Why a current television show or movie is so popular Essay

Why a current television show or movie is so touristy - Essay Examplehas emerged to be not comely bingle of the most popular (it is ranked within the top ten biggest grosser of all time) but one artifact that have crept in our consciousness and embedded itself as a lingering icon of modern culture.In a study of the movie, several axiomatic elements can be seen why the masses embraced Star Wars in an almost cult-like manner. The movie appealed both to children and adults alike because of the combination of the superhero tale and science fiction.For children, there is the report card about a boy who became a hero by fighting his own shadow. The narrative is reminiscent of the plotlines that have made myths and fairy tales endure for ages such as the Greek Odyssey. There are several elements, including those that are symbolic, that are present to appeal to the young minds the robots, Princess Leia, loyal friends, the mystical Jedi knights, amazing locales and gadgets, epical adve ntures, and so forthFor adults, the fiction depicting the struggle between good and evil and its science fiction genre proved tantalizing. Then, there were the mature themes of politics and religion, which explored value and subject matter in life. The spectacular graphics and epic storytelling communicated to adult preference as well. This appeal is pivotal to the success of the movie.As the movie combined all the human body fiction genres and stepped into the mythological narrative traditions, people flocked to the theaters. Star Wars was able to introduce a family movie wherein parents and children go, watch and enjoy the movie together. Family outings would have been unthinkable during the prosperous age of Hollywood.Star Wars is an embodiment of the rise of pop culture in the modern world. Todays coevals look to the media television, movies and electronic games not just for entertainment but solace amid a world of busy people, stressed and working parents. As with the oth er artifacts of the pop culture, the content of Star Wars became for the young generation

The causes of the increase in turnover at the Roanoke branch of Assignment

The causes of the increase in turnover at the Roanoke branch of Phoenix Advertising - Assignment ExampleThe first method used to steady down this was through informal one-on-one sessions with staff from various levels in the company. I had meetings with the Graphics and the Design teams interviews were conducted and group discussions were held with various staff members so that individually as well as collectively their thoughts could be heard. This was to discover employee satisfaction and morale. These sessions were designed to gather how the employees see the company, understand its values and picture themselves fitting into the overall abstract of things. They were encouraged to share how the information flowed from each department to the next and whether there were any gaps. A short survey was also conducted.The second assessment was regarding customers. solely the frontline staff including account managers and department heads, was brought together in a group meeting on cust omer service. They were asked how they served the clients, what the service process was like and what kind of hindrances they face up in their work. Everyone was collectively asked to define what they think of it.

Liverpool Street Essay Example for Free

Liverpool Street Essaycapital of the United Kingdom is a vast city, with people of unlike religions, cultures, traditions and backgrounds. It is a city, which allows people to have necessitousdom and choice. capital of the United Kingdom is the commercial centre of Great Britain with diverse institutions. It is also famous for tourism millions of people come to London to experience what it can offer. It has populacey famous historical buildings, botanical gardens, and great landmarks, which are an essential when visiting London. It is an honoured country to be proud of. We studied and analysed both stories.A Christmas Carol by Charles monster, and a Kiss Miss Carol by Farrukh Dhondy. Both stories portray disadvantage. A Christmas Carol is about a man called Scrooge who has a mean character and sees no good in spiritedness, he never makes the best out of things. He hates poor people and thinks that Christmas is a humbug. A Kiss Miss Carol is about a young Bangladeshi boy nam ed Jolil whose life is in monopoly control of his father. He has no free will whatsoever. Jolil is overwhelmed to be included in a Christmas play at school, but realises that his parents are not ready to support him.The leanness in London from the story A Christmas carol is described through depressing gloomy language. Dickens brings the settings to life by using adjectives like cold bleak dingy. These dustup give a poor effect to the clime, and make it seem dull and exanimate. Dickens describes ho ingestions using boring colours like black. He contrasts the black lifeless colours with the duster sheet of snow so that the bleak depressing colours stand out more. These lifeless colours, make the atmosphere feel unhealthy, Dickens varies his sentence length for great effect and breaks them up by the use of colons and commas.His choice of words such as dirtier and dingy mist make the climate seem crowded and filthy. Dickens uses many methods of writing in detail. He makes the read er want to read on by his lengthy descriptions, extensive use of vocabulary, humorous style of writing and his use of dialogue, for the characters. Though some of the techniques Dickens used are tedious, but the humour and communicating with the reader (the dialogue) helps balance this out. The poverty in London from the story A Kiss Miss Carol is described in a lot of detail as we can earn images of some of the scenes Jolil describes.The author describes corrugated estates, which looked like huge skulls, which had been picked out cleanse. The term skull signifies death, the estates are described as if all signs of life from the building have been extracted, as if the estates are completely dead, old, and a little haunted. When a Lion kills a Reindeer, it eats the parts he desires, the remaining carcass is then picked out clean by little insects, taking every bit they can, taking all the life and essence they can from the remains of the dead animal.Similarly, this shows how the bui lding is savagely pulverise every essence of life from the estates has been picked out clean, and nothing if left of it. The area in which Jolil lives is portrayed as mixed and quite poor. Jolil has to save up his propel money to bribe his brother-no luxury pocket money there. (Lines 161-163). He watched the needle go in and out of the patches of grey clothes, like the beak of a skirt pecking down a lines of crumbs. The grey cloth shows a dullness in the work that Jolil is doing, that there is absolutely no vitality, its shows the dull, dreary, depressed and deprived type of life Jolil is leading.The bird pecking crumbs show a state of desperacy that Jolils family is leading, that they work hard, but get paid very little money, and this also shows how desperate Jolil is to go and perform at the Christmas Concert. The wealth shown in the story A Christmas Carol is through describing the rich colourful, tasty textures of food. The wealth is emphasised through language. Dickens desc ribes how round the chestnuts are, bringing them into life, stunt flying out into the streets in their opulence. This word describes the wealth, affluence, and fortune in the chestnuts that taste so tender.The bunches of grapes which dangle from the shopkeepers hooks, that peoples mouth might water gratis. Gratis describes how peoples mouth would water without charge, and in as much freedom when passing by the round, green, squidgy sweet grapes, which taste absolutely exhilarating. Dickens describes the fragrance of the food market, the cool sensation, that sweet and pleasant odour, the aroma, which leads to the beaming fruits, those glowing lights, beaming brilliantly to sheer perfection. The gold and silver fish symbolise wealth, fortune and prosperity. Dickens can make the most awful fruits die to sweet and sugary.This is how wealth is shown in London, through the rich, colourful, fragranced fruits in the market. The wealth shown in the story A Kiss Miss Carol is by many white businessmen wearing suits rushing towards Liverpool Street station. Thousands of white people hurrying towards the train station. Liverpool Street is an industrial area with many huge companies in competition. It is in the heart of London. These people flocking to and from the station are either going to or from work, which tells us that London is able to sustain itself as millions of people are earning money.

Children learn Essay Example for Free

Children learn EssayThe Guidance for the Foundation Stage Curriculum (2001) purposes that an appropriate curriculum for young children is a play-based curriculum, offering children a choice of play based activities and experiences. Siraj-Blatchford and Clarke (2000) agree that play has been well documented as a means by which young children learn.Play is proudly set in the Early historic period for its top executive to stimulate and integrate a wide range of childrens intellectual, physical, cultural, social and creative abilities. (Siraj-Blatchford and Clarke 2000, p.76)However, unstructured play, in its purest sense, may begin a number of problems when providing suitable render for children demonstrating hyperactive, impulsive or inattentive behaviour due to lack of structure and continual distraction. Kewley (1999,p.151) would agree when stating, Unstructured situations much(prenominal) as playtime often author problems for children with minimal brain dysfunctionbec ause of the over-reaction to the stimulus and their impulsive behaviour.Ballard (1997) defines an inclusive setting as one where differentness is an ordinary part of human experience. Indeed, differentiation is the secernate to effective teaching and learning. However, problems arise when the whole structure of the curriculum is inappropriate for the necessitate of a particular child. Cooper (1999) would agree that it is invaluable for the practitioner to be aw ar of the specific circumstances in which individual children perform best in order to plan for the learning postulate of these children and suggests that some aspects of an Early Years curriculum may aggravate symptoms of minimal brain damage when stating,Children with hyperkinetic syndrome place become overwhelmed by the massive over stimulation they experience in a free radical situation and through free-play activity. (Cooper 1999, p.144)In addition,Barrow (in Merton 1998) and Toothhill and Spalding (in Sefton 2000) also bring that children with ADHD responded better in highly structured lessons than less organised ones.Children with ADHD are often hypersensitive to distraction. It is important, therefore, to ensure that they are seated in a place that is relatively free from distraction. (Cooper 1999, p.146)Thus, making the task of suitable inclusive provision difficult for practitioners in Early Years settings. However, many opportunities for structured, adult-directed play do exist within the Early Years. (Siraj-Blatchford and Clarke 2000) Games such as those with rules, card games, matching games, and outside games with balls all provide opportunities for adult-directed play and provide the child with instructions and pleader for playing the game, rules of turn taking and developing new information. In addition a play-based curriculum offers opportunities for high levels of adult support and encouragement and a kinaesthetic based approach to learning, which is a preferred style of learni ng for many children with ADHD. Kewley (1999,p.146) concurs, stating,Children with ADHD tend to be intuitive and need a practical approach to learning rather than a highly theoretical approach.Research suggests however, that a high number of children with ADHD are not acknowledged as having SEN and instead their inappropriate behaviour highlighted as unsuitable candidates for mainstream settings. Hayden (1997) suggests that this attitude does not improve as the children enter formal education.Hayden researched children who had been excluded from old school and found that children with ADHD are more likely that most to be excluded from school for behavioural reasons. This does depend at first glance to be surprising, when considering the evidence to suggest that a structured environment is more appropriate for a child with ADHD. Cooper (2005) offers an explanation for this however, and suggests that when considering the constructions of ADHD that, it is influenced by both biology a nd the social environment. Cooper infers that school plays a major part in the process of social constructions and indicates that children with ADHD are evaluate to conform to an unsuitable and ridged social framework and inappropriate curriculum when stating,Pupils from an early age are expected to internalise and behave in ossification with a set of rules that derive from constraints imposed by a teacher-centred, curriculum-focused method of teaching pupils in age related groups. (Cooper 2005,p.128)Cooper also suggests that inappropriate teacher/child ratios may create social disorder problems that are met by a set of lineal rules, designed to regulate peer interaction and causal agency around school. Concluding that the majority of problems arise from an externally imposed age determined curricula as apposed to a negotiated curriculum.These findings are alarming when considering recent developments, legislation and guidance relating to children with SEN and may indicate that t he behaviour aspect of children with ADHD is being used as a scapegoat strategy for settings who are not suffering the need of these children.When examining the issues surrounding ADHD it is clear that successful inclusion body both in the Early Years and Primary school settings is problematic. On the one hand a play-based curriculum is the most suitable form of learning for the majority of young children and is endorsed in Early Years Settings, whilst on the other the symptoms that children with ADHD display suggest that such a curriculum would exasperate these symptoms. However, as previously discussed, some aspects of a play-based curriculum are preferable to the more formal approach of primary school.The PLA (2001) suggest once children have been admitted to the setting, an environment that is created should be one that encourages all children to flourish. Furthermore, Kewley (2001, p6) states the inclusion of children with ADHD is a moral imperative, however, Farrell and Pol at (2003) argue that the inclusion of children with EBD has the potential to cause barriers to the government implementation of their policy of social inclusion.This would suggest that although differing levels of ability can be quiet easily catered for, behavioural and worked up differences are not as easily accommodated in educational settings. Visser and Stokes (2003) found that many people agreed with the inclusion of children with SEN, however when it came to children with EBD they were often denied inclusion due to their SEN. This supports the research under acceptn by Hayden (mentioned previously) that children with ADHD are excluded from primary school due to behavioural reasons. The DfES (2006, p.1) suggest that children with ADHD can have an overwhelming affect in the setting when stating,pupils with ADHD arrange challenges for teachers, both in effective behaviour management and in keeping them focused on the task in hand. onlineTeachers may feel threatened by having to deal with a child with ADHD, particularly if they have no training in the area and lack confidence, in addition to having to give instruction to a further 30 children or more. The parents of other children may feel that the attention has been drawn away from their children as more time needs to be fatigued dealing with disruptive outbursts and one to one tuition. All these factors effect the successful inclusion of children with ADHD.Swinson, Wolf and Meling however, disagree that these childrens needs would be addressed more effectively in special schools and conclude that there is much evidence of mainstream schools successfully including children with EBD and there was no evidence to suggest children with EBD benefit from special school. Rose (2002) found that teachers felt they could successfully include children with EBD, but only with additional classroom support. This may suggest a lack of confidence in their ability to meet the needs of children with ADHD in their care. Sw inson, Wolf and Meling (2002) suggest that this view is not uncommon, they found that many teachers felt they were not sufficiently trained to meet the needs of inclusion.Another reason that teachers insist on additional classroom support may be due to the time and attention children with ADHD need. Newelle (2001) agree that children with EBD take up a lot of time and resources. All of the barriers above are not isolated to ADHD or indeed EBD they are general inclusion issues that have been successfully addressed throughout a majority of mainstream settings, particularly Early years settings.Albeit ADHD may manifest itself in differing ways and appear to centre around continuous, disruptive behaviour, for some leading to exclusion, however, all children with SEN should have their needs met and advice devoted by the DfES (2000) should apply to all children when stating,Children with special educational needs all have learning difficulties that make it harder for them to learn than m ost children at the same age. These children may need extra or different help from that given to children of the same age onlineAccording to the National Institute of Mental Health (NIMH) online, ADHD can have long term effects on the childs ability to make friends and over time these children may develop emotional problems such as poor self-esteem and depression if the childs needs are not met. McEwan (1998) identifies emotional reactivity and conduct problems, which include symptoms such as a shot fuse due to getting easily frustrated, overreacting to things that happen, defiant behaviour, verbal hostility and wrothful outbursts. Fletcher-Campbell (2001) looks at the problems of children with EBD and suggests that these children alienate themselves from their peers, due to their behaviour. Thus,Some manifestations of the disorder tend to isolate children with ADHD from their peers, who will sometimes react with hostility to impulsive and hyperactive behaviour. This can result in long term difficulties in relation to other individuals and developing and sustaining relationships and the emotional problems that follow often exacerbate the struggle to learn. (Question Publishing 2003) online effects of inattention and impulsivity causes children problems with turn taking and this suggests they often interrupt when others are talking or playing. (Cooper and ORegan (2001) In addition McEwan (1998) argues that children with ADHD can often be egoistical and self-centred, which means they are likely to find it hard to make friends and build relationships. They are often unaware of social cues and do not worry close the consequences of their behaviour.

High School and Old Cassette Recorder Essay Example for Free

High School and Old Cassette Recorder EssayMy hobbies Almost everybody has some kind of hobby. My hobbies are listening to music , watching goggle box and reading books. I am very fond of music. When I am free, I often listen to my favorite songs from an old cassette recorder. At weekends, I unremarkably go to music shops in the downtown areas to buy good CDs. Of the famous pop singers, I prefer Frank Sinatra, Elvis Presley, Madona and Paul MC Cartney. I also spend an hour after dinner watching news and documentary programmes. I particularly enjoy the program The World Here and there because it broadens my knowledge of nature and human civilizations. My favourite book is Treachery. Its author is Elxan Elatli. I think that my hobbies are very useful. They widen my knowledge, relax my mind, and make me flavor infract about myself. My favorite hobby is melt downing drums. I spend a lot of my free time playing drums. I started learning to play drums when I was 9 years old. I pl ayed in my schools band. When I was 12, I got a private drum teacher and started to truly enjoy playing.My parents bought me a drum set. An important event in my life There are so many events happened in my life and most of them live to be an important part of my life. They are precious because I can learn much from them or sometimes they can make me feel better when I am sad. I think the event which influent me most is happened at my older high school. When I was in my third grade of senior high school, I should choose the university and the major which I want to go on my further study after the college entrance examination.After the score came out, I chose doctoring as my first major. But my parents disagreed that strongly. Because I never said that I wanted to do something in the future relative with the medical career before. two of them let me thought carefully because to be a doctor was very toilsome. Also, doctors always shift their work and they should go to work at nigh t even. Thats a tired job. In addition, the process of being a doctor was difficult, too. My mother wanted me to be a teacher as her. At that time, I was so confuse that I didnt know which one was suitable for me to choose.I knew what the advice my parents gave was good for me. I also knew my future was belongs me and I should make the superior by myself, non my parents. Maybe to be a teacher was good, but I didnt like .After this event, I decided all over the things by myself. i chose the tourism. Like the debates, although sometimes our opinions are different, we communicate our thoughts and make the choice depend on our own. If we hesitate to do one thing and do not make up our mind, we cant do the thing successfully

Issues in Reporting Adverse Drug Reactions (ADRs)

Issues in Reporting Adverse Drug Re implements (ADRs)India is becoming a hub in the world of clinical look into and a center for medicate discovery and development and this advancement has created an urgent accept to strengthen the current medicine safety measures. Pharmacovigilance has emerged as an important field of science related to activities regarding spying, assessment, understanding strikeion and pr pointtion of obstinate drug reactions (ADRs) and another(prenominal) drug related issues. The current pharmacovigilance system is non fully able to address these issues because of certain ch allenges being posed to it. While major advancements of the discipline of pharmacovigilance have taken place in the West, not untold has been actiond in India. few of the important challenges to our existing pharmacovigilance activities are under-reportage, neglect of knowledge, proper training, education, attitude and motivation, confusion regarding terminology and definitions used in pharmacovigilance. Increasing use of biologics and herbal medicines in current medicine practice further pose challenges to our pharmacovigilance systems. There is lack of information about the active principle, efficacy, adverse effect profile, quality toast/quality control, informal selling interaction potential in case of herbal drugs. On the other hand, a complex production process, limited predictability of preclinical to clinical data, high potential for immunogenicity possibility of an underlying exaggerated pharmacology in case of biologics further grieve the situation. Also thither is need to rectify the unprompted reporting and causality assessment scales with high quality data submission.KEY WORDS Pharmacovigilance, India, ADRs, AEs, ChallengesINTRODUCTIONIndia is an emerging hub in the field of clinical research and a destination for drug discovery and development. Several unsanded drug entities, juvenile dosage forms, vaccines etc. are being introduced in the country gainsay the monitoring of adverse drug reactions over a large population base. The monitoring of both know and unknown side effects of medicines is important correct if the drug is in use for several years so that the safety profile of the drug can be ascertained. This has paved the way for pharmacovigilance. Pharmacovigilance may be defined as the pharmacological science relating to the detection, assessment, understanding and prevention of adverse drug reactions or any other possible drug related problems (1), specially long term and short term side effects of medicines. While major advancements of the discipline of pharmacovigilance have taken place in the West, not untold has been achieved in India. Although in India, pharmacovigilance has progressed from the situation as it was in past, but for different types of problems and limitations progress is yet not very rapid. (2)The current review focuses on a number of elusive issues which require attention addres salUnder-reporting India specific causes possible solutionsUnder-reporting is a major limitation of spontaneous reporting systems for suspected adverse drug reactions (ADRs) in India. It is both a technical and a psychological issue. Under-reporting may lead to failure to recognize an unacceptable take a chance associated with a particular drug. Furthermore, differences in reporting between different drugs may lead to apparent differences in the toxicity which may be spurious. It can lead to delay in signal detection and underestimation of the magnitude of the problem.There is a long exhaustive list focusing on the causes of under-reportingLack of awarenessThere is a general lack of awareness among health care professionals in terms of increasing health core of ADRs. Those who are aware of this fact, fail to recognize the logistics of ADR reporting like who all can report, where to report what to report.Lack of knowledge attitudeA large proportion of studies have found that th e knowledge and attitudes of health care professionals appear to be strongly related with reporting. This result may have important implications in terms of public health, if knowledge and attitude are viewed as potentially modifiable factors. (5, 6)Lack of motivationDue to the passive nature of collection of reports, data collection is not exhaustive as it depends upon the attitude motivation of the clinicians. Hence, some ADRs even if observed are not likely to be reported. Some feel that reporting a single ADR wont help much in modifyFear of litigation loss of reputationSometimes healthcare professionals fear that the acknowledgement of adverse reactions may reflect damagingly on their competence or put them at risk of litigation. There is excessively a general fear of loss of reputation among the medical fraternity patients.Misconceptions about what to reportSome are reluctant to report adverse reactions because of doubts regarding the causal role of the drug. There is a u ncertainity in majority of the cases regarding the drug causing the particular adverse drug reaction.Unfriendly ADR reporting forms hassel of posting of the formsSome health care professionals fail to report due to the complexity of ADR reporting form. At any given antecedent of time all the information required to be filled is not available. Even later filling the form up to now there remains a hassel of posting of the forms. So, one always prefers to stay away from the problem. At times, difficulties in accessing the forms also contribute.Lack of time to reportExcessive patient load in the health care set up in a developing country like India further worsen the situation.The other factors which contribute towards under-reporting include flutter lack of confidence.Correcting for under-reporting is difficult because the exact magnitude of under reporting is unknown. It has been seen that more number of ADRs are reported spontaneously usually after a varan or following scienti fic workshops, conferences or other awareness programs and it decreases gradually over a period of time. So sustainability is an important factor for determining the spontaneous reporting of ADRs. (3) In addition, it has been found that salutary, unexpected ADRs those associated with newly marketed drugs are more likely to be reported.Easy access to ADR reporting forms, clarity of criteria for reporting, simple procedures and honest motivational practices such as acknowledging the receipt of adverse drug reaction reports by personal letter or phone call, providing feedback to reporters in the form of articles in journals, adverse drug reaction bulletins or newsletters, organizing scientific workshops, trainings at regular intervals are all influential in addressing the problem. The periodic e-mail update on the safety of drugs represents an effective and inexpensive way to raise the awareness of clinicians on the importance of spontaneous ADR reporting. For continuous motivation there appears to be a need to adopt a policy of regular updates and educational strategies for health professionals. (4)There is an urgent need for regular training of all health care force see in the form of workshops, symposiums scientific meetings. The training sessions must clarify the roles of the various healthcare professionals in pharmacovigilance. There should be closer relationship between the doctors and the pharmacovigilance optics. The paramedical staff should also be equally trained since they are in closer contact with the patients for a longer duration and can play an important role in making the pharmacovigilance programs more efficacious. Information analysis of the reported material is a highly specialized and complex job. It should be make as simple as possible by the use of sequesterly trained staff, so that one may be able to provide an resolving power with greater certainty. Causality assessment scales are an example where there is need of improvement so that proper causal relationship between the drug and the adverse effect can be established. Appropriate training and education regarding Pharmacovigilance should also be introduced during the formal teaching of medical graduates as a welcome step. Unfortunately, this drill is missing in our existing medical education system. Though we are now involving many of the medical colleges as Pharmacovigilance centres but still most of the undergraduates are unaware of this process. (7) The reporting of adverse reactions needs continuous stimulation. Therefore, it seems necessary to hold awareness architectural plans at regular intervals to improve the ADR reporting. It is important to achieve the development of a positive attitude towards pharmacovigilance among healthcare professionals so that adverse reaction reporting becomes an accepted culture in India.Vaccine Safety/PharmacovigilanceThe oddment of pharmacovigilance of vaccines is the early detection and timely response to adverse e vents following immunization, in order to minimize negative effects to the health of individuals and lessen the potential negative impact on immunization of population. A stringent safety surveillance of vaccines is crucial since the majority of vaccines are administered not only to vulnerable children but also to healthy population. Moreover, vaccines are complex biological products, which may include multiple antigens, live organisms, adjuvants, and preservatives which can be responsible for the ADRs. e.g. lymphocyte meningitis after anti-mumps vaccine. (8) So, each fraction has unique safety implications, which is important to capture as compared to other drugs. (9) In addition, difficulties in causality assessment in case of vaccines makes the situation more worse. (10, 11) motion of Adverse Event Following immunization (AEFI) surveillance program in India is a challenge taking into account its large geographical area. Capacity to detect respond to AEFIs needs improvement in I ndia. A multipronged approach is the need of the hour to ensure effective vaccine safety surveillance.Pharmacovigilance in clinical discharges A newer approach to patient safety in clinical visitationsSafety monitoring of drugs during clinical trials is now recognized as one of the major concerns for new drug development due to the increasing complexity of clinical trials involvement of large cohorts of participants. In a clinical trial, all adverse events experienced, irrespective of the causality should be monitored, accurately documented and adequately reported in a timely manner following the local regulatory requirements. Safety data from clinical studies is a key component that drug regulatory authorities consider in the decision-making as to whether to grant or deny market authorization for a drug. In addition, safety data from clinical trials helps not only in restricting harm at one centre but provides further vigilant action at other centres also. As per recent gazette notifications, Any unexpected serious adverse event (SAE) (as defined in GCP Guidelines) occurring during a clinical trial should be communicated promptly (within 14 calendar days) by the Sponsor to the Licensing Authority and to the other Investigator(s) participating in the study (Appendix XI In cases of any trial related injury, the safety data from clinical trials also serves as a basis for casuality aseessment for calculating compensation. Regarding reporting responsibilities of the investigators, Schedule Y states thatInvestigator(s) shall report all serious and unexpected adverse events to the sponsor within 24 h and to the Ethics Committee that accorded approval to the study protocol with 7 working days of their occurrence.Pharmacovigilance in clinical trials needs to be encouraged and fostered. The present scenario requires reform and needs recommendations for building a robust safety surveillance system for clinical trials in India.Arora D. Pharmacovigilance obligations of the pharmaceutical companies in India. Indian J Pharmacol 2008 February , 40 (Suppl 1) S13-S16Focused PharmacovigilanceHIV/AIDS, Malaria Kala-azar are major public health concerns in India. Adequate systems and al-Qaida for ADR monitoring and risk management activities are largely absent in India, adequate national or regional quality and safety monitoring systems after drug distribution are also lacking. With increase in number of patients, availability of new drugs, generic fixed-dose combinations and the ignorance of pharmaceutical company sector in world(prenominal) pharmacovigilance activities, there is a great need of focused pharmacovigilance.In India, a total of 2.4 million patients were suffering from HIV/AIDS in 2009 and about 200,000 new HIV-positive individuals are diagnosed each year. (12) Antiretroviral therapy reduces morbidity and mortality in people living with HIV infection, but adverse drug reactions remain a potential roadblock to treatment success as they ar e an important cause of poor adherence due to inability to tolerate antiretroviral therapy. ADR monitoring and causality assessment in resource-limited countries like India remain major challenges.In India, Post-marketing ADR monitoring often relies exclusively on spontaneous reporting which is a major issue. As of now there is no pre-existing surveillance system solely dedicated to ADR monitoring of anti- HIV/AIDS drugs in India. (13, 14) We can develop an HIV-focused pharmacovigilance program which can mix both active and passive ADR surveillance for antiretroviral therapy (ART). Moreover integrating the HIV-focused pharmacovigilance program with the existing health care program of AIDS can go a long way. (15)As per WHO report 2011-2012, South East Asian Region bears the second largest burden of malaria (13%), only second to African region (81%). Among South-East Asia region, India shares two-thirds of the burden (66%) followed by Myanmar (18%) and Indonesia (10%). (16)Emerging c hloroquine-resistance especially in P. falciparum is considered as one of the important contributing factors responsible for an increase in its occurrence in India. Because of this there is a wide scale use of Artemisinin based combination therapies (ACTs) and other new drug combinations. Our health systems have a very little experience with these new drugs. Pharmacovigilance for ACTs and other combination treatments in India is essential as malaria transmission is high and antimalarial drug drug drugs are used very frequently. Moreover, drugs can be obtained without a prescription. unceremonious use of antimalarial drugs may increase the risk of incorrect dosing, inappropriate treatment, and drug interactions which may impact negatively on drug safety. Furthermore, the administration of antimalarial treatments in patients with concomitant illness, including HIV/AIDs, tuberculosis and malnutrition, is a concern. So all these factors demand a focused pharmacovigilance activity to en sure safe use of antimalarial drugs especially the ACTs and other new drug combinations. (17, 18).In India Kala azar cases are mostly concentrated in Bihar, Uttar Pradesh, West Bengal and Jharkhand with over 165.4 million people at risk (19). Sodium antimony gluconate (SAG) and miltefosine are the first line drugs for the treatment of kala-azar are known to cause several side effects. Sodium antimony gluconate (SAG) has been known to cause anorexia, nausea, regurgitate, abdominal pain, metallic taste in mouth, diarrhoea, pancreatitis, reversible elevation of liver enzyme activities, myalgia, arthralgia, proteinuria, ECG changes (T wave inversion,prolongation of QT interval, ST segment abnormalities), phlebitis, uveitis, optic atrophy, acute renal failure, liverwort necrosis and bone marrow hypoplasia. (20)Miltefosine is known to cause mild adverse effects which are mainly gastrointestinal in which loss of appetite, nausea and vomiting were found to be the major dose-limiting side effects. Other frequently observed miltefosine-related toxicities are mainly associated with the kidneys and liver. (21) Teratogenicity is the main limitation to the use of miltefosine which calls for responsible surveillance appropriate mechanisms to protect the women of child-bearing age. (22) In addition to the adverse-effects, quality of the generic products also need to be monitored. (23) In view of the current side effect profile other related issues monitoring of adverse effects to anti-leishmanial drugs is utmost. Focused Pharmacovigilance for anti-leishmanials can be integrated with the National Vector Borne Disease Control Programme (NVBDCP) which is an umbrella programme for prevention and control of vector borne diseases.

The Evaluation And Selection Construction Method Of Smart Construction Essay

The Evaluation And Selection Construction Method Of Smart Construction EssayMalaysia is a rainy season country especially from November to March it ordain have heavy rainfall during this period. Unfortunately our capital Kuala Lumpur (KL) is located at the valley positions which frequently happen barrageing problem since according to (Sin Chew day-to-day 2011) started from 31 December 1970 years three quarter of the city were flooded during rainy season. The flooding problem provide ca utilise the climaternise of our country. The impact concern of constipations the lives of human, effect the economic use of the land such as the cost of land will be number one because none of the owner would kindred have the land which frequently faced flood problem and also the structural damage such as the maintenance cost or the counterbalance cost. Take an example according to (Datuk IR Hj) ab prohibited 445 hect atomic number 18s of land in the city were inundated to various depths of up to 2 meter and the cost of damage was estimated to be region of RM 36 million, it was a broad amount if the problem continue for feature. Therefore Malaysia government have come forth with a final result which is invested in a program call new turn over take to or Storm pee Management and Road Tunnel project.According to (Siao 2003) The ache turn over project ar located nearby the confluence point of Sg.Ampang river and Sg Klang river in the north and ends at the lake at Desa Water Park .The total cut into length is 9.7 km with a bore diameter of 13.26m.The usage of briskness delve is to solve the problem floods in Kuala Lumpur and also reduce traffic jam a broad Jalan Sungai Besi and low yew at Pudu during speed up hour therefore there are two components of this turn over, the StormWater turn over and motorway tunnel. It is the longest multi-purpose tunnel in the world.1.2 BackgroundThe Stormwater management and bridle-path tunnel is located at the eastern side of Kuala Lumpur in a north east-south west direction. Due to the geographical environment of Kuala Lumpur are located at the valley it will stagnant water more easily and our rivers today do not have the capacity to discharge the water to another orient cause Kuala Lumpur suffered serious damages during the flash flood from years 1970 until now.Accroding to(Smart project 2012) That may the reason the government come out with a solution that is refreshing tunnel project, the idea of smart tunnel is to decrease the flooding problem that Kuala Lumpur is face up to each time of heavily rain by detach the water entering from the critical location which is Sg.Klang,Sg.Ampang and Sg.Gombak using a holding basin ,storage reservoir and the bypass tunnel and reduce the traffic jam during rush hours in Kuala Lumpur .(Stormwater management and road tunnel project .viewed on 19 June 2012.The Smart Tunnel project was initiated by the former Prime Minister Tun Dr. Mahatir Mohammad nether the Ma laysian development. This project is included of cooperation of local authorities, private sectors, and some international engineer consultant. For the government segment involved in this project are the department of irrigation and drainage Malaysia and Malaysian Highway Authority. For the private sectors are MMC Berhad and GAMUDA Berhad .The site of Smart tunnel ground assign which consisting overburden (siltssand,alluvial tin deposits, mine tailings,slump regularizes over the karstic rockhead) and the calxstone which are deep fissured erratic Rockhead with relief of 30m . Due to the complex ground condition the contractor of smart tunnel project have decide to use tunnel dumb utensil as tunnelling jibe regularity and few part by using cut and fill .1.2 Problem statement and Research researchThe smart tunnel is consisting of two components 9.7 km route and 11.83 internal diameter was in part sized to provide a motorway and rage water tunnel, there was a problem from the different level of motorway due to when flood event whether the component of the road provide sufficient strength to promote water load to transmit water throughout the tunnel. (Robert Wilson 06)The another problem of this use up is smart tunnel located in Kuala Lumpur which consists of large amount of lime stone know as proudly erratic karstic features. (siow 2006) because of the formation there are few difficulty problem during the excavation process there are included the earth retaining system for the shaft excavation , the selection of the suitable tunnel sluggish forge (TBM) for SMART project, the ground water inside the ground.The smart tunnel project completed at end of January 2007 and started with the operation mode of storm water tunnel but however the Malaysia government has allocated a huge amount of money for flood control project drainage system in smart tunnel project but the smart tunnel is unable(p) to curb flood in Kuala Lumpur flood hit after a few days of defeatpour 40 years ago but today, the incubus return after an hour of heavy rain .Is it because the river hireting slimmer. (Sin Chew Daily 2011). According to(The Star 2012) There are few selected flooding flying field even the smart tunnel are operating but it did not solve the flooding problem in those area like KampungBaru,Ampang, Jalan Bangsar,Ampang Jaya, Jalan Pinang and Jalan sultan ismail.1.2.1Research doubtfulnessHow the excavation method is carried out?What is the major excavation problems occurred?How the operation mode is functions?What the selection characteristics have to be considered for tunnel dim shape?1.3 ObjectiveTo study the excavation methods of smart tunnelTo analyse the major problem during excavationTo ascertain the mode of operation stage for smart tunnelTo compare the selected tunnel dense instrument with alternative (TBM)1.4 Scopes of studyThe scopes of study are as followDue to the smart tunnel location the study for this topic will be conduct ed in the area of Kuala Lumpur, and the area will be focus on those area involved flood problem there are Kampung Baru, Ampang, Jalan Bangsar, Ampang Jaya, Jalan Pinang and Jalan Sultan Ismail. Furthermore to study the excavation method that only applied in the construction of smart tunnel and also the ground primer condition of the smart tunnel. After that will be study on the selection characteristic tunnel verbose machine, lastly is the 3 mode of operation of smart tunnel1.5 Research MethodologyIntroductionThis section usually is to presents an overview of the process and method to use in the study of the topic and the aim of this study is to collect schooling such as what is the excavation selected method of smart tunnel, during the excavation what are the major problem occurred, how the operation mode is functioned and the consideration of qualify during selection of tunnel boring machine.1.5.2 Primary data source Questionnaire and InterviewThe research that I am conducting is a plain research, which intends to find out the information of why the flooding problem is still occurring and the consideration while selecting the construction method. I am going to collect primary data through check into method by using both questionnaires and interviews. The reason for combining both questionnaire and interview methods is to collect both quantitative and qualitative information from respondents. Besides, collecting data through the survey method is quicker and economic. .By utilizing the questionnaires and interview in this research I able to comprise both the quantitative and qualitative methodologies. The purpose of the interviews is to obtain an insight into the respondents. This methodology will enable me to acquire more complete picture of respondents understanding of the smart tunnel and processes by them to produce answers. The main idea is let the respondents to mold judgments base on the question. Paper and pen will be prepared for those respond ents which will be held separately at different times. For questionnaires, I will be targeting cytosine respondents, which consists of the public field member from age 20-60.Second question from the quantitative paradigm statistically compares data, this technique will be fancy the loads in the results and enable me to answer the question from the score.1.5.3 Secondary data source-Literature reviewThe literature review is one of the important processes in order to get more understanding what the construction method was selected. All the review end be collected from the pertinent article, newspaper, internet and the references book. Through the review it tolerate develop more understanding on the selected construction method of smart tunnel. The way to collect article and newspaper can be from internet and the references book can be found out a t the college library.1.7 Outline ChapterChapter 1 IntroductionThis chapter is the introduction to explain the reason to develop the sm art tunnel project. In this chapter, it will look penetrate deeply to the selected excavation method of smart tunnel, the comparison between selected tunnel boring machine (TBM) with alternative (TBM) and also the mode of operation for Smart Tunnel in order to achieve the aim and the objective of the topic and by suggest of the research methodology to gather the relevant information.Chapter 2 Literature reviewFor this chapter are going to collect the important relevant information from the article, newspaper, data from internet and also reference book from college library. The succeeding(a)(a) information will be list down for understanding for this topic in order to achieve the objective of this topic.This Chapter will be mark down the information as the followingThe selected excavation method for smart tunnel.The major problem and the solution during the excavation.The three mode of operation of smart tunnel.The selected tunnel boring machine and alternative tunnel boring machin e.Chapter 3 Research MethodologyFor this chapter it will explain the process of the research, which means the way of the researcher to find out more information and to collect the required data for data analysis purpose. For my method I will go to use interview and questionnaire to achieve my objective.Chapter 4 Data AnalysisFor this chapter, all the data gathered from the interview and questionnaire will then be analysed after conduct the interview and questionnaires to the relevant manager and the 100 responder from the public field to collected primary data. It will be presented in table and histogram form in order to make a coating for this topic.Chapter 5 Conclusion and RecommendationFor this chapter it will base on the result obtained and write out the conclusion. Furthermore, base on the 4 chapter that was conducted out to write out the final summary for what have been studied is written.Chapter 2 Literature ReviewIntroductionThis chapter will present the general information about the excavation method of smart tunnel, the major excavation problem occurred in smart tunnel, the operation mode of the smart tunnel and the characterise between selected tunnel boring machine (TNB) and alternative TNB.Definition of excavation workExcavation consider is one of a the greatest hazardous and complex construction operations (Western Australia, 2005), excavation can divided to many type they are include of trench, deep foundation ,tunnel , shaft and also open excavation. The excavations describe as by removing the earth soil and formed a hollow or cavity earth surface.2.2.1 The excavation method of smart tunnelThe selection of excavation method of smart tunnel have consider and study by the project promoter MMC-GAMUDA joint venture and their consultants SSP in assocition with Mott MacDonald(SSP/MM) and come out with the result. According to Keizrul(2004) the choice of tunnel excavation method to have three choice there are i.e. cutcover,NATM and TBM . He point out that the cut cover method will take long time during the contraction process either selected method from bottom up or top down .On the other hand this method will be suitable for uncertain soil through the tunnelling. Furthermore according to sivalingam(2006) the meaning of cut and cover method for the smart tunnel are Lformed walls on high rock head part and secant pile walls keyed into the rock and tieback with anchors on part where the rock head drops. The rock was to be excavated by drilling and blasting as in a quarry, the walls supported by rock bolts and concrete. The same method was selected for the excavation of the shafts, egress ingress road trenches and of the uniting boxes.Furthermore for NATM namely as New Austrian tunnelling .He have point out this method are suitable for the structure of soil to tunnel is totally understood. It will be not suitable to select this method when founded the ground condition are belong to non homogeneous material or cavity modify rock , the drill and blast.For the last excavation method point out by the Keizrul (2004) are TBM namely as Tunnel Boring Machine .The article show that the general type of TBM to pick to have three main function i.e. the open face machine for rock boring, the earth pressure balance (EPB) machine generally used for boring loose soil and the misxshield TBM for media comprising hard material interfaced with loose soil. Furthermore according to sivalingam(2006)The major excavation problemAccording to (Malcolm Puller, 1996) the super acid excavation problem will be occurred on site is the excessive deformation of the soil, soil support structure, and inadequate groundwater leaving out and not fair to middling durability and strength of the soil support structure. Those are the major problem maybe occurred during the excavation stage.2.3.1 The major excavation problem have occurred in smart tunnel2.4. Operation mode of the smart tunnelThe smart tunnel consisting 3 type of the operation mode , the operation mode will be based on the flood condition at the upstream of Klang River and Ampang River. (Mohd saleh santhiman Looi Hong Weei,2006,)Figure_____Tunnel operation modeFigure_____Cross section of the motorway tunnelModeNameDescription2.4.1 Mode 1Normal conditionIn this mode of condition where the motorway of tunnel are allow for the driver to access ,where there are no storm or low rainfall, does not have any flood water will be divert into the (SMART) system2.4.2 Mode 2Most stormsIn this mode of condition where the motorway of tunnel are still allow for the driver to access and the (SMART) system will be activated, the stormwater from moderate rainfall is diverted into the bypass tunnel at the invert level(lowers segment)of the motorway tunnel.2.4.3 Mode 3Major StormsIn this mode of condition where the motorway of tunnel will be closed to traffic. The whole tunnel will be used to mitigate the stormwater.Once the flood water level have reach a limit , in a sufficient time will be evacuate all passenger vehicles and automated water gates are activated to occupy the flood water. The anticipated duration of switching to from mode 2 to mode 3 is estimated to be about one hour. After the flood recede, the targeted duration for tunnel reopening is lower limit of two days to enable for flood dewatering and cleaning.2.5 Tunnel Boring MachineNow a days the tunnel boring machine are expire popular in the construction industry while the project involved of the tunnelling process, compare with the traditional excavation method by using the tunnel boring machine the excavation process become safer, and economic for creating underground space. There is different type of the machines an example for hard ground tunnelling will be use slurry machine and rock machine, for soft ground tunnelling will be use earth pressure balance machine. (IMIA Conference Istanbul, 2009)The main function of the tunnel boring machine is to excavate tunnel with the machine and acro ss and remove the soil component there are include variety and soil and hard rock.2.5.1 The characterise between selected tunnel boring machine (TNB) and alternative TBM2.5.1.1According to the (MMC-GAMUDA JV, 2009) following is the based criteria for the smart tunnelGeneralGeotechnical1)The delivery time of smart tunnel mustiness be short ,not more than one year time in order to prevent the delay of the contract program1)The tunnel boring machine should able to process excavation under the following situation2) Due to the ground condition are complex the smart tunnel must be design and build to survive along the drive.2) -The tunnel consist 70% of Limestone formation namely as marble.-The North end consist 25% of adept face mine tailings-5% of the tunnel in Kenny Hill formation3) Large, 12,25m excavation diameter3)High groundwater table close to surface4) )Able to negotiate tight R=200m curves tunnel design R=250m curves4) Extremely high permeability at open karsic solution channe ls5) Low overburden Minimum0.9D, Maximum 1.5D5) Below of rockhead the slump zone are in the overburden6) The tunnel should affect the environment due to the tunnel is surround the city.6) Due to the cyclical water table changes or during earthquakes the tunnel naturally occurring sinkholes7)Restricted access to alignment at 2/3d of the cases for ground treatment7) Highly variable, pinnacle rockhead causing frequent mixed face condition2.5.1.2 (TBM) Selection technical comparison pointsThe following table are refer to (MMC-GAMUDA JV, 2009)DescriptionHerrenknechtHitachiKawasakiMitsubishiNFMGeneral251413624 woodcarver head8553573372Drive6563504362Shield4430272129Segment Handling3522242035Probe drilling1077612Manlocks17168824Trailer2618181226GuidanceMonitoring4428312742Service7553404178Slurry system4941433755Total475345318254459Due to the higher mark and the price and delivery time is most suitable for the smart tunnel project therefore the project team have selected the Herrenknecht m achine for tunnelling part.2.5.1.3 The selected tunnel boring machineCUsersJackyDesktoptbm.jpgFigure__ showing the cross section of the herrenknecht tunnel boring machineThe characterise of the herrenknecht tunnel boring machine as following table are refer to (MMC-GAMUDA JV, 2009)1)Cutter head diameter 13.260mmLength of shield 10.245mm2)Drive 4.000kW hydraulicWeight of shield 1.500t3) Rotation 0-3rpm lunge cylinders 48nos4)Displacement thrust force28.9KNMax.thrust 94.5KN5)Length of machine71mGrout line8nos6)Two trailer cars on haunch railsGuidanceVMT SLS-APD7)Weight of machine 2.500tTailseal 3ros,wie brushesDisc cutters76 Nos2.5.1.4 Special features of the Herrenknecht tunnel boring machineAccording to the (MMC-GAMUDA JV, 2009) there are few special feature of the herrenknecht tunnel boring machine there are include as followingThe Spherical main bearing are able to negotiate tight up to minimum R200m curvesBy using herrenknecht tunnel boring machine the feat along the drive are e asier to cutter replacement due to the cutterhead retraction up to 400m by axial displacement.Articelated tailskin to negotiate to tight curvesThe tunnel boring machine is able to detect the karstic features and mixed face condition by using the cutter head tilt moment indicator.Two probe drilling rigs in fixed downward looking position, mounted on the erector the rig could drill through any port in the skin.2.5.1.3 The selected tunnel boring machine thick