Acute Myeloid Leukemia: Causes and Treatment Strategies

Acute Myeloid Leukemia: Causes and Treatment Strategies Pathology Acute myeloid leukemia is a disease that primarily afflicts adults. The likelihood of being diagnosed with AML increases with age; the median age of diagnosis is 65 with very few cases reported in those under the age of 40 [4]. Several risk factors have been associated with increased incidence of AML including: Li-Fraumeni disease, Klinefelter’s syndrome, radiation exposure, chemotherapy, and chemicals (benzene, herbicides, etc) (See supplementary figure S.1) [4]. However, the initiation of AML is a multistep process and can be the result many different genetic aberrations [4][5]. Therefore, the aforementioned risk factors do not account for all cases of AML [4]. Acute myelogenous leukemia is the result of oncogene-driven accumulation of immature myeloblasts within the bone marrow [5]. Myeloblasts are progenitor cells, which will ultimately give rise to neutrophils, basophils, eosinophils, and mast cells (collectively known as the granulocytes) [6]. In AML, the genes that govern proper differentiation of myeloblasts into one of the aforementioned cell types are mutated. This prevents differentiation and leads to a buildup of myeloblasts within the marrow [5]. The clinical consequences of myeloblast buildup are marrow failure leading to low white-blood cell count, low red-blood cell count, and insufficient levels of clotting factors [5]. Therefore, clinical symptoms are depressed immune function, anemia, and continued hemorrhaging. The molecular pathogenesis of AML (and all cancers) begins with the acquisition of genetic abnormalities. There are two models that describe how these acquisitions arise. The conventional model of cancer cell initiation proposes that the cell gradually acquires certain mutations to genes involved in mitotic signaling (KRAS or APC) and tumor suppression (P53), thereby allowing the cell to divide uncontrollably [7]. However, Recent work by Stephens et al. [8] showed that multiple mutations can be induced in a â€Å"one off† event by the random shattering and re-ligation of one or more chromosomes [8]. They termed this event â€Å"Chromothripsis† [8]. Chromothripsis results in massive translocations and changes to copy number state, but is distinct from the conventional model of cancer cell initiation by the presence of large-scale inter-chromosomal rearrangements [8]. Thus, the chromothripsis model differs from its conventional counterpart in the time taken for the cell t o reach malignancy and the scale to which the genome is altered. Chromothripsis is observed in a portion of AML cases; Rausch et al. [9] found nearly half of the AML cohort showed chromosomal rearrangements consistent with chromothripsis [9]. This shows that, accumulation of the necessary mutations that drive AML may occur by more than one mechanism. By either mechanism of AML initiation, myeloblasts lose the ability to differentiate. The molecular pathogenesis commonly shows two frequent chromosomal aberrations – a translocation between chromosome 8 and 21, and an inversion of chromosome 16 [5]. These changes affect two genes crucial for myeloid differentiation (CBF1ÃŽ ± and CBF1ÃŽ ²) [5]. The effect of the inversion and translocation results in a gene chimera, which is translated into a protein that interferes with proper CBF1ÃŽ ± and CBF1ÃŽ ² function [5]. However, these specific chromosomal alterations are not observed in every case of AML. DNA-damage inducing agents like radiation or certain chemicals, may cause aberrations to chromosome 5 and 7, which has also been implicated in the initiation of AML [5]. This shows that there are several factors involved in proper myeloid differentiation and that interference to any of them may result in AML. Visual differentiation of healthy myeloblasts from leukemic myeloblasts can be challenging. Myeloblasts should contain 3 5 nucleoli, which are full of uncondensed chromatin [6]. Some leukemic myeloblasts may show more than 3 – 5 nucleoli [5]. Also, they do not normally contain granules, however, leukemic myeloblasts may have granules, which can serve as a potential marker for diagnosis [5]. It is important to stress that these morphological changes may not appear in all cases of AML. Therefore, prognosis is confirmed by the presence of greater than 20% myeloblasts in bone marrow biopsy [5]. Treatment There are different avenues for treating AML. Treatment may include supportive care (in advanced cases), chemotherapy, and stem cell transplantation. However, chemotherapy is the most common and effective method of treatment [3]. When medicinal chemists began isolating antibiotics produced from bacteria in search of potential leads for drug design, Aurelio Di Marco and his research team discovered a new species of bacteria, Streptomyces peucetius, within a soil sample they obtained from an area near Bari, Italy [10][11]. This new strain of bacteria was produced a compound that was efficacious as a chemotherapeutic agent against many tumors; the compound was later named daunorubicin and is now considered a key intervention administered to patients with AML [12]. Daunorubicin and doxorubicin are part of the class of antibiotics collectively known as the anthracyclines. Anthracyclines can cause cytotoxicity by different mechanisms depending on their intracellular concentration. As reviewed by Gerwitz [13], in vitro studies show there are several possible mechanisms for the anti-tumor effects of these agents including: Inhibition of DNA synthesis, free radical generation leading to either DNA damage or lipid peroxidation, inhibition of DNA topoisomerase resulting in helix super-coiling, DNA alkylation, and DNA cross-linking [13]. The induction of apoptosis was also mentioned as a mechanism of cytotoxicity, but it is likely that apoptosis is a byproduct of the aforementioned cellular stresses, rather than a direct consequence of anthracycline exposure [13]. It is important to note that these mechanisms were observed in vitro, and that in vitro conditions allow for exposure at concentrations that may greatly exceed in vivo concentrations [13]. Pharmacodynamics Although, daunorubicin and doxorubicin are thought to cause cytotoxicity by several different processes, their ability to bind to DNA and prevent DNA replication or transcription is considered to be the primary means of anti-tumor activity in vivo [13][14]. This is because replication is inhibited at anthracycline concentrations that can be reached in vivo following a standard dosage [13]. The two anthracyclines appear to intercalate preferentially to regions of DNA with select base-pair composition, specifically, regions with CGATCG sequences [14]. Rabanni, Finn, Ausio [15] suggest that intercalation stabilizes hydrogen bonds between the two strands of DNA [15]. This means that the energy required to separate the strands is higher, and cannot be achieved by DNA helicase [15]. Thus, strand separation is inhibited, preventing DNA replication and tumor cell proliferation. For both compounds, the chromophore portion (DCBA in fig. 1) of the molecule intercalates between complementary guanine-cytosine (GC)  base pairs on each side of the DNA double-helix (fig. 2). The compound is stabilized in this position by hydrogen bonds on either side of the molecule. The â€Å"D† side of the molecule is held in position with aid from a solvent atom (believed to be ionic sodium), which forms hydrogen bonds between oxygen 4 and 5 to  nitrogen 7 of guanine12 (fig. 2) [14]. The â€Å"A† side of either drug is coordinated by hydrogen bonds from oxygen 9 to nitrogens 2 and 3 of guanine 2 (fig. 2) [14]. As previously mentioned, all of these interactions occur between both daunorubicin/doxorubicin and C/G DNA sequences. However, the added hydroxyl group on C14 of doxorubicin creates an extra association. The hydroxyl appears to shift solvent molecules such that indirect interactions between itself and the phosphate backbone of DNA are created (fig. 3) [14 ]. This added interaction might explain the slightly higher in vitro affinity constant between doxorubicin-DNA (Ka = 1.610-5) as compared to daunorubicin-DNA (Ka = 1.210-5) (in vitro Ka determination performed at 37 °C in 10% fetal calf serum) [17]. Doxorubicin is more potent than daunorubicin. In the case of anthracycline induced inhibition of DNA strand separation, the potency and efficacy are directly related. The increased binding affinity of doxorubicin means that it will associate with DNA and prevent DNA separation at a lower concentration (See supplementary fig.S2). Therefore, pharmacological factors aside, it will be more potent and will prevent tumor cell proliferation at lower concentrations. Synthesis Doxorubicin is a semi-synthetic analog of daunorubicin. The daunorubicin producing bacteria, Streptomyces peucetius, was mutated to the doxorubicin producing subspecies Streptomyces peucetius subsp. caesius [18]. This mutated strain was found to carry an oxidizing cytochrome P450 isoform capable of hydroxylating the C14 of daunorubicin [19]. The gene that encodes this P450 is called doxA [19]. Although, this gene is crucial for doxorubicin production, its presence does not guarantee collectable quantities of doxorubicin (See supplemental figure S.2) [20]. Enzymes, such as dnrH and dnrX, may further oxidize or reduce the newly formed doxorubicin into other metabolites that do not have antitumor abilities [18]. Therefore, in order to make doxorubicin production sustainable, the down regulation of such genes is required to increase doxorubicin yield. Pharmacokinetics Despite their similar molecular structure, daunorubicin and doxorubicin have distinct pharmacokinetic properties. This section will begin by contrasting the differences in elimination, metabolism, and distribution. Bioavailability will not be contrasted because both of these agents are administered intravenously. The section will then conclude with a description of tissue distribution, intracellular distribution, and toxicity. Administration As already mentioned, both anthracyclines are administered via intravenous injection [21][22]. They should not be injected subcutaneously or intramuscularly due to the significant risk of tissue death at and near the injection site [23]. The exact dosage schedule for both daunorubicin and doxorubicin is dependent on several different factors including: age, health, pre-exisiting heart conditions, and renal functioning, therefore exact dosages vary among different patient populations. In terms of daunorubicin, dosage ranges between 30 and 45 mg/m2, whereas doxorubicin dosages range between 40 and 75 mg/m2 during the initial course of treatment [24][25]. Elimination Both compounds are eliminated from the plasma via urinary and biliary mechanisms [23]. However, a much greater proportion of a daunorubicin dose is excreted through the kidneys (14-23%) as compared to doxorubicin (5%), while a larger proportion of doxorubicin was reported to be excreted through the bowels (50%) compared to daunorubicin (40%) [23]. Daunorubicin and doxorubicin are considered to be high clearance drugs. They have a similar clearance value of 1-2 L/Kgà ¯Ã¢â‚¬Å¡Ã… ¸h [26]. The elimination of either drug, along with their metabolites, follows a triphasic decline in plasma concentration [23]. After a 60ml/m2 infusion of daunorubicin/doxorubicin, the plasma concentration/time graph shows that both drugs are eliminated with a similar rate (fig.3) [26]. However the Medsafe ® [23] datasheet for daunorubicin/doxorubicin reports that the plasma T1/2 for the first phase averages 45min daunorubicin and 12min doxorubicin, while the second phase is 18.5hrs daunorubicin, 3.3hrs doxorubicin. Metabolism The primary metabolites of daunorubicin and doxorubicin are daunorubicinol and doxorubicinol respectively. Because of their similar structures, the metabolism of either compound occurs in a likewise fashion. The enzyme most implicated in metabolism is NADPH (nicotinamide-adenine-dinucleotide-phosphate) dependent cytochrome P450 reductase [27]. This enzyme reduces the ketone at C13 to an alcohol to produce daunorubicinol and doxorubicinol [28]. These two products are believed to retain their cytotoxicity and are cleared from the plasma at a similar rate [28][29]. Another common metabolite for either compound is generated via reduction of the glycosidic bond by gycosidases. Glycosidic reduction results in removal of the amino-sugar that is bonded to C7 [28]. This reaction eliminates the anti-tumor capabilities of either compound [28]. Following removal of the amino-sugar, the remaining aglycone is demethylated and then undergoes phase II metabolism (sulfonation or glucuronidation) [23]. Phase II metabolism by sulfonation or glucuronidation increases plasma clearance and enhances elimination. Two other metabolites are listed in literature, 7-deoxydoxorubincolone and 7-deoxydoxorubinone, however the enzyme or enzymes that facilitate these reactions were not noted [30]. Two other enzymes metabolize both daunorubicin and doxorubicin under aerobic conditions, xanthine dehydrogenase and xanthine oxidase, and produce reduced semiquinones and oxygen radicals [31]. These radicals could provide added efficacy to the drug therapy. It has been suggested that advanced stage cancer cells exhibit high oxidative stress and that it may be advantageous to exploit this finding to preferentially and specifically attack and destroy them [30]. Under anaerobic conditions, xanthine dehydrogenase metabolizes doxorubicin to 7- deoxydoxorubicin aglycone, which has been found to be efficacious in the reduction of the drug’s toxicity [31]. Volume of Distribution Daunorubicin and doxorubicin localize in the tissues. The Vd for daunorubicin is 39.2 L/Kg, while the Vd for doxorubicin is 24.6 L/Kg [26]. This indicates that both compounds have high tissue distribution [26]. Although the addition of a hydroxyl group at C14 markedly reduces doxorubicin’s ability to distribute into the tissues (relative to daunorubicin), doxorubicin remains within leukemic cells for a longer duration than daunorubicin (fig. 5) [26]. Upon administration, daunorubicin accumulates within leukemic cells more rapidly than does doxorubicin (fig 5). This is likely because of the increased polar surface area brought on by the added hydroxyl group of doxorubicin, which hinders its ability to cross membranes. However, the added hydroxyl group provides increased binding affinity to DNA [17]. Therefore, it will not leave the cell as rapidly because it will remain bound to DNA [26]. Toxicity The clinical use of doxorubicin and daunorubicin may be limited by their similar inherent toxicity. It goes without saying that chemotherapeutics should not be administered to women who are lactating or pregnant due to significant health complications that can be incurred by the infant or fetus, respectively, therefore these drugs should not be considered in these populations [33]. The use of these agents in a long-term manner is cautioned due to their ability to cause cardiotoxicity [29]. Under aerobic conditions, the semiquinone radical that may be produced during metabolism undergoes redox cycling [27]. Accumulation of reaction oxygen species soon occurs and can cause cytotoxicity [27]. This is believed to account for tissue death in cardiac cells, and is one of the major implications of using the anthracycline class of anti-tumors agents [27]. The cardiotoxicity itself includes effects such as functional damage to mitochrondrial DNA, interference of cytochrome c oxidase, and dysf unctional lipid peroxidation [13]. Personalised Cancer Treatment: Known Markers in Treatment Personalised Cancer Treatment: Known Markers in Treatment Personalised cancer treatment – known markers and what they mean for treatment Contents (Jump to) Known markers and what they mean for treatment Overview Drug target markers Diagnostic and prognostic markers Meta description Keywords Copyscape Known markers and what they mean for treatment Overview Personalised, targeted and hormonal treatments all depend on genetic mutations that can be identified in cancer cells to be effective. These mutations are sometimes referred to as â€Å"markers†. The markers can manifest through over-expression, lack of expression or mutated expression of specific proteins. Some markers can be targeted using specific treatments whereas some can act as measurements for disease diagnosis, prognosis and treatment response. Drug target markers The genes listed below have all been associated in cancer, the majority of which can also be treated. (*) – Targetable genes and proteins that can also be measured to determine treatment response, cancer diagnosis and prognosis. Diagnostic and prognostic markers The following markers are all related to diagnosis, prognosis and treatment progress. Meta description Cancer markers can help with the diagnosis and treatment of cancer and can give access to targeted therapies. Keywords Cancer markers, genetic markers, diagnostic markers, drug target markers Copyscape Checked Sep 2014 CIGNPOST: KNOWN MARKERS AND WHAT THEY MEAN FOR TREATMENT © Cignpost Ltd 2014PAGE | 1 [EB1]If these are genes not proteins then they should be in italics Psychology Christianity: Five Views | Eric L. Johnson Psychology Christianity: Five Views | Eric L. Johnson Review of â€Å"Psychology Christianity- Five Views† by Eric L. Johnson. Title: Psychology Christianity Five Views Author: Eric L. Johnson Publisher: InterVarsity Press. (U.S.A.) 2000 Price:  £14.37 ISBN: 978-0-8308-2848-7 Introduction: In this book review, I intend to cover the following outcomes: evaluate psychological theories against biblical teaching, discuss the contribution psychology has to make to Christian counselling, assess the compatibility of psychology (research and psychotherapy) with Christian counselling and critical examination of psychological theories. About the editor Eric L. Johnson is a teacher, editor, author and director. He attended Toronto Baptist Seminary and proceeded on to Calvin College before going on to Michigan State University where he bagged his PhD. He is an academic psychologist and initially lectured for nine years at the Northwestern College in Minnesota teaching Christian worldview, psychology and theology. Johnson wrote â€Å"Foundations for Soul Care: A Christian Psychology Proposal† and contributed several articles for the Baker Encylopedia of Psychology and Counselling. He argued for the necessity of theology in counselling and psychological research. He is with the Journal of Psychology and Theology as an associate editor. Johnson edited a special issue of the Journal of Psychology and Christianity, entitled â€Å"Psychology within the Christian Tradition† in 1998. He made contributions in two books: â€Å"Christianity and Psychology: Four Views† and â€Å"God under Fire: Modern Scholarship Reinvents God† in addition to editing this book that I am reviewing. Johnson is currently the director of the Society for Christian Psychology and the Lawrence and Charlotte Hoover Professor of Pastoral Care at The Southern Baptist Theological Seminary in Louisville, Kentucky. About the Book Psychology and Christianity: Five Views, is divided into seven chapters and has three hundred and nineteen pages. It is a review and expansion of the first edition titled â€Å"Psychology and Christianity: Four Views†. This book essentially lends to give a precise understanding of human nature and this is an issue that has refused to go. In page 104, we see that Adams argues that the Bible is sufficient to understand human nature and there is nothing psychology can offer but there are opposing arguments. Freud cited in Chapman (2007:41) argues that religion is an illusion. However, Crabb cited in Lutzer (1998:72) argues that we can spoil the Egyptians; take the best of both Christianity and Psychology for our use and become more effective as long as they are not in conflict with the Bible because the Bible will always be superior. The Wesleyan Quadrilateral advocates that four factors (Scripture, Tradition, Experience and Reason) must be considered when reaching decisions. In view of all this on-going debates, Johnson tries in this book to advance the argument for a relationship between Psychology and Christianity, and address the issue of helping Christians to understand and grasp the nettle of psychology. In this edition, there is a fifth view which has been added to the first edition of four views. This fifth view is contributed by John H. Coe and Todd W. Hall and it is titled â€Å"A Transformational Psychology view†. The other four view contributors were still involved in this edition but with revised contributions. The authors put forward five different views of how Psychology and Christianity can be integrated. They are David G. Myers who deals with the levels of explanation; an integration view by Stanton L. Jones, biblical counselling view by David A. Powlison and Christian psychology by Robert C. Roberts co-authored by P.J. Watson. Johnson wrote the opening chapter discussing the history of Christian psychology and also the closing chapter which talks about gaining understanding through the five views put forward by the various authors. The authors gave very good account of themselves in their respective views. Every chapter is concise, well laid out and the thought flow pattern is quite consistent and credible. Content of the book Johnson sandwiches the five views in between two chapters that he authored. He started in this first chapter by looking at the history of Christians in Psychology. In this chapter, Johnson looks at a generic background of psychology but with special reference to how psychology is viewed today. He argues (page 10) that science is a gift from God and that the scientific revolution was initiated by mostly Christians. Some Christians have unreservedly incorporated modern psychology while others like (Bobgan Bobgan 1987) have out-rightly rejected it and called it â€Å"psychoheresy†. Johnson explained in this chapter about the neutrality of this book and that it is rather a picture of the views of the majority of Christians. The second chapter was by David Myers and it deal with levels of explanation. This chapter delves into the subject of human characteristics. This view recognises that Christian theology and Psychology are different and should be treated so but that both should combine well. Myers argues (page 49) that both vary especially in the methodology of research and so each should free to explore as they deem fit. He further argues (page 72-74) that scientific data has enabled him along with some other Christian thinkers to shift from their view of seeing homosexuality as a sin, to understanding the biological explanation of prenatal influences to brain differences especially also considering the fact that the Bible did not have much coverage on the subject matter. Stanton Jones wrote the third chapter which is on the integration view. He shares the same view as Myers; that both Christian theology and Psychology have something to contribute to each other and consequently should be integrated; an aspect that is contrary to Myers view that they should be separated. Christianity is God’s word and psychology is God’s work. Jones argues (page 101) that God’s sovereignty prevails over every facet of human life and that Christian psychologists should benefit from that. However, Jones also shares a common view as Myers with regards to the fact that the Bible does not address some issues adequately (page 101). Jones shares a personal testimony of the tension points that he struggled with in-between Christianity and Psychology. (103-104). Jones became more confused as he desired to be faithful to the Bible, yet, he could not argue with the result that he was actually learning a lot about human nature in Psychology and so through excl usion, he found himself blending both Psychology and Christian theology. The fourth chapter deals with Christian psychology and was co-authored by Roberts and Watson. They argue that understanding God which is revelation (general and special) should be the starting point for the development of psychological theories. These authors (page 155-156) argue that Christian sermons (using Jesus’ sermon on the Mount as an example) are aimed at helping people to live well; dealing with character and transformation of persons and that psychology also deals with how to live, and changing a person’s character with the aim of living well. They identify terminology as the only difference between both. They argue (page 157) that sermon conceptualises psychology. John Coe and Todd Hall co-authored this fifth chapter which deals with the transformational view. They set out, not to develop or defend a model but to shed light on their argument, (page 200) that psychology and Christianity are closely related and that psychology is only an expression of faith and love. This view is the view that has just been added in this edition making it five views. They argue (page 200) in favour of the process and methodology of psychology as a process to new ways of transforming people. This approach looks into the psychologist’s transformation (emotional and spiritual). David Powlison authored the sixth chapter which discusses a Biblical counselling view. He started with a very bold statement â€Å"Christian faith is a psychology†. Also that â€Å"Christian ministry is a therapy† These statements summarises his view. Powlison argues (page 245) that the Scriptures talks about thoughts and intentions of the heart. He further argues that God through the scriptures reveals how human beings should achieve their potentials and a clear change process of attaining such too. Powlison assumes a very new approach in his view; the approach is to delve into the meanings of the word â€Å"psychology† in the very context in which it is used. He argues (page 248) that obviously the meaning is relative. In a bid to drive home his argument, he develops sub themes; Psych 1 – 6. Psych 1 looks at how you work,; Psych 2 looks at the detailed knowledge of human functioning; Pych 3 looks at the competing theories of human personality; Psych 4 de als with the practical application to psychotherapy; Psych 5 looks at a system of professional and institutional arrangements and Psych 6 deals with a mass of ethos. Powlison was really keen on ensuring that his readers have a very clear understanding of his view and goes a step further with a case study as he argues (page 262) that looking at cases is the best way to understand psychological views including biblical counselling. Eric Johnson authored the seventh and closing chapter where he made reference to similar books that has multiple views on the same subject. According to him, this book helps to highlight the point that a group of people, and specifically Christians in this instance, have the same belief but varied perspectives even within the same belief. Johnson (page 293) uses Proverbs 12:15 to affirm that a wise man will be humbled, by that awareness of what he does not know. No one has absolute knowledge except God. He argues that because we are finite creatures, we are limited in terms of views but God is the omniscient observer. He further argues that the more views we are open to, the better our understanding will be, and he encourages his readers especially Christians to dialogue, engage, critique and integrate the strengths of these views as it will enhance their understanding and scope in other to develop their own â€Å"postformal synthesis† (page 309). There is something I found very fascinating about this book. I found out that each chapter have contributing responses from the perspective of the other authors highlighting the strengths and weaknesses of the particular view in light of their own view. My thought. I think that the writing style is easy to read and understand. The chapters are logically laid out and concise and the literary genre is prose. The subsequent contributions from diverse perspectives to each chapter are not common and made it all seem like a conference, answering most questions that readers could have raised. I am the pastor of my local church; I encourage members through prayers, teaching, preaching and pastoral care, based on the Scriptures. I have found myself at crossroads in some contemporary issues which are similar to the observations of Myers and Jones, where they have found the Bible silent on some issues and inadequately addressing some other issues. This is one of my reasons of studying Counselling, and a book like this has opened me up to differing views highlighting both strengths and weaknesses of those views. This review has been an eye opener for me. CONCLUSION In conclusion, I consider the book well-structured as Johnson sets the stage with the historical background and after taking the five views, he borders the book at the end, encouraging scholars to critically and constructively engage to progress the work. Finally, I observe that Johnson claims (page 10) that the book is neutral and that the views represent the collective views of a majority of Christians. This is a very good claim but it would have been very good if he had gone a step further to substantiate his claim with data. However, overall, I consider this book to be of immense value to any Christian psychologists irrespective of their chosen model; it will open them up to differing views even within the Christian community of Psychotherapists. . I identify with Stanton Jones who authored the Integrative view and I will recommend this book to anyone who is seeking a clearer understanding of the integrative model of counselling. References: Chapman, C.N. (2007). Freud, Religion, and Anxiety. USA: Lulu.com. Page 41 Lutzer, E.W. (1998) Pastor to Pastor: Tackling the Problems of Ministry. USA: Kregel Publications. Page 72 Peter Emordi Psychology of Christian Counselling COU2001 1

Diversity and Individual Behaviour

Diversity is what the world is made of. Without diversity, the world would be an uninteresting and inhospitable place. Without diversity, there would be no variety of opinions or alternate views. There would be no different views or ways of thinking. Being diverse provides a way for people to express opinions and views to others who may not have pictured a situation the same. Four factors that cause diversity are ethnicity, gender, religion and sexual affinity. These groups have an outcome on the course of daily choices. The author of this paper will look into each of the groups and how the aspects have an impact on individual behavior. Ethnicity has an influence on behavior that cannot easily be ignored. At work the influences of ones ethnicity is dealt with everyday. African-American stereotypes have led to â€Å"being black as similar to having a felony conviction when regarding the chances of finding a job. The results of a study suggested black men must work at least twice as hard as equally qualified white men to rise above the stigma their skin color provides (Pager, 2009).† The humiliation is, for the most part, due to labeling. According to Devine and Elliot (1995), in the 1930’s the adjectives used to describe an African-American were superstitious, lazy, and ignorant, and today the adjectives vary from unintelligent, loud, and criminal to musical, athletic and very religious. Discrimination is often difficult to observe, and yet, despite the antidiscrimination laws discrimination still occurs. The author of this paper is a case manager for individuals with developmental disabilities, and observes the subtle nuance of bigotry almost on a day to day basis. Being articulate and having a name that belies the true ethnicity frequently surprises people when meeting in person. The dumbfounded expression is not easily hidden regardless of one’s efforts to mask it. Statements such as ‘you sounded different over the phone, or you look nothing as I imagined’ are uttered frequently during these meetings. After such meetings, those who are truly prejudiced will request to work with someone else; giving superficial explanations to the request.  For example, ‘we prefer to work with someone with more experience’, or with a man, regardless of the fact the author has more than 20 years of experience in the profession. Being African-American has its hardships. In addition to that adversity, consider the privation of being an African-American woman. The author’s supervisor admitted to being cautious with relaying the information about the requests of those who had recently met the author in person. Why was the supervisor afraid to approach the author? Because, the African-American woman is often portrayed as a defiant, smart-mouthed, sassy, finger-waving and eye-rolling person, it is easy to understand her fear. The African-American woman has to be diligent in the efforts to contradict the assumptions. Just being female impacts a woman’s behavior. Women are portrayed as and believed to be whiners, nags, flakes and shopaholics. Women are thought to be helpless and in need of rescuing; by a man, of course. In the business world certain jobs have traditionally been considered gender specific. A woman who holds a stereotypical masculine position, such as construction ‘foreman’, is capable to use the equipment just as successfully has the men, but often the men see her as delicate; unable to work too hard, resulting in less productivity and more stress in the workplace. Women want the same respect, opportunities and responsibilities as men. However, chauvinistic attitudes often obstruct a woman’s advancement. The author has overheard such comments as: ‘she doesn’t need a promotion, her husband makes more’, presuming a female employee has no right to a full fledged career, or a larger salary comparable to the male employees. Surprisingly, th e comment was made by a female. Sexism is evident in all areas of life. For example, people debate if women should play a sport traditionally played by men. The year 1896 is when women playing football was first documented. The men’s reaction to the football game was mentioned more than the game itself: ‘the crowd of men looking on, excited by the struggle, closed in with a rush.’ It was not until 1970 that a woman was allowed to play on a men’s semipro football team and not until 1999 did  The Women's Professional Football League begin playing professional women’s tackle football games (Women's Professional Football League, n.d). Sexism exists in religion as well. To the Catholic Church, Mary, the mother of God is the most perfect human being. Yet, a woman cannot be ordained as a priest. The woman’s highest role in the Catholic Church is that of a Nun; a servant living under vows of poverty, chastity, and obedience. In other faiths women have more of a role, for instance in the Episcopalian religion; a woman may be a priest. In Judaism rabbis have been known to depict women as envious, unproductive, lazy, greedy, and prone to gossip. In Judaism a Jewish woman’s role in life is traditionally a wife, mother and keeper of the household. The Jewish woman knows her place and the depictions have discouraged many women from pursuing an education, career advancement and sexual affinity (Marcy Hyatt, personal communication, January 7, 2009). Marcy Hyatt, a Jewish woman and a homosexual, also reported her experience of being homosexual and being Jewish as parallel. She has fought prejudice and fought for civil rights, and although she no longer has to fear being visible, she continues to work to maintain her self-worth in the face of ignorance and bigotry. According to the American Psychological Association (2004) while sexual orientation is not a conscious choice that can be voluntarily changed, several homosexual and bisexual people seek to change their sexual orientation through therapy, often coerced by family members or religious groups. In the United States, homosexual and bisexual people often meet widespread violence, discrimination, and prejudice. The discrimination takes many forms from being denied raises, promotions and getting poor performance evaluations to bullying in schools. The fear of being known as a homosexual or bisexual has led to men hiding sexual orientation from loved ones and doctors thereby possibly putting themselves and loved ones at an increased risk for HIV/AIDS. Regardless of the fact that no one can avoid diversity, people fear differences and seek only what is perceived as safe; remaining ignorant to what others have to offer. Fearing people different from us is a natural tendency because of how we were raised. When we treat one another as individuals with feelings, then we will experience true multiculturalism.

Obesity Improving Health Outcomes - 520 Words

While exploring possible health issues and a population to focus on for my project, I was overwhelmed by the number of issues we are faced with everyday. I narrowed the search down to obesity and the population I would like to focus on is the adolescents. Health People 2010 identified overweight and obesity as one of the top ten leading health indicators that needs serious attention. Obesity has reached epidemic levels globally; being a significant threat to our own nation’s health. Adolescent obesity rates have more than tripled, as the adult obesity rate has doubled since 1980’s (Trust for Americas Health, 2011a). It was interesting to learn of particular statistics and trends concerning adolescent obesity in our nation. Geographic†¦show more content†¦It’s not easy growing up in today’s world as an adolescent. The psychological, physical, social, and environmental factors can have significant negative impacts on their health. During the adolescent phase it is a very â€Å"extraordinary plasticity† period (Steinbeck, Baur, Cowell Pietrobelli, 2009, p. 2). These individual’s habits, attitudes, and physical morbidity develop during this phase. This establishes the pathway and blueprint that influence their long term health and wellbeing. When deciding what approach I would take when addressing this epidemic problem, I decided on health promotion and prevention. The two are so closely interrelated that it is hard to separate. However, health promotion and prevention also have over lapping boundaries with health management, marketing, community empowerment, and policy. In order to promote and prevent this epidemic, we need to rely on the policies (that regulate food and exercise in our schools and communities), the marketing (that promote and provide the tools to make our nation aware about this epidemic), and community empowerment (to support our nation about how to permanently change their lifestyles and way of thinking). I chose health promotion and prevention as it draws from the actions of these other elements. In order to be most effective, a system-wide approachShow MoreRelatedThe Healthy People 2020 Objective Nutrition And Weight Status Essay1451 Words   |  6 PagesThe Healthy People 2020 objective Nutritio n and Weight Status has a goal of improving the diet of Americans, thus improving their overall health. â€Å"Diet quality is critically important to the prevention of many types of chronic disease† (Wilson et al, 2015, p. 302.) 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Escapism And Disassociation In The Sun Also Rises - Free Essay Example

Sample details Pages: 6 Words: 1841 Downloads: 8 Date added: 2019/08/16 Category Literature Essay Level High school Tags: The Sun Also Rises Essay Did you like this example? In The Sun Also Rises, written by Ernest Hemingway, we are met with many problems faced by the lost generation after WW1, including the search for fulfillment, love, and the aimlessness of the lost generation. However, readers are also met with another and more problematic conflict. Dissociation and escapism which is presented through the main protagonists Jacob Barnes and Lady Brett Ashley who display similarities with Maladaptive Daydreamers. Don’t waste time! Our writers will create an original "Escapism And Disassociation In The Sun Also Rises" essay for you Create order Just like those who are Maladaptive Daydreamers, Jake and Brett are constantly trying to dissociate and escape from the world around them, because they cant bear to live the life they have post-war or stand to be the people they have become, this results in them further losing their sense of self and becoming more dissatisfied. As shown above Maladaptive daydreaming is an under researched and a unrecognized mental disorder. In a article written by Eli Somer, he describes it as a extensive fantasy activity that replaces human interaction and/or interferes with academic, interpersonal, or vocational functioning (1). The symptoms include highly vivid daydreams that are abnormally long, a strong attachment to such daydreams, inability to carry out everyday tasks, insomnia, and daydreams triggered by real life events or stimuli. Those who maladaptive daydream tend to have some other underlying mental disorders alongside it, for example, within the article it is mentioned that six patients who were identified to be maladaptive daydreamers, four were diagnosed with dissociative disorder, and two were diagnosed with narcissistic personality disorder. However, if they dont have a mental health issue, they have some sort of traumatic experience that has happened to them instead. According to the article Maladaptive Daydreaming: A Qualitative Inquiry, written by Eli Somer, people who maladaptive daydream, often do so to cope with what is going on in their lives or an traumatic experience, but also as a way to express themselves. Through their daydreams they are able to disengage from stress and pain, have fulfilling fantasies, and companionship. In their dreams there is recurring themes such as violence, power, control, and an idealized-self (1). Many people view this disorder as an quirky trait, but its much more than that, some think of it as a addiction, not being able to stop it, others view it as a much deeper issue. The issue of you not wanting to be you. Which therefore leads to them daydreaming a different world in which they are someone they want to be and are able to escape who they are in reality. Just like the maladaptive daydreamers both Jake and Brett had gone through a traumatic experience themselves, which leads to both of them trying to disengage from themselves in order to forget and not feel the pain caused from those experiences. Jakes traumatic experience is being wounded while fighting in WW1, in which it can be assumed he also saw many horrors. Bretts traumatic case would be losing the so called love of her life in WW1, but it can also be assumed since she was a nurse during WW1 that she some horrific injuries and the deaths of other soldiers who could have possibly been under her care. Therefore, in order to forget such incidents, they try to suppress their emotions, and both start to dissociate from the world around them and themselves hoping to escape, especially Jake. Therefore, Jake resorts to alcohol, in which he uses it to suppress his emotions, and just like any Maladaptive Daydreamer, Jake cuts ties with his ego and insecurities. An example of this, I swung at him and he ducked. I saw his face duck sideways in the light. He hit me and I sat down on the pavement. As I started to get on my feet he hit me twice. I tried to get up and felt I did not have any legs. (Hemingway, 195). Leading up to this Jake shows a great deal of anti semitism and hate towards Robert Cohn, however, when he is sober Jake holds it back, and at most is passive aggressive. Whereas in this scene, Jake being intoxicated, gets in a argument with Cohn, starts a fight and throws the first punch, and ultimately ends up getting knocked out and losing the fight. The significance of this scene shows us that by attempting to escape through the use of alcohol and in a attempt to abandon his emotions, he only engages in them, doing the exact opposite of what he intended to do thro ugh the use of alcohol. According to the article, Painful interpersonal experiences encountered during a time when basic assumptions about the world and their self-images were developing, sent these young persons into their much safer imaginary world. (Somer 14). For many Maladaptive Daydreamers, when daydreaming, will often have their daydreams, even though a complete fantasy, reflect the emotions they feel, because through these daydreams just like Jakes alcoholic tendencies, they express what they fail to express in real life. We see the feelings they didnt express, the words they didnt say, the journeys they didnt make, and the beliefs they didnt defend. Jake in his attempts to cut ties with who he is, fails in cutting ties with his emotions, and in his attempt to escape and dissociate he ends up causing more misery and despair for himself. Whereas Brett uses neither alcohol nor Maladaptive Daydreaming to escape, but rather uses relationships instead. By trying to seek that happiness and fulfillment and essentially fill that role of the true love she lost, she only ends up becoming more and more dissatisfied. She uses these relationships thinking theyll fix everything yet they always fail and some poor mans heart is broken for the most part. Brett is especially aware of the role she is playing in her relationships, and she is also aware of the fact that she is hurting others whenever she goes into and out of such relationships, however she continues to act like this. In the end of it all, she leaves, every time she isnt able to get what she wants, or when she isnt able to gain full control of the relationship. She has troubles in her interpersonal relationships just like Maladaptive Daydreamers. For example, Im going back to Mike. I could feel her crying as I held her close. Hes so damned nice and hes so awful. Hes my s ort of thing. (Hemingway 247). After which Pedro Romero and Brett end their relationship, for the first time in the novel we see Brett not only truly upset. But we also see that Brett is capable of emotional depth, and that she is also capable of expressing it, yet she doesnt and in fact tries to avoid doing so in an attempt to dissociate from herself. Furthermore, just like Maladaptive Daydreamers, Brett is running, because shes afraid of emotional depth because it means commitment, but it also means coming to terms with who she is and acknowledging what she feels. As a result, Brett chooses not to express her emotions and ends up trying to hide them in an effort of trying not to ever face them, so she engages in these meaningless relationships with no emotional connections. However, by running and trying to get away by having these disconnected relationships, we can see Brett only further disappoints herself, and even though she breaks someone elses heart, she also ends up breakin g her own in the process. And in all these attempts of running and the constant search of fulfillment she only finds more heartache and sorrow, the very things she didnt want to find. Jake is also very clearly not happy, not only with himself but the life he is living, because of his wound he is not capable of having children nor is he able to be in a relationship with Brett, his true love, which is not only the main source of conflict in the novel, but also one of the main reason for his unhappiness and why he doesnt want to be who he is. Jake is constantly dissociating, shifting focus from himself to immediately something else as though by not thinking about the pain and bitterness, that itll go away. For example, Undressing, I looked at myself in the mirror of the big armoire beside the bed. That was a typically French way to furnish a room. (Hemingway 38). Through this example we can see the shame Jake feels by immediately changing narration and the main focus from himself to something immensely different. Not only is Jake depressed, unhappy, but he is also not proud of himself, because just like Maladaptive Daydreamers, he is not his idealized self. Hes this veteran of World War 1, hes suppose to be the traditional male hero, and what better way to show that by him fighting in a war and coming back alive. However, he isnt or at least he doesnt feel like it, but instead he feels insecure because hes emasculated since he doesnt have the ability to have sex anymore. By having Hemingway present Jake the way he is, he allows for Jake to represent the lost generation, including their feelings of aimlessness and unhappiness. He does this by making Jake display the actions that some of those of the lost generation did. Such as becoming an expatriate, and leaving behind America, his home country, which is a clear and physical example of an attempt to escape, because perhaps by physically leaving jake could leave behind the part of himself he doesnt like, and give himself a fresh start. However, by leaving America, living and working in Paris, and traveling all over Europe, Jake doesnt change, he doesnt get that fresh start, he doesnt gain more power or control over his situation. He doesnt magically get with Brett and everythings happily ever after, and he doesnt stop drinking, and he certainly doesnt reach nirvana, but even in the last lines of the novel, Bretts still there beside him, and nothing much changes for her either. If anything, nothing from the beginning of the book changed towards the end, but maybe thats how things are suppose to be. By constantly trying to escape and dissociate from the world around them and who they are, in an attempt to disengage from their emotions as well, how would Brett and Jake ever know what made them happy, or more importantly how would they ever know how to move on, when they couldnt confront the issue head on or be capable of being who they really are. They werent able to change their situations because they never confront ed the issue that was the source of their pain because such confrontations or conflicts are too difficult to face. So they ran and tried to live being something else, just like how Maladaptive Daydreamers dreamed another life, the life they wanted to live, but thats the problem, they dreamed and nothing more, and tried to be something they werent. They couldnt be happy because they werent themselves, after all thats what they were running from ultimately leading to their dissatisfaction and despair.

Egyptian Legacy Stolen by Greeks Essay - 1004 Words

The main idea of Stolen Legacy is to prove that the ancient Egyptian teachings and education was taught to certain historical figures, was then brought to Athens and taught there and then passed of as Greek philosophy, basically Stolen. Men that went down in history as great philosophers or great thinkers were the ones that made it seem as if they were creating this knowledge. Men such as Socrates, who was from Athens; Plato, also from Athens; and even Aristotle who was from Greece but was forced to leave when Socrates was sentenced to death. These men and others went to Egypt and studied with Egyptian priests and students and returned to Greece with these teachings and ideas and passed them off as their own. When Alexander invaded†¦show more content†¦One of the main teachings that James talks about in Stolen Legacy is the Egyptian Ancient Mystery System. This was the oldest society in the world. It was like a secret organization where membership could only be gained by a pledge of secrecy. In this organization the uneducated were known as a Neophyte, which was a person who was educated in the ways of the Mystery System in order to gain membership to the secret society. In the schools of ancient Egypt there were certain teachings that were common to all. These were taught in secrecy and they were never and could never be written or published. Those Initiates who did a feasible job in their training would be promoted and given that rank of Master or Teacher. The only way for the teachings of the Egyptian Mystery System to come out would be if the outsiders were to learn the ways of the mystery system and publish them and spread them on their own. There are other things that Mr. James points out in his book; for instance, the number of books that Aristotle wrote is seen as impossible for one man in those ancient times because everything was written by hand. It is also said that Aristotle taught Plato, but Aristotle was a great scientist and there is no way Aristotle couldve taught Plato the teachings he taught him if he didnt even learn those things himself. When it comes down to it even theShow MoreRelated`` Stolen Legacy, By George James, A Guyanese Historian And Author874 Words   |  4 Pagesfathers of philosophy and greatest contributors to civilization. In the 1954 book, Stolen Legacy, George James, a Guyanese historian and author, argued that the highly acclaimed Greek philosophy actually originated in ancient Egypt. James’ arguments on Ancient Egypt being the basis of Greek philosophy will be discussed as it relates to the goals of Egyptian theory of salvation and Egyptian Mystery system. The Stolen Legacy begins with uncovering how the Egyptian’s held a Mystery System, which was theRead MoreSignificance Of Restoring African World History2510 Words   |  11 Pageswith ancient Greek and Roman history. To acknowledge the role African people had in establishing Kemet, would cause for the need of a retraction of the statements made by Hegel and other historians. With the research done by recent historian like in George J.M James’ Stolen Legacy: Greek Philosophy is Stolen Egyptian Philosophy, we have rediscovered that the ancient Greeks learnt their philosophy from the Kemetians. Kemetians had acquired this knowledge hundreds of years before the Greek philosophersRead MoreComparing Mexicos Pyramids to Egypts3404 Words   |  14 Pagesto be aware of the pyramids of the ancient Egyptians or did the Mesoamerican pyramids arise spontaneously from the culture of the Inca and subsequently from that of the Maya? The latter is believed to be the case. There is no convincing evidence that the methods of designing, and constructing the pyramids built by the ancient Egyptians thousands of years earlier could have in any way been communicated to the Inca and the Maya. At the time the Egyptians were building their pyramids the Inca and theRead More The Perception of African Americans in the Media and How it Affects Their Self-Identity3877 Words   |  16 Pagescontinuing latent prejudice; African Americans are still searching for their true identity. African American Identity Just as children that were adopted tend to long for a true identity most of their lives, so is the plight of the African American. Stolen from their homeland and forced into enslavement in a new country, African Americans were basically victims of identity theft. Although much progress has been made in the way of an American identity for African Americans, a true identity has not yetRead MoreRastafarian79520 Words   |  319 Pagescharismatic movements. When the interpretation of the signiï ¬ cance of Rastafari is approached from this perspective, it becomes quite clear that the movement is a conscious attempt to deal with the historical experience of colonialism and its contemporary legacies. From this perspective, Rastafari represents an attempt of the African soul to free itself from the alienating fetters of colonial domination and exploitation and to recreate itself in the image of Africa. In the light of the foregoing discussionRead MoreLibrary Management204752 Words   |  820 Pagescontrolling. Around 2000 b.c.e., the principle of decentralized control was introduced, by a vesting of control in the individual states of Egypt; it was only later that the pharaoh established central control over all.1 There is also evidence that Egyptians employed long-range planning techniques and staff advisers. Similar records exist for activities in ancient China. In the China of 3,000 years ago, there were â€Å"concepts that have a contemporary managerial The Evolution of Management Thought Read MoreStephen P. Robbins Timothy A. Judge (2011) Organizational Behaviour 15th Edition New Jersey: Prentice Hall393164 Words   |  1573 PagesKemetic religion, based on ancient Egyptian faith, and affiliates himself with a tribe numbering fewer than ten members. He states that he believes in various deities and follows the faith’s concept of Ma’at, a guiding principle regarding truth and order that represents physical and moral balance in the universe. During a religious ceremony he received small tattoos encircling his wrist, written in the Coptic language, which express his servitude to Ra, the Egyptian god of the sun. When his employer

Capital Markets and Investment Banking Process Free Essays

The investment environment is vast and can be overwhelming if not entered into correctly. Firm’s issuing new securities to enhance revenues understand the complexities and risks involved when entering the primary market, and will employ investment bankers to mitigate those risks. Described throughout this paper is the investment banking process and portfolio construction, factors for selecting the portfolio asset classes, the capital market instruments used in portfolio construction, and recommendations for the composition of an investment portfolio. We will write a custom essay sample on Capital Markets and Investment Banking Process or any similar topic only for you Order Now Investment Banking Process and Portfolio Construction Investment bankers work with firms issuing new securities as both an advisor and intermediary in setting security prices, interest rates, and marketing the new securities for sale in the primary market (Bodie, Kane, Marcus, 2008). The primary market is where firms are able to sell their new securities and obtain funds that are needed to increase their capital base. Firms issuing new securities are strategically working to raise funds; however, there is a potential risk that all the newly issued securities will not sell and the strategy to raise funds could fail.To mitigate this potential risk firms hire an investment banker as an underwriter. As an underwriter the investment banker assumes the risks by purchasing the firms new securities at a fixed price lower than the offering price to the public, and then sells the securities at the current market price for a profit (Hirt Block, 2008). â€Å"With underwriting, once the security is sold, the investment banker will usually make a market in the security, which means active buying and selling to ensure a continuously liquid market and wider distribution† (Hirt Block, 2008, P. 27).After the investment banker has sold the new securities issued by a firm in the primary market, those securities then become an existing asset that is traded in the secondary market between investors (Hirt Block, 2008). In the secondary market investors buy and sell the different existing assets which allow the market to operate efficiently, competitively, continually, and liquidity. Investors investing in these existing assets create a portfolio to monitor their current investment assets, and make their investment decisions based on their portfolio size (Bodie, Kane, Marcus, 2008).In the construction of a â€Å"top-down† portfolio the first step is asset allocation. â€Å"The process of building an investment portfolio usually begins by deciding how much money to allocate to broad classes of assets, such as safe money-market securities or bank accounts, longer-term bonds, stocks, or even asset classes such as real estate or precious metals† (Bodie, Kane, Marcus, 2008, P. 24). Once the asset class allocation has been determined by the investor the next step in the process is to select which securities to purchase.Once a security in an asset class is decided on an investor may perfor m a valuation through a security analysis. The security analysis will aid the investor’s decision by estimating the securities value and the positive or negative impact on the portfolio (Bodie, Kane, Marcus, 2008). Factors among asset classes in an investment portfolio During the asset allocation process in an investment portfolio there are different factors that must be considered by the investor before an asset class is decided upon.The three factors important to investors when creating an investment portfolio and conducting the asset allocation process is: their investing goals, their investing time horizon, and their level of risk tolerance (Investor Guide, 2010). When considering the factor of investing goals during the asset allocation the investor is determining both long- and short-term goals in terms of income, or return, requirements. When considering this factor an investor is able to factor out any of the asset classes that will not work with their investing goals.The next factor investors should consider once the goals have been established is the expected investing time horizon. This is an important factor to consider when deciding asset classes because asset classes that perform better long-term, such as stocks, could create a portfolio loss if the investor had only required a short-term investment and sold the stocks too soon while they were down (Investor Guide, 2010). If the investor had realized their short-term time horizon they could have purchased securities in the money market, such as a U.S. Treasury Bill, and avoided the portfolio loss. The last factor to consider in creating an investment portfolio, and during the asset allocation process, is the level of the investors risk tolerance. The risk tolerance factor is very important to consider because depending on the level of risk the investor is willing to take on will determine the asset class with the best suited securities, and the level of diversification needed to maintain that desired level of risk.Creating an investment portfolio can be overwhelming for investors when deciding on the asset classes that work best for their portfolio. However, during the asset allocation process investors should consider three factors in their investment needs to aid in the elimination of the asset classes that least fit those needs. An investor that factors in their goals, investment time horizon, and level of risk tolerance will narrow down the asset classes that will likely meet their investment needs. Capital market instruments in portfolio constructionThere are several capital market instruments that are used in the construction of an investment portfolio but the two main capital market instruments are stocks or equity securities, and bonds or debt instruments. â€Å"While all capital market instruments are designed to provide a return on investment, the risk factors are different for each and the selection of the instrument depends on the choice of the investor† (Maps of World Finance, 2009, para. 6). Investors that use stocks in their portfolio construction are investing in equity securities that represent an ownership share in a publically traded company.Investors that purchase a company’s common stock are seeking to profit through capital gains, which is a profit gained if the stock price at the time of purchase is less than the stock price at the time of sale (Bodie, Kane, Marcus, 2008). Using stocks as a capital market instrument in an investment portfolio is beneficial to investors that desire a long-term investment with moderate risk. Investors still take on the risk that the stock price will fall below the purchase price at the time of sale, or that the company will go bankrupt and the stocks will be worthless.The other major capital market instrument used in portfolio construction is debt instruments, or bonds. The debt instruments in the capital market are, â€Å"Treasury notes and bonds, corporate bonds, municipal bonds, mortgage securities, and federal agency debt† (Bodie, Kane, Marcus, 2008, P. 30). Investors that use bonds in their investment portfolio are investing in long-term debt instruments in an expectation to receive some form of income during the term of the security investment, and the total bond value when the security matures (Bodie, Kane, Marcus, 2008).Recommendation for composition of an investment portfolio Creating an investment portfolio before investing in any securities is an important part in earning the returns expected by an investor. When creating an investment portfolio inve stors should always consider their ultimate goal for the portfolio, the time horizon in which to achieve that goal, and the level of risk tolerance they are willing to take. Once these factors have been realized the investor then allocates the asset classes’ best suited for them.Once the asset classes are allocated, the investor then decides on the securities to invest in and conducts an analysis of the proposed securities value and the potential impact to the portfolio. These first recommended steps in the composition of an investment portfolio are an important aspect to building a profitable and long lasting portfolio. Through the planning and analysis of the portfolio requirements, investors will perform their due diligence, and create an investment portfolio that meets their investment needs and can be easily rebalanced as those needs and market conditions change.ReferencesBodie, Z. , Kane, A. , Marcus, A. J. (2008). Essentials of Investments (7th ed. ). New York, NY: McGraw-Hill/Irwin. Hirt, G. A. , Block, S. B. (2008). Fundamentals of investment management (9th ed. ). New York, NY: McGraw-Hill/Irwin.Investor Guide. (2010). Understanding asset allocation while building a portfolio. Retrieved from http://www. investorguide. com/igu-article-541-asset-allocation-understanding-asset-allocation-while-building-a-portfolio. htmlMaps of World Finance. (2009). Capital market instruments. Retrieved from http://finance. mapsofworld. com/capital-market/instruments. html How to cite Capital Markets and Investment Banking Process, Essays

Logistics and Supply Chain Management Manufacturing Process

Question: Discuss about the Logistics and Supply Chain Management for Manufacturing Process. Answer: Introduction Jebsen Jessen (SEA) is a South East Asian company dealing in manufacturing, engineering as well as distribution of its key products. The products of the company comprise cable technology, ingredients, life sciences, technology along with material handling, offshore and packaging. The company was incorporated in Singapore and Malaysia in the year 1963. The companys headquarter is based in Singapore and conducts its operations largely in the ASEAN countries. The company supplies cables to the industries in ASEAN region, thereby operating in nine countries therein. The company also endorses and distributes ingredients related to life cycles and chemicals for various engineering and manufacturing purposes. The company also has over 100 dealer partners with 3500 customers in the ASEAN countries. The ingredients business deals in coating resins, feed ingredients, pharmacy as well as plastic and rubber. Jebsen Jessens business has changed over the years and has transformed into a complet ely engineering based company, providing solutions related to its offshore operations. The company manufactures the products that are essential for the customers. It also deals in packaging and has been fulfilling the needs of the people over the last 40 years. The company has been able to maintain its position due to excellent distribution (Jebsen Jessen (SEA), 2011). The objective of the paper is to understand the key flows in the supply chain, the make process and the supply chain forecasting of the company. There are four key flows in the supply chain, which are reserve flow, cash flow, information flow and the make process, which shows the flow of reserves, cash transactions, information and the steps that are required in the production process. The supply chain forecasting shows the methods that are needed for estimating customers demand for the products for being able to manage its production process effectively, thereby leading to the satisfaction of the customers The Key Flows in Supply Chain Reserve flow Some people believe that reverse flows are quite a new occurrence. The reverse flow has been a part of supply chain and logistics for a long period of time. The companies associated with logistics always had problems related to damaged goods that were returned to the company. The transportation companies always accepted the liability that has occurred as a result of the damaged goods (Coyle, Langley, Gibson, Novack Bardi, 2008). The illustration given below provides a clear inference of the reverse supply flow, where the channels of product tend to pass from the suppliers to the consumers in a particular pattern: Figure: Reverse Supply Chain (Source: Treasury Today, 2010) Jebsen Jessen group has a regional set-up of warehouses and offices for sales with over 300 products in the stock. The company has also got over 250 employees within the ASEAN countries. The company imports the best German cable technology and supplies it to markets of the ASEAN countries manufacturing the cable therein. The company also has inventory, which is valued in millions of dollars (1Jebsen Jessen (SEA), 2011). Jebsen Jessen has over 300 sales staff to serve 6100 customers within the ASEAN countries. The company supplies more than 100,000 tonnes of specialty chemicals every year. Over 100 partners in the field of technology support the company. The team consisting of the experts for import and exports, regulatory affairs and supply chain management. The company also clears, stores and distributes the goods with well-organized, accommodating and responsive services (2Jebsen Jessen (SEA), 2011). The company with a facility of developing the infrastructure has been able to avoid the problems related to delays (Jebsen Group, 2016). Cash flow Jebsen Group in the present scenario has become the market-leader in distributing premium products to China. It is also recorded to have attained a turnover of HK$ 15.2 million in the year 2014, which had been increased up to 4.8% as compared to that of its previous earnings (Jebsen Co. Ltd, 2015). Cash flow shows the overall inflow as well as the outflow of the cash in the business. It shows the movement of the cash through a business (IFRS Foundation, 2014).This can be clearly understood from the illustration provided below: Figure: Cash Flow (Source: Bloomsbury Publishing, 2014). Information flow The company includes data regarding the quality control and testing of the products, inventory information about the sales and operations. The use of modern technology in the company has enabled the company to attain highest levels of precision, efficiency and management of the warehouse operations. The company with a complete reorganization of the business has been able to address the requirements of every business unit and suppliers within the companys unique focus and capability (1Jebsen Group, 2016). The company has been able to maintain a good relationship with its suppliers and became partners in regard to the manufacturing and distribution of malted ingredients to the F B industry in the ASEAN countries. The company also joined hands with the Muntons, which is itself a manufacturing industry (3Jebsen Jessen (SEA), 2011). The following diagram represents the flow of information among the shareholders such as suppliers and various departments of the organisation. Figure: Information Flow Diagrams (Source: uml-diagrams.org, 2016) Make process The company with the use of leading technology has been providing cable supplies to the ASEAN countries. Many companies rely on the cable technology to control their manufacturing facilities. The company imports cable technology from Germany and manufactures them within the country. The companys vision is to supply companies with excellent cable solutions. The manufacturing process of the company sticks firmly to the quality and standards so the companies are provided with the best cable for their use (JJ-Lapp Cable, 2014). The make process as a part of the supply chain management as showed below provides a clear hint of the flow of the products at the time of manufacturing: Figure: Make Process (Source: Acquisition Community Connection, 2012) Make process Jebsen Jessen Group engineers, manufactures and distributes its key products to the countries within the ASEAN region.. The company uses the best cable technology, which has been imported from Germany and is the leading cable solution provider in the whole of ASEAN region. The company after importing the technology manufactures the cables within the country and supplies it to those companies, who are in need of them. The company produces the cable locally, in partnership with the cable-manufacturing corporation of India. The company manufactures PVC control pipes, fireproof pipes, automotive cables and instrumentation cables. The company also follows strict measures concerning the quality and standards of the manufacturing process (1Jebsen Jessen (SEA) 2011). The company also manufactures offshore equipments for lifting and pulling. The company has become the largest distributor of offshore cables in the world. The company has also become one of the biggest producers of the offshore winches. The company manufactures the products with the help of the largest team of engineers (Jebsen Jessen (SEA), 2011). The company manufactures products at technical, commercial and qualitative level (Jebsen Jessen (SEA), 2013). Process of making copper wire The first step in making a copper cable is the wire draw. The copper rod is first taken out from a series of artificial diamond dies, which gets reduced in size. The rod and the dies are mixed with the help of synthetic lubricant and coolant to increase dies durability and for preventing the wire from getting overheated. The copper wire is then transferred to the area of insulation, where it is left for two days to get nourished. The insulate line has innumerable functions such as including an additional drawing of the wire and annealing it. The process also tends to reduce the size of the copper for further wire draw. The wire after becoming soft is passed through the extruder, where the plastic coating is done. A thick polyethylene pellets are added on the backside of the extruder and are heated further until they soften (PennWell Corporation, 2016). The coated wire then passes through a cooling channel and then gets coiled on the reels. The reels then move to the next process of twisting and stranding, where the insulated wires are then twisted in pairs. Twist process involves transferring of the steel reels of the wire, whichrequire twist operators for completing the activities effectively. The process also needs two operators to start one stranding machine. The reels are then aligned on the supply stand specified with distinct color and twist length by one of the operator. The wire pair next is processed through a rotating faceplate, which prevents it from having same patterns and getting mixed up with other finished cables. The second operator then manages the wire into 25 sub-units. The wires are further passed through flyer blow that makes additional twist making the wire more flexible (PennWell Corporation, 2016). Figure: Make process of cable (Source: Asian Electric Appliances Cables Technology Co. Ltd., 2015) Supply Chain Forecasting Forecasting has always been an essential part of the supply chain management as it determines the operational performance of the company. Overestimation of demand might lead the company to incur more expenses while the underestimation would prevent the business from fulfilling the needs of the customers. Supply chain managements includes designing, planning, executing, controlling and checking of the activities within the supply chain. The result of overestimation of the demand leads to higher labour and storage costs. The underestimation of the demand might in turn lead the company to suffer from losses (Karajan Oztaysi, 2014). The organization uses demand forecasting to reduce the risk by estimating the demand and sales in future. Demand forecasting is an organized process that helps the company in determining the future demand of the product along with its competitive forces. The process of forecasting helps the authority of the company to make various decisions regarding the production process and purchasing decisions. Demand forecasting is therefore largely essential for the effectiveness of the operations (Davydenko, 2008). Quantitative forecasting Quantitative forecasting can be primarily used in two cases, when past numerical data are accessible and assuming that some of the aspects of the past designs might again be used in the near future. There are different types of quantitative forecasting methods, each having its own characteristics. Quantitative forecasting is used in case of time series or cross- sectional data (OTexts, 2016). Cross-sectional forecasting is used when the company wants to predict the value which has not been observed before. This method is used only when the variable, which is to be forecasted, shows connection with the predictor variable. This forecasting method is performed to observe the value of the variable that has been examined before (OTexts, 2016) Qualitative forecasting This method of forecasting is used when the company does not have access to historical data. The company with no past information takes the help of experts to forecast the future demand of the products. For example, a company uses sales force to forecast a new product. The use of this forecasting technique is not appropriate for supply chain forecasting. The forecasting is done by collecting data from surveys or by consensus meetings (Bowersox, 2011). Production forecasting Production forecasting is an essential part of the decision-making process and evaluation of the investment. The forecasting of the production is the central and the most important part of the company, which helps to recognize opportunities and attain it. The forecasting process involves six steps. The first step is the identification of objectives where the company uses past data to forecast future demands. This is followed by the determination of the data to be used for forecasting the demand. The third step is to select the best forecasting method for achieving the desired results, which is again followed by the fourth step that is to examine the accuracy of the method used for predicting the future demand. The next step is to meet the demand along the supply chain and lastly the process of production is ended with the effective evaluation of the outcomes related to the forecasting process (Li, 2007). Figure: Supply Chain Forecasting (Source: Prepared for the Study) Conclusion It can be seen that the Jebsen and Jessen pvt.ltd is the leading manufacturing and distributor company in the ASEAN region, dealing in cables, ingredients, life science, material handling, offshore products, packaging and products. The company imports the cable technology from Germany and manufactures them by using the same technology. The company then supplies the cable to the nine countries within the ASEAN region and has even maintained good relationship with its suppliers, which is one of the reasons for the company to achieve success. The company aim is to achieve autonomy flexibility by meeting the needs of the customers. The company also possesses good reserve and cash flow. The company with the use of modern technology has helped in collecting information for warehousing operations. Jebsen Jessen has managed warehousing to attain accuracy. The company also includes receiving, cross-docking, quality assurance and inventory control of the products. The company also follows the supply chain forecasting in predicting the demand of the products and subsequently meeting the demand needs of the customers. The company has been successful because of maintaining the operations and meeting the demand of the suppliers. References Asian Electric Appliances Cables Technology Co., Ltd. (2015). Manufacturing process. Retrieved from https://www.asiawirecable.com/products-manufacturing-process.html Bloomsbury Publishing. (2014). QFINANCE: The Ultimate Resource. UK: Bloomsbury Publishing. 1Jebsen Jessen (SEA). (2011). Cable technology. Retrieved from https://www.jjsea.com/doc/CableTechnology 1Jebsen Group. (2016). Modern technology. Retrieved from https://www.jebsenlogistics.com/PageDisplay.aspx?did=e6dab814-3d2f-4110-97b7-05e5ce11d8ea 2Jebsen Jessen (SEA). (2011). Life sciences. 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