Steven Boldis January 7,1999 Essays - Literature, Literary Realism

Steven Boldis January 7,1999 English 9 Mr. Moratto The Catcher in the Rye In The Catcher in the Rye, Holden views the world as an evil and corrupt place where there is no peace. This perception of the world does not change significantly through the novel. However as the novel progresses, Holden gradually comes to the realization that he is powerless to change this. During the short period of Holden's life covered in this book, Holden does succeed in making us believe that the world is crazy. Shortly after Holden leaves Pencey Prep he checks in to the EdmontHotel. This is where Holden's turmoil begins. Holden spends the following evening in this hotel which was full of perverts and morons. (There were) screwballs all over the place. His situation only deteriorates from this point on as the more he looks around this world, the more depressing life seems. Around every corner Holden sees evil. He looks out on a world, which appears completely immoral. The three days we learn of from the novel place a distressed Holden in the are of Manhattan. The city is decked with decorations and holiday splendor, yet, much to Holden's despair seldom yields any occasions of peace, charity or even genuine merriment. Holden is surrounded by what he views as drunks, perverts, morons and screwballs. These convictions which Holden holds waver very momentarily during only one particular scene in the book. The scene is that with Mr. Antolini. After Mr. Antolini patted Holden on the head while he was sleeping, Holden jumped up and ran out thinking that Mr. Antolini was a pervert as well. This is the only time during the novel where Holden thinks twice about considering someone as a pervert. After reviewing Mr. Antolini, Holden finally concludes that maybe he wasn't making a flirty pass at him. Maybe he just like patting guys heads as they sleep. This is really the only time in the novel where Holden actually considers a positive side. This event does not constitute a significant change. As Holden himself says, It's not too bad when the sun's out, but the sun only comes out when it feels like coming out. The sun of course i s a reference to decency through the common association of light and goodness. His perception of the world remains the same. The one conviction that does change during the novel is Holden's belief that he can change the world. On his date with Sally, Holden reveals his feelings. Did you ever get fed up?... I mean did you ever get scared that everything was going to go lousy unless you did something...Holden goes through several plans. Holden at one point contemplates heading out west where he will pretend to be a deaf-mute and live a quiet life. At another point Holden proposes to Sally to escape this world with him. It is finally to his younger sister Phoebe that Holden reveals his ultimate plan. Although Holden describes the situation in a very picturesque and symbolic manner he essentially tells Phoebe that he wants to prevent children from growing up. He blames the world's corruption on adults and believes that when he stops the children from growing up he will preserve their innocence and save the world. It takes most of the book before Holden begins to realize that he is helpless to stop this corruption. Finally, he realizes that not only is there nothing that he can do, but there is nowhere he can go to hide from it. Holden takes awhile to comprehend these concepts. One good example is when Holden is delivering the note to his sister. He encounters a *censored*-you written on the wall. Holden careful rubs this off with his hand so as to protect the innocent children from reading it. Later on he finds *censored*-you scratched into the surface with a knife. He discovers that he can't efface this one. Even in the timeless peace of the Egyptian tomb room at the museum there is an un-erasable *censored*-you. This incident is the beginning of Holden's realization that his dreams are infeasible. Strangely enough, it is one of the innocent children that he is trying to protect who helps him come to terms with this realization. It is Phoebe who

What Are Contractions (Warning Not a Guide to Pregnancy)

What Are Contractions (Warning Not a Guide to Pregnancy) What Are Contractions? If you’re heavily pregnant and noticing a tightness in your uterus at regular intervals, congratulations! You’re probably about to go into labor. However, if you’re looking for advice on that issue, we’re afraid you’re in the wrong place. The â€Å"contractions† we’re interested in are words. But what are these contractions? And how can you avoid errors when using them in your writing? Read on below to find out! What Are Contractions? A contraction is an abbreviation formed by combining two words. For instance: Could not = Couldn’t I am = I’m Where is = Where’s As shown above, we use an apostrophe to indicate that letters have been dropped from the new word. All contractions are formed like this, so make sure not to miss the apostrophe out! When to Use Contractions Contractions are very common in speech. As a result, you can use them in writing if you’re aiming for an informal, friendly tone. They’re also very useful in fiction, especially dialogue. However, since contractions are informal, you should not use them in formal writing (e.g., college papers and technical writing). The one exception to this is â€Å"o’clock† if you’re writing down a time in full (this is actually a contraction of â€Å"of the clock†). What time of the clock is it? Watch Out for These Sneaky Words! Finally, we’ll end on a list of common contractions that are regularly misused or that could be confusing. Look out for these terms in your writing and make sure that you’ve got them right: Contraction What It Means Common Errors It’s It is or it has Don’t confuse this term with the possessive determiner â€Å"its† (no apostrophe). They’re They are Not to be confused for the possessive determiner â€Å"their† or the adverb â€Å"there.† We’re We are Not to be confused with the past tense verb â€Å"were† or the adverb â€Å"where.† You’re You are Not to be confused with the possessive â€Å"your.† Can’t Cannot The full form of this term is written as a single word, so make sure not to write â€Å"can not† in formal writing. Won’t Will not This term is technically short for â€Å"woll not,† since â€Å"woll† is an old-fashioned spelling of â€Å"will.† And although â€Å"will† became standard for the positive form, the â€Å"o† spelling became standard for the negative contraction. With these terms, if you’re not sure whether the contraction is correct, try using the expanded version in the sentence. For example, while â€Å"we’re† and â€Å"were† look similar written down, there is an obvious difference between â€Å"they were happy† (grammatical) and â€Å"they we are happy† (ungrammatical).

How to establish a performance improvement plan

How to establish a performance improvement plan One of the biggest challenges of working in Human Resources can be the role that you play in employee struggles and difficulties: poor performance reviews, disciplinary action, conflicts between employee and manager, etc. It can feel like you’re caught in the middle- you’re not necessarily the employee or the manager, but you’re there to represent both their interests and those of the company, so your role is a delicate one. Part of that role is facilitating performance improvement plans (PIPs) to help struggling employees get back on track in their jobs.Why use a performance improvement plan?A PIP is a tool at HR’s disposal to help restore a worsening situation. Maybe the employee has chronic difficulties with his or her role, or maybe there was an incident that has shaken his or her manager’s confidence in their job performance. A PIP is a chance to say, â€Å"Okay, this situation is not great, but there’s potential to turn things around.à ¢â‚¬  It’s a formal document and process, acknowledged by the employee and his or her manager, that there are certain steps that the employee needs to complete before his or her performance is stabilized.It’s important to note that a PIP is not necessarily a last stop on the way to firing an employee. Instead, look at it as a way to acknowledge that performance has been poor, but that there are ways to move on with clearer expectations from all involved. It can help ensure that the employee is receiving the resources he or she needs to do the job, if that support was lacking before and contributed to mistakes or poor performance.What is HR’s role in creating a PIP?The Human Resources role can vary according to the size and type of company, but there are some baseline issues you can expect to address as an HR manager:Documenting circumstances- why the employee is being placed on a PIP, what the manager’s concerns are, what the employee’s response i s, and any other factors that need to be made clearEnsuring that the employee knows his or her rights in the situationProviding information or resources that the employee needs to succeed under the PIP, such as training or company policySupporting the manager in implementing the PIP for the employeeDeveloping an action plan for both the manager and the employeeThe HR role is one of support and guidance, and making sure that all parties are engaged in the process of making the work situation better for all involved.  hbspt.cta.load(2785852, '9e52c197-5b5b-45e6-af34-d56403f973c5', {});What’s included in a PIP?The PIP is not meant to be an accusatory tool, piling on to scare or intimidate the employee into improving, or else. Rather, it’s a way to get everything in writing and make sure that everyone is clear on expectations moving forward- particularly if there are consequences if the employee does not meet particular benchmarks.A PIP should include:Written documentati on of the problematic behavior or performance issueA specific description of the expectations for the employee’s performanceA list of the resources that will be provided to the employee to improve performanceAn explicit follow-up plan, including timeframes, a schedule of meetings with the employee, or other milestones set between the manager and employeeConsequences for failure to meet the benchmarks in the plan, if applicableThere may not be a one-size-fits-all PIP for your HR department. As the HR rep, you’re part of a collaborative process so it’s important to make sure that the PIP you’re developing is applicable to the particular situation and allows for input by both the manager and employee as well.Best practices for implementing a PIPAs you know, part of your role in HR is helping to defuse tense workplace situations with proactive steps and productive solutions. The employee probably isn’t happy (hence the issues), the manager isn’t happy to have to deal with this, and no one wants to be told they’re not doing well. Navigating an unhappy situation while trying to put a mechanism in place to get things back on track is challenging, no question. Here are some best practices you should consider as you create a PIP.Be clear, in writing, about the behavior or performance that merits the PIP.Provide specific examples of each type of behavior or poor performance.Create a dialogue about potential reasons for the behavior or poor performance. Give the employee an opportunity to express his or her understanding of the issue and of the performance expectations.Create a written improvement plan with specific, measurable goals for the employee to meet on a clear timeline. Make sure to include any consequences that may happen if the employee fails to meet particular benchmarks, if applicable.Set up a time to meet with the employee or manager to review the employee’s progress along the way.If at all possible, u se an automation system to track performance and ease your way into a PIP implementation planRemember, the goal here is growth- not punishment. You want everyone involved to feel comfortable with the plan moving forward. And ideally, the plan will help address the underlying issues that caused the poor performance in the first place.How to approach a PIP with an employeeImplementing a PIP can be a touchy situation- the employee is likely feeling embarrassed that things have gotten to this point and could be emotional or defensive. Here are some things you can do to help make the plan implementation easier on everyone.Let them know you’re in their corner. The employee may feel overwhelmed, so the idea that someone has their best interests at heart during a tough time can help.Get the employee’s perspective on the issue. Let them explain where they think things went wrong and see if they have a different perspective on what the expectations were, whether they were lackin g in resources, etc. It’s possible the employee has a different interpretation of how or why things went wrong, and it’s important to get both sides.Balance the negative with some positive. Let the employee know what he or she is doing well, instead of hitting the negative over and over.Don’t be vague or ambiguous. Provide clear examples of the problematic behavior, as well as the next steps needed to correct the issue. Also be clear about the impact of his or her behavior or poor performance.Give constructive feedback. Saying â€Å"this is unacceptable,† or â€Å"just be better,† without offering potential solutions or next steps is unlikely to help the employee correct the issue. Give recommendations about how they can improve. He or she already knows that she has to improve, but may not be clear on how to approach it.Make time to meet with the employee. Make sure he or she feels supported throughout the process. It’s not enough to say, â €Å"Okay, here’s the plan, do this.† Checking in can help ensure that a) progress is happening, and b) the employee understands what’s expected at every step.One thing to remember is that PIPs are not a magic fix for work disasters or poor performance. They’re a tool you can offer to your employees as a way to right the ship before it sinks and before someone loses a job or the company suffers further consequences from the poor performance. As long as everything is clearly defined (the source of the problem, the consequences of the problem, and the specific plan for remedying the problem) and you work closely with employees and managers to implement it, it can be one of the most effective and successful tools you have for turning around poor performance. A bit of optimism and a lot of careful documentation can go a long way in ensuring employee success, even after a failure.

Discuss how Starbucks downsizing in the USA impacts their global Essay

Discuss how Starbucks downsizing in the USA impacts their global growth strategy - Essay Example It is worthwhile to mention that Starbucks considers factors such as purchasing power of potential customers, demographics, societal norms and standards, consumers’ attitudes, perceptions and inclination towards its brand, the competitors’ strategies and their pricing policy, the availability of raw material in host nations, the exchange rate fluctuations, corporate tax rates, interest rates and government support to formulate and implement its strategies and make decisions for long-term business growth and monetary gains. (Merced, 2008) and (White, 2008) The strategic planners at Starbucks started observing fall in sales revenue and volume in 2008 when USA suffered with a sub-prime property mortgage crises and trade deficits. This in turn resulted in bankruptcies and closures of many financial and production related business institutions thereby intensifying the unemployment issue and deteriorating future employment prospects. The skyrocketing international oil prices also resulted in inflation that then forced customers to tighten their belts and demand fewer luxurious products such as Automobiles and Coffee. Hence, Starbucks planned to expand its Chinese operations where a large pool of potential customers has an inclination towards branded products offered by supranational organizations. Chinese government also supported Starbucks so that it could enhance interaction and communication with Chinese farmers in Yunnan (an agricultural area), which produces over 30,000 tons of Coffee Beans. In simple words, this region alone accounts for over 95% production of Coffee Beans, so Chinese officials seek help and guidance of Starbucks in business management, production and marketing process to ensure higher yield per acre and premium quality for domestic use and exports. (White, 2008) and (Haoting, 2009) Indeed, China is a best available alternative for Starbucks since it has

Information Security at Al Nahda Hospital Essay

Information Security at Al Nahda Hospital - Essay Example This is because internet users are potential customers and suppliers, and potential threats, as well. In case information stored in the hospital premises is tampered with, serious, adverse effects may result, because there are so many people who are dependent on this information. It is the responsibility of management to liaise with other departments to protect an organization’s information assets. This report analyses and evaluates information security at Al Nahda Hospital. In this report, the main categories of information assets that may be at risk and have to be protected have been described. The report also appraises the actual and potential threats and vulnerabilities of Al Nahda Hospital’s information assets. The report then formulates a security plan that describes counter measures that will manage the threats that put Al Nahda Hospital’s information assets at risk from a risk management perspective. A comprehensive information security education and awar eness program for use by management, staff and contractors for Al Nahda Hospital is also provided in this report. The report also explores the social, legal, and ethical issues or constraints that may be associated with the implementation of the comprehensive information security plan at Al Nahda Hospital. Finally, the report recommends valid actions that can be taken to improve the information security situation of Al Nahda Hospital. Introduction Al Nahda Hospital is a government hospital which is located in Oman. The hospital has a client server application called â€Å"Health Information Management system (HIMS)† on a local network. It also has applications that have been developed with oracle database, forms and reports. Al Nahda Hospital’s medical staff users can access and use the system from a local network using desktops, Personal Computers, or they can use laptops with WIFI, during wards round. Also, this system is connected to the headquarters with MPLS line. Users have access to both the operating system username and password and the database username and password. After a careful assessment of the information security situation, a security plan for the protection of the information holdings of the Al Nahda Hospital is required. The security plan will ensure that the security personnel oversee the security of information from deliberate and accidental threats to the hospital so as to improve Al Nahda Hospital’s information security. 1.0: Main Categories of Information Assets that may be at Risk and have to be protected Al Nahda Hospital’s information assets may be at risk, as far as the information status is concerned. These assets may be categorized into information assets, software, hardware, systems and people. 1.1: Information Assets Information assets of Al Nahda Hospital that may be at risk and need to be protected include documented information. Documented information contains both printed or written information an d electronic information stored on the hospital’s servers, website, extranets and internets. Electronic information can be stored in laptops, personal computers, cell phones, CD ROM and USB sticks, among other devices. The information that may be threatened

Association of Lipid Profile in Pregnancy with Pre-eclampsia

Association of Lipid Profile in Pregnancy with Pre-eclampsia Association of Lipid Profile in Pregnancy with Pre-eclampsia, Gestational Diabetes Mellitus and Preterm delivery Babita Ghodke*,1, Raghuram Puskuru2, Varshil Mehta3, Kunal Bhuta4 1Associate Professor, 2Senior Resident, 3Intern, 4Junior Resident Department of Medicine, MGM Medical College, Navi Mumbai, India. Abstract Introduction: During last two trimesters of pregnancy, glucose is spared (for the foetus) while the concentration of fatty acids in plasma increases which can create complications like Preeclampsia, Gestational diabetes mellitus and preterm delivery. Aim: To study the association of serum lipid levels during second and third trimester with the development of pregnancy associated diseases like preeclampsia, GDM and preterm. Methods and Materials: The present study was carried out at MGM Hospital, Navi Mumbai, India.   200 antenatal cases from October, 2012 to October 2014 were enrolled after taking an informed consent. Statistical analyses were performed using Statistical Package for Social Sciences (SPSS) version 20. All reported p-values are two-tailed, and confidence intervals were calculated at the 95% level. Results: In pre-eclamptic patients, the mean Systolic Blood Pressure was 151.40 mm/Hg and mean diastolic blood pressure was 74.03 mm/Hg in third trimester. In pre-eclamptic patients, the mean serum triglyceride levels in second trimester was 204.00 mg/dl while 243.20 md/dl in third trimester. In Gestational Diabetes Mellitus patients, the mean serum triglyceride was 214.33 mg/dl in second trimester while 230.50 mg/dl in third trimester. In patients with preterm, the mean triglycerides levels 212.83 mg/dl and 240.16 mg/dl in second and third trimester respectively. In pre-eclamptic patients the mean serum cholesterol levels in second trimester was 210 mg/dl, while in third trimester, it was 243.60 mg/dl. In GDM patients, the mean serum cholesterol was 223.50 mg/dl and 242.83 mg/dl in second and third trimester respectively. 213.33 mg/dl and 243.66 mg/dl were the means cholesterol levels in second and third trimester respectively in patients with preterm. Out of total 200 patients 168 had no complications, while 20 {10%} had preeclampsia, 6 {3%} had Gestational Diabetes Mellitus and 6 {3%} had preterm deliveries. Conclusion:An association between maternal early pregnancy triglyceridaemia, and the subsequent risk of pre-eclampsia, gestational diabetes and preterm deliveries was observed. Occurrence of Preeclampsia, Gestational Diabetes and Preterm deliveries cannot be predicted based on the values of Serum Cholesterol, HDL-Cholesterol, LDL-Cholesterol and VLDL-Cholesterol. Hence estimation of lipid profile is strongly recommended during pregnancy to prevent deleterious effect of hyperlipidaemia associated with pregnancy. Keywords: Lipid Profile, Gestational Diabetes Mellitus, Preterm, Preeclampsia, Pregnancy related disease. 1. Introduction Pregnancy is a physiological process which causes profound changes in the body. It leads to an increase in demands for metabolic fuels and also causes alteration in hormonal levels which may cause few changes in lipid profile during pregnancy [1]. During last two trimesters, glucose is spared (for the foetus) while the concentration of fatty acids in plasma increases which leads to Gestational Diabetes Mellitus (GDM) and Gestational Hypertension (GHTN) respectively. Freinkel had described this process as accelerated starvation, and facilitated anabolism [2]. GDM and GHTN can lead to peri and postpartum complications. Pregnancy is often also complicated with diseases which can hamper Cardio-Vascular System. GDM and GHTN are few of them which can develop type 2 diabetes and systemic hypertension in later part of life [3,4]. In our previous study, we showed that total cholesterol, triglycerides, LDL-cholesterol, VLDL-cholesterol increases in last two trimesters. The increase is even greater in third trimester, when compared to the second. However, HDL-Cholesterol levels are decreased in third trimester when compared to that of second. The study concluded that the estimation of lipid profile is highly recommended during pregnancy due to its association with high levels of triglycerides which may lead to Pre-eclampsia, GDM and preterm delivery [5]. The present study is a continuation of our previous study and here, it evaluates the clinical significance of the lipid profile level in pregnancy and its effect on the development of pregnancy induced diseases like GDM, pre-eclampsia and preterm. 2. Aim To study the association of serum lipid levels during second and third trimester with the development of pregnancy associated diseases like preeclampsia, GDM and preterm. 3. Material, Methods, Ethics, Statistical Analysis, Inclusion and Exclusion Criteria The present study is a continuation of our previous study and the material, methods, ethics, inclusion and exclusion criteria could be obtained from our previous study [5]. In brief, the present study was conducted at Mahatma Gandhi Mission Hospital, Navi Mumbai, India. A total of 200 pregnant local women were enrolled from October 2012 to 2014. Out of the 200 subjects, 10 developed GHTN in late third trimester which was detected after 32nd week during follow-up which were also included. The venous blood sample was collected from all subjects for measurement of lipid profile in the 16th week and 32nd week of gestation for analysis. All pregnant women with a singleton pregnancy with a gestational age of 13-28 weeks, irrespective of parity and gravida were included. Pregnant women in whom hypertension (HTN) was detected before 14 weeks and those with diseases or complications like chronic HTN, Diabetes, Renal Disorders and Thyroid Disorders, Obstetric and Foetal Complications (Hydrops foetalis, congenital foetal anomalies) were excluded. Statistical analyses were performed using Statistical Package for Social Sciences (SPSS) version 17.0. All reported P values are two-tailed, and confidence intervals were calculated at the 95% level. The data was presented using frequencies, percentages, descriptive statistics followed by charts and graphs. Level of significance was set at 5%. All p-values less than 0.05 were treated as significant. 4. Results The mean age of patients was 24.87 years with a SD of 2.7 years. The minimum age was 18 years and the maximum age was 30 years. 4.1 Blood Pressure The mean Systolic Blood Pressure (SBP) in second trimester was 117.03 mm/Hg with a SD of 10.33 mm/Hg. In third trimester, it was increased to 120.77 with a SD of 14.675. In pre-eclamptic patients, the mean SBP was 151.40 with a SD 6.05. (p =0.00) in third trimester. There was a highly significant statistical difference in the mean blood pressure values among normal and pre-eclamptic women in third trimester. The mean Diastolic Blood Pressure in our study in third trimester was 72.11 mm/Hg with a SD of 6.88 mm/Hg. In third trimester, the mean SBP was increased to 74.03 with a SD of 8.616. In pre-eclamptic patients the mean was 92.00 with a SD 2.59 (p =0.00). There was a highly significant statistical difference in the mean blood pressure values among normal and pre-eclamptic women in third trimester. Out of total 200 patients 168 had no complications, while 20 had preeclampsia, 6 had GDM and 6 had preterm deliveries. 4.2 Association of Triglycerides with Preeclampsia, GDM and Preterm The below table (figure 1) indicates the 95% confidence interval for triglyceride levels for patients with outcomes of Preeclampsia, GDM and Preterm. The mean triglyceride level in second trimester was 188.68 mg/dl with a standard deviation of 20.88 mg/dl. In third trimester, the mean triglyceride (TG) level was increased to 216.78 mg/dl with a standard deviation of 20.09 mg/dl [5]. In pre-eclamptic patients, the mean serum triglyceride levels in second trimester was 204.00 with a SD 18.904 (p =0.00), while in third trimester, the mean was 243.20 with a SD of 15.58 (p =0.00). There was significant statistical significance observed between serum triglyceride levels and pre-eclampsia in both second and third trimesters (figure 1). Outcome Trimester Mean N SD SEM 95 % CI Lower Bound Upper Bound Preeclampsia Second Trimester 204.00 20 18.90 4.23 195.71 212.29 Third Trimester 243.20 20 15.58 3.48 236.37 250.03 GDM Second Trimester 214.33 6 18.64 7.61 199.42 229.25 Third Trimester 230.50 6 17.03 6.95 216.88 244.12 Preterm Second Trimester 212.83 6 11.99 4.90 203.24 222.43 Third Trimester 240.17 6 7.73 3.16 233.98 246.35 Figure 1. Association of Triglycerides with Preeclampsia, GDM and Preterm 4.3 Association of Cholesterol with Preeclampsia, GDM and Preterm The below table (figure 2) indicates the 95% confidence interval for cholesterol levels for patients with outcomes of Eclampsia, GDM and Preterm. In pre eclamptic patients the mean serum cholesterol levels in second trimester was 210.75 with a SD 24.248 (p =0.320), in third trimester, the mean was 243.60 with a SD of 25.84 (p =0.826). There was no statistical significance observed between serum cholesterol and pre-eclampsia in both second and third trimesters. Compared to the normal value of 200mg/dl, cholesterol level is raised in normal pregnancy. In pre- eclamptic women cholesterol level is raised more than the values in normal pregnancy. Outcome Trimester N Mean SD SEM 95% CI Lower Bound Upper Bound Preeclampsia 2nd Trimester 20 210.75 24.25 5.42 199.401 222.10 3rd Trimester 20 243.60 25.85 5.78 231.50 255.69 GDM 2nd Trimester 6 223.50 25.16 10.27 197.09 249.90 3rd Trimester 6 242.83 27.14 11.08 214.35 271.31 Preterm 2nd Trimester 6 213.33 20.23 8.25 192.10 234.55 3rd Trimester 6 243.66 27.200 11.10 215.12 272.21 Figure 2. Association of Cholesterol with Preeclampsia, GDM and Preterm 4.4 Association of HDL Cholesterol with Preeclampsia, GDM and Preterm The below table (figure 3) indicates the 95% confidence interval for HDL cholesterol levels for patients with outcomes of Preeclampsia, GDM and Preterm. In third trimester, the mean serum HDL Cholesterol (HDL-C) level in normal patients was 42.78 with a SD of 4.31, in pre eclamptic patients the mean was 45.60 with a SD 4.12 Compared to the normal value of 40-60 mg/dl, HDL-Cholesterol level is within normal range in normal pregnancy. In pre-eclamptic women HDL-C level was higher than normal pregnancy but within normal range. In pre eclamptic patients the mean serum HDL Cholesterol levels in second trimester was 51.8 with a SD 5.8 (p =0.040), in third trimester, the mean was 45.60 with a SD of 4.1 (p =0.006). There was significant statistical significance observed between serum HDL -Cholesterol and pre-eclampsia in both second and third trimesters. Outcome Trimester N Mean SD SEM 95% CI Lower Bound Upper Bound Preeclampsia 2nd Trimester 20 51.80 5.84 1.30 49.06 54.53 3rd Trimester 20 45.60 4.12 .92 43.67 47.52 GDM 2nd Trimester 6 52.00 7.07 2.88 44.57 59.42 3rd Trimester 6 41.16 7.27 2.97 33.52 48.80 Preterm 2nd Trimester 6 49.00 6.13 2.50 42.56 55.43 3rd Trimester 6 45.50 4.03 1.64 41.26 49.73 Figure 3. Association of HDL Cholesterol with Preeclampsia, GDM and Preterm 4.5 Association of LDL Cholesterol with Preeclampsia, GDM and Preterm The below table (figure 4) indicates the 95% confidence interval for LDL cholesterol levels for patients with outcomes of Preeclampsia, GDM and Preterm. In third trimester, the mean serum LDL-Cholesterol level in normal patients was 137.80 with a SD of 13.67, in preeclamptic patients the mean was 137.80 with a SD 11.5.   Compared to the normal value of 130 mg/dl [5], triglyceride level is raised in normal pregnancy. In preeclamptic women LDL-C level was same as in normal pregnancy (figure 4). In preeclamptic patients the mean serum LDL-C levels in second trimester was 92.7 with a SD 18.2 (p =0.943), in third trimester, the mean was 137.8 with a SD of 11.5 (p =0.996). There was no significant statistical significance observed between serum LDL-C levels and pre-eclampsia in both second and third trimesters. Outcome Trimester N Mean SD SEM 95% CI Lower Bound Upper Bound Preeclampsia 2nd Trimester 20 92.70 18.22 4.07 84.17 101.23 3rd Trimester 20 137.80 11.59 2.59 132.37 143.22 GDM 2nd Trimester 6 96.83 31.39 12.81 63.89 129.77 3rd Trimester 6 150.16 9.88 4.03 139.79 160.54 Preterm 2nd Trimester 6 84.50 6.12 2.50 78.07 90.92 3rd Trimester 6 127.83 10.64 4.34 116.66 139.00 Figure 4. Association of LDL Cholesterol with Preeclampsia, GDM and Preterm 4.6 Association of VLDL Cholesterol with Eclampsia, GDM and Preterm The below table (figure 5) indicates the 95% confidence interval for VLDL cholesterol levels for patients with outcomes of Eclampsia, GDM and Preterm. In third trimester, the mean serum VLDL-Cholesterol (VLDL-C) level in normal patients was 35.88 with a SD of 6.5, in pre eclamptic patients the mean was 39.7 with a SD 7.1.   Compared to the normal value of 35 mg/dl [5], VLDL-C level is raised in normal pregnancy. In pre- eclamptic women VLDL-C level was increased more than that in normal pregnancy. In pre eclamptic patients the mean serum VLDL-C levels in second trimester was 30.9 with a SD 7.9 (p =0.93), in third trimester, the mean was 39.7 with a SD of 7.1 (p =0.016). There was no significant statistical significance observed between serum VLDL-C levels and pre-eclampsia in second trimester but significance was found in third trimesters. Outcome Trimester N Mean SD SEM 95% CI Lower Bound Upper Bound Eclampsia 2nd Trimester 20 30.95 7.93 1.77 27.23 34.66 3rd Trimester 20 39.70 7.11 1.59 36.36 43.03 GDM 2nd Trimester 6 27.16 6.01 2.45 20.85 33.47 3rd Trimester 6 34.00 5.65 2.30 28.06 39.93 Preterm 2nd Trimester 6 25.66 3.98 1.62 21.48 29.84 3rd Trimester 6 36.83 6.96 2.84 29.52 44.14 Figure 5. Association of VLDL Cholesterol with Eclampsia, GDM and Preterm 4.7 Mean values of lipid parameters with outcome in 2nd and 3rd trimester The mean values of Serum cholesterol, Serum TG, HDL-C, LDL-C, VLDL-C are given in figures 6 and 7. Trimester Outcome Serum Cholesterol {mg/dl} Serum Triglycerides {mg/dl} HDL-CHOLESTEROL {mg/dl} LDL-CHOLESTEROL {mg/dl} VLDL-CHOLESTEROL {mg/dl} Second Trimester Preeclampsia 210.75 204.00 51.80 92.70 30.95 GDM 223.50 214.33 52.00 96.83 27.16 Preterm 213.33 212.83 49.00 84.50 25.66 Third Trimester Preeclampsia 243.60 243.20 45.60 137.80 39.70 GDM 242.83 230.50 41.16 150.16 34.00 Preterm 243.66 240.16 45.50 127.83 36.83 Figure 6. Mean values of lipid parameters with outcome in 2nd and 3rd trimester Figure 7. Comparison of Lipid parameters between second and third trimester 4.9 Complications outcome distribution Out of total 200 patients 168 had no complications, while 20 {10%} had preeclampsia, 6 {3%} had Gestational Diabetes Mellitus and 6 {3%} had preterm deliveries (Figure 8). Complication No of Cases Percentage No Complication 168 84% Pre-eclampsia 20 10% GDM 6 3% Preterm 6 3% Total 200 100% Figure 8. Distribution according to Complications 5. Discussion Hypercholesterolemia is known to cause excessive lipid peroxidation and coexistent diminution in antioxidant activity which may result in an imbalance between peroxidases and antioxidants, leading to oxidative stress. Oxidative stress and elevated atherogenic index may lead to atherogenicity in Pre-eclampsia [6]. 5.1 Triglycerides In a study conducted by Arnon Wiznitzer et. al., to prove the association of lipid levels during gestation with preeclampsia and GDM in 9911 pregnant women, they observed that the composite endpoint (GDM or preeclampsia) occurred in 1209 women (12.2%). During the index pregnancy, GDM was diagnosed in 638 women (6.4%) while Preeclampsia was diagnosed in 625 pregnancies (6.3%) [7]. In a study by Lorentzen et al., it was observed that the mean triglyceride concentrations of pre-eclampsia patients were higher than normal pregnant women at 16-18 weeks [8]. Later, a large prospective cohort study conducted in Norway by Clausen et al. (2001) also demonstrated that women with triglycerides above 212 mg/dL (2.4 mmol/L) had a five-fold increased risk (95% CI 1.1-23.1) of early onset pre-eclampsia (onset before 34 weeks) compared with those with triglycerides levels 133 mg/dL [9]. A study done by S. Niromanesh et. al., to compare the outcomes of forty five pregnant women who had high TG levels (>195 mg/dl) with 135 pregnant women having TG levels [10]. In a study done by Kandimalla et. al., comprising 156 pregnant women attending antenatal clinic visits were included prior to 20 weeks and were analysed for lipid levels. 102 participants were followed until delivery and were monitored for pre-eclampsia. They reported that mean triglyceride levels were found significantly higher in the pre-eclampsia group. Women with triglycerides above 130 mg/dL had increased risk of pre-eclampsia compared with those with triglycerides levels of 91 mg/dL or less [11]. In the present study, compared to the normal value of 150 mg/dl [12], during second trimester, the 95% CI for triglyceride level with Preeclampsia was between 195.71 and 212.29, the 95% CI for triglyceride level with outcome GDM was between 199.42 and 229.25; while the 95 % CI for triglyceride with preterm outcome was between 203.24 and 222.43. Hence, we can conclude that triglyceride level of more than 195 mg/dl during second trimester can lead to complications like Preeclampsia, and triglycerides greater than 199.42mg/dl lead to GDM and levels above 203.24mg/dl lead to Preterm delivery. During third trimester, the 95% CI for triglyceride level with Preeclampsia was between 236.37 250.03, the 95% CI for triglyceride level with outcome GDM was between 216.88 244.12 and the 95 % CI for triglyceride with preterm outcome was between 233.98 and 246.35. Hence, we can conclude that triglyceride level of more than 236 mg/dl during second trimester can lead to complications like Preeclamps ia, triglyceride level of more than 216.88 mg/dl leads to GDM and triglyceride level of more than 233.98mg/dl leads to Preterm delivery (figure 1). Our findings correlate with the findings of a study done by Kandimalla et. al [11]. 5.2 Cholesterol

The feasibility of wind energy from strategic management perspective in Russia

1. INTRODUCTION This research proposal has been complied to outline how an investigation into one part of the feasibility studies for wind energy developments are undertaken. From a strategic management perspective the socio-economics aspects of this shall be examined. These shall be considered by examining a number of case studies in Russia (as an example see; POWER, 2013; BAREC, 1998). 2. INTRODUCTION TO THE STUDY This study shall be undertaken by critically evaluating how these assessments are currently implemented in practice. The effectiveness of these shall then be assessed by comparing them to practices adopted by other countries (see as an example: Bell, Gray & Haggett, 2005; Bergmann, Hanley & Wright, 2006; Van der Horst & Toke, 2010). This could help to identify some opportunities, which may be utilised in Russia, to improve the undertaking of feasibility studies. 4. PROBLEM STATEMENT In Russia, feasibility studies are conducted to establish if wind turbine projects are viable (as an example see; POWER, 2013; BAREC, 1998). However, a variety of practices have been adopted to undertake these to date (Devine?Wright, 2005). This research seeks to ascertain if these practices could be improved, by establishing how these assessments have been undertaken in other countries. 5. RESEARCH AIMS AND OBJECTIVES In conjunction with the problem statement above, the following aims have been formulated: To use available and relevant data, to investigate how socio-economic assessments are managed by using various management strategies (during the feasibility investigation phase of wind farm developments). To use available and relevant data, to investigate how socio-economic assessments are implemented by using various management strategies (during the feasibility investigation phase of wind farm developments). To use the findings from the above two aims make recommendations for how practices may be improved in Russia. Additionally, the following objectives have been developed: To evaluate how socio-economic assessments are strategically managed and implemented (during the feasibility phases of wind farm projects in Russia and other countries). To evaluate if these assessments may be improved in Russia. 6. PROPOSAL STRUCTURE The proposed outline of the dissertation is described in the next section. 7.LITERATURE REVIEW To date, studies have been undertaken into the development of wind farms (see as an example: Bell, Gray & Haggett, 2005; Bergmann, Hanley & Wright, 2006; Van der Horst & Toke, 2010). The majority of these have been focused on developments in Europe or the United States of America. There are a few case studies, which are pertinent to these types projects in Russia (as an example see; POWER, 2013; BAREC, 1998). Mainly, these case studies show that a variety of techniques are used to seek to ascertain if these developments are feasible. To ensure that this is the case a number of assessments are undertaken (see as an example: Bell, Gray & Haggett, 2005; Bergmann, Hanley & Wright, 2006). This helps to ensure that each aspect of the development and its impacts are fully considered. One assessment, which is important, seeks to evaluate the socio -economic impacts of wind farm developments (Wolsink, 2007). It is the management and implementation of these in Russia, which this study s eeks to explore. This shall be achieved by examining the literature from Europe or the United States of America (see as an example: Bell, Gray & Haggett, 2005; Bergmann, Hanley & Wright, 2006; Van der Horst & Toke, 2010) and comparing this to the Russian case studies (as an example see; POWER, 2013; BAREC, 1998). This will enable the researcher to understand how these are undertaken in a number of countries and how practices may be improved in Russia. 7.3 LITERATURE REVIEW SUMMARY The findings from this review shall be detailed in a summary and the research questions shall be outlined. 7.4. RESEARCH QUESTIONS Provisionally, the following research questions have been developed. How have socio-economic assessments been strategically managed (during the feasibility studies of wind farms in different countries) How have the socio-economic assessments been implemented (during the feasibility phases of wind farm developments in Russia and other countries) To date, what lessons have been learnt from one and two, and how may these be applied in Russia 7.5 METHODOLOGY Due to the nature of this study, the research shall be based on an extensive review of the literature and case studies. Once all of these have been examined and collated a number of recommendations shall be made. 7.6 RESEARCH PHILOSOPHY The research philosophy, which has been adopted for this study is positivism. This will allow the investigation to be a critical and objective base method (Sundars, 2003). 7.7 RESEARCH APPROACH The research approach, which has chosen for this study is qualitative in nature, as it will be based on a literature review (Sundars, 2003). This will allow the research to explore the problem, which was outlined above, to see if any improvements may be made. 7.8 RESEARCH STRATEGY The research strategy, which has been chosen for this study is a literature review (Sundars, 2003). 7.9 DATA COLLECTION The literature review shall be conducted by searching websites electronic journals, case studies and relevant books. Once a number of relevant sources have been identified these shall be used to collect information to investigate the research problem. 7.10 DATA ANALYSIS All analyses shall be based on the literature, which is identified during the data collection phase of this study (Sundars, 2003). 7.11 ACCESS Access to this literature shall be established through searching library resources, electronic journals and websites. 7.12 RELIABILITY, VALIDITY, AND GENERALISABILITY The reliability and validity of this research shall be ensured by only using sources of information, which are deemed to be suitable for this study. The generalizability of the findings from this study shall be limited as it will be based on secondary sources and the study findings will only be valid whilst these sources of information remain current (Sundars, 2003). 7.11 ETHICAL ISSUES There are no ethical issues which need to be considered whilst this research is being conducted. 7.12 RESEARCH LIMITATIONS As this research is based on secondary sources, the data, which is available, may limit the findings from this and as already stated as the study is based on the current situation in Russia, its findings may only be valid for a limited time. 8 CONCLUSION In conclusion, this study shall be undertaken by seeking to identify and critically evaluate a number of secondary sources. This will enable the strategic management and implementation of socio –economic analyses to be critically evaluated. The effectiveness of these in Russia shall then be assessed by comparing them to practices adopted by other countries. Then a number of recommendations may be made where this is appropriate. 9 TIME CHART TasksTask LeadStartEndDuration (Days) DissertationResearcher7/06/137/15/1310 Write Up Results 7/06/137/20/1315 Write up analysis 7/21/138/01/1312 Write Recommendations 1/08/1313/08/201310 Draw Conclusions 13/08/201318/08/20135 REFERENCES BAREC (1998) Conditions for the development of Wind Power in the Baltic Sea Region. Available from http://www.basrec.net/files/basrecdocs/Projects/BASREC-wind%201_enabling%20studies_120424.pdf (Accessed 03/07/2013) Bell, D., Gray, T., & Haggett, C. (2005). The ‘social gap’ in wind farm siting decisions: explanations and policy responses. Environmental politics, 14(4), 460-477. Bergmann, A., Hanley, N., & Wright, R. (2006). Valuing the attributes of renewable energy investments. Energy Policy, 34(9), 1004-1014. Devine?Wright, P. (2005). Beyond NIMBYism: towards an integrated framework for understanding public perceptions of wind energy. Wind energy, 8(2), 125-139. POWER (2013) Perspectives of Offshore Wind Development. Available from http://www.corpi.ku.lt/power/ (Accessed 03/07/2013). Saunders, M. (2003) Research Methods for Business Students. South Africa: Pearson Education. Van der Horst, D. (2007). NIMBY or not Exploring the relevance of location and the politics of voiced opinions in renewable energy siting controversies. Energy policy, 35(5), 2705-2714. Van der Horst, D., & Toke, D. (2010). Exploring the landscape of wind farm developments: local area characteristics and planning process outcomes in rural England. Land Use Policy, 27(2), 214-221. Wolsink, M. (2007). Planning of renewables schemes: Deliberative and fair decision-making on landscape issues instead of reproachful accusations of non-cooperation. Energy policy, 35(5), 2692-2704.