras, Boyd, Gaehle, (2009) using a one hour video on prostate cancer risks and screening, showed only 12 % of participants gained knowledge from the video using a 19-item post test questionnaire.One of the biggest challenges facing African American men is the lack of underrepresentation in research and clinical trials. A study done in Virginia showed that word of mouth and social networking were found to be an important recruitment strategy in enrolling a population that has been to be challenging to recruit for research (Jones, Steeves, Williams, 2009). A study conducted by Friedman (2012) found that focus groups along with an open-ended questionnaire, resulted in 69% of the participants to participate in phase two of the project.In another study, subjects were given a one hour church based educational seminar delivered through an African American health educator and awareness scores increased from 26% to 73% after the session (Holt, 2009). A fourth study in which test subject were given a letter to come to the clinic for prostate screening, and the control group was given print material and telephone contact show that on review, the group that received the â€Å"two-step† intervention was more compliant with adherence to screening (Reynolds, 2008). PlanTitle: Elevating Prostate Cancer Awareness among African American Men in Orange County The target audience for this plan is Orange County African American men age 45 and older. Short Term: The prospective participants will voluntarily sign up for focus group program at local community events such as churches, physician offices, events, etc. Three Measureable, Time Specific Learner Objectives: 1. At the end of the three-day program, participants will verbalize importance of prostate screening and its associated benefits. 2. At the end of the three-day program, participants will name 3 risk factors of prostate ancer 3. At the end of the three-day program, participants will be able to verbalize benefits of early treatment and prognosis if diagnosed. This plan seeks to educate this target population to promote prostate cancer screening among a high-risk group through knowledge base, discussions, focus groups, and audio-visual methods there by increase the proportion of African American men to undergo prostate screening. The three-day program taught by student nurses will include teaching on benefits of early detection, importance of prostate screening, risk facts, associated symptoms, PSA test, and prognosis.Each session will be of one-hour duration with 20 participants in each focus group. The three-day program will be repeated weekly over the course of a month, for a total of 80 men educated in a month’s time. To gain the trust of our population, African American student nurses will teach the program. The educatio n program will be a church based session, in hopes to promote familiarity and confidence. Participants will receive a $15 incentive gift card upon completion of the educational program and transportation will be offered through local church services as a complimentary.To measure retention and knowledge gained from the program, participants will be given a 10-item, multiple-choice exam, with a 85% score needed to demonstrate comprehension. Participants who score below, will be given reinforcement and allow for discussion on material. Budget |Item |Price |Quantity |Frequency |Total | |Student Nurses |$14. 00/hr |3 student nurses |3 hours/week for 1 month |$504. 0 | |Gift Cards |$15 |80 |Upon completion of program |$1,200. 00 | |Church |$0 |One |3 days/week for 1 month |$0 | |Transportation |Free |1 bus with 20 occupants |3 days/week for 1 month |$0 | |Print Material |8 cents/page |80 |80 participants for 4 weeks |$64. 0 | | | | | |$1,768 | Nursing Process- Intervention and Evaluation |Objectives |Learning Domain |Topical Outline |Evaluation | |1.At the end of the three-day|Cognitive |Primary: The student nurse will teach the signs and |The client will be given a 10-item, multiple-choice | |program, participants will |Affective |symptoms of prostate cancer, available diagnostic |exam regarding prostate cancer risk factors, signs and| |verbalize importance of | |exams and laboratory data to discuss with their |symptoms, early treatment modalities, prognosis if | |prostate screening and its | |health care provider. detected promptly, and importance of annual prostate | |associated benefits. | |Secondary: The student nurse will assess client’s |screening for AAM older than 45 years old with an 85% | | | |ability to recall importance of PSA tests and DRE, |score needed to demonstrate comprehension. | | |and allow for questions on how exams are performed. |Participants who do no succeed on first attempt, will | | | | |review exam and discuss with the student n urse. | | | |Re-examination will take place the same day and an 85%| | | | |is needed to show competency and comprehension of | | | | |educational program. |2. At the end of the three-day|Cognitive Psychomotor |Primary: The student nurse will teach risk factors |The client will be given a 10-item, multiple-choice | |program, participants will | |of prostate cancer, give print material, and show |exam regarding prostate cancer risk factors, signs and| |name 3 risk factors of | |DVD on risk factors and African American men. symptoms, early treatment modalities, prognosis if | |prostate cancer. | |Secondary: The student nurse will perform a focused |detected promptly, and importance of annual prostate | | | |health history, family history, social habits, |screening for AAM older than 45 years old with an 85% | | | |diet/nutrition, and provide feedback.Referral to |score needed to demonstrate comprehension. | | | |providers as applicable. |Participants who do no succeed on first attempt , will | | | | |review exam and discuss with the student nurse. | | | |Re-examination will take place the same day and an 85%| | | | |is needed to show competency and comprehension of | | | | |information. |3. At the end of the three-day|Cognitive |Primary: The student nurse will teach evidence based|The client will be given a 10-item, multiple-choice | |program, participants will be |Affective |statistics and prognosis if diagnosed early. exam regarding prostate cancer risk factors, signs and| |able to verbalize benefits of | |Secondary: The student nurse will teach client |symptoms, early treatment modalities, prognosis if | |early treatment and prognosis | |available options for early treatment and importance|detected promptly, and importance of annual prostate | |if diagnosed. | |of annual prostate screening. screening for AAM older than 45 years old with an 85% | | | | |score needed to demonstrate comprehension. | | | | |Participants who do no succeed on first attempt, will | | | | |review exam and discuss with the student nurse. | | | |Re-examination will take place the same day and an 85%| | | | |is needed to show competency and comprehension of | | | | |information. | References American Cancer Society. (2012, February 27). Prostate key statistics. Retrieved  March  26, 2013, from http://www. ancer. org/cancer/prostatecancer/detailedguide/prostate-cancer-key-statistics Arras-Boyd, R. , Boyd, R. , & Gaehle, K. (2009). Reaching men at highest risk for undetected prostate cancer. International Journal Of Men's Health, 8(2), 116-128. Baker, S. A. (2008). Prostate cancer screening intention among african american men: An instrument development study. University of South Florida). ProQuest Dissertations and Theses, 149. Retrieved from http://ezproxy. net. ucf. edu/login? url=http://search. proquest. com/docview/304467092? accountid=10003. (304467092) Carter, V. L. & Tippett, F. Anderson, D. L. & Tameru, B. (2010). Increasing prostate cancer screening amo ng african american men. Journal of Health Care for the Poor and Underserved 21(3), 91-106. The Johns Hopkins University Press. Retrieved March 21, 2013, from Project MUSE database. CHARTS Generated Report. (2011). FloridaCHARTS. com – Florida Health Statistics and Community Health Data. Retrieved from http://www. floridacharts. com/charts/DisplayHTML. aspx? ReportType=7244=48=2011=32 Friedman, D. , Johnson, K. , Owens, O. , Thomas, T. , Dawkins, D. , Gansauer, L. , & †¦ Hebert, J. (2012). Developing